Striving to establish a care relationship -Mission possible or impossible? : Triad encounters between patients, relatives and nurses

BACKGROUND: When patients, relatives and nurses meet, they form a triad that can ensure a good care relationship. However, hospital environments are often stressful and limited time can negatively affect the care relationship, thus decreasing patient satisfaction. OBJECTIVE: To explain the care relationship in triad encounters between patients, relatives and nurses at a department of medicine for older people. DESIGN: A qualitative explorative study with an ethnographic approach guided by a sociocultural perspective. METHOD: Participatory observations and informal field conversations with patients, relatives and nurses were carried out from October 2015-September 2016 and analysed together with field notes using ethnographic analysis. RESULT: The result identifies a process where patients, relatives and nurses use different strategies for navigating before, during and after a triad encounter. The process is based on the following categories: orienting in time and space, contributing to a care relationship and forming a new point of view. CONCLUSION: The result indicates that nurses, who are aware of the process and understand how to navigate between the different perspectives in triad encounters, can acknowledge both the patient's and relatives' stories, thus facilitating their ability to understand the information provided, ensure a quality care relationship and strengthen the patient's position in the health-care setting, therefore making the mission to establish a care relationship possible

Significant others' perceptions of being taken seriously by the Swedish Ambulance Service when the patient is assessed as non-urgent

BackgroundAt least 50% of all ambulance assignments are deemed nonurgent, while 47–96% are initiated by someone other than the patient. Previous research has highlighted the importance of being taken seriously. However, additional knowledge of how significant others experience the situation when a patient is assessed as nonurgent is needed.ObjectiveThe aim of this study was to explore the person‐centred climate in the Ambulance Service from the perspective of significant others by means of the Person‐centred Climate Questionnaire – Family version (PCQ‐F), to psychometrically investigate the construct validity of additional items intended to measure perceptions of being taken seriously and to explore possible relationships between the person‐centred climate and these additional items.MethodsA retrospective, explorative, cross‐sectional survey design was employed. In total, 241 questionnaires were distributed. Descriptive and comparative statistics and a factor analysis of eight items possibly constructing person‐centredness are presented.ResultsThe 100 respondents experienced the climate as very person‐centred. Relationships were found between the items that might constitute person‐centredness and the PCQ‐F. The PCQ‐F can explain perceived person‐centredness through the additional items that may constitute person‐centredness in the Ambulance Service context.ConclusionSignificant others consider eight aspects of being taken seriously as the core of person‐centredness in nonurgent Ambulance Service assignments. There is a relationship between the psychosocial climate and the additional items that might constitute person‐centredness

What’s the meaning of the concept of caring? : a meta-synthesis

Background: Registered Nurses are expected to have acquired knowledge about the fundamental concepts within nursing science throughout their training and clinical work. However, the terminology and the concept of caring are debated; therefore, there is a need for a continuous critical investigation of scientific concepts within the area of nursing. Objectives: To illuminate nurses’ perception about the meaning of the scientific concept of caring. Design: A qualitative systematic literature search was performed that subsequently underwent a descriptive meta-synthesis in line with Deborah Finfgeld’s descriptive meta-synthesis methodology. Data sources/review method: Scientific articles published between 1 January 2003 and 25 January 2018 were identified and retrieved from CINAHL and PubMed. Each included study was assessed and critically appraised. Data were extracted, analysed and coded into categories resulting in four different themes in accordance with descriptive meta-synthesis. Results: Four themes emerged in the analysis: ‘To be’, ‘To want’, ‘To be able to’ and ‘To do’. These comprise different aspects within physical and metaphysical dimensions where simultaneously interact and influence each other. Conclusion: There are central elements to the practice of caring that are separated in their simplicity but at the same time coherent, where no part can exist without the others in the practice of caring. There are shortcomings concerning current nursing theories, nursing philosophies and organisational documents related to varied aspects based on what is included in the practice of caring.