Et langt lerret å bleke : Om personalerfaringer etter implementeringsprosjekt med Dementia Care Mapping i en sykehjemsavdeling

Formål: Hensikten med masteroppgaven er å utforske og beskrive personalerfaringer i sykehjemsavdelingen 1 ½ år etter at kartleggingsverktøyet Dementia Care Mapping (DCM) ble anvendt på én av to mulige personalgrupper i en sykehjemsavdeling i Norge. Studien søker å beskrive langtidserfaringer ved anvendelse av DCM-verktøyet, både for den personalgruppen som deltok i prosjektet, og for den gruppen som ikke deltok. Teoretisk forankring: Litteratur rundt utvikling av demensomsorg, personsentrert omsorg og miljøbehandling presenteres sammen med kartleggingsverktøyet DCM. Problemstillingen belyses gjennom teoretiske perspektiver om pleiekultur, utvikling av praksiskunnskap og endringsteori. Metode: Studien er utforskende og benytter fokusgruppeintervju som datainnsamlingsmetode, 2 fokusgrupper med til sammen 9 deltakere fra samme avdeling. I tillegg ble det gjort individuelt intervju med avdelingsleder. Intervjuer og analyse av data ble utført ved å benytte prinsipper fra Kvales metodebeskrivelser. Resultater: Feedback fra DCM-kartleggingen gav prosjektgruppa et betydningsfullt læringsløft som utviklet praksiskunnskapen. Prosjektdeltakerne utviklet en sterk gruppekultur ved å oppfattes som endringsvillige og fagligdyktige. Økende pleietyngde og redusert ressurstilgang truer imidlertid utvikling og vedlikehold av personsentrert omsorg. Fordi kun én av de to personalgruppene i avdelingen erfarte DCM-verktøyet, ser det ut som det utviklet seg en sprikende pleiekultur i avdelingen med et skjevt styrkeforhold mellom de to personalgruppene. Konklusjon: En sterk, balansert gruppekulturutvikling kan styrke pleiepersonalets fagutvikling, dersom DCM-feedback brukes som konkret og nyttig evaluering av miljøbehandlingen. En god fagutvikling bør imidlertid inkludere alle ansatte i en avdeling om man ønsker å innføre og vedlikeholde en personsentrert omsorgsform Nøkkelord: DCM-evaluering, miljøbehandling, sykehjem, pleiekultur, endringsproses

How will care at a distance affect understandings of care?

Avstandsoppfølging av alvorlig kronisk syke eldre i hjemmetjenesten har økt i omfang de senere år som følge av nye digitale og effektive løsninger for brukeroppfølging. Artikkelen beskriver hvordan bruk av telemonitorering kan påvirke sykepleieres omsorgsforståelser når alvorlig kronisk syke brukere selv skal registrere vitale målinger og i større grad følge opp sin sykdom. Utvalgte studier av sykepleieres erfaringer fra prosjekter med avstandsomsorg beskriver relevante utfordringer. Vi anvender omsorgsforståelser, både som relasjonelle og som deler av en kontekst, i drøfting av tematikken. Drøftingen belyser hvordan den kontekstuelle omsorgsforståelsen kan bidra til å nyansere oppfatninger av omsorgsinnhold ut over en relasjonell omsorgsforståelse. I avstandsomsorg bør teknologien integreres og tilpasses den komplekse og foranderlige omsorgen sykepleieren utøver. En forståelse av omsorgens kompleksitet,samt en styrket teknologisk/digital og analytisk kompetanse i dagens og fremtidens sykepleieutøvelse, vil kunne bidra til at sykepleiere står bedre rustet til å mestre fremtidens omsorgsutfordringer.publishedVersio

First-time parents' experiences related to parental self-efficacy: A scoping review

Becoming a parent for the first time is a major transition, and parental self‐efficacy (PSE) is considered an important predictor of parenting functioning. We aimed to describe and synthesize qualitative studies that explore first‐time parents' experiences related to PSE in the transition to parenthood in the first‐year postpartum. We conducted a scoping review in accordance with international guidelines. The main search strategy consisted of searches in six electronic databases. We selected studies based on predetermined inclusion and exclusion criteria, extracted data, and conducted a descriptive qualitative thematic analysis. We included 58 studies (presented in 61 reports) with 1341 participants from 17 countries. Most of the participants (89%) were mothers, and a third of the studies were task‐specific regarding breastfeeding. The thematic analysis of the findings concerning PSE revealed five main, interconnected themes: culture—factors in society and the healthcare services; parents—processes within the parents; tasks—different parental tasks; support —parents' perceived support from professionals, peers, friends, family, and partner; and child—the child's well‐being and feedback. This scoping review describes qualitative studies on first‐time parents' experiences related to PSE. The findings inform future studies of PSE and clinical practice by confirming the importance of PSE in the transition to parenthood, the complexity of different factors that may have an impact, and the centrality of breastfeeding in PSE. Based on these findings, we suggest that a full systematic review with quality assessment would be appropriate

First-time parents' experiences related to parental self-efficacy: A scoping review

This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.Becoming a parent for the first time is a major transition, and parental self‐efficacy (PSE) is considered an important predictor of parenting functioning. We aimed to describe and synthesize qualitative studies that explore first‐time parents' experiences related to PSE in the transition to parenthood in the first‐year postpartum. We conducted a scoping review in accordance with international guidelines. The main search strategy consisted of searches in six electronic databases. We selected studies based on predetermined inclusion and exclusion criteria, extracted data, and conducted a descriptive qualitative thematic analysis. We included 58 studies (presented in 61 reports) with 1341 participants from 17 countries. Most of the participants (89%) were mothers, and a third of the studies were task‐specific regarding breastfeeding. The thematic analysis of the findings concerning PSE revealed five main, interconnected themes: culture—factors in society and the healthcare services; parents—processes within the parents; tasks—different parental tasks; support —parents' perceived support from professionals, peers, friends, family, and partner; and child—the child's well‐being and feedback. This scoping review describes qualitative studies on first‐time parents' experiences related to PSE. The findings inform future studies of PSE and clinical practice by confirming the importance of PSE in the transition to parenthood, the complexity of different factors that may have an impact, and the centrality of breastfeeding in PSE. Based on these findings, we suggest that a full systematic review with quality assessment would be appropriate.publishedVersio

Experienced barriers in the use of ICT for social interaction in older adults ageing in place: a qualitative systematic review protocol (SYSR-D-22–00848)

Background Several information and communication technologies (ICT) have been developed to enhance social connectedness of older adults aging in place, although they are not accessible for all. Barriers in using ICT might for example relate to health issues, sensory loss, lack of technical skills, or reluctance to use technologies. Though knowledge on these barriers is crucial for the development and implementation of ICT for older adults, no systematic review was found on this subject. The proposed qualitative systematic review aims to explore barriers experienced by older adults aging in place in using ICT for social interaction. Methods The review will be conducted in accordance with the JBI methodology. Databases for search will include MEDLINE (via PubMed), CINAHL (via EBSCO), and Web of Science (ISI), among others. Included studies focus on older adults ageing in place 60 years or older. Pairs of authors will independently, by following agreed guidelines, assess the eligibility of studies, and extract data. The testing of eligibility criteria and screening of titles, abstracts, and full texts will be performed. The findings will describe for example populations, context, culture, and the phenomena of interest. Qualitative research findings will, where possible, be pooled by using JBI SUMARI for the meta-aggregation approach. Discussion The mapping of published studies has the potential to identify research gaps in the existing literature, which again may inform developers and stakeholders in designing more user-friendly and adaptive ICT solutions for older people ageing in place.info:eu-repo/semantics/publishedVersio

First‐time parents' experiences related to parental self‐efficacy: A scoping review

Becoming a parent for the first time is a major transition, and parental self-efficacy (PSE) is considered an important predictor of parenting functioning. We aimed to describe and synthesize qualitative studies that explore first-time parents' experiences related to PSE in the transition to parenthood in the first-year postpartum. We conducted a scoping review in accordance with international guidelines. The main search strategy consisted of searches in six electronic databases. We selected studies based on predetermined inclusion and exclusion criteria, extracted data, and conducted a descriptive qualitative thematic analysis. We included 58 studies (presented in 61 reports) with 1341 participants from 17 countries. Most of the participants (89%) were mothers, and a third of the studies were task-specific regarding breastfeeding. The thematic analysis of the findings concerning PSE revealed five main, interconnected themes: culture—factors in society and the healthcare services; parents—processes within the parents; tasks—different parental tasks; support—parents' perceived support from professionals, peers, friends, family, and partner; and child—the child's well-being and feedback. This scoping review describes qualitative studies on first-time parents' experiences related to PSE. The findings inform future studies of PSE and clinical practice by confirming the importance of PSE in the transition to parenthood, the complexity of different factors that may have an impact, and the centrality of breastfeeding in PSE. Based on these findings, we suggest that a full systematic review with quality assessment would be appropriate

Older patients’ perspectives on illness and healthcare during the early phase of the COVID-19 pandemic

Background Equal access to healthcare is a core principle in Norway’s public healthcare system. The COVID-19 pandemic challenged healthcare systems in the early phase – in particular, related to testing and hospital capacity. There is little knowledge on how older people experienced being infected with an unfamiliar and severe disease, and how they experienced the need for healthcare early in the pandemic Aim To explore the experiences of older people infected by COVID-19 and their need for testing and hospitalisation. Research design An explorative and descriptive approach, with qualitative interviews conducted in October 2020. Participants and research context Seventeen participants above 60 years of age hospitalised due to COVID-19 during spring 2020 were recruited 6 months after discharge. Ethical considerations Ethical approval was granted by the Regional Committee for Medical and Health Research Ethics in South-Eastern Norway (155425). Findings The main finding was that the informants experienced vulnerability and arbitrariness. This finding was supported by three sub-themes: experiences with a severe and unfamiliar disease, the strict criteria and the importance of someone advocating needs. Discussion Participants described varying access to healthcare. Those who did not meet the national criteria to be tested or hospitalised struggled against the system. Findings reveal arbitrary access to healthcare, in contrast to Norway’s ethical principle of fair and just access to health services. Moreover, to access and receive necessary healthcare, informants were dependent on their next-of-kin’s advocacy. Conclusion Even when dealing with an unfamiliar disease, health professionals’ assessments of symptoms must be performed with an ethical obligation to applicate competent appraisal and the exercise of discernment; this is in line with care ethics and ethical standards for nurses. These perspectives are a significant part of caring and the intension of doing good.publishedVersio

Health Care Professionals’ Experiences and Perspectives on Using Telehealth for Home-based Palliative Care: Scoping Review

Background: Telehealth seems feasible for use in home-based palliative care (HBPC). It may improve access to health care professionals (HCPs) at patients’ homes, reduce hospital admissions, enhance patients’ feelings of security and safety, and increase the time spent at home for patients in HBPC. HBPC requires the involvement of various HCPs such as nurses, physicians, allied health professionals, dietitians, psychologists, religious counselors, and social workers. Acceptance of the use of technology among HCPs is essential for the successful delivery of telehealth in practice. No scoping review has mapped the experiences and perspectives of HCPs regarding the use of telehealth in HBPC. Objective: The aim of this review was to systematically map published studies on HCPs’ experiences and perspectives on the use of telehealth in HBPC. Methods: A scoping review was conducted using the methodology of Arksey and O’Malley. The review was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews. A systematic search was performed in AMED, CINAHL, Embase, MEDLINE, PsycINFO, and Web of Science for studies published in peer-reviewed journals between January 1, 2000, and August 23, 2022. The reference lists of the included papers were hand searched to identify additional studies. The inclusion criteria were (1) studies using qualitative, quantitative, or mixed methods; (2) studies including HCPs using telehealth with patients in HBPC; (3) studies on HCPs’ experiences and perspectives on the use of telehealth in HBPC; (4) studies published between January 1, 2000, and August 23, 2022; and (5) studies published in English, Portuguese, Norwegian, Danish, Swedish, or Spanish. Pairs of authors independently included studies and extracted data. The first 2 stages of thematic synthesis were used to thematically organize the data. Results: This scoping review included 29 papers from 28 studies. Four descriptive themes were identified: (1) easy to use but technological issues undermine confidence, (2) adds value but personal and organizational barriers challenge adoption, (3) potential to provide useful and meaningful patient-reported data, and (4) mutual trust as a prerequisite for interpersonal relationships. Conclusions: Telehealth in HBPC seems to be easy to use and may improve the coordination of care, time efficiency, clinical assessments, and help build and enhance personal and professional relationships. However, the introduction of technology in HBPC is complex, as it may not align well with the overall aim of palliative care from HCPs’ point of view. Further, changes in practice and requirements for HCPs may reduce motivation for the use of telehealth in HBPC. HCPs consider themselves to have central roles in implementing telehealth, and a lack of acceptance and motivation is a key barrier to telehealth adoption. Policy makers and telehealth developers should be aware of this potential barrier when developing or implementing new technology for use in HBPC.publishedVersio

‘Brain fog’, guilt, and gratitude: experiences of symptoms and life changes in older survivors 6 months after hospitalisation for COVID-19

Purpose Several of those who have been infected with COVID-19 suffer from the post-COVID-19 condition months after the acute infection. Little is known about how older survivors have experienced the consequences and how these have affected their lives. The aim of this study was to explore how older survivors experienced post-COVID-19 condition and life changes approximately 6 months after hospitalisation for COVID-19. Methods The study had an explorative and descriptive design. Semi-structured interviews were performed with 17 participants from two local hospitals, 11 men and 6 women, aged 60 years and older (age range 60–96), approximately 6 months after hospitalisation for COVID-19. A thematic descriptive analysis inspired by Braun and Clarke was used. Results Two main themes and seven subthemes were revealed. The main themes were: From few to various persistent symptoms and Existential thoughts and reflections. Most of the participants experienced various physical and/or cognitive symptoms, such as reduced physical fitness, heavy breathing, fatigue, and ‘brain fog’. On the other hand, they also experienced guilt and gratitude for having survived. The recognition of having achieved other life perspectives was also present. Conclusion Six months after undergone COVID-19 the participants still experienced various distressing symptoms, which were in line with larger studies. The novel findings of this study were connected to the existential area, where the patients’ thoughts and reflections of guilt, gratitude, and new life perspectives were revealed. These findings are important for health professionals to consider when treating patients after COVID-19.publishedVersio

Welfare technology interventions among older people living at home—A systematic review of RCT studies

This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.The main goal of health services is for the elderly to maintain their mental and physical health and live at home independently for as long as possible. Various technical welfare solutions have been introduced and tested to support an independent life. The aim of this systematic review was to examine different types of interventions and assess the effectiveness of welfare technology (WT) interventions for older people living at home. This study was prospectively registered in PROSPERO (CRD42020190316) and followed the PRISMA statement. Primary randomized control trial (RCT) studies published between 2015 and 2020 were identified through the following databases: Academic, AMED, Cochrane Reviews, EBSCOhost, EMBASE, Google Scholar, Ovid MEDLINE via PubMed, Scopus, and Web of Science. Twelve out of 687 papers met the criteria for eligibility. We used riskof-bias assessment (RoB 2) for the included studies. Based on the RoB 2 outcomes that showed a high risk of bias (>50%) and high heterogeneity of quantitative data, we decided to narratively summarize the study characteristics, outcome measures, and implications for practice. The included studies were conducted in six countries, namely the USA, Sweden, Korea, Italy, Singapore, and the UK. One was conducted in three European countries (the Netherlands, Sweden, and Switzerland). A total of 8437 participants were sampled, and individual study sample sizes ranged from 12 to 6742. Most of the studies were two-armed RCTs, except for two that were three-armed. The duration of the welfare technology tested in the studies ranged from four weeks to six months. The employed technologies were commercial solutions, including telephones, smartphones, computers, telemonitors, and robots. The type of interventions were balance training, physical exercise and function, cognitive training, monitoring of symptoms, activation of emergency medical systems, self-care, reduction of death risk, and medical alert protection systems. The latter studies were the first of their kind and suggested that physician-led telemonitoring could reduce length of hospital stay. In summary, welfare technology seems to offer solutions to supporting elderly people at home. The results showed a wide range of uses for technologies for improving mental and physical health. All studies showed encouraging results for improving the participants’ health status.publishedVersio