Aims and Objectives
To investigate the association between perceived nurse–patient interaction and quality‐of‐life among nursing home residents, adjusted for loneliness, anxiety and depression.
...Background
Symptoms of anxiety and depression are known to residents of nursing homes along with cognitive impairment, physical inactivity and low quality‐of‐life. Anxiety, depression and loneliness are found detrimental to NH residents' quality‐of‐life. The nurse–patient relationship is important for patient's well‐being, both in terms of illness and symptom management.
Design
Cross‐sectional design.
Methods
Data were collected in 2017 and 2018 from 188 residents in 27 nursing homes resided in two large urban municipalities in Middle and Western Norway. The inclusion criteria were: (1) local authority's decision of long‐term NH care; (2) residential stay 3 months or longer; (3) informed consent competency recognised by responsible doctor and nurse; (4) capable of being interviewed, and (5) aged 65 years or older. This article is executed in accordance with STROBE statement.
Results
Adjusting for age, sex, anxiety, depression and loneliness, perceived nurse–patient interaction was statistically significant to quality‐of‐life. While anxiety and depression showed insignificant estimates, loneliness demonstrated a significant relation with quality‐of‐life. Nurse–patient interaction and loneliness explained together 25% of the variation in quality‐of‐life.
Conclusion
This study suggests that loneliness is frequent as well as more detrimental to quality‐of‐life among nursing home residents compared to anxiety and depression. Furthermore, the present results show that the nurse–patient interaction represents an essential health‐promoting resource for Quality‐of‐life in this population.
Relevance to clinical practice
Staff nurses need to exercise their awareness of loneliness to meet residents' needs. Nursing educations should provide knowledge about nurse–patient interaction, and students as well as staff nurses in NHs should be trained, for instance by simulation, to use the nurse–patient interaction as a health‐promoting resource. Finally, loneliness represents a bigger challenge than depression and anxiety; accordingly, building nurses that are capable of meeting patients' needs and facilitate care that counteracts loneliness is highly warranted
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.
The aim of the present study is to gain a deeper understanding of women's experiences of midwifery care in connection with home visits during the early postnatal period.
A qualitative approach was ...chosen for data collection, and the data presented are based on six focus group interviews (n: 24). The women were both primiparous and multiparous, aged 22–37, and lived with their partners. All participants had given birth at a maternity unit responsible for about 4000 births a year. The transcribed interviews were analysed through systematic text condensation.
The findings are reflected in three main themes: ‘The importance of relational continuity’, ‘The importance of a postpartum talk’ and ‘Vulnerability in the early postnatal period’. When the woman had a personal relationship with the midwife responsible for the home visit she experienced predictability, availability and confidence. The women wanted recognition and time to talk about their birth experience. They also felt vulnerable in their maternal role in the early postnatal period and the start of the breast-feeding process.
It is important to promote relational continuity models of midwifery care to address the emotional aspects of the postnatal period. Women generally wish to discuss their birth experience, preferably with the midwife who was present during the birth. Due to the short duration of postnatal care in hospitals, the visit from the midwife a few days after childbirth becomes all the more important.
This open access textbook represents a vital contribution to global health education, offering insights into health promotion as part of patient care for bachelor’s and master’s students in health ...care (nurses, occupational therapists, physiotherapists, radiotherapists, social care workers etc.) as well as health care professionals, and providing an overview of the field of health science and health promotion for PhD students and researchers. Written by leading experts from seven countries in Europe, America, Africa and Asia, it first discusses the theory of health promotion and vital concepts. It then presents updated evidence-based health promotion approaches in different populations (people with chronic diseases, cancer, heart failure, dementia, mental disorders, long-term ICU patients, elderly individuals, families with newborn babies, palliative care patients) and examines different health promotion approaches integrated into primary care services. This edited scientific anthology provides much-needed knowledge, translating research into guidelines for practice. Today’s medical approaches are highly developed; however, patients are human beings with a wholeness of body-mind-spirit. As such, providing high-quality and effective health care requires a holistic physical-psychological-social-spiritual model of health care is required. A great number of patients, both in hospitals and in primary health care, suffer from the lack of a holistic oriented health approach: Their condition is treated, but they feel scared, helpless and lonely. Health promotion focuses on improving people’s health in spite of illnesses. Accordingly, health care that supports/promotes patients’ health by identifying their health resources will result in better patient outcomes: shorter hospital stays, less re-hospitalization, being better able to cope at home and improved well-being, which in turn lead to lower health-care costs. This scientific anthology is the first of its kind, in that it connects health promotion with the salutogenic theory of health throughout the chapters. the authors here expand the understanding of health promotion beyond health protection and disease prevention. The book focuses on describing and explaining salutogenesis as an umbrella concept, not only as the key concept of sense of coherence.
The aim of the present study was to investigate the interrelationships between school-related stress (school performance, teacher interaction), life satisfaction, and depressive symptoms, as well as ...the potential mediating role of life satisfaction on the association between school-related stress and depressive symptoms. A total of 1,239 adolescents (13–18 years of age) from public elementary and secondary schools in mid-Norway participated in the school-based survey. The data were analysed using structural equations modelling. The present study showed that stress of school performance was significantly and positively related to depressive symptoms and significantly and inversely related to life satisfaction. At the bivariate levels, stress of teacher interaction was associated with more depressive symptoms and reduced life satisfaction. However, these associations were non-significant in the multivariate analyses, controlled for stress of school performance. A significant inverse association was found between life satisfaction and depressive symptoms. Further, life satisfaction partly mediated the association between stress of school performance and depressive symptoms. The results reflect the complexity of the interaction between adolescents’ experience of school performance stress and mental health, and the role of life satisfaction as a potentially relevant mediator of this association.
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.
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.
Health literacy (HL) has been identified as an important and modifiable determinant of health. To succeed in promoting HL, it is crucial to evaluate interventions addressing HL using validated ...instruments. However, HL measurement is an under-researched area among adolescents. The Health Literacy for School-Aged Children (HLSAC) scale is developed in Finland to measure the subjective HL levels of school-aged children. The HLSAC has been used and validated across Europe. No validated instrument for measuring HL among Norwegian adolescents has been identified. Therefore, the aim of this study was to assess the psychometric properties of the HLSAC among Norwegian adolescents in upper secondary schools. Cross-sectional data were collected in 2017 from 1 054 adolescents with a response rate of 93.5%. The participants were students aged 16-21 (mean = 17.3) years from four upper secondary schools in an urban area in Mid-Norway. Confirmatory factor analysis (CFA) was utilized to investigate the underlying dimensionality of the data together with composite reliability based on Raykov's reliability coefficient and certain aspects of construct validity. The original ten-item one-dimensional version of the HLSAC revealed a poor fit. A one-dimensional version including six of the original ten items presented the best fit to our data, demonstrating good reliability and construct validity. This validation study suggests a one-dimensional solution of the HLSAC scale including six of the original ten items, i.e., the HLSAC-6 as a statistical valid and reliable measure for HL among adolescents in upper secondary schools. However, the modifications of the instrument indicate the need for further investigation of the HLSAC in this age group, i.e. by conducting cognitive interviews and focus-group discussions on the concept of HL among adolescents. Testing the wording of the HLSAC prior to additional psychometric evaluations of both the original HLSAC and the suggested HLSAC-6 is recommended. Finally, developing more age-appropriate items for the measurement of HL in this age-group is suggested.
Aim
Older residents of nursing homes have several illnesses and face various challenges regarding losses of physical and mental functioning. Thus, coping and the quality of life are vital aspects in ...long‐term care. Sense of coherence is considered an important resource for coping and the quality of life, and sense of coherence therefore needs to be validly and reliably measured in this population. We investigated the dimensionality, reliability and construct validity of the Orientation to Life Questionnaire in assessing sense of coherence among cognitively intact nursing home (NH) residents.
Methods
We collected cross‐sectional data from 227 cognitively intact NH residents (30 NHs) with one‐on‐one interviews. We performed confirmative factor analysis and correlations with the selected construct.
Results and conclusion
In accordance with the salutogenic theory of sense of coherence, the three‐factor model revealed the best fit to our data. In particular, item OLQ2, defined as ‘concerns the experience of being surprised by the behaviour of people whom you know well’, seemed troublesome. Removing this item resulted in good fit to the present data. Rewording or deleting item OLQ2 seems needed to get a reliable instrument measuring sense of coherence among nursing home residents.
Due to the shift to an older population worldwide and an increased need for 24-h care, finding new and alternative approaches to increase wellbeing among nursing home (NH) residents is highly ...warranted. To guide clinical practice in boosting wellbeing among NH residents, knowledge about nurse-patient interaction (NPI), inter- (ST1) and intra-personal (ST2) self-transcendence and meaning-in-life (PIL) seems vital. This study tests six hypotheses of the relationships between NPI, ST1, ST2 and PIL among cognitively intact NH residents.
In a cross-sectional design, 188 (92% response rate) out of 204 long-term NH residents representing 27 NHs responded to NPI, ST, and the PIL scales. Inclusion criteria were: (1) municipality authority's decision of long-term NH care; (2) residential time 3 months or longer; (3) informed consent competency recognized by responsible doctor and nurse; and (4) capable of being interviewed. The hypothesized relations between the latent constructs were tested through structural equation modeling (SEM) using Stata 15.1.
The SEM-model yielded a good fit (χ2 = 146.824, p = 0.021, df = 114, χ2/df = 1.29 RMSEA = 0.040, p-close 0.811, CFI = 0.97, TLI = 0.96, and SRMR = 0.063), supporting five of the six hypothesized relationships between the constructs of NPI, ST1, ST2 and PIL.
NPI significantly relates to both ST1, ST2 and PIL in NH residents. ST revealed a fundamental influence on perceived PIL, while NPI demonstrated a significant indirect influence on PIL, mediated by ST.
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