Objective

The digital transformation of society has significant implications for healthcare. Despite a growing body of research on telemedicine implementation, studies specifically examining chat-based care assessments by primary care nurses remain limited. The aim of the present study was to explore nurses’ work experiences and training needs regarding chat-based care assessments in primary healthcare.

Method

This qualitative exploratory study employed semi-structured in-depth interviews with six nurses trained in telemedicine chat technique. Data were analysed inductively using reflexive thematic analysis.

Results

The findings indicated that chat-based care assessments could lead to prolonged assessment processes, and that nurses needed proficiency in chat techniques and effective communication skills to ensure clarity in conversations and accurate medical history acquisition. Training gaps were noted, particularly in fostering effective patient-professional relationships through brief text exchanges in the chat. The prolonged process had both advantages and disadvantages. Although it was more time-consuming, nurses got better opportunities to consider their responses and consult with colleagues, which was thought to improve the accuracy of medical assessments. Further benefits of chat-based assessments included access to chat history, the ability to share informational links, and opportunities for professional development. Nurses pointed to the need for system improvements, such as auto-anamnesis and auto-triage features, to better support their work in the future.

Conclusion

The study offers valuable insights for healthcare professionals, technology designers, and policymakers regarding the nuances of nurses’ chat-based interactions with patients in primary care settings. The results can inform the development of targeted training programs in chat techniques and communication skills, enhancing the effectiveness of digital consultations and fostering therapeutic relationships with patients. Chat-based assessments offer clear benefits within the care process but also come with challenges.

Aim

To explore residents' experiences of the mealtime environment in nursing home.

Design

An exploratory qualitative design was employed to gain in-depth insights.

Methods

Twenty semi-structured interviews were conducted with residents at a nursing home. Data were analysed using thematic analysis as outlined by Braun and Clarke. The consolidated criteria for Reporting Qualitative research checklist were used to support the research process.

Results

Four main themes emerged from the analysis: (1) The significance of food, emphasising the centrality of food quality and variety in residents' mealtime experiences. (2) Security through routines, illustrating how established mealtime routines provide comfort and predictability. (3) Variability in staff influence, reflecting residents' perceptions of staff competence and their impact on the dining experience. (4) Limited social interactions, highlighting the varied social dynamics and their effects on residents' sense of community and isolation.

Conclusion

The study underscores the critical importance of food quality, staff compliance and consistent routines in enhancing mealtime experiences in nursing homes. Additionally, it reveals that the ability to choose social interactions plays a significant role in residents' satisfaction and social well-being.

Implication for Patient Care

This study provides valuable insights for improving mealtime experiences in nursing homes, suggesting that person-centred care and resident involvement in meal planning can enhance satisfaction and nutritional intake.

Impact

The findings offer practical guidance for healthcare management, emphasising the need to prioritise and personalise mealtime environments to better meet residents' needs and preferences.

Abstract

Background Graphic novels - full-length stories published in comic-strip format are a proven method for putting student nurses ‘into the shoes’ of health service users and offer nurse educators an alternative to traditional modes of instruction. Their use can support the teaching of palliative care related topics, which remains a challenge in nurse education. This study aimed to explore the views and perspectives of nurse educators about how the graphic novel Vivian could be used to prepare undergraduate nursing students for palliative care and beyond.

Methods Focus groups and individual interviews were conducted with 12 nurse educators at universities in the United Kingdom, New Zealand and Sweden and analysed using thematic analysis.

Results Four themes were generated: (1) impact of visual storytelling, (2) arts-based learning in palliative care, (3) refinement of the graphic novel, (4) recommendations about future graphic novels. Participants noted Vivian’s usefulness for teaching issues related to palliative care and the health care system, including gender inequities, ageing, and economic crises.

Conclusions There is scope to use arts-based learning when engaging audiences from diverse backgrounds. The educators stressed Vivian could help students think ‘outside of the box’ and stressed the importance of a teaching and learning approach that extended beyond textbooks to include other interactive forms. Future research is needed to adapt and refine the graphic novel by considering social and cultural contexts and evaluate how the graphic novel is implemented in nurse education across different settings and countries

Background: When moving to a nursing home, the new resident also meets a new kind of culture, including communal, shared meals. Gaining greater insight into the resident experience of mealtimes in nursing homes is essential to identify the meaning that mealtime situations have and highlight the potential barriers and facilitators to the implementation of mealtime situations that create wellbeing for residents. The aim of this integrative review was therefore to shed light on mealtime situations in nursing homes from the residents’ perspective. Methods: The literature search was performed using a combination of MeSH keywords and free text terms in ASSIA, CINAHL, PsycInfo, PubMed, and Web of Science. After scrutinizing the articles and quality checks, 13 articles were chosen. The analysis was performed following Whittemore and Knafl’s instructions for integrative reviews. Results: The experiences of the mealtime situations were partly connected to residents’ personhood and partly to the nursing home’s organization of the mealtimes. Three main categories emerged: mealtimes as a source of well-being in nursing home life, mealtimes (re)creating continuity in life and preserving identity, and mealtimes as a balancing act between autonomy and need of support. Residents in nursing homes want the possibility to choose both what to eat, with whom they will eat and where they eat. The mealtimes in nursing homes and how they are constructed have an important role in residents’ feelings of having control over their life situation and can also strengthen residents’ identity and autonomy. Conclusion: Staff needs to be aware of the meaning of mealtimes to promote person-centered care in regard to meals. Further research is needed to explore how different mealtime situations have an impact on nursing home residents’ lives as well as on the care the staff gives. 

In the context of long-term care facilities, mealtime situations have been linked to residents’ health and well-being. The optimisation of mealtime situations is dependent on multiple aspects and is complex. To better understand this complexity, this qualitative study aimed to identify staffs’ beliefs about the values of mealtime situations for residents’ health and well-being and to explore the facilitators of, barriers to, and challenges and actions in accomplishing and upholding these values. The results demonstrated that staffs’ belief consisted of achieving social and relational values, vitality values, self-strengthening values and atmospheric values. During mealtimes, participating staff had to constantly balance these values in relation to mealtime situational preconditions and residents’ individual and communal needs. Experienced facilitators, challenges, barriers and actions could be traced to and explained by identified beliefs, implying that knowledge regarding beliefs about values could be helpful for understanding and managing the complexity inherent in the mealtime situation.

Aim: Dignity in older persons is a goal of palliative care. This study aimed to perform a process evaluation of the Swedish Dignity Care Intervention (DCI-SWE) in municipal palliative care in Sweden, focusing on implementation, context, and mechanism of impact.

Methods: This study had a process evaluation design. The Knowledge to Action framework supported the implementation of the DCI-SWE. The intervention was used by community nurses with older persons (n = 18) in home healthcare and nursing homes. Data were collected by focus groups- and individual interviews with community nurses (n = 11), health care professionals (n = 5) and managers (n = 5), reflective diaries, and field notes.

Results: Grasping the DCI-SWE was challenging for some community nurses. Enhanced communication training and increased engagement from managers were requested. However, the DCI-SWE was perceived to enhance professional pride in nursing. In terms of fidelity, dose and reach the project was not fully achieved. Regarding mechanism of impact the DCI-SWE contributes to address older persons' loneliness and existential life issues, as it put conversations with older persons on community nurses' agenda.

Conclusions: The DCI-SWE provided opportunities to maintain older persons' dignity and quality of life. However, with refinements of design and the DCI-SWE, the sustainability in the context may increase.

Background: Undergraduate nursing programme teaching and learning methods and content must evolve to meet the changing evidence base, healthcare context and needs of new generations of nurses. Art-based and narrative methods have been employed to help student nurses explore complex issues, including patient experiences of health and illness, person-centred care and social determinants of health. One creative visual teaching tool is the graphic novel. However, little is known about student perceptions of graphic novels and how they facilitate student nurses' reflection, engagement and learning. Gaining such an understanding may be of especial value for teaching Generation Z students who are used to interacting with complex visual imgery and prefer alternatives to text-heavy documents.ObjectiveThe objective was to explore student nurses responses to Vivian, and graphic novels in general, as teaching resources in undergraduate nursing curricula in England, Sweden, and Aotearoa New Zealand.

Design: A social constructionist critical framework informing a descriptive qualitative study.Setting and participantsUndergraduate nursing students in Sweden, England, and Aotearoa New Zealand.

Method: Data were collected using focus groups and semi-structured interviews. Braun & Clark's method for thematic analysis was used to analyse the data.

Results: Three themes were developed: 1) reflections on clinical practice, including reflections on palliative care, holistic care for older people and communication between patients and staff; 2) graphic novels' usefulness as a teaching resource, in which students regarded them as an alternative way to learn; and 3) Vivian as a form of the graphic novel.

Conclusion: The graphic novel Vivian helped nursing students engage in critical reflection and with challenging theoretical concepts. It, and graphic novels in general offer an alternative to print-based texts, which may heighten their appeal to Generation Z learners.

Sweden’s strategy during COVID-19 with restrictions but no firm closure of the society surprised the rest of the world and was questioned, not least by neighbouring countries. This article analyses public discourses on space and place for health and care in the Swedish daily press during the first year of the pandemic, 2020. Critical discourse analysis was conducted on daily press newspaper articles to approach issues of space, place, health and care during the COVID-10 pandemic. The findings suggest three main discourses. First, a powerful discourse on unity against the threat is articulated, urging citizens in Sweden to be loyal in the national space. Secondly, an affirming national reconstructing discourse is manifested, related to constructions of borders of national space but also in relation to places of family life and social contacts to ‘flatten the curve’ and stay healthy. Thirdly, later in the period the overarching discourse of the nation and its loyal citizens was torn apart and increasing tensions were articulated due to, as it appeared, the uncertain actions from the government. This study adds to the literature on a theoretical and practical level. Raising awareness on nationalist discourses in relation to place, space, health, and care could prove important in combating inequalities in the local society as well as when cooperating on an international level.

Aims and Objectives

To further develop and validate the Mealtime instrument, an observational instrument for assessing mealtime environments in nursing homes originating from the theoretical framework: Five Aspects Meal Model (FAMM).

Methodological Design and Justification

A mealtime experience is significant for a sense of well-being. In nursing homes, residents' personal preferences, combined with their diagnoses and different stages of illness, influence their mealtime experience and provide a complexity that has been found difficult to assess. Using FAMM, a theoretical framework as its base, this study, attempts to look at different parts of the mealtime environment. FAMM structures the mealtime environment in to five aspects: room, meeting, product, management control system and atmosphere.

This study's design includes instrument development and validation.

Ethical Issues and Approval

This study has been approved by the Swedish Ethical Review Authority (dnr 2019–05477).

Design

Methodological study.

Research Method

An existing instrument, the Mealtime instrument with FAMM as a theoretical framework, was used as a foundation for the development of the Five Aspects Mealtime Environment Observation Instrument (FAME-OI). Content validity index (CVI) was used to validate FAME-OI.

Results

FAME-OI's item-CVI, scale-CVI and modified Kappa displayed high validity. Changes were made in its structure and phrasing. These developments resulted in having a distinct structure in FAME-OI, in reference to FAMM.

Conclusion

FAME-OI is applicable for clinical use in nursing homes and in research; however, adjustments may be needed before its use in other health care facilities.

Purpose: A patient is vulnerable and exposed due to illness, relies on and surrender to other people. In caring this means a special dependency. The aim of this study was to describe the origin of the concept ‘exposed’, to elucidate how the definition of this term has changed over time, and to outline its relevance in caring science. Method: A semantic concept analysis in two phases was conducted. Results: The findings show that over time, the degree of binding of the following synonyms has become stronger; unprotected/defenseless, naked/bare, pressed/jostled and unsafe/unprotected and can easily be transferred to a clinical nursing context. Conclusions: This study provides a deeper understanding of the concept 'exposed' semantically. Being exposed is a profound experience for patients who need to be seen as the person they really are. A life-world led care has an existential power that can support professionals, strengthen patients’ health processes, and alleviate the patient’s suffering.