Shared Care, Elder and Family Member Skills Used to Manage Burden

Aim. The aim of this paper is to further develop the construct of Shared Care by comparing and contrasting it to related research, and to show how the construct can be used to guide research and practice. Background. While researchers have identified negative outcomes for family caregivers caused by providing care, less is known about positive aspects of family care for both members of a family dyad. Understanding family care relationships is important to nurses because family participation in the care of chronically ill elders is necessary to achieve optimal outcomes from nursing interventions. A previous naturalistic inquiry identified a new construct, Shared Care, which was used to describe a family care interaction that contributed to positive care outcomes. Methods. A literature review was carried out using the databases Medline, CINAHL, and Psych-info and the keywords home care, care receiver, disability, family, communication, decision-making and reciprocity. The results of the review were integrated to suggest how Shared Care could be used to study care difficulties and guide interventions. Results. The literature confirmed the importance of dyad relationships in family care. Shared Care extended previous conceptualizations of family care by capturing three critical components: communication, decision-making, and reciprocity. Shared Care provides a structure to expand the conceptualization of family care to include both members of a care dyad and account for positive and negative aspects of care. Conclusions. The extended view provided by the construct of Shared Care offers practitioners and scholars tools to use in the context of our ageing population to improve the effectiveness of family care relationships

A description of approachable nurses: An exploratory study, the voice of the hospitalized child

Purpose: The 1989 Convention on the Rights of the Child drew international attention to the right of a child to be heard. Researchers have enhanced the child’s voice in many settings, albeit few in the hospital. Nurse researchers investigating the hospital experiences of children have identified positive and negative patterns of communication. Potential characteristics of an approachable nurse were hinted at, although none explored the concept of approachability. Design and methods: A qualitative, descriptive research design, including semi-structured interviews with seven school age children (ages 8-12, four girls and three boys) in a pediatric oncology service, was used to gain children’s perceptions and descriptions of approachable nurses. Drawings were used to supplement and glean a greater understanding of descriptive characteristics. All but one child had endured multiple hospitalizations related to their diagnosis of cancer. Interviews were recorded and data were content analyzed using immersion/crystallization and editing organizational styles. Results: The children had experiences with more than one approachable nurse and described approachable nurses as smiling and happy, playful, creative, competent and willing to talk and listen to them. Conclusion and practice implications: The school age children in this study were able to describe their perceptions of an approachable nurse. The voices of these children illuminate the importance of nurses’ words and behaviors and provide exemplars of approachable nurses. It can be argued that the responsibility remains with nurses to create an environment where in hospitalized children feel their voices are heard, they are understood and respected with unprecedented dignity

STEER: Factors to consider when designing online focus groups using audio-visual technology in health research

Technological advancements and ease of Internet accessibility have made using Internet-based audiovisual software a viable option for researchers conducting focus groups. Online platforms overcome any geographical limitations placed on sampling by the location of potential participants and so enhance opportunities for real-time discussions and data collection in groups that otherwise might not be feasible. Although researchers have been adopting Internet-based options for some time, empirical evaluations and published examples of focus groups conducted using audiovisual technology are sparse. It therefore cannot yet be established whether conducting focus groups in this way can truly mirror face-to face discussions in achieving the authentic interaction to generate data. We use our experiences to add to the developing body of literature by analyzing our critical reflections on how procedural aspects had the potential to influence the data we collected using audiovisual technology to conduct synchronous focus groups. As part of a mixed methods study, we chose to conduct focus groups in this way to access geographically dispersed populations and to enhance sample variation. We conducted eight online focus groups using audiovisual technology with both academic researchers and health-care practitioners across the four regions of the United Kingdom. A reflexive journal was completed throughout the planning, conduct and analysis of the focus groups. Content analysis of journalentries was carried out to identify procedural factors that had the potential to affect the data collected during this study. Five themes were identified (Stability of group numbers, Technology, Environment, Evaluation, and Recruitment), incorporating several categories of issues for consideration. Combined with the reflections of the researcher and published experiences of others, suggested actions to minimize any potential impacts of issues which could affect interactions are presented to assist others who are contemplating this method of data collection

Home: The place the older adult can not imagine living without

<p>Abstract</p> <p>Background</p> <p>Rapidly aging populations with an increased desire to remain at home and changes in health policy that promote the transfer of health care from formal places, as hospitals and institutions, to the more informal setting of one's home support the need for further research that is designed specifically to understand the experience of home among older adults. Yet, little is known among health care providers about the older adult's experience of home. The aim of this study was to understand the experience of home as experienced by older adults living in a rural community in Sweden.</p> <p>Methods</p> <p>Hermeneutical interpretation, as developed by von Post and Eriksson and based on Gadamer's philosophical hermeneutics, was used to interpret interviews with six older adults. The interpretation included a self examination of the researcher's experiences and prejudices and proceeded through several readings which integrated the text with the reader, allowed new questions to emerge, fused the horizons, summarized main and sub-themes and allowed a new understanding to emerge.</p> <p>Results</p> <p>Two main and six sub-themes emerged. Home was experienced as the place the older adult could not imagine living without but also as the place one might be forced to leave. The older adult's thoughts vacillated between the well known present and all its comforts and the unknown future with all its questions and fears, including the underlying threat of loosing one's home.</p> <p>Conclusions</p> <p>Home has become so integral to life itself and such an intimate part of the older adult's being that when older adults lose their home, they also loose the place closest to their heart, the place where they are at home and can maintain their identity, integrity and way of living. Additional effort needs to be made to understand the older adult's experience of home within home health care in order to minimize intrusion and maximize care. There is a need to more fully explore the older adult's experience with health care providers in the home and its impact on the older adult's sense of "being at home" and their health and overall well-being.</p

Learning to Endure Long-Term Musculoskeletal Pain in Daily Life at Home: A Qualitative Interview Study of the Older Adult’s Experience

Background: Worldwide, there is an increasing number of older adults, the majority of whom remain living at home. Not infrequently they live with long-term pain, especially musculoskeletal pain, which is associated with increased disability (physical, psychological, social) and a negative impact on quality of life. A deeper understanding of how older adults experience living with this type of pain is needed in order to improve well-being and quality of life. The study focused on the actual experience by living with this global, prevailing and disabling type of pain. The aim was to describe commonalities in how older adults endure long-term musculoskeletal pain in their daily life at home. Methods: This inductive, descriptive study included qualitative semi-structured face-to-face interviews with 19 participants (66 to 88 years) in their homes. Qualitative content analysis by Graneheim and Lundman was used to identify themes crossing participants’ experiences of enduring long-term pain in their daily life. Interviews were audio recorded and transcribed verbatim. Results: All participants felt forced into “learning to live with pain” (main theme), in order to endure their pain. In time, they learned that: taking the pain as it comes, one day at a time; balancing the pain with activity, thoughts and emotions; self-talking; decreasing the burden to family and others; and capturing, enjoying and valuing moments of pleasure (sub-themes) helped them endure the pain. Conclusions: This experience was dominated by learning. The approaches generated to learn to endure pain in daily living by these participants should be discussed with older adults in similar situations for further additions, refinements and validation. Nurses can help to ease the older adult’s suffering by tailoring individualized and holistic care focused on guiding the older adult in learning to live with pain and preserving and promoting health and well-being with a maximum of care and a minimum of intrusion

Under the Desert Sun

On a tour of the Ivanpah Solar Power Facility in California’s Mojave Desert, the author discusses the risks and potential benefits of large solar farms like this one. The article is accompanied by stunning black and white photographs of the Ivanpah facility by Jamey Stillings.</jats:p