Content and comprehensiveness in the nursing documentation for residents in long-term dementia care: a retrospective chart review.

Background: Insight into and understanding of content and comprehensiveness in nursing documentation is important to secure continuity and high-quality care planning in long-term dementia care. The accuracy of nursing documentation is vital in areas where residents have difculties in communicating needs and preferences. This study described the content and comprehensiveness of nursing documentation for residents living with dementia in nursing homes. Methods: We used a retrospective chart review to describe content and comprehensiveness in the nursing documentation. Person-centered content related to identity, comfort, inclusion, attachment, and occupation was identifed, using an extraction tool derived from person-centered care literature. The fve-point Comprehensiveness in the Nursing Documentation scale was used to describe the comprehensiveness of the nursing documentation in relation to the nursing process. Results: The residents’ life stories were identifed in 16% of the reviewed records. There were variations in the identifed nursing diagnoses related to person-centered information, across all the fve categories. There were variations in comprehensiveness within all fve categories, and inclusion and occupation had the least comprehensive information. Conclusion: Findings from this study highlights challenges in documenting person-centered information in a comprehensive way. To improve nursing documentation of residents living with dementia in nursing homes, nurses need to include residents’ perspectives and experiences in their planning and evaluation of care.publishedVersio

Resilience as a concept for understanding family caregiving of adults with Chronic Obstructive Pulmonary Disease (COPD): an integrative review

Abstract Aims: This paper was a report of the synthesis of evidence on examining the origins and definitions of the concept of resilience, investigating its application in chronic illness management and exploring its utility as a means of understanding family caregiving of adults with Chronic Obstructive Pulmonary Disease. Background: Resilience is a concept that is becoming relevant to understanding how individuals and families live with illness, especially long-term conditions. Caregivers of adults with Chronic Obstructive Pulmonary Disease must be able to respond to exacerbations of the condition and may themselves experience cognitive imbalances. Yet, resilience as a way of understanding family caregiving of adults with COPD is little explored. Design: Literature review – integrative review. Data sources: CINAHL, PubMed, Google Scholar and EBSCO were searched between 1989–2015. Review methods: The principles of rapid evidence assessment were followed. Results: We identified 376 relevant papers: 20 papers reported the presence of the concept of resilience in family caregivers of chronic diseases patients but only 12 papers reported the presence of the concept of resilience in caregivers of Chronic Obstructive Pulmonary Disease patients and have been included in the synthesis. The term resilience in Chronic Obstructive Pulmonary Disease caregiving is most often understood using a deficit model of health

Conceptualizing health assets in a nursing context : Synthesis of findings from multiple perspectives

Health assets, or peoples’ capacities and strengths, have been recognized by the World Health Organization (WHO) as being necessary to strengthen and maintain health and wellness. However, the concept of health assets has not been well defined in recent years and there is little consensus. The purpose of this doctoral dissertation was to synthesize findings about health assets based on conceptualization and knowledge from various perspectives: literature, patients and nurses, and the nursing terminology system International Classification for Nursing Practice (ICNP). First, a concept analysis was conducted to examine the meaning of the concept, its underlying attributes, antecedents and consequences, and its uses in health care. A definition of health assets and a descriptive model of its components and possible relationships were proposed. Health assets were defined as the “repertoire of potentials—internal and external strength qualities in the individual, both innate and acquired—that mobilize positive health behaviors and optimal health/wellness outcomes” (Study I). Five strength dimensions were uncovered: relational, motivational, volitional, protective strengths, and mobilization. To further explore and describe the concept empirically, focus group interviews with 26 cancer patients and cancer survivors who were members of patient support groups (Study II), and 26 nurses experienced in cancer care were conducted (Study III). Patients reported a rich repertoire of personal strengths they used or wished for during their illness and recovery, resulting in seven themes and 12 subthemes of health assets. Most striking was their experience that care providers did not ask for, discuss, or build on patients’ own strengths. Patients wanted to be involved, and they possessed a considerable number of potential strengths that they wished could have been mobilized with the help of care providers. Patients preferred a more active role in their care than they actually had or were invited to take. Nurses in the focus groups were not very familiar with the concept of health assets, and realized that they did not focus much on patients’ strengths in their care. The discussions and reflections on health assets directed their attention to the patient as an active agent contributing to his or her own health rather than a passive recipient of care. Three additional dimensions of health assets appeared from the nurses’ focus groups: cognitive, emotional, and physical strength. Additionally, various themes and subthemes related to health assets were elicited. Furthermore, it became apparent that health assets were not static, but may fluctuate between more or less of the same asset and/or between two or more health assets. Contextual and individual circumstances also affected what constitutes a health asset. The findings of these studies suggest a need for a greater focus on patients’ health assets; patients want their strengths to be utilized and to contribute to their own care. However, nurses do not fully utilize patients’ strengths, but realize their importance when made aware of them and aspire to become more aware of this aspect of care. This dissertation provides an improved understanding of health assets, particularly within cancer care, and contributes to knowledge about health assets from several perspectives. A synthesis of the findings from the five studies resulted in a refinement of the definition and conceptual model for health assets. However, further studies are needed to substantiate the model and test its suitability for research and teaching, and to develop support systems for patients and nurses that foster the use of health assets. Knowledge gained from this work can assist nurses in balancing the traditional problem-oriented approach with a health assets approach. In this manner, nursing care can help patients move from being passive recipients of care to becoming active agents of wellness and health, sharing power, and having more control over their illness

Content and comprehensiveness in the nursing documentation for residents in long-term dementia care: a retrospective chart review.

Background: Insight into and understanding of content and comprehensiveness in nursing documentation is important to secure continuity and high-quality care planning in long-term dementia care. The accuracy of nursing documentation is vital in areas where residents have difculties in communicating needs and preferences. This study described the content and comprehensiveness of nursing documentation for residents living with dementia in nursing homes. Methods: We used a retrospective chart review to describe content and comprehensiveness in the nursing documentation. Person-centered content related to identity, comfort, inclusion, attachment, and occupation was identifed, using an extraction tool derived from person-centered care literature. The fve-point Comprehensiveness in the Nursing Documentation scale was used to describe the comprehensiveness of the nursing documentation in relation to the nursing process. Results: The residents’ life stories were identifed in 16% of the reviewed records. There were variations in the identifed nursing diagnoses related to person-centered information, across all the fve categories. There were variations in comprehensiveness within all fve categories, and inclusion and occupation had the least comprehensive information. Conclusion: Findings from this study highlights challenges in documenting person-centered information in a comprehensive way. To improve nursing documentation of residents living with dementia in nursing homes, nurses need to include residents’ perspectives and experiences in their planning and evaluation of care