Globally, perinatal death is on a decline. However, its impact on the healthcare profession is huge. The existing literature focuses on examining perinatal death from parents’ perspectives and ...patient death from the perspectives of nurses and a few doctors in critical care, oncology, and neonatology in the West. Due to the unique setting of maternity units where death is not routinely anticipated, as well as distinctive socio-cultural views surrounding death, there is a need to comprehensively review literature examining the impact of perinatal death on the perspectives of healthcare professionals working in maternity units.
To examine available literature on the needs and experiences of healthcare professionals working in maternity units who have experienced perinatal death.
A scoping review of published and unpublished data.
A systematic literature search from 1st January 1996 to 5th August 2016 was made in the following databases: PubMed, CINAHL, Embase, PsycINFO, ScienceDirect, and Web of Science. Cochrane Library, Joanna Briggs Institute Library of Systematic Reviews, York Centre for Reviews and Dissemination, Open Grey, ProQuest Dissertation and Theses, and Mednar were reviewed for grey literature. A hand search of the reference lists of the included papers was performed.
Based on the pre-set inclusion criteria, 1519 articles were screened for their titles and abstracts. Eighty-five full-text papers were reviewed, resulting in 30 papers included for this review. The data were extracted and cross-checked between the reviewers. Any discrepancy between the authors’ views would be discussed with a third reviewer until consensus was reached. Thematic analysis was used to categorise the results into themes.
Two major themes emerged from the review: the experiences and needs of healthcare professionals. Six subthemes emerged from the experiences of healthcare professionals: 1) psychological impact, 2) physical impact, 3) positive feelings, 4) coping strategies, 5) personal factors influencing the experience, and 6) cultural factors influencing the experience. Three subthemes including 1) social support, 2) training and education, and 3) other needs explained the needs of healthcare professionals. Studies focusing on the experiences and needs of physicians were scarce.
Perinatal death has a profound impact on the psychological and physical wellbeing of healthcare professionals. They have unmet needs that need to be addressed. Though they use internal and external resources to combat their stress, institutional support acknowledging their stress and their needs is essential. Culturally-sensitive education and training are needed to provide support to these professionals.
Evidence-based practice has been the desirable healthcare standard for decades. To ensure evidence-based healthcare in the future, nursing education curricula must include strategies for teaching ...evidence-based practice to nursing students. Learning outcomes about evidence-based practice might be incorporated into courses like the bachelor's thesis.
This study investigates whether writing a bachelor's thesis influences nursing students' practice, skills, and attitudes towards evidence-based practice, and explores whether there are differences between students writing the thesis as a literature study and students conducting empirical studies.
This Nationwide Prospective Cohort Study collects data on students' practice, skills, and attitudes towards evidence-based practice through the Student Evidence-Based Practice Questionnaire and two questions from the Norwegian version of the Evidence-Based Practice profile questionnaire.
The sample consists of 314 nursing students writing their bachelor's thesis in the last term of their nursing education. The responding students represent all institutions of higher education in Norway.
Paired t-tests were used to examine changes in the subscales practice, retrieving/reviewing, sharing/applying, attitudes and total scale for the Student Evidence-Based Practice Questionnaire from before they started to submission of the bachelor's thesis. Linear multiple regression analyses were conducted to explore differences between students writing a literature study and students conducting empirical studies.
The analysis showed that the nursing students significantly increased in the three subscales practice, retrieving/reviewing, and sharing/applying, in addition to the total scale for the questionnaire, while writing the bachelor's thesis. Further, the analysis showed no difference on the scales between the groups of students writing a literature study or conducting an empirical study.
The results indicate that writing the bachelor's thesis leads to increased learning about evidence-based practice and does not depend on the kind of thesis the students write.
•Curricula in nursing education must include strategies to teach EBP.•Learning outcomes about EBP might be incorporated into the bachelor's thesis.•Writing a bachelor's thesis leads to increased learning about EBP.
To successfully achieve change in healthcare, a balance between technology and "people ware", the human recourses, is necessary. However, the human aspect of the change implementation process has ...received less attention than the technological issues. The aim was to explore the factors that characterize the work culture in a hospital unit that successfully implemented change compared with the factors that characterize the work culture of a hospital unit with unsuccessful implementation.
The Systematizing Person-Group Relations method was used for gathering and analyzing data to explore what dominate the behavior in a particular work environment identifying challenges, limitations and opportunities. This method applied six different dimensions, each representing different behavior in a work culture: Synergy, Withdrawal, Opposition, Dependence, Control and Nurture. We compared two different units at the same hospital, one that successfully implemented change and one that was unsuccessful.
There were significant statistical differences between healthcare personnel working at a unit that successfully implemented change contrasted with the unit with unsuccessful implementation. These significant differences were found in both the synergy and control dimensions, which are important positive qualities in a work culture.
The results of this study show that healthcare personnel at a unit with a successful implementation of change have a working environment with many positive qualities. This indicates that a work environment with a high focus on goal achievement and task orientation can handle the challenges of implementing changes.
The bachelor's thesis (BT) in undergraduate education is often an autonomous and individual assignment. It aims to demonstrate knowledge gained through education, to be an assessment tool, and to ...give new learning outcomes through working on the thesis. The process of working with the BT most often includes individual supervision. There is an absence of support for teachers supervising undergraduate nursing theses, which includes a lack of national or institutional guidelines, role definitions and research material.
Given the lack of helpful guidelines, this study aims to explore what the teachers emphasize as important regarding their supervision of nursing students writing their BT.
The study has a qualitative approach, featuring individual semi-structured interviews with nursing teachers supervising nursing students on the BT. Reflexive thematic analysis is used as the method of analysis.
The analyses resulted in two generated themes, each with two subthemes, describing the patterns the teachers emphasize as important aspects of their supervision of nursing students writing their BT. The themes were "The pedagogical approach to the supervision" and "The advantages of the bachelor's thesis to the nursing profession."
The teachers balanced different roles in the supervision of the students. They wanted the students to grow through challenging them, grounded in a relationship of trust and confidence. They were role models for how to be critical thinkers and incorporated critical thinking as a pedagogical implement in supervision, wanting to raise the students to become nurses who think critically. The teachers sought to combine clinical relevance with academic literacy to secure a new generation of nurses able to be a part of the future development of the profession. They wanted to equip the students with knowledge, skills, and confidence to speak up and communicate nursing. Last, the teachers combined their clinical and academic identities in the supervision of the BT.
For cancer patients and their family, an important factor that determines the choice to die at home is the caregivers' feeling of security when caring for the patient at home. Support to caregivers ...from healthcare professionals is important for the feeling of security. In rural areas, long distances and variable infrastructure may influence on access to healthcare services. This study explored factors that determined the security of caregivers of patients with advanced cancer who cared for the patients at home at the end of life in the rural region of Sogn og Fjordane in Norway, and what factors that facilitated home death.
A qualitative study using semi-structured in-depth interviews with bereaved with experience from caring for cancer patients at home at the end of life was performed. Meaning units were extracted from the transcribed interviews and divided into categories and subcategories using Kvale and Brinkmann's qualitative method for analysis.
Ten bereaved caregivers from nine families where recruited. Five had lived together with the deceased. Three main categories of factors contributing to security emerged from the analysis: "Personal factors", "Healthcare professionals" and "Organization" of healthcare. Healthcare professionals and the organization of healthcare services contributed most to the feeling of security.
Good competence in palliative care among healthcare professionals caring for patients with advanced cancer at home and well- organized palliative care services with defined responsibilities provided security to caregivers caring for advanced cancer patients at home in Sogn og Fjordane.
Abstract
Background
Nursing homes are under strong pressure to provide good care to the residents. In Norway, municipalities have applied the ‘Joy-of-Life-Nursing-Home’ strategy to increase a ...health-promoting perception that focuses on the older persons` resources. Implementations represent introducing changes to the healthcare personnel; however, changing one’s working approaches, routines and working culture may be demanding. On this background, we explored how the ‘Joy-of-Life-Nursing-Home’ strategy is perceived by the employees in retrospective, over a period after the implementation and which challenges the employees experience with this implementation.
Method
We used a qualitative approach and interviewed 14 healthcare personnel working in nursing homes in one Norwegian municipality, which had implemented the ‘Joy-of-Life-Nursing-Home’ strategy. The analysis was conducted following Kvale’s approach to qualitative content analysis.
Results
The main categories were: (a) the characteristics of care activities before implementations of ‘Joy-of-Life-Nursing-Home’, (b) how ‘Joy-of-Life-Nursing-Home’ influenced the care activities, and (c) challenges with the implementation of ‘Joy-of-Life-Nursing-Home’. Some of the informants spoke well about the implementation concerning the care quality stating “
to see the joy in the eyes of the resident then I feel we have succeeded”.
For informants who experienced resistance toward the implementation, they felt it was too much to document, it was too complicated, and the requirements were too many.
Conclusions
Quality of care seems to have increased after the implementation, as perceived by the informants. Nevertheless, the fact that the informants seemed to be divided into two different groups related to their main perspective of the implementation is concerning. One group has positive experiences with the implementations process and the benefits of it, while the other group focuses on lack of benefits and problems with the implementation process. To understand what facilitates and hinders the implementation, research on contextual factors like work environment and leadership is recommended.
Currently, we are facing a demographic shift to an older population and its consequences worldwide: in the years to come, several older people will need nursing home (NH) care. The work culture is ...important for care quality in NHs. Some Norwegian municipalities have implemented the Joy of Life Nursing Home (JoLNH) strategy, representing a resource-oriented health-promoting approach. Knowledge about how implementation of the JoLNH approach impacts the work culture is scarce.
We hypothesized that the JoLNH strategy impacts positively on the work culture: (1) when comparing measurements at two time points (T1 and T2) and (2) when comparing two municipalities, among which one has implemented the JoLNH and the other has not.
With a 1-year interval, healthcare personnel in 43 NHs located in two large Norwegian municipalities responded to a survey in two waves (T1 and T2). In total, 558 healthcare personnel participated at T1 and 515 at T2. Work culture was assessed by the Systematizing Person-Group Relations Instrument (SPGR).
The municipality implementing the JOLNH strategy experienced significant increases in SPGR dimensions, representing positive orientations towards a better work culture, whereas those working in the non-JoLNH municipality reported an increase in SPGR dimensions, signifying a worsened work culture.
The data indicate that the implemented JoLNH strategy has endorsed positive effects in the work culture. The JoLNH strategy emphasizes on the quality of patient care, which is what healthcare personnel, in general, are much concerned about. Furthermore, attention to task orientation and independent work seem to encourage a better work culture in NHs.
This study suggests that the JoLNH strategy impacts positively on the work culture in Norwegian NHs.
Well-adapted and validated quality-of-life measurement models for the nursing home population are scarce. Therefore, the aim of this study was to test the psychometrical properties of the OPQoL-brief ...questionnaire among cognitively intact nursing home residents. The research question addressed evidence related to the dimensionality, reliability and construct validity, all of which considered interrelated measurement properties.
Cross-sectional data were collected during 2017-2018, in 27 nursing homes representing four different Norwegian municipalities, located in Western and Mid-Norway. The total sample comprised 188 of 204 (92% response rate) long-term nursing home residents who met the inclusion criteria: (1) municipality authority's decision of long-term nursing home care; (2) residential time 3 months or longer; (3) informed consent competency recognized by responsible doctor and nurse; and (4) capable of being interviewed.
Principal component analysis and confirmative factor analyses indicated a unidimensional solution. Five of the original 13 items showed low reliability and validity; excluding these items revealed a good model fit for the one-dimensional 8-items measurement model, showing good internal consistency and validity for these 8 items.
Five out of the 13 original items were not high-quality indicators of quality-of-life showing low reliability and validity in this nursing home population. Significant factor loadings, goodness-of-fit indices and significant correlations in the expected directions with the selected constructs (anxiety, depression, self-transcendence, meaning-in-life, nurse-patient interaction, and joy-of-life) supported the psychometric properties of the OPQoL-brief questionnaire. Exploring the essence of quality-of-life when residing in a nursing home is highly warranted, followed by development and validation of new tools assessing quality-of-life in this population. Such knowledge and well-adapted scales for the nursing home population are beneficial and important for the further development of care quality in nursing homes, and consequently for quality-of-life and wellbeing in this population.
Background: Finding new approaches to increase health and well-being among nursing home (NH) residents is highly warranted. From a holistic perspective, several Norwegian municipalities have ...implemented the certification scheme framed “Joy-of-Life Nursing Home” Aims: In a holistic perspective on NH care, this study investigated if NH residents despite potential symptom severity experience joy-of-life (JoL). Therefore, we examined the frequency of common symptoms and the association between common symptoms and JoL in cognitively intact NH residents. Methods: A cross-sectional design was employed. Using the QLQ-C15–PAL quality-of-life questionnaire, hospital anxiety and depression scale, and JoL scale, a total of 188 cognitively intact NH residents participated. Results: Symptom severity was high; 54% reported fatigue, 52% reported constipation, 45% reported pain, 43% reported dyspnea, 32% reported insomnia, 22% reported appetite loss, and 20% reported nausea, while 20% reported anxiety and 23% reported depressive symptoms. Nevertheless, 59% of the NH residents reported high JoL, which was significantly positively related to the quality of life and negatively associated with anxiety and depression.
The increasing proportion of people growing old, demands expanded knowledge of how people can experience successful aging. Having a good life while growing old is dependent on several factors such as ...nutrition, physical health, the ability to perform activities of daily living, lifestyle and psychological health. Furthermore, unhealthy food intake is found to be a modifiable risk factor for depression in elderly people. To promote elderly's health and wellbeing, the influence of nutrition, lifestyle, physical functioning, and social support on psychological distress needs exploring. Therefore, the purpose of this present study is to investigate the associations between psychological distress and diet patterns when adjusting for other life style behaviors, wellbeing, health status, physical functioning and social support in elderly people.
The present study is cross sectional, using data from wave three of the Nord-Trøndelag Health Study (2006-2008). Data include psychological distress measured by the Hospital Anxiety and Depression Scale (HADS), sociodemographic information, measurements of lifestyle behaviours (including diet patterns), wellbeing, health status, social support and physical functioning.
The sample consisted of 11,621 participants, 65 years or older. Cluster analysis categorized the participants in two food clusters based on similarities in food consumption (healthy N = 9128, unhealthy N = 2493). Stepwise multivariable linear regression analyses revealed that lesser psychological distress in the elderly was dependent on gender, diet, smoking, better scores on health and wellbeing, social support and less problems performing instrumental activities of daily living.
Knowledge about the influence of diet patterns in relation to psychological distress provide valuable insights into how society can promote healthy lifestyles to an ageing population, e.g. by increasing older people's food knowledge.
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