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Objective: This study aimed to describe registered nurses' (RNs) experiences of providing respiratory care in relation to hospital acquired pneumonia (HAP), specifically among patients with acute stroke being cared for at in-patient stroke units., Background: One of the most common and serious respiratory complications associated with acute stroke is HAP. Respiratory care is among the fundamentals of patient care, and thus competency in this field is expected as part of nursing training. However, there is a paucity of literature detailing RNs' experiences with respiratory care in relation to HAP, specifically among patients with acute stroke, in the context of stroke units. As such, there is a need to expand the knowledge base relating to respiratory care focusing on HAP, to assist with evidence-based nursing., Design: A qualitative descriptive study., Method: Eleven RNs working in four different acute stroke units in Southern Sweden participated in the current study. The data were collected through semi-structured interviews, and the transcribed interviews were analysed using inductive content analysis., Results: Three overarching categories were identified: (1), awareness of risk assessments and risk factors for HAP (2) targeting HAP through multiple nursing care actions, and (3) challenges in providing respiratory care to patients in risk of HAP. These reflected the similarities and differences in the experiences that RNs had with providing respiratory care in relation to HAP among in-patients with acute stroke., Conclusions: The findings from this study suggest that the RNs experience organisational challenges in providing respiratory care for HAP among patients with acute stroke. Respiratory care plays a vital role in the identification and prevention of HAP, but our findings imply that RNs' knowledge needs to be improved, the fundamentals of nursing care need to be prioritised, and evidence-based guidelines must be implemented. RNs would also benefit from further education and support, in order to lead point-of-care nursing in multidisciplinary stroke teams.

Background: Studies have highlighted deficiencies in the information given by nurses to surgical patients. Studies also show that the role of the nurse in connection with the discharge of patients after surgery is unclear. The aim of the study was therefore to elicit and to explore registered nurses' conceptions of the phenomenon of nursing care information given to surgical patients in connection with hospital discharge ., Method: Semi-structured interviews were conducted with fifteen nurses at surgical unites at the southern parts of Sweden. The interviews were transcribed and then analysed according to the phenomenographic approach., Result: The analysis resulted into three descriptive categories which conjointly may be said to express the general conceptions of the informants. Thus, according to the informants, the provision of nursing care information in connection with the discharge of surgical patients is: (i) not a nursing priority, (ii) adapted to the context of care, and (iii) a possible enhancement of the nursing process and the quality of care., Conclusion: The result of the study implies that the discharge conversation may be seen as an opportunity for the nursing profession to formalise and to enhance the quality of care in connection with the discharge of surgical patients., Competing Interests: Competing interestsThe authors declare that they have no competing interest., (© The Author(s) 2020.)

Background: Depressive symptoms and/or depression are commonly experienced by older people. Both are underdiagnosed, undertreated and regularly overlooked by healthcare professionals. Healthcare facilities for people aged ≥75 years have been in place in Sweden since 2015. The aim of these care centres, which are managed by registered nurses (RNs), is to offer care adjusted to cater to the complex needs and health problems of older people. Although the mental health of older people is prioritised in these centres, research into the experience of RNs of depressive symptoms and/or depression in older people in this setting is limited. Therefore, this study aimed to illuminate RNs, working at care centres for older people, experience of identifying and intervening in cases of depressive symptoms., Methods: The data for this qualitative descriptive study were collected through interviews ( n  = 10) with RNs working at 10 care centres for older people in southern Sweden. The transcribed texts were analysed using inductive content analysis., Results: The participants' experiences could be understood from four predominant themes: (1) challenging to identify, (2) described interventions, (3) prerequisites for identification, and (4) contextual influences. Key findings were that it was difficult to identify depression as it often manifested as physical symptoms; evidence-based nursing interventions were generally not the first-line treatment used; trust, continuity and the ability of RNs to think laterally; and the context influenced the ability of RNs to manage older people's depressive symptoms and/or depression., Conclusions: The process of identifying depressive symptoms and performing an appropriate intervention was found to be complex, especially as older people were reluctant to present at the centres and provided obscure reasons for doing so. A nurse-patient relationship that was built on trust and was characterised by continuity of care was identified as a necessary prerequisite. Appropriate nursing interventions-afforded the same status as pharmacological treatment-are warranted as the first-line treatment of depression. Further research is also needed into efficacious nursing interventions targeting depressive symptoms and/or depression., Competing Interests: Competing interestsThe authors declare that they have no competing interests.

Background: Research suggests that registered nurses (RNs) do not feel adequately prepared to support patients with intellectual disability disorder (IDD). This is unsurprising, as few European health sciences curricula include undergraduate and graduate training courses in IDD. As RNs are often in the front line of care, eliciting in-depth knowledge about how they experience nursing this group of patients is vital. Our aim in this study was to develop a conceptual understanding about RNs' experiences of nursing patients with IDD., Method: We undertook a systematic review and meta-ethnography to synthesise qualitative research studies found in PubMed, CINAHL, PsycINFO, ERIC databases and by manual searching to identify additional studies. We condensed translatable second-order constructs, and developed an idiomatic translation. Finally, we formulated line of argument (LOA) syntheses to capture the core of the idiomatic translations., Results: We included eighteen published studies from eight countries involving 190 RNs. The RNs' experience of nursing patients with IDD were reflected in 14 LOAs. Six of these reflected a tentatively more distinctive and at times unique conceptualisation of RNs' experience of nursing this group of patients. The remaining eight LOAs represented a conceptualisation of nursing per se, a conceptualisation of nursing that was interpreted as a universal experience regardless of context and patient group., Conclusion: Lack of awareness and knowledge are likely breeding grounds for the 'otherness' that still surrounds this group of patients. In encounters between patients and RNs, focusing on the person behind the disability label could be one way to secure relevant nursing care for patients with IDD. Undertaking appropriate under- and postgraduate education alongside the implementation of nursing models focusing on patient-centred care would help RNs in reducing the health and care inequalities this group of patients still face., Trial Registration: PROSPERO 2017: CRD42017077703., Competing Interests: The author declare that they have no competing interest.MA is a doctoral student in Caring Science at the Faculty of Health and Society at Malmö University in Malmö, Sweden. MA also works in the community as an enrolled nurse caring for patients with IDD. Dr. CB is a registered nurse and a senior lecturer at the faculty of Health and Society at Malmö University in Malmö, Sweden. CB also serves as an expert adviser for the Swedish Agency for Health Technology Assessment and Assessment of Social Services. Dr. KP is a registered nurse and senior lecturer at the Faculty of Health and Society at Malmö University in Malmö, Sweden. Her research expertise is the oral health of patients with IDD. Both CB and KP are experienced in systematic reviews. Finally, Dr. GB is a senior lecture and reader in nursing at the Faculty of Health and Society at Malmö University in Malmö, Sweden. Her area of expertise is nursing, older people, quantitative and qualitative designs as well as mixed method designs.Not applicable.Not applicable.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Background: The evaluation and treatment of older people's nutritional care is generally viewed as a low priority by nurses. However, given that eating and drinking are fundamental human activities, the support and enhancement of an optimal nutritional status should be regarded as a vital part of nursing. Registered nurses must therefore be viewed as having an important role in assessing and evaluating the nutritional needs of older people as well as the ability to intervene in cases of malnutrition. This study aimed to illuminate the experience of participating in nutritional care from the perspectives of older people and registered nurses. A further aim is to illuminate the latter's experience of nutritional care per se., Methods: A qualitative, descriptive design was adopted. Data were collected through semi-structured interviews ( n  = 12) with eight registered nurses and four older persons (mean age 85.7 years) in a city in the southern part of Sweden. The subsequent analysis was conducted by content analysis., Result: The analysis reflected three themes: 'participation in nutritional care equals information', 'nutritional care out of remit and competence' and 'nutritional care more than just choosing a flavour'. They were interpreted to illuminate the experience of participation in nutritional care from the perspective of older people and RNs, and the latter's experience of nutritional care in particular per se., Conclusions: Our findings indicate that a paternalistic attitude in care as well as asymmetry in the nurse-patient relationship are still common characteristics of modern clinical nursing practice for older people. Considering that participation should be central to nursing care, and despite the RN's awareness of the importance of involving the older persons in their nutritional care this was not reflected in reality. Strategies to involve older persons in their nutritional care in a nursing home context need to take into account that for this population participation might not always be experienced as an important part of nursing care., Competing Interests: This study was conducted in compliance with the established ethical guidelines of the Declaration of Helsinki. Although under the Swedish Ethical Review Act 2003:460 this study did not require ethical clearance, we applied for and received ethical guidance from the Ethical Advisory Board in Southern Sweden (No. HS2016/28). The researcher gave oral and written information and obtained written informed consent from all participants before the interviews. Participation was voluntary, and the participants had the right to withdraw at any time without further explanation. The participants gave consent for direct quotes from their interviews to be used in this paper. To ensure confidentiality, each quotation was assigned a pseudonym in the form of a capital letter. Data were stored securely and anonymously in compliance with the Data Protection Act.The authors declare that they have no competing interest.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Background: Nursing has come a long way since the days of Florence Nightingale and even though no consensus exists it would seem reasonable to assume that caring still remains the inner core, the essence of nursing. In the light of the societal, contextual and political changes that have taken place during the 21st century, it is important to explore whether these might have influenced the essence of nursing. The aim of this study was to describe registered nurses' conceptions of caring., Methods: A qualitative design with a phenomenographic approach was used. The interviews with twenty-one nurses took place between March and May 2013 and the transcripts were analysed inspired by Marton and Booth's description of phenomenography., Results: The analysis mirrored four qualitatively different ways of understanding caring from the nurses' perspective: caring as person-centredness, caring as safeguarding the patient's best interests, caring as nursing interventions and caring as contextually intertwined., Conclusion: The most comprehensive feature of the nurses' collective understanding of caring was their recognition and acknowledgment of the person behind the patient, i.e. person-centredness. However, caring was described as being part of an intricate interplay in the care context, which has impacted on all the described conceptions of caring. Greater emphasis on the care context, i.e. the environment in which caring takes place, are warranted as this could mitigate the possibility that essential care is left unaddressed, thus contributing to better quality of care and safer patient care.