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The bright side of life: support in municipal elderly home care
Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
2013 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Registered nurses in municipal elderly home care have in some occasionsdifficulties in identifying the patients’ needs and prioritize intervention inaccordance with the patients’ preferences, which is to obtain social and emotional support. The overall aim was to explore and describe which supportive interventions registered nurses use in municipal elderly home care settings and if it is in agreement with the patient’s preferences. Methods: A retrospective descriptive study (I ) were conducted and followed up by a qualitative approach with Grounded Theory as a method (II IV ). Sample to study; I , registered nurses (62) performed interventions to 6138 patients between 80- 109 years. II , 12 registered nurses, who performed 36 home visits to patients between 80- 102 years. III , 16 registered nurses. IV , 18 patients between 80- 96 years. Data was collected by; I , between 2004- 2008, during the months of April and October using a web- based form which was filled in by registered nurses. II , through nonparticipant observations when the registered nurse made a home visit. III and IV , using informal conversational interviews. Results: Combined, the four studies show that emotional support is important to a group of older patients because it helps them to experience serenity. Serenity is a state of relief and the moment required for the patient to be able to move forward in a dignify way. Patients lost or reduced ability to process their emotions makes so that they get stuck in a state, which fatigue them with additional experience of disease and illness. To get out of their state the patient uses the registered nurse as a reliever whose mission is to identify their needs and guide them into a state of serenity. Registered nurses on the other hand, makes priorities based on patients preferences. Registered nurses strengths was their profession that contributed to the patient's emotions became available to them. Weaknesses was registered nurses workload and lack of knowledge about the identification of emotions. Emotional support should be developed as a nursing intervention and be integrated as a part of nursing.

Place, publisher, year, edition, pages
Örebro: Örebro universitet , 2013. , p. 70
Series
Örebro Studies in Medicine, ISSN 1652-4063 ; 45
Keywords [en]
Emotion, elderly home care, intervention, priorities, support, registered nurse, older patients, serenity
National Category
Nursing
Research subject
Nursing Science
Identifiers
URN: urn:nbn:se:oru:diva-28939ISBN: 978-91-7668-940-0 (print)OAI: oai:DiVA.org:oru-28939DiVA, id: diva2:619560
Public defence
2013-06-14, Hörsal 2 Prismahuset, HSP2, Örebro universitet, Fakultetsgatan 1, Örebro, 13:00 (Swedish)
Opponent
Available from: 2013-05-05 Created: 2013-05-05 Last updated: 2017-10-17Bibliographically approved
List of papers
1. Care priorities: registered Nurses' clinical daily work in municipal elderly care settings
Open this publication in new window or tab >>Care priorities: registered Nurses' clinical daily work in municipal elderly care settings
2013 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 27, no 2, p. 388-95Article in journal (Refereed) Published
Abstract [en]

Care priorities- Registered Nurses' clinical daily work in municipal care settings Common in Swedish elderly home care is that Registered Nurses work independently, and lead the care team without being a part of it. People involved in the care of the patient can be social services, physician, Registered Nurse (RN), nurses in inpatient care and family. In according to current model for nursing documentation RNs interventions is described as participation, information/education, support, environment, general care, training, observation/surveillance, special care drug administration and coordination. Time pressure is perceived as high, but the nurses have the opportunity to influence their daily work situation and make priorities. The purpose of this study was to investigate how RNs prioritise interventions in municipal elderly care settings. A quantitative descriptive method was used for the study. Data were collected during the months of April and October 2004 - 2008, using a web-based form. The nurses filled in patient's type of housing, performed interventions, and if the interventions were delegated. Interventions were described as keywords and were attributed a certain amount of time, calculated in previous time studies. The inclusion criteria were: all patients 80 years of age and older, in a municipality in south-western Sweden, who received some form of health care from a RN, or performed by non-certified staff by delegation. Results indicate that differences in priority could be observed, depending on the patient's gender, or whether the patient was living in independent or sheltered housing. Drug administration was prioritised for female patients, while coordination became a priority for patients living in ordinary housing. Support received the highest priority, regardless if the patient lived in ordinary or sheltered housing. However, it is not entirely clear what support signifies in municipal health care settings, and this issue would therefore require further investigation.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2013
National Category
Nursing
Research subject
Nursing Science
Identifiers
urn:nbn:se:oru:diva-29654 (URN)10.1111/j.1471-6712.2012.01051.x (DOI)000318815700023 ()23003218 (PubMedID)2-s2.0-84877795395 (Scopus ID)
Available from: 2013-06-20 Created: 2013-06-20 Last updated: 2017-12-06Bibliographically approved
2. Dealing with daily emotions: supportive activities for the elderly in a municipal care setting
Open this publication in new window or tab >>Dealing with daily emotions: supportive activities for the elderly in a municipal care setting
2012 (English)In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 7, article id 9510Article in journal (Refereed) Published
Abstract [en]

There are diverse descriptions of supportive activities in nursing to be found in the literature. What they have in common is their association with good care outcomes, but they may differ depending on the context in which the care is given. In a Swedish municipal elderly care setting, registered nurses (RNs) work in a consultative way and they describe a part of their tasks as comprising supportive activities, without specifying what kind of supportive activities they mean. The aim of the study was to explore the main concern of the support given by RNs to a group of patients in an elderly home care setting. The study was conducted using Grounded Theory. Data were collected using nonparticipant observations regarding the supportive activities of 12 RNs at the home of 36 patients between the ages of 80 and 102 years. Most of the home visit lasted about 40 min but some lasted for 90 min. The central category was about dealing with daily emotions. This was done by encouraging the situation and reducing the patient's limitations, but situations also occurred in which there was a gap of support. Support was about capturing the emotions that the patient expressed for a particular moment, but there were also situations in which RNs chose not to give support. To develop a holistic eldercare, more knowledge is needed about the factors causing the RNs to choose not to provide support on some occasions.

Place, publisher, year, edition, pages
Järfälla, Sweden: Co-Action Publishing, 2012
Keywords
Support, maintaining wellness, municipal care, the elderly
National Category
Nursing
Research subject
Caring sciences
Identifiers
urn:nbn:se:oru:diva-22132 (URN)10.3402/qhw.v7i0.9510 (DOI)000300455000001 ()22312410 (PubMedID)2-s2.0-84875208481 (Scopus ID)
Available from: 2012-03-16 Created: 2012-03-16 Last updated: 2017-12-07Bibliographically approved
3. Trying to cope with everyday life: emotional support in municipal elderly care setting
Open this publication in new window or tab >>Trying to cope with everyday life: emotional support in municipal elderly care setting
2012 (English)In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 7, p. 1-7Article in journal (Refereed) Published
Abstract [en]

Emotional support is considered to be important to older patients because it is a contributing factor to experiencing good health and it has been shown that it can prevent depression after a hip fracture. Opinions differ on whether emotional support falls within the field of nursing, and studies also show that nurses in an elderly home care setting fail when it comes to giving emotional support. The aim of this study was to explore reasons for registered nurses to give emotional support to older patients in a municipal home care setting. The study was conducted using Grounded Theory. Data collection was carried out through interviews with 16 registered nurses. The inclusion criteria were emotional support given to patients aged 80 years and above living in ordinary or sheltered housing and who were in need of help from both the home help service and registered nurses. The results show that the main concern of emotional support was "Trying to relieve the patient from their emotions so they are able to cope with everyday life." This core category illustrates how registered nurses tried to support the patients' own strength, so that they were able to move forward. Registered nurses consider that they could support the patients because they give them access to, or could create access to, their emotions, but there were also times when they felt helplessness and as a result, consciously opted out. The results also indicate that registered nurses were keen to give emotional support. To develop patient-centered elderly care, more knowledge of emotional support and the elderly's need for this support is required.

Place, publisher, year, edition, pages
Järfälla, Sweden: Co-Action Publishing, 2012
Keywords
Support, maintain strength, municipal care, the elderly
National Category
Nursing
Research subject
Caring sciences
Identifiers
urn:nbn:se:oru:diva-29657 (URN)10.3402/qhw.v7i0.19613 (DOI)000312581100001 ()23237630 (PubMedID)2-s2.0-84875190747 (Scopus ID)
Available from: 2013-06-20 Created: 2013-06-20 Last updated: 2017-12-06Bibliographically approved
4. "It's amazing that I can take coverage!": emotional support to a group of older patients in municipal home care setting
Open this publication in new window or tab >>"It's amazing that I can take coverage!": emotional support to a group of older patients in municipal home care setting
(English)Manuscript (preprint) (Other academic)
National Category
Nursing
Research subject
Nursing Science
Identifiers
urn:nbn:se:oru:diva-29658 (URN)
Available from: 2013-06-20 Created: 2013-06-20 Last updated: 2017-10-17Bibliographically approved

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