How best to support working carers is being paid increased attention across Europe and internationally. This article examines a largely unexplored area within the empirical literature, namely, information and communication technology-mediated support for working carers of older people. Using an integrative review methodology to draw on both quantitative and qualitative data, 14 studies were identified. Themes included making work–life balance easier, reducing the burden of caregiving and promoting well-being. Factors to consider in the design, implementation and evaluation of innovative support solutions for working carers are put forward. However, a lack of longitudinal studies and biased samples warrants further investigation.

Policy makers in Sweden and other European Member States pay increasing attention as to how best support working carers; carers juggling providing unpaid family care for older family members while performing paid work. Exploring perceived benefits and challenges with web-based information and communication technologies as a means of supporting working carers' in their caregiving role, this paper draws on findings from a qualitative study. The study aimed to describe working carers' experiences of having access to the web-based family care support network 'A good place' (AGP) provided by the municipality to support those caring for an older family member. Content analysis of interviews with nine working carers revealed three themes: A support hub, connections to peers, personnel and knowledge; Experiencing ICT support as relevant in changing life circumstances; and Upholding one's personal firewall. Findings indicate that the web-based family care support network AGP is an accessible, complementary means of support. Utilising support while balancing caregiving, work obligations and responsibilities was made easier with access to AGP; enabling working carers to access information, psychosocial support and learning opportunities. In particular, it provided channels for carers to share experiences with others, to be informed, and to gain insights into medical and care issues. This reinforced working carers' sense of competence, helping them meet caregiving demands and see positive aspects in their situation. Carers' low levels of digital skills and anxieties about using computer-based support were barriers to utilising web-based support and could lead to deprioritising of this support. However, to help carers overcome these barriers and to better match web-based support to working carers' preferences and situations, web-based support must be introduced in a timely manner and must more accurately meet each working carer's unique caregiving needs.

BACKGROUND: Working family carers are an important resource for the care of older people but can experience negativepressures without support.

OBJECTIVE: This study examined the perceived value of forms of support and the level of receipt of valued forms of supportamong Swedish working carers, with a focus on information and communication technology (ICT)-mediated support.

METHODS: A convenience sample (N = 129) of working carers caring for an older (> 65 years) relative completed a webbasedquestionnaire that addressed: caring characteristics; work-care conflict; and valued and received forms of support.

RESULTS: Overall non-ICT forms of support were the most highly valued, while receipt of valued support was low: on averageonly 16.9% of participants who valued ICT-mediated forms of support received such support, while the figure was only slightlyhigher (23.4%) for non-ICT forms of support. Higher levels of work-care conflict were associated with higher perceived value ofsupport for 13 out of fourteen forms of support.

CONCLUSIONS: The findings suggest that ICT-mediated and non-ICT forms of support should be regarded as complementary,while the low level of receipt of valued forms of support could indicate high levels of unmet need in working carers. Implicationsfor further research and policy on working carers are considered.

There is a need for a suitable instrument for the Swedish context that could measure family members’ perceptions of cognitive and emotional support received from nurses. The purpose of this study was to translate and test the psychometric properties of the Swedish version of the Iceland-Family Perceived Support Questionnaire (ICE-FPSQ) and, further, to report perceptions of support from nurses by family members of children with congenital heart defects (CHDs). A sample of 97 parents of children with CHD, living in Sweden, completed the Swedish translation of ICE-FPSQ. The Swedish version of ICE-FPSQ was found to be reliable and valid in this context. Parents scored perceived family support provided by nurses working in pediatric outpatient clinics as low, which suggests that nurses in these outpatient contexts in Sweden offered family nursing only sparingly.

Purpose: The purpose of this study was to describe families' perceptions of relational practice when interacting with health care professionals in emergency departments in the South African context. Background: Relational practice is seen as an approach that amplifies the voices of families through creating meaningful connections with health care professionals. However, the voices of families maybe obliterated by factors in the clinical environment including the pressure to perform and timely patient flow. Design: The study adopted a qualitative design. Methods: Qualitative data were collected from six family members by means of semi-structured interviews and were analysed using qualitative content analysis. Results: Four major categories emerged from family members' perceptions regarding relational practice when interacting with health care professionals in the emergency department, Disrupted worlds; Care is what you see and hear; Powerlessness; Feeling disconnected. Conclusions: Findings highlighted the need for improved relational practice between families and health care professionals in the emergency department. Pathways need to be created to involve families in decision-making and genuinely engage with them. There is a need to move away from the hierarchical "expert" emergency department culture towards one that seeks to include the voices of families in driving emergency department care.

Background: Emergency departments are regarded as stressful working environments, associated with staff shortages, increased patient numbers and long waiting times. Increased organisational demands for performance can compromise genuine interactions between families and healthcare providers working in emergency departments. A relational practice approach in caring for families can enhance the capability of healthcare providers to simultaneously overcome these difficulties and provide emergency healthcare of high quality. Objectives: The purpose of the study was to describe healthcare providers’ perceptions of relational practice with families in three emergency departments in KwaZulu-Natal, South Africa. Method: Using a qualitative descriptive approach data were collected through semi-structured interviews with healthcare providers working in emergency departments. The data were analysed and categorised using qualitative content analysis. Results: Four categories emerged from data analysis: (1) families and healthcare providers connecting; (2) recognising the uniqueness of families; (3) caring interactions; and (4) taking charge when necessary. Conclusion: The study elicited that healthcare providers working in emergency departments perceived that despite high patient volumes and resource constraints, collaborative relationships with families were important. However, these collaborative relationships cannot be willed into practice, instead training workshops are needed to develop relational skills of healthcare providers which can facilitate family and healthcare professional collaboration. © 2020. The Authors. Licensee: AOSIS. This work is licensed under the Creative Commons Attribution License.

Relational practice is characterised by genuine interaction between families and healthcare professionals that promotes trust and empowerment. Positive clinical outcomes have been associated with relational practice. To assess and examine in-hospital interventions designed to promote relational practice with families in acute care settings of emergency departments, intensive care units and high care units. The preferred reporting Items for Systematic Reviews and Meta-Analyses guidelines informed the design of this scoping review. To identify relevant studies, databases (Academic Search Complete; CINAHL; PubMed; PsyInfo) and the search engine Google Scholar were searched using terms for core elements of relational practice and family engagement. Of the 117 articles retrieved, eight interventional studies met the search criteria. The interventions focused on relational practice elements of collaborating with and creating safe environments for families, whilst only one addressed healthcare professionals being respectful of families' needs and differences. In relation to the nature of engagement of families in interventions, the focus was mainly on improving family functioning. Family engagement in the interventions was focused on involving families in decision-making. The scoping review revealed a limited number of in-hospital interventions designed to promote relational practice with families in acute care settings. Further research is encouraged to develop such interventions.

Contribution: The scoping review has highlighted specific elements of relational practice that have been overlooked in the mapped interventions. This provides guidance on where future interventional research may be focused.

Doing violence and evil always indirectly or directly leads to making someone else suffer. Such is the dialogical structure of evil and it seems to be the dialogical structure of elder abuse as well. There is a perturbing sameness between definitions of evil and definitions of elder abuse. It is hard at times to see how or if there is any line of demarcation between the subjects. Two modern-day philosophers, Paul Ricoeur and Simone Weil have delved particularly into the concept of evil. The symbolism Ricoeur analyses in depth is that of defilement, sin, and guilt and the concept of the servile will. Integral in Weil's description of evil are the concepts of suffering and the special situation of extreme suffering, termed affliction. Grounded in the writings of Ricoeur and Weil, this paper is a series of reflections on the intersection of evil and elder abuse as exemplified in the narrative of an abused older woman. This woman provided around the clock care at home for her husband who had vascular dementia. She was also abused by her husband. This was witnessed by both family and others but no one intervened. In her narrative there were indications of defilement, sin, guilt, and true affliction as a servile will. This paper illuminates the evil of elder abuse that is harm and suffering, and the challenge of untangling issues of blame, free will, responsibility, and self-determinism. When engaging with abused, older persons it can be worthwhile for nurses to enter the encounter with non-judgemental compassion founded on the human to human connection and recognition of our mutual fallibility and potential for evil that is part of our human fragility.

The article presents a study which investigates the emotional reaction of a lay person to a sketch pertaining to elderly abuse situation which involves an elderly caregiver and his spouse in Sweden. It states that emotional reactions were explored using questionnaire items which includes anger, impatient, and a desire to help. The study reveals different reactions from the participants wherein the analysis showed a difference in response process related to gender and marital status.

Writing therapeutic letters to families is discussed in this article as an educational strategy encouraging students to think reflectively about family nursing. At the University of Kalmar, Sweden, undergraduate nursing students in a primary care module interviewed families using the Calgary Family Assessment Model and wrote therapeutic letters to these families. This article describes (a) the examination process, which was the context for writing therapeutic letters, (b) results of analyses of the letters, and (c) student's post-examination evaluation comments. Results indicate that most students needed encouragement to focus on the family's strengths and resources instead of focusing on own feelings or problems they perceived the family as having. Students also needed support in relinquishing their hierarchical role of “expert nurse.” Students' evaluation comments showed that writing therapeutic letters provided students with opportunities to reflect about the connections between family nursing theory and the family itself.

Pilotprojektet Konst och Hemslöjd i Emmaboda (KoHiE) genomfördes som en del av det treårigaprogramet Hälsa och kultur i hälsolänet Kalmar län. KoHiE hade som mål attundersöka om kulturinsatser i form av studiecirklar har effekt på upplevd hälsa ochrehabilitering hos personer med psykisk ohälsa. Hypotesen var att deltagande ikulturaktiviteter är en rehabiliteringsform som underlättar återhämtning och därigenomfrämjar hälsan hos deltagarna. Två cirklar, en baserad på konstaktiviteter, den andra påtovning, genomfördes under hösten 2015 fram till maj 2016. Varje cirkel pågick under 10veckor med två träffar i veckan á tre timmar/träff och leddes av en konstnär och enullslöjdare.Utvärdering av KoHiE skedde vid tre datainsamlingstillfällen (vid cirkel 1 start, vid cirkel 2start, och vid avslutning av cirkel 2). Vid dessa tillfällen var det möjligt för deltagare att låtasig intervjuas och lämna in en enkät. Tio personer medverkade vid utvärderingen och totaltgenomfördes 16 intervjuer och 14 enkäter inlämnades. Intervjuerna analyserades medmanifest innehållsanalys och enkäterna med deskriptiv statistik.Resultatet var entydigt att KoHiE har erfarits som hälsofrämjande och som ett forum förpersonlig utveckling och återhämtning. I resultatet framgick att deltagarna mådde bättre efteratt ha deltagit i aktiviteten och att verksamheten uppfattades som mycket positiv, motiverandeoch inspirerande. Träffarna upplevdes som ett andningshål och en plats där man kände siglugn och fokuserad så att man inte längre tänkte på vardagens bekymmer. Gemenskapen igruppen var av central betydelse i resultatet. Att skapa tillsammans med andra upplevdes somvärdefull då det blev en kraftfullare dynamik och öppet klimat att erbjuda och få återkopplingoch stöd. Träffarna utgjorde också en plattform att bygga nya sociala nätverk. Något som haruppfattats vara extra värdefullt i sammanhanget är att gruppens deltagare delar sammaproblematik i vardagen med att må dåligt psykiskt. Deltagarna berättade om ökadsjälvuppskattning och självförtroende och att det hade blivit lättare att umgås socialt.Resultatet tydliggör att aktiviteterna har hjälpt deltagarna att få tillbaka sin framtidstro och förmånga var det att hitta en väg framåt, se möjligheter, och att utvecklas, både privat och ioffentliga arenor. För en deltagare ledde deltagandet till att hon t.o.m. slutat användapsykofarmaka just för att upprätthålla sin mentala skärpa under KoHiE träffarna.En av deltagarna var en asylsökande kvinna. Hennes berättelse stödjer ett antagande att dennaoch liknande aktiviteter, dvs. kreativa, handfasta, praktiska aktiviteter i en grupp tillsammansmed svenskfödda deltagare, har en enorm potential i att bistå med en smidig övergång förnyanlända, både gällande att lindra symtom från traumatiska minnen såväl som att inge hopp,självförtroende, självuppskattning att man är en värdefull människa.KoHiE var planerad som ett återhämtningsorienterat rehabiliteringsprojekt med förhoppningarom att höja välbefinnande och hälsa hos personer med psykisk ohälsa. Deltagarnas mycketpositiva erfarenheter av att medverka i denna skapande aktivitet ger tydlig evidens på attKoHiE varit framgångsrik. Rekommendationen är därför att liknande cirkelverksamhet förkulturaktiviteter bör finnas att tillgå och det är högst befogat att implementera verksamheterliknande KoHiE som en beständig del av kommunal omsorg.

There is a growing recognition for the important role played by qualitative research and its usefulness in many fields, including the emergency care context in Africa. Novice qualitative researchers are often daunted by the prospect of qualitative data analysis and thus may experience much difficulty in the data analysis process. Our objective with this manuscript is to provide a practical hands-on example of qualitative content analysis to aid novice qualitative researchers in their task. (C) 2017 African Federation for Emergency Medicine. Publishing services provided by Elsevier B.V.

In order to provide some guidance for the researcher unfamiliar with qualitative research, this article compares quantitative and qualitative research, and introduces a number of qualitative methods. Aspects of methodological rigor are also presented as well as an example of qualitative data analysis using content analysis. Qualitative research methods explore, in a holistic fashion, the complex reality constructed by individuals in the context of their everyday worlds. Qualitative research is based on the subjective, looking at human realities instead of concrete realities of objects. When conducting a qualitative study the researcher is part of the study and is, in fact, the research instrument. The qualitative researcher embraces the ontological assumption of multiple truths, multiple realities, i.e., persons understand reality in different ways that reflect individual perspectives.

PURPOSE: The purpose of this study was to compare and contrast descriptions of "family" amongst Swedish and South African university nursing students.

DESIGN AND METHODS: This qualitative inquiry, using convenience sampling, explored how 232 undergraduate and postgraduate nursing students responded to a two-query, open-response questionnaire designed to elicit a definition of family and a description of who students considered to be members of their own families. Free-text responses were analyzed using manifest and qualitative content analysis.

FINDINGS: Five categories emerged from the data: Ties of Kinship, Ties of Love, Ties of Influence, Ties of Everyday Life, and Tied by Slipknots. Analysis clarified that students' responses from both countries were addressing the same issues and as such were in general very similar. Contrasting Swedish and South African responses, a noticeable difference in proportions of responses coded into each category was evident. Three conceptualizations of family are offered: for the total sample, Swedish sample, and South African sample.

CONCLUSIONS: The study provides data on students' conceptualization of family usable in family research, nursing education, and practice as a basis for comparison, and as a starting point for discussions on the nursing of families, not only in South Africa and Sweden, but also in broader international contexts.

CLINICAL RELEVANCE: Because understanding family is important for healthcare providers in their everyday work, awareness about what is meant by family can assist nurses through increasing understanding of the complexities surrounding this issue and encouraging cultural sensitivity and openness to patients' and families' views about who is a family member.

Family members who witness elder abuse could be valuable partners to nurses and support personnel in case identification and intervention. The aim of this study was to explore an adult family member’s experiences of witnessing family situations of elder abuse. Interviews were conducted with a woman who had witnessed situations of elder abuse involving her uncle, his wife with disabilities, and health care personnel. Interviews were analyzed using van Manen’s thematic analysis and conception of narrative anecdotes, and development of poetic representations. The witness described conflictual feelings about her family and caregiving situation but felt there were no support personnel she could trust. She felt powerless and remained passive out of loyalty to family, need to protect family, and feeling shame that this was her family. Although she knew what she ought to do she could not live up to her ideals and instead tolerated escalating abuse. The family member witness viewed healthcare personnel as also tolerating and carrying responsibility for the abuse situation. For nurses and support personnel these findings point to the importance of personal and professional reflection and collegial discussions on morality, practice, what we see, and more importantly, what we do not see or want to see.

Our aim was to investigate connections between Swedish family caregivers’ health and providing care for an ill relative by conducting a systematic search and synthesis of previous research. We analyzed 31 articles using first qualitative content analysis then hermeneutic analysis. Analysis resulted in three derived themes—sliding sideways into caregiving, caregiving in reciprocity, and caregiving in disintegration—and a main interpretation and conceptual model of Swedish family caregivers’ health—caregiving in a sphere of beliefs. Results indicated that Swedish family caregivers’ beliefs, experiences of reciprocity, or nonsupport, together with quality of interpersonal relationships and feelings of responsibility and guilt, have a profound impact on their health. These results point to the value and importance of nurses gaining an understanding of family caregivers’ beliefs and experiences of reciprocity or nonsupport to effectively promote family caregivers’ health.