Collaboration between relatives of frail elderly patients and nurses in acute hospital wards. Dimensions, prerequisites and outcome

The aim was to investigate collaboration between relatives of frail elderly patients and nurses in acute hospital wards, and to develop and test an instrument to investigate, from the relatives? perspective, dimensions of collaboration in this context and the association between collaboration and satisfaction with the hospital care trajectory. The underpinning assumption for the study was that relatives hold knowledge of the patients? situation, which is important for nurses to make a relevant and sufficient care plan. The first two studies were qualitative, investigating relatives? and nurses? experiences of the collaboration with each other. Eight relatives of elderly patients ³ 75 years of age, living at home and dependent on formal and informal help participated. Eight nurses (6 RN + 2 LPN) who conducted the discharge of the elderly patient participated in the second study. In the third study an instrument was developed for measuring collaboration, its prerequisites and outcomes from the relatives? perspective, and put through psychometric testing. In this study, and in the fourth study, which investigated the association between collaboration and satisfaction with the hospital care trajectory, 156 relatives of elderly patients participated. The context was acute medical and geriatric wards in two Danish hospitals. The lived experience of being a relative to a frail elderly patient revealed itself in two main essences: The history reflected the relationship and care history and was the frame of reference in which the hospital admission was interpreted and understood. The constituents were: The adult child, Parent for my mother, It is always in the back of my mind and A full time job. The essence Standing Guard encompassed the encounter with the hospital system and the constituents were: My God, is it now?, Powerless, If you relax, you fail, Watchdog and case manager and Those poor, poor people. The main theme in the interviews with nurses was Encountering relatives ? To be caught between ideals and practice and reflected that the nurses seemingly held two sets of conflicting attitudes towards relatives and the collaboration with them: One ideal and in accordance with their professional values, and another seemingly governing collaboration in practice. Themes were: The coincidental encounter ? the collaboration, which reflected that though ideally described as a structured process, collaboration appeared to be coincidental and rare; and Relatives ? a demanding resource. The sub themes were: Flee or fight ? the nurses? response, A matter of prioritising ? Barriers and promoters, The unwritten rules and The new relatives ? the demanding and unrealistic relatives. A model for collaboration was developed from literature and constituted the basis for development of instrument variables and items. In the factor analysis (PCA) five factors were extracted: ?Influence on decisions?, ?Quality of contact with nurses?, ?Trust and its prerequisites?, ?Achieved information level? and ?Influence on discharge?. The factor analysis supported the assumption that collaboration was a multi-dimensional construct characterised by shared decision-making and exchange of knowledge and information, with prerequisites such as quality of the contact and communication based on trust and respect. The instrument was mainly reliable and valid, although caution should be made due to the sample being small, and the design being cross sectional. Systematic dropout indicated that the study might have missed the most strained, the oldest and the least educated relatives. Further testing after a reduction of items as well as revising of the wording in some items is warranted. Dimensions of collaboration were predictors for the relatives? satisfaction with the hospital care trajectory, and lower ratings of collaboration were significantly associated with lower level of satisfaction. Further, powerlessness, guilt, having provided help less than one year and not providing psychosocial help were predictors for relatives? satisfaction with the hospital care trajectory. Whereas relatives rated poorly on influence on decisions and exchange of knowledge and information, the contact and relationship qualities with nurses were seemingly more satisfactory, although accessibility of nurses appeared to be a problem

Narrating Religious Realities:: Conversion and testimonies in Chilean Pentecostalism

In this paper I explore the complex and constitutive role of narrative practice in Chilean Pentecostalism. I argue that it is in large part through different kinds  of storytelling that Pentecostal self identities are produced, nourished and modified. Particular attention is focused on testimonies of salvation, and life  stories as narrative practices through which converts engage in ongoing construction of biographic identities and provide themselves with symbolic schemes for present and future action. I further argue that Pentecostal story telling should be seen as a specific kind of social interaction, creating and unfolding  eligious realities to be inhabited by narrator and listener alike. I pursue this argument by examining different linguistic as well as non-linguistic strategies  through which the listener is invited to project him or herself into the world of the story. Keywords: Pentecostalism, Chile, conversion, narratives, identit

Biblioteket vejleder online

AU Library tested an online library chat aimed at helping students along with their 48-hour exam at AU Health, Aarhus University, Denmark. The chat was part of the Nordplus project and had as its prime focus to test if a chat would be a valuable and useful tool for the students. The article describes the objectives of the chat and the setup around it as well as the feedback we received from students, teachers and colleagues. The article also presents the evaluations of the project as well as some potential next steps

The lived experience of migrating women spouses : a phenomenological study

Includes bibliographical references (leaves 118-127).Migration has become more common as globalisation has required more and more people to be transferred to countries other than their own for short or long term placements. Numerous women experience migration due to their husbands being transferred, yet the literature does not reveal much about how women adapt to their new situation as migrating women. If there are implications of this phenomenon for health, little research has been done to describe this. The aim of this study was to explore the lived experiences of women who have migrated as expatriates. The study aimed to ascertain if there were health effects as a reult of migration and how these are understood and experienced

Hvordan måler man dækningen af de matematiske kompetencer i læremidler?

Kommentar til Stig Toke Gissel, Mette Hjelmborg, Bo Teglskov Kristensen og Dorte Moeskær Larsen: “Kompetencedækning i analoge matematiksystemer til mellemtrinnet”, MONA 2019‑3

"Her på landet hjælper vi hinanden, men vi render ikke hinanden på dørene": Alderdom og stoisk stolthed i sønderjyske landområder

Denne artikel belyser, hvorledes ældre borgere bosiddende i sønderjyske landområdernavigerer mellem et eksplicit ideal om autonomi eller om ikke at ligge232andre til last og et lige så eksplicit ideal om at være der for og hjælpe hinanden ilokalområdet. Blandt ældre respondenter i den undersøgelse, artiklen bygger på,var idealet om autonomi eller den stoiske stolthed ved at klare sig selv afspejletbåde i lave forventninger til politiske løsninger på infrastrukturelle udfordringerog i den betydning, en lokal købmand tilskrives for en landsbys selvopretholdelse.Endelig understregede respondenterne igen og igen, at man ikke børligge hverken familiemedlemmer eller jævnaldrende venner til last. Samtidigfremhævede respondenterne nærmest enstemmigt fællesskabet og det, at mankendte hinanden, som den største fordel ved at bo i landområder/små landsbyer.Artiklen belyser, hvorledes det stærke ideal om autonomi kombineret med forskelligeformer for social deltagelse for de ældre respondenter udgjorde kilder tilopretholdelse af stabile selvidentiteter i sene leveår, der ellers kan være prægetaf forskellige former for forandring