Registered nurses’ (RNs’) perceptions and understanding of the health problems and care needs of patients with chronic obstructive pulmonary disease (COPD) play a crucial role in the quality and continuity of care. This qualitative multiple-case study aimed to explore how RNs identify patients’ problems and care needs during home visits to older adults with COPD. In addition, the study explored the agreement and disagreement between RNs’ and patients’ perceptions and priorities regarding problems and needs. The study followed consolidated criteria for reporting qualitative research (COREQ). Data were collected through observations of five home care visits, interviews with RNs, and mapping forms administered to both RNs and patients. Deductive content analysis of five cases revealed that RNs identified the patients’ problems through observation, dialogue, and direct questions during home visits. RNs and patients had different perceptions of the patients’ problems and care needs, particularly regarding psychosocial and communication-related issues. This knowledge contributes to improvements in patient safety in COPD care.

Registered nurses (RNs) play a crucial role in the clinical judgment (CJ) and documentation of the health conditions and the healthcare of patients diagnosed with chronic obstructive pulmonary disease (COPD). Using a multiple case study approach, the aim of the present study was to explore and describe RNs’ CJ in homecare visits for older patients with COPD as they appeared in the electronic patient records (EPRs) and how well the content corresponded to what the RNs explained verbally was important to report. Data were collected through observations of 16 homecare visits, interviews with RNs, and retrospective reviews of EPRs. The study is reported in accordance with COREQ. Quantitative and qualitative content analysis revealed that the RNs’ CJs in homecare visits were represented only to a small extent in the documentation in the EPRs. The documentation was mainly about procedures and tasks performed and did not correspond to what the RNs explained verbally was important to report. This knowledge contributes to improvements to ensure patient safety in this research field.

This study explored first-line managers’ leadership behavior profiles regarding their goals for utilizing the garden at residential care facilities for older people. Semi-structured interviews were conducted with a convenience sample of first-line managers (n = 12) in Sweden. Data were analyzed using deductive content analysis theoretically guided by the Three-dimensional Leadership Model. The results showed that the main leadership behavior profiles were related to the dimensions structure, relation and change. The managers emphasized workplace regulations and goals. They allowed staff to make decisions and encouraged them to see problems and opportunities.

Aims and Objectives: To examine how gendered discursive norms and notions of masculinity and femininity were (re)produced in professional conversations about users of long-term municipality psychiatric care. Focus is on the staff's use of language in relation to gender constructions.

Background: Psychiatric care in Sweden has undergone tremendous changes in recent decades from custodian care in large hospitals to a care mainly located in a municipal context. People who need psychiatric care services often live in supporting houses. In municipal psychiatric care, staff conduct weekly professional meetings to discuss daily matters and the users' needs. Official reports of the Swedish government have shown that staff in municipal care services treat disabled women and men differently. Studies exploring gender in relation to users of long-term psychiatric care in municipalities have problematised the care and how staff, through language, construct users' gender. Therefore, language used by staff is a central tool for ascribing different gender identities of users.

Design: The content of speech derived from audio recordings were analysed using Foucauldian discursive analysis. The COREQ checklist was used in this article.; Results: The results indicate that by relying on gender discourses, staff create a conditional care related to how the users should demonstrate good conduct. In line with that, an overall discourse was created: Disciplined into good conduct. It was underpinned by three discourses inherent therein: The unreliable drinker and the confession, Threatened dignity, Doing different femininities.

Conclusion: The community psychiatric context generates a discourse of conduct in which staff, via spoken language (re)produces gendered patterns and power imbalances as a means to manage daily work routines. Such practices of care, in which constant, nearly panoptic, control despite the intention to promote autonomy, urgently require problematising current definitions of good conduct and normality. 

Ökningen av befolkningen 65 år och äldre har lett till ökat intresse för den äldre människans hälsa och sociala engagemang i samhället. Som en följd av detta har Gävle kommun sökt och antagits som medlem i WHO:s nätverk för äldrevänliga städer och samhällen 2019 med ambitionen att förbättra för de äldre kommuninvånarna utifrån WHO:s åtta utvecklingsområden, samhällsstöd med transporter och mobilitet, boende och bostäder, social delaktighet, god hälso- och sjukvård, utomhusmiljöer, parker och byggnader, respekt och social tillhörighet och möjliga utvecklingsområden. Syftet med denna forskningsstudie var att beskriva äldre personers erfarenheter av sin livssituation i Gävle kommun utifrån WHO:s åtta utvecklingsområden. Tretton äldre personer mellan 66 och 85 år deltog fördelat i tre fokusgruppsintervjuer. I Resultatet framkom sju teman som belyste deltagarnas erfarenheter; möjligheten att komma ut i samhället, hur boendet fungerade i vardagen, känslan av social tillhörighet och delaktighet, möjligheten att få stöd och service av hälso- och sjukvården, upplevelserna av att känna sig respekterade, möjligheten till att delta i olika aktiviteter samt hur de som kommuninvånare har möjlighet till medborgardeltagande. Slutsatsen av studien visar att de äldre kommuninvånarna är en grupp att räkna med när det handlar om framtidens äldrevänliga kommuner. Äldre personer vill vara delaktiga i och kunna påverka utvecklingen av de beslut som fattas i kommunen när det gäller frågor som rör äldre personer. Mot den bakgrunden ges förslag på åtgärder som kan förbättra Gävle kommuns intention till en äldrevänlig kommun där de äldre kommuninvånarna får möjlighet att vara delaktiga i kommunens fortsatta arbete.

Nurses working in home care play a significant role in observing and identifying changes in the health status of patient with chronic obstructive pulmonary disease (COPD). The aim of this study was to explore and describe nurses? observations of older patients with COPD when providing home nursing care. In this qualitative explorative study, data were collected through observations of 17 home care visits using the think-aloud technique, followed up with individual interviews with the nurses. Qualitative content analysis was used to analyze the data. The findings showed that the nurses? observations (focus, methods, and interpretation) were characterized by their search for deviations from what they judged to be the patient?s habitual state. The nurses did not use any tool or guidelines, nor did they follow a standard procedure. Instead, when observing and interpreting, they performed a complex process guided by their experience and knowledge of the patient, and the patient?s individual and contextual circumstances. This knowledge contributes to warranted reflection on nurses? practice in this context to secure COPD patients? safety and quality of life.

Background: Compassion is seen as a core professional value in nursing and as essential in the effort of relieving suffering and promoting well-being in palliative care patients. Despite the advances in modern healthcare systems, there is a growing clinical and scientific concern that the value of compassion in palliative care is being less emphasised.

Objective: This study aimed to explore nurses’ experiences of compassion when caring for palliative patients in home nursing care. Design and participants: A secondary qualitative analysis inspired by hermeneutic circling was performed on narrative interviews with 10 registered nurses recruited from municipal home nursing care facilities in Mid-Norway. Ethical considerations: The Norwegian Social Science Data Services granted permission for the study (No. 34299) and the re-use of the data.

Findings: The compassionate experience was illuminated by one overarching theme: valuing caring interactions as positive, negative or neutral, which entailed three themes: (1) perceiving the patient’s plea, (2) interpreting feelings and (3) reasoning about accountability and action, with subsequent subthemes.

Discussion: In contrast to most studies on compassion, our results highlight that a lack of compassion entails experiences of both negative and neutral content.

Conclusion: The phenomenon of neutral caring interactions and lack of compassion demands further explorations from both a patient – and a nurse perspective. 

Background: Scientific knowledge and theory constitute part of the nurse’s competence and evidence-based nursing practice. To obtain and maintain these skills, nurses require access to research utilization. The aim of the present study was therefore to describe and compare nurses in nursing homes and home-based nursing care and their use of research knowledge in their practice in elderly care in Norwegian rural districts.

Methods: The Research Utilization Questionnaire (RUQ) was employed in cross-sectional quantitative design. One hundred nurses were recruited from ten rural municipalities that participated in the study. Inclusion criteria for participating were registered nurses and employees working in the municipal elderly care service for 6 months or more.

Results: Most participants were younger than 55 years old, worked in permanent jobs, and were educated more than 5 years ago. The result showed that nurses in nursing homes were significantly more positive compared to nurses in home-based nursing care when analyzing all three domains in the RUQ together, as well as for attitudes towards research when testing each domain separated. Overall, each item in the domains revealed opinions that were more positive for nurses in nursing homes. The regression analysis showed that attitudes towards research, as well as availability and support of research utilization predicted the use of research in daily practice.

Conclusions: Positive attitudes, availability, and support for research utilization can contribute to greater use of research in nursing practice and improve the quality of service. Younger nurses’ knowledge about using research should be shared with senior colleagues, who possess much experience in practice. In collaboration, they can develop evidence-based practice by the implementation of research seen in the context of nurses’ experiences, user involvement, and person-centred practice. The i-PARIHS (Promoting Action on Research Implementation in Health Services) framework can be a useful tool in this implementation process.

AIMS AND OBJECTIVES: To examine how gendered discursive norms and notions of masculinity are (re)produced in professional conversations about men cared for as patients in forensic psychiatric care, with a particular focus on the centrality of language and gender.

BACKGROUND: During verbal handovers and ward rounds, care staff converse to share information about patients and make decisions about their mental status. Spoken language is thus a pivotal tool in verbal handovers and ward rounds, one able to reproduce discourses and gender norms.

DESIGN: Qualitative. Data collected from audio recordings of verbal handovers and ward rounds in a forensic psychiatric clinic were subjected to discourse analysis. The COREQ checklist was used.

RESULTS: While discussing patients, staff subordinated them by reproducing a discourse typical of heteronormative, family-oriented care. The overarching discourse, which we labelled subordinated masculinities, was supported by three other discourses: being unable to take responsibility, being drug-addicted and performing masculinity. Such discourse was identified as a disciplining practice that subordinate's patients as a means to maintain order, rules and gender norms.

CONCLUSION: The study reveals a caring practice that position male patients as children or disabled individuals and, in that way, as subordinated other men within a context were staff reproduces a heteronormative family structured care. The process also reveals a practice were downplaying aggressive and deviant behaviour could disempower and reduce patients´ responsibility for personal actions and their possibilities to participate in their care. That finding especially seems to contradict previous findings that patients want to be able to act responsibly and, to that end, want care staff to help them.

RELEVANCE TO CLINICAL PRACTICE: Nurses need to deepen their understanding of how language (re)produces discursive norms of gender and masculinity in forensic care and that process's consequences for such care.

Frontotemporal dementia (FTD) is a neurodegenerative disease with symptoms that differs from other dementias. Commonly early symptoms in FTD are changes in personality and behavior, which can be interpreted as psychiatric disease. The delay in FTD diagnosis contributes to the burden of family caregivers. Therefore, it is important to have more knowledge about the pre-diagnostic stage. In this qualitative interview study, we explored fourteen family caregiver's experiences of the pre-diagnostic stage of frontotemporal dementia (FTD). Our findings suggest that the family caregivers experienced the pre-diagnostic stage of FTD as changes in the interpersonal relationship with their loved one. These changes were often subtle and difficult for family caregivers to explain to others. The findings from our study illuminate the importance of medical staff paying attention when a next of kin is concerned about subtle changes in a loved one. The findings also illuminate that awareness of FTD should be raised.