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The bright side of life: support in municipal elderly home care
2014 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Registered nurses in municipal elderly home care have in some occasionsdifficulties in identifying the patients’ needs and prioritize intervention inaccordance with the patients’ preferences, which is to obtain social and emotional support. The overall aim was to explore and describe which supportive interventions registered nurses use in municipal elderly home care settings and if it is in agreement with the patient’s preferences. Methods: A retrospective descriptive study (I ) were conducted and followed up by a qualitative approach with Grounded Theory as a method (II IV ). Sample to study; I , registered nurses (62) performed interventions to 6138 patients between 80- 109 years. II , 12 registered nurses, who performed 36 home visits to patients between 80- 102 years. III , 16 registered nurses. IV , 18 patients between 80- 96 years. Data was collected by; I , between 2004- 2008, during the months of April and October using a web- based form which was filled in by registered nurses. II , through nonparticipant observations when the registered nurse made a home visit. III and IV , using informal conversational interviews. Results: Combined, the four studies show that emotional support is important to a group of older patients because it helps them to experience serenity. Serenity is a state of relief and the moment required for the patient to be able to move forward in a dignify way. Patients lost or reduced ability to process their emotions makes so that they get stuck in a state, which fatigue them with additional experience of disease and illness. To get out of their state the patient uses the registered nurse as a reliever whose mission is to identify their needs and guide them into a state of serenity. Registered nurses on the other hand, makes priorities based on patients preferences. Registered nurses strengths was their profession that contributed to the patient's emotions became available to them. Weaknesses was registered nurses workload and lack of knowledge about the identification of emotions. Emotional support should be developed as a nursing intervention and be integrated as a part of nursing.

Place, publisher, year, edition, pages
Örebro: Örebro universitet , 2014. , 70 p.
Series
Örebro Studies in Care Sciences 45, ISSN 1652-1153 ; 45
Keyword [en]
Emotion, elderly home care, intervention, priorities, support, registered nurse, older patients, serenity
National Category
Medical and Health Sciences Nursing
Identifiers
URN: urn:nbn:se:hh:diva-25804ISBN: 978-91-7668-940-0 OAI: oai:DiVA.org:hh-25804DiVA: diva2:727908
Public defence
2013-06-14, Hörsal 2 Prismahuset, HSP2, Örebro universitet, Fakultetsgatan 1, Örebro, 14:10 (English)
Opponent
Available from: 2014-06-27 Created: 2014-06-23 Last updated: 2015-02-18Bibliographically approved
List of papers
1. Dealing with today’s emotions - supportive activities for the elderly in a municipal care setting
Open this publication in new window or tab >>Dealing with today’s emotions - supportive activities for the elderly in a municipal care setting
2012 (English)Conference paper, Abstract (Refereed)
Abstract [en]

Background; There are diverse descriptions of supportive activities in nursing to be found in the literature. That which they have in common is their association with good care outcomes, but they may differ depending on the context in which the care is given. In a Swedish municipal elderly care setting registered nurses work in a consultative way and they describe a part of their tasks as being comprised of supportive activities without specifying what kind supportive activities they mean. Aim; The aim of the study was to explore the main concern of the support given by registered nurses to a group of patients in an elderly home care setting. Method; The study was conducted using Grounded Theory (GT). Data was collected using non participant observations regarding the supportive activities of 12 registered nurses at the home of 36 patients between 80 and 102 years. Result; The core category was about dealing with today's emotions. This was done by encouraging the situation and reducing patient's limitations, but situations also occurred in which there was a gap of support. Support was about capture the emotions that the patient expressed for the moment, but there were also situations in which registered nurses chose not to give support. Conclution; The main purpose of supportive activities to a group of elderly persons in a municipal care setting is about dealing with today's emotions. The core category reflects the moment and emotions significance in the care of elderly. In some occasions it occurred a gap of support and this coincided with the inability of the RN to identify the patient’s inner needs. In order to develop a holistic elderly care more knowledge about psychological and spiritual needs is needed.

National Category
Nursing
Identifiers
urn:nbn:se:hh:diva-21976 (URN)
Conference
Vårdforskningens dag – Individen i Fokus, Universitetssjukhuset Örebro, Örebro, Sverige, 14 november, 2012
Available from: 2013-05-02 Created: 2013-05-02 Last updated: 2017-04-25Bibliographically approved
2. Trying to cope with everyday life - Emotional support in municipal elderly care setting
Open this publication in new window or tab >>Trying to cope with everyday life - Emotional support in municipal elderly care setting
2012 (English)In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 7, 19613Article in journal (Refereed) Published
Abstract [en]

Emotional support is considered to be important to older patients because it is a contributing factor to experiencing goodhealth and it has been shown that it can prevent depression after a hip fracture. Opinions differ on whether emotionalsupport falls within the field of nursing, and studies also show that nurses in an elderly home care setting fail when it comesto giving emotional support. The aim of this study was to explore reasons for registered nurses to give emotional support toolder patients in a municipal home care setting. The study was conducted using Grounded Theory. Data collection wascarried out through interviews with 16 registered nurses. The inclusion criteria were emotional support given to patientsaged 80 years and above living in ordinary or sheltered housing and who were in need of help from both the home helpservice and registered nurses. The results show that the main concern of emotional support was ‘‘Trying to relieve thepatient from their emotions so they are able to cope with everyday life.’’ This core category illustrates how registered nursestried to support the patients’ own strength, so that they were able to move forward. Registered nurses consider that theycould support the patients because they give them access to, or could create access to, their emotions, but there were alsotimes when they felt helplessness and as a result, consciously opted out. The results also indicate that registered nurses werekeen to give emotional support. To develop patient-centered elderly care, more knowledge of emotional support and theelderly’s need for this support is required. © 2012 N. Dauman & S. I. Erlandsson.

Place, publisher, year, edition, pages
Järfälla: Co-Action Publishing, 2012
Keyword
support, maintain strength, municipal care, the elderly
National Category
Nursing
Identifiers
urn:nbn:se:hh:diva-21974 (URN)10.3402/qhw.v7i0.19613 (DOI)000312581100001 ()23237630 (PubMedID)2-s2.0-84875190747 (Scopus ID)
Available from: 2013-05-01 Created: 2013-05-01 Last updated: 2017-04-24Bibliographically approved
3. Care priorities: Registered nurses’ clinical daily work in municipal elderly care settings
Open this publication in new window or tab >>Care priorities: Registered nurses’ clinical daily work in municipal elderly care settings
2012 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 27, no 2, 388-395 p.Article in journal (Refereed) Published
Abstract [en]

Common in Swedish elderly home care is that Registered Nurses work independently, and lead the care team without being a part of it. People involved in the care of the patient can be social services, physician, Registered Nurse (RN), nurses in inpatient care and family. Inaccording to current model for nursing documentation RNs interventions is described as participation, information/education, support, environment, general care, training, observation/surveillance, special care drug administration and coordination. Time pressure isperceived as high, but the nurses have the opportunity to influence their daily work situation and make priorities. The purpose of this study was to investigate how RNs prioritise interventions in municipal elderly care settings. A quantitative descriptive method was used for the study. Data were collected during the months of April and October 2004 – 2008, using a web-based form. The nurses filled in patient’s type of housing, performed interventions, and if the interventions were delegated. Interventions were described as keywords and wereattributed a certain amount of time, calculated in previous time studies. The inclusion criteria were: all patients 80 years of age and older, in a municipality in southwestern Sweden, who received some form of health care from a RN, or performed by non-certified staff by delegation. Results indicate that differences in priority could be observed, depending on the patient’s gender, or whether the patient was living in independent or sheltered housing. Drug administration was prioritised for female patients, while coordination became a priority for patients living in ordinary housing. Support received the highest priority, regardless if the patient lived in ordinary or sheltered housing. However, it is not entirely clear what support signifies in municipal health care settings, and this issue would therefore require further investigation. © 2012 Nordic College of Caring Science.

Place, publisher, year, edition, pages
Chichester: Wiley-Blackwell, 2012
Keyword
delegation, elderly, home care, intervention, municipal care, priorities, Registered Nurse, support
National Category
Nursing
Identifiers
urn:nbn:se:hh:diva-19324 (URN)10.1111/j.1471-6712.2012.01051.x (DOI)000318815700023 ()23003218 (PubMedID)2-s2.0-84877795395 (Scopus ID)
Available from: 2012-08-23 Created: 2012-08-23 Last updated: 2017-04-13Bibliographically approved
4. "It's amazing that I can take coverage!": emotional support to a group of older patients in municipal home care setting
Open this publication in new window or tab >>"It's amazing that I can take coverage!": emotional support to a group of older patients in municipal home care setting
(English)Manuscript (preprint) (Other academic)
National Category
Nursing
Research subject
Nursing Science
Identifiers
urn:nbn:se:hh:diva-25940 (URN)
Available from: 2013-06-20 Created: 2014-06-27 Last updated: 2015-02-18Bibliographically approved

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