73 research outputs found
Nurse's attunement to patients 'meaning in life. A qualitative study of experiences of Dutch adults ageing in place
Background
Meaning in life (MiL) is considered to be an important part of health and is associated with many positive outcomes in older adults, such as quality of life and longevity. As health promotors, nurses may take patientsâ MiL into account in the care process. There is a knowledge gap in terms of what constitutes good care in relation to older patientsâ MiL, and what the benefits may be for patients when nursing is attuned to this aspect. The purpose of this study was to explore the experiences of home nursing older adults in relation to nursesâ attunement to MiL.
Methods
Gadamerian hermeneutic phenomenological design with semi-structured interviews. Participants were 24 aged home nursing patients. A framework of care ethical evaluation was used in the analysis. Multiple dialogues enhanced understanding.
Results
Patients did not expect nursesâ regard for their MiL. They rather expected ânormal contactâ and adequate physical care. Nurses showed that they were open to patientsâ MiL by being interested in the patient as a person and by being attentive to specific and hidden needs. Participants explained that the nurseâs behaviour upon arrival set the tone: they knew immediately if there was room for MiL or not. All participants had positive and negative experiences with nursesâ behaviour in relation to MiL. Valued nursing care included maintaining a long, kind and reciprocal relationship; doing what was needed; and skilled personalised care. Participants mentioned âspecial onesâ: nurses who attuned to them in a special way and did more than expected. Benefits of care that was attuned to patientsâ MiL were: experiencing a cheerful moment, feeling secure, feeling like a valuable person and having a good day. Older adults also stressed that consideration for MiL helps identify what is important in healthcare.
Conclusion
Aged homecare patients value nursesâ attunement to their MiL positively. Although patients regard MiL mostly as their own quest, nurses play a modest yet important role. Managers and educators should support nursesâ investment in reciprocal nurse-patient relationships
'Meaning in life? Make it as bearable , enjoyable and good as possible!' A qualitative study among community-dwelling aged adults who receive home nursing in the Netherlands
The population of adults ageing in place and using homeâcare services is growing rapidly worldwide. Meaning in life (MiL) of this group of clients is relevant for healthcare and social workers. MiL is associated with many positive outcomes, but can be challenging for aged persons. Objective of this study was to explore MiL in daily life of communityâdwelling aged persons who receive homecare. A hermeneutic phenomenological approach was followed. Three waves of semiâstructured interviews took place among 24 clients of a homeâcare organisation in the Netherlands between November 2015 and July 2018. Photoâelicitation was part of the interview procedure. Interpretative Phenomenological Analysis and dialogues enhanced understanding. Findings show that participants derived meaning from self, others, environment and living. The process of retaining MiL involved maintaining, adapting and discovering. We conclude that communityâdwelling aged adults can draw MiL from many sources. Retaining MiL is interwoven in everyday life and requires continuous adaptation to everâchanging life conditions during later life. Although relevant general themes were sketched in this paper, the importance of each, and the connections between them, vary and come to light at the individual level. The themes in this paper and the cases in the appendices provide insights that may help professionals recognise MiL in their work. Besides listening to the stories of aged adults, personâcentred interventions should support aged adult's strategy to retain MiL
Meaning in life of older adults in daily care: A qualitative analysis of participant observations of home nursing visits.
Meaning in life of older adults in daily care: A qualitative analysis of participant observations of home nursing visits.
Accessibility and implementation in UK services of an effective depression relapse prevention programme - mindfulness-based cognitive therapy (MBCT): ASPIRE study protocol
notes: PMCID: PMC4036706types: Journal Article© 2014 Rycroft-Malone et al.; licensee BioMed Central Ltd.Mindfulness-based cognitive therapy (MBCT) is a cost-effective psychosocial prevention programme that helps people with recurrent depression stay well in the long term. It was singled out in the 2009 National Institute for Health and Clinical Excellence (NICE) Depression Guideline as a key priority for implementation. Despite good evidence and guideline recommendations, its roll-out and accessibility across the UK appears to be limited and inequitably distributed. The study aims to describe the current state of MBCT accessibility and implementation across the UK, develop an explanatory framework of what is hindering and facilitating its progress in different areas, and develop an Implementation Plan and related resources to promote better and more equitable availability and use of MBCT within the UK National Health Service.NIHRHS&D
Gender differences and gender convergence in alcohol use over the past three decades (1984â2008), The HUNT Study, Norway
Design and respondent selection of a population-based study on associations between breast cancer screening, lifestyle and quality of life
Wound-healing evaluation of ointment from Stryphnodendron adstringens (barbatimĂŁo) in rat skin
Long-term outcomes of clinical complete responders after neoadjuvant treatment for rectal cancer in the International Watch & Wait Database (IWWD): an international multicentre registry study
Background: The strategy of watch and wait (W&W) in patients with rectal cancer who achieve a complete clinical response (cCR) after neoadjuvant therapy is new and offers an opportunity for patients to avoid major resection surgery. However, evidence is based on small-to-moderate sized series from specialist centres. The International Watch & Wait Database (IWWD) aims to describe the outcome of the W&W strategy in a large-scale registry of pooled individual patient data. We report the results of a descriptive analysis after inclusion of more than 1000 patients in the registry.
Methods: Participating centres entered data in the registry through an online, highly secured, and encrypted research data server. Data included baseline characteristics, neoadjuvant therapy, imaging protocols, incidence of local regrowth and distant metastasis, and survival status. All patients with rectal cancer in whom the standard of care (total mesorectal excision surgery) was omitted after neoadjuvant therapy were eligible to be included in the IWWD. For the present analysis, we only selected patients with no signs of residual tumour at reassessment (a cCR). We analysed the proportion of patients with local regrowth, proportion of patients with distant metastases, 5-year overall survival, and 5-year disease-specific survival.
Findings: Between April 14, 2015, and June 30, 2017, we identified 1009 patients who received neoadjuvant treatment and were managed by W&W in the database from 47 participating institutes (15 countries). We included 880 (87%) patients with a cCR. Median follow-up time was 3·3 years (95% CI 3·1â3·6). The 2-year cumulative incidence of local regrowth was 25·2% (95% CI 22·2â28·5%), 88% of all local regrowth was diagnosed in the first 2 years, and 97% of local regrowth was located in the bowel wall. Distant metastasis were diagnosed in 71 (8%) of 880 patients. 5-year overall survival was 85% (95% CI 80·9â87·7%), and 5-year disease-specific survival was 94% (91â96%).
Interpretation: This dataset has the largest series of patients with rectal cancer treated with a W&W approach, consisting of approximately 50% data from previous cohort series and 50% unpublished data. Local regrowth occurs mostly in the first 2 years and in the bowel wall, emphasising the importance of endoscopic surveillance to ensure the option of deferred curative surgery. Local unsalvageable disease after W&W was rare.
Funding: European Registration of Cancer Care financed by European Society of Surgical Oncology, Champalimaud Foundation Lisbon, Bas Mulder Award granted by the Alpe d'Huzes Foundation and Dutch Cancer Society, and European Research Council Advanced Grant
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