The aim of the study was to describe the opportunities for using video games in daily intercourses among elderly with dementia. Data were collected by interviews, a questionnaire and participated observation. The results were shown that the staffs were unknown with technology in general, but they were positive to test video games among the persons receiving care. It was shown that video games were suited among elderly with dementia, but it required help from the staffs. Thus, video gaming was an excellently opportunity for being together. However, the question if video games are suitable also for rehabilitation is still remaining.

The aim of this study was to investigate how overall health, participation in physical activities, self-esteem and social and financial resources are related to life satisfaction among people (65+) with reduced Activities of Daily Living (ADL) capacity in six European countries. A subsample of the European Study of Adults’ Well-Being (ESAW), consisting of 2195 people with reduced ADL capacity from Sweden, the UK, the Netherlands, Luxembourg, Austria, and Italy, was included. The Older Americans’ Resources Schedule (OARS), the Life Satisfaction Index Z, and the Self-esteem scale were used. In all national samples, overall health, self-esteem and feeling worried, rather than ADL capacity, were significantly associated with life satisfaction. The findings indicate the importance of not only taking the reduction in functional capacity into account, but also the individual’s perception of health and self-esteem, when outlining health care and nursing aimed at improving life satisfaction. The study thus suggests that personal, rather than environmental, factors are important for life satisfaction among people with reduced ADL capacity living in Europe.

Life satisfaction is a concept frequently used to measure wellbeing of older people. However, there is still a lack of cross-national comparative research investigating factors associated with life satisfaction. There may be unique and common factors associated with life satisfaction across European countries. This study aimed to investigate life satisfaction among people aged 60–89 years in six European countries in relation to health problems, ADL capacity, self-esteem, social and financial resources. A cross-sectional study was performed, including 7699 people aged 60–89 years, in Sweden, the UK, the Netherlands, Luxemburg, Austria and Italy, participating in the European Study of Adult Wellbeing, using questions from the Older Americans Resources and Services schedule, Multidimensional Functional Assessment Questionnaire, Life Satisfaction Index Z and Rosenberg’s Self-Esteem Scale. Logistic regression analysis was performed to determine factors associated with life satisfaction in the six national samples. In cases where people were less satisfied with their life it was fairly satisfactory and unsatisfactory social contacts (Odds Ratio (OR) 1.5–13.8), poor financial resources (OR 1.7–15.1), feeling greatly hindered by health problems (OR 2.2–5.4) and self-esteem (OR 2.1–5.1) rather than the ability to perform activities of daily living and the extent of social contacts that gave the greatest risk of low life satisfaction in all the six European countries. There were both common and country-specific factors important for life satisfaction in the six European countries. However, the importance of satisfactory social contacts, financial resources, self-esteem and feeling hindered by health problems seems universal in the six included countries and thus important to target in preventive interventions.

The problems and challenges that arise in the task of improving discharge planning have been an area of concern for many years, including problems related to the lack of time for professionals to participate. In a county council area in South East Sweden, video conferencing was implemented in discharge planning sessions to enable distance participation. As part of a larger research study of the implementation process, interviews were conducted with two of the implementers. The interviews were analysed qualitatively, using directed content analysis with a deductive approach to considering a framework developed by Nilsen et al. The results of this study are consistent with the actual framework but with the addition of time, i.e. time to prepare, time to understand, time to run through and time to reflect. Further research is proposed to focus more on leadership during the implementation process and its influence on the meaning of time.

Background/Objective: This paper sets out to describe experience-based reflections on discharge planning as narrated by nursing staff in primary healthcare, along with their concerns about how the introduction of video conferencing might influence the discharge planning situation.

Methods: Interviews were conducted with nursing staff working at a primary healthcare centre in South East Sweden. Each interview took place was conducted on a one-to-one basis in dialogue form, using open questions and supported by an interview guide. It was then analysed using a phenomenological hermeneutic method. Participants were eligible for the study if they had given their informed consent and if they worked with discharge planning and home-based healthcare provision. In total, 10 of the 30 persons working at the primary healthcare centre participated in the study.

Results: It was found that nursing staff in primary healthcare regarded the planning session as stressful, time-consuming and characterised by a lack of respect between nursing staff at the hospital and nursing staff in primary healthcare. They also described uncertainty and hesitation about using video conferences where patients might probably be the losers and nursing staff the winners.

Conclusions: It is suggested that there is a need for improvement in communication and understanding between nursing staff at the hospital and nursing staff in primary healthcare in order to develop discharge planning. There is also a need for the nursing staff in primary healthcare to obtain more information about how Information Technology (IT) solutions could support their work and help them to find ways to collaborate.

Challenges of improving discharge planning have been an area of concern for many years, including problems related to the lack of time for professionals to participate. In a county in South East Sweden, video conferencing was implemented in discharge planning sessions to enable distance participation of the professionals. To examine the implementation process, interviews were conducted with the implementers, who were project leaders, discharge planning coordinators in the hospital, and in home-care. The interviews were analyzed qualitatively, using directed content analysis with a deductive approach to a theoretical framework that was composed from theories about implementation processes to be suitable for the healthcare sector, consisting of the factors: implementation objects; implementation actions; actors; users; inner context and outer context. The results of this study are consistent with the framework but with the addition of a new dimension – time, i.e. time to prepare; time to understand; time to run through and time to reflect. It is suggested that implementation frameworks are useful when IT is introduced in healthcare. Framing the implementation process supports the exposure of factors and highlights relationships and states of dependence between those factors which may affect implementation.

This article describes healthcare managers' experiences of leading the implementation of video conferencing in discharge planning sessions as a new tool in everyday practice. Data collection took place through individual interviews and the interviews were analyzed using qualitative content analysis with an inductive approach. The results indicate that managers identified two distinct leadership perspectives when they reflected on the implementation process. They described a desired way of leading the implementation and communicating about the upcoming change, understanding and securing support for decisions, as well as ensuring that sufficient time is available throughout the change process. They also, however, described how they perceived that the implementation process was actually taking place, highlighting the lack of planning and preparation as well as the need for support and to be supportive, and having the courage to adopt and lead the implementation. It is suggested that managers at all levels require more information and training in how to encourage staff to become involved in designing their everyday work and in the implementation process. Managers, too, need ongoing organizational support for good leadership throughout the implementation of video conferencing in discharge planning sessions, including planning, start-up, implementation, and evaluation.

This development project was aimed at engaging nursing students in a project targeting the prevention and reduction of pressure ulcers on an education based hospital ward. An intervention was implemented based on systematic assessment, skin observation, together with training and educational sessions, i.e. on how to make risk assessments and how to prevent and treat a pressure ulcer, were carried out. The project demonstrated the importance of offering nursing students an environment for clinical practice which supports them in participating and developing patient care starting from Evidence-Based Practice. During the project no patients developed pressure ulcers while on the ward. The opportunityto act as facilitators of evidence-based methods was found to enhance student ability to draw conclusions and make connections between quality of care and end result.

A hospital round is a long tradition in which nurses and physicians communicate to develop an integrated plan of care together with the patient. There is insufficient knowledge of care professionals’ experiences of communication during hospital rounds, particularly in surgical units, where the physician is frequently absent during daily care. Hence, the aim of this study was to describe nurses’ experiences of communication with physicians during hospital rounds in a surgical unit. Nine qualitative unstructured interviews with nurses were conducted and analysed using Burnard’s description of content analysis. ‘An encounter involving opportunities for and challenges to teamwork’ was found to be the predominant theme. The hospital round in a surgical unit is a short encounter that can be challenged by missing patient care goals, difficulties in transmitting messages and frustration over unshared information. Further studies are needed to overcome existing knowledge gaps about communication during hospital rounds.

Aim

To describe and obtain a deeper understanding of social challenges and their influence on the implementation process when implementing Information systems in a Swedish health-care organisation.

Background

Despite positive effects when implementing Information systems in health-care organisations, there are difficulties in the implementation process. Nurses' experiences of being neglected have been dismissed as reasons for setbacks in implementation.

Methods

An Institutional Ethnography design was used. A deductive content analysis was made influenced by empirically identified social challenges of power, professional identity and encounters. An abstraction was made of the analysis.

Results

Nineteen nurses at macro, meso and micro levels were interviewed in focus groups. Organisational levels are lost in different ways in how to control the reformation, how to introduce Information systems as reformation strategies and in how to translate new tools and assumptions that do not fit traditional ways of working in shaping professional identities.

Conclusion and implication for nurse management

Different focus may affect the reformation of health-care organisations and implementation and knowledge processes. An implementation climate is needed where the system standards fit the values of the users. Nursing management needs to be visionary, engaged and work with risk factors in order to reform the hierarchical health-care organisation.

Implementation of information systems in healthcare has become a lengthy process where healthcare staff (eg, nurses) are expected to put information into systems without getting the overall picture of the potential usefulness for their own work. The aim of this study was to explore social challenges when implementing information systems in everyday work in a nursing context. Moreover, this study aimed at putting perceived social challenges in a theoretical framework to address them more constructively when implementing information systems in healthcare. Influenced by institutional ethnography, the findings are based on interviews, observations, and written reflections. Power (changing the existing hierarchy, alienation), professional identity (calling on hold, expert becomes novice, changed routines), and encounter (ignorant introductions, preconceived notions) were categories (subcategories) presented in the findings. Social Cognitive Theory, Diffusion of Innovations, organizational culture, and dramaturgical analysis are proposed to set up a theoretical framework. If social challenges are not considered and addressed in the implementation process, it will be affected by nurses’ solidarity to existing power structures and their own professional identity. Thus, implementation of information systems affects more aspects in the organization than might have been intended. These aspects need to be taken in to account in the implementation process.

A National Strategy for E-health has been introduced in Swedish county councils. The strategy indicates that health care needs to become more accessible. To generate usable and sustainable e- Health solutions in Swedish health care, Participatory Design (PD) was introduced as a working method in an e-Health project in the south of Sweden. The project has met with opposition; e-health solutions are not exactly what Swedish health care wanted at the same time as different arenas within the health care organization have difficulties understanding each other. The aim of this study is to find work methods that result in applicable, usable, and sustainable ICT- solutions in every day work within Swedish health care. The study suggests that a modification of third generation of PD may be one way to the challenges PD has come across in the health care context.

A challenge when groups from different disciplines work together in implementing health information technology (HIT) in a health-care context is that words often have different meanings depending upon work practices, and definition of situations. Accessibility is a word commonly associated with HIT implementation. This study aimed to investigate different meanings of accessibility when implementing HIT in everyday work practice in a health-care context. It focused on the perspective of nurses to highlight another view of the complex relationship between HIT and information in a health-care context. This is a qualitative study influenced by institutional ethnographic. District nurses and student nurses were interviewed. The results indicate that when implementing HIT accessibility depends on working routines, social structures and patient relationship. The findings of the study suggest that interaction needs to take on a more important role when implementing HIT because people act upon words from the interpreted meaning of them. Symbolic interactionism is proposed as a way to set a mutual stage to facilitate an overall understanding of the importance of the meaning of words. There is a need for making place and space for negotiation of the meaning of words when implementing HIT in everyday work practice.

The Verbal and Social Interaction Nursing Students questionnaire (VSI-NS) has been created to measure the development of verbal, social and interactional skills of nursing students with patients, from their perspective in nursing care. The aim of the present study was to determine the construct validity and internal consistency reliability of the questionnaire. The study had a methodological and developmental design and was carried out in four steps: adjustment of the items, face validity, data collection and data analysis. The number of items was reduced from 48 to 31. The factor analysis of the final 31 items resulted in four quite distinct factors: “Inviting to talk about feelings and thoughts”, “Building a caring relationship”, “Encouraging social and practical aspects in daily life” and “Caring towards health and wellbeing”. The results showed satisfactory psychometric properties in terms of content validity, construct validity and the internal consistency reliability of the questionnaire.  It could be concluded that the original conceptual model could serve as a theoretical foundation to explain and understand nurses’ caring interactions with their patients.