Patient influence in home-based reablement for older persons: qualitative research

Abstract Background Reablement services are rehabilitation for older people living at home, being person-centered in information, mapping and the goal-setting conversation. The purpose of this study was to gain knowledge about conversation processes and patient influence in formulating the patients’ goals. There are two research questions: How do conversation theme, structure and processes appear in interactions aiming to decide goals of home-based reablement rehabilitation for the elderly? How professionals’ communication skills do influence on patients' participation in conversation about everyday life and goals of home-based reablement? Methods A qualitative field study explored eight cases of naturally occurring conversations between patients and healthcare professionals in a rehabilitation team. Patients were aged 67–90 years old. The reablement team consisted of an occupational therapist, physiotherapist, nurse and care workers. Data was collected by audio recording the conversations. Transcribed text was analyzed for conversational theme and communication patterns as they emerged within main themes. Results Patient participation differed with various professional leadership and communication in the information, mapping and goalsetting process. In the data material in its entirety, conversations consisted mainly of three parts where each part dealt with one of the three main topics. The first part was “Introduction to the program.” The main part of the talk was about mapping (“Varying patient participation when discussing everyday life”), while the last part was about goal setting (“Goals of rehabilitation”). Conclusions Home-based reablement requires communication skills to encourage user participation, and mapping of resources and needs, leading to the formulation of objectives. Professional health workers must master integrating two intentions: goal-oriented and person-centered communication that requires communication skills and leadership ability in communication, promoting patient influence and goal-setting. Quality of such conversations is complex, and requires the ability to apply integrated knowledge, skills and attitudes appropriate to communication situations

Experiences of participation inbereavement groups from significant others’ perspectives : a qualitative study

Background: When death ends a life, the impact of caring for person who suffered a period of illness or diseasecontinues for significant others who are left to grieve. They should be offered support to avoid complicated grief.This can be provided in different ways and individually or in groups. This study aims to describe significant others’experiences of participation in bereavement groups.Methods: Ten bereavement groups that each met five times offered support for the significant others of deceasedloved ones who had been cared for by a palliative-care team. After the five meetings, the grieving members (n =46)completed written comments about the role of the groups; they also commented one year after participating (n =39).Comments were analyzed with qualitative content analysis with a directed approach using the theory of a good deathaccording to the 6S’s: self-image, self-determination, social relationships, symptom control, synthesis and summation,and surrender.Results: Bereavement groups were found to be a source for alleviating grief for some significant others, but not allexperienced relief. Moreover, grief was found to persist during participation. Another finding involved the impact ofthe role of the palliative home-care team on bereavement support. To evaluate the experience of participating in abereavement group, the use the 6S’s as a model was a strength of the analysis. Bereavement groups could enhancethe self and offer relief from grief. Participation was described as social relationships that offered a sense of coherenceand understanding in grief. The effects of participation were more meaningful close to the loss and could lose efficacyover time. Bereavement support provided before a loved one’s death was seen as valuable.Conclusion: Overall, the bereavement groups eased the grief of significant others close to the death of their lovedone. However, moving forward, several of the significant others were not sure that their participation eased their grief.To identify persons who may remain in a state of complicated grief, a routine of planned contacts with the bereavedshould begin before death and be followed up later than six months after the death of a loved one

An advanced lithium-air battery exploiting an ionic liquid-based electrolyte

A novel lithium−oxygen battery exploiting PYR14TFSI−LiTFSI as ionic liquid-based electrolyte medium is reported. The Li/PYR14TFSI−LiTFSI/O2 battery was fully characterized by electrochemical impedance spectroscopy, capacity-limited cycling, field emission scanning electron microscopy, high-resolution transmission electron microscopy, and X-ray photoelectron spectroscopy. The results of this extensive study demonstrate that this new Li/O2 cell is characterized by a stable electrode−electrolyte interface and a highly reversible charge−discharge cycling behavior. Most remarkably, the charge process (oxygen oxidation reaction) is characterized by a very low overvoltage, enhancing the energy efficiency to 82%, thus, addressing one of the most critical issues preventing the practical application of lithium−oxygen batteries