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Background: The electronic medication administration record (eMAR) is an eHealth system that has replaced the traditional paper‐based medication administration used in many healthcare settings. Research has highlighted that eHealth technologies can change working methods and professional roles in both expected and unexpected ways. To date, there is sparse research that has explored how nurses and nurse assistants (NA) in home healthcare experience eMAR in relation to their work environment. Aim: The aim was to explore how nurses and nurse assistants experienced their work environment, in terms of job‐demand, control, and support in a Swedish home healthcare setting where an electronic medication administration record had been implemented to facilitate delegation of medical administration. Method: We took a qualitative approach, where focus groups were used as data collection method. The focus groups included 16 nurses and nine NAs employed in a Swedish municipality where an eMAR had been implemented 6 months before the first focus groups were performed. The analysis adapted the job‐demand‐control‐support model, by condensing the professionals' experiences into the three categories of demand, control, and support, in alignment with the model. Results: NAs experienced high levels of job demand and low levels of job control. The use of the eMAR limited NAs' ability to control their work, in terms of priorities, content, and timing. In contrast, the nurses described demands as high but manageable, and described having a high level of control. Both professions found the eMar supportive. Conclusion: Nurses and NAs in home healthcare experienced changes in their work environment regarding demand, control, and support when an eMAR was implemented to facilitate delegation of medical administration. In general, nurses were satisfied with the eMAR. However, NAs felt that the eMAR did not cover all aspects of their daily work. Healthcare organisations should be aware of the changes that digitalisation processes entail in the work environment of nurses and NAs in home healthcare. [ABSTRACT FROM AUTHOR]

This paper explores essential characteristics of current nursing practice from the perspectives of clinically experienced registered nurses in various fields of health care in Sweden. Nursing practice has been the subject of much debate in the past and because of its complexity as well as continuous changes in society it is important to continue the debate. A qualitative study, including 16 group interviews with altogether 74 participants, was conducted. Nursing practice was viewed as a multifaceted field. The participants struggled to define nursing but were able to describe it using concrete examples. The analysis, using interpretive description, identified current practice as essentially consisting of: 'A practice pervaded by comprehensive responsibility', 'A practice that recognises a patient's unique needs', 'A practice based on multifaceted knowledge' and 'A practice that mediates between traditional values and changing demands'. Current nursing practice can be understood as striving to be in close proximity to the patient, but in tension with pervasive requirements and societal changes. Going forward, it is necessary to continue to reflect on and discuss the nature of nursing practice in an interprofessional context. Studies from primary and home care are also needed to broaden the understanding of nursing practice. [ABSTRACT FROM AUTHOR]

Aim.  To describe the expectations of and to illuminate the meaning of the Nurse Assistants’ (NA) expectations of Registered Nurses (RN) who are responsible for the care of older people living in residential care homes in Sweden. Background.  Older people in Sweden who are provided with residential care are extremely frail and incapable of independent living. Therefore, when providing care, RN and NA encounter older people who require a great deal of care. An important precondition for the provision of satisfactory care is to have adequate collaboration between NAs and RNs and their expectations of each other. In this paper, the focus is on the NAs expectations of the RNs. Method.  The study is based on a qualitative approach and a phenomenological-hermeneutical method. Ten NAs were interviewed and asked to narrate as freely as possible, about their expectations of RNs. The narratives were audio taped and transcribed verbatim. The analytical process includes the following steps; naïve reading, structural analysis, comprehensive understanding and reflection. Results.  The RNs were expected to take responsibility for being fellow human beings and experts in providing care as well as always available to participate in caring. The RNs were expected to make stand-alone decisions and create a sense of safety for both older people and the NAs and have the courage to work alone and create a safe environment for both the older people and the NAs. The meaning of these expectations was that the RNs are like a captain in providing care, but at the same time, fellow workers. Conclusion.  When the RNs do not meet the NAs expectations, there is a risk of conflict and therefore also a risk that an unsafe environment being created when caring for older people. [ABSTRACT FROM AUTHOR]

This paper reports on a study of the interplay between nurses and doctors in medical and surgical wards in Sweden. The social order on the wards is seen as a negotiated order, the result of a continuous negotiation between doctors and nurses. The negotiated :order perspective is argued to be a more appropriate means of understanding the interaction on wards than the traditional doctor-nurse game model which has dominated research until now. In particular, the study shows the importance of analysing the structural basis of negotiations and its knowledge context in order to understand the interplay, of doctors' and nurses' opportunities for exerting power on the wards. [ABSTRACT FROM AUTHOR]

The role of nurses and nursing in CAP inpatient care is unclear, and nurses are at risk of moral distress due to having to deal with complex demands while lacking organizational support. This study aimed to describe nurses' and assistant nurses' experiences working in child and adolescent psychiatric inpatient care. Eight nurses and seven assistant nurses working in a child and adolescent ward in Sweden participated in the study. Data were collected in 2019 using semi‐structured qualitative interviews and subject to qualitative content analysis. Results describe nurses' and assistant nurses' experiences of child and adolescent psychiatric inpatient care in one theme, Constrained nursing, and four categories: Striving to be there for children and parents; Finding a way to manage work; Depending on others; Lacking nursing leadership. Findings suggest that good, person‐centred and recovery‐oriented nursing practice can exist in CAP inpatient care but remain unrecognized and lacking support due to unclear roles and responsibilities and lack of nursing leadership. This study is reported in accordance with the COREQ guidelines. [ABSTRACT FROM AUTHOR]

Background: Young children's experiences of everyday life with cancer are vital in guiding care. The universal and interdisciplinary language of the International Classification of Functioning (ICF) and the International Classification of Functioning, Disability and Health for Children and Youth (ICF‐CY) has wide reaching effects for the care of young children in need. The aim of this study was to select and validate the content of a clinical assessment tool (CAT) for health and everyday functioning in young children with cancer. Methods: A comprehensive set of ICF‐CY codes (n = 70) mapping everyday function and health was previously identified from the transcripts of 12 interviews with young children with cancer and their parents at a paediatric oncology centre in the west of Sweden. Three transcripts were from data collected shortly after diagnosis, three transcripts from 6 months after diagnosis, three transcripts from 12 months after diagnosis, and three transcripts from 18 months after diagnosis. The present study involved the development of items based on the ICF‐CY codes. Results: The CAT consists of 52 items grouped in four dimensions: "the child herself/himself," "the child's everyday life," "the child's need for support," and "the child's contacts with health care." Conclusion: The questions correlate well with known research results and highlight areas that are important for health and everyday life for young children with cancer. This tool, based on children's experiences, can be used by both parents and health care personnel such as nurses to highlight aspects of health and function in everyday life for the young child with cancer that otherwise might be missed. This novel approach using the ICF‐CY could be used to guide the delivery of care towards living an everyday life with a long‐term illness. [ABSTRACT FROM AUTHOR]

Scand J Caring Sci; 2010; 24; 427–435 Left alone – Swedish nurses’ and mental health workers’ experiences of being care providers in a social psychiatric dwelling context in the post-health-care-restructuring era. A focus-group interview study The professional role of nurses and mental health workers in social psychiatry is being re-defined towards a recovery, client-focused perspective. Approximately 0.7 percent of the adult population in Sweden suffers from severe mental illness leading to a need for community services. The primary aims of the Mental Health Reform in 1995 in Sweden were to improve the quality of life for people with severe, long-term mental illness and, through normalization and integration, enhancing their opportunities to communicate with and participate in society. This study examines nurses’ and mental health workers’ views and experiences of being care providers in a municipal psychiatric group dwelling context when caring for clients suffering from severe mental illness. Three focus group interviews were made and thematic content analysis was conducted. Four themes were formulated: ‘Being a general human factotum not unlike the role of parents’, ‘Having a complex and ambiguous view of clients’, ‘Working in a mainly ‘strangled’ situation’, and ‘Feeling overwhelming frustration’. The staff, for instance, experienced a heavy workload that highly involved themselves as persons and restricted organization. The individual relational aspects of the nursing role, the risk of instrumentalizing the staff due to an organizational economical teleopathy (meaning a pathological desire to react goals), and the high societal demands on accomplishing the Mental Health Reform goals are discussed. To redefine the professional role of nurses and mental health workers in the community, in Sweden known as municipality, they need support in the form of continuously education, supervision, and dialogue with politicians as well as the public in general. [ABSTRACT FROM AUTHOR]

Aims and objectives. To identify factors which may influence attitudes to spiritual care, test the relevance of these identified influencing factors in a Swedish nursing context, and replicate a part of a previous study by Strang et al. ( Journal of Clinical Nursing 2002; 11:48-57) dealing with attitudes to spiritual care in a holistic perspective. A questionnaire was handed out to all nursing staff at a Swedish oncology clinic ( n = 93) excluding the radiation therapy ward. Data were obtained from 68 nurses or nursing auxiliaries. Design and methods. (i) Literature review of international research reports concerning spiritual care in a nursing context. (ii) Construction of a questionnaire comprising 17 questions with given alternatives based on the previous literature study. (iii) Operationalization of the concept 'attitudes to spiritual care' into some more easily measurable questions through identification in earlier research reports of conceivable indicators of attitudes to spiritual care. (iv) Construction of a suggestion for a definition of the concept 'spiritual care' from the results of Strang et al. (2002) to be used in the questionnaire. (v) Statistical analysis of the data from the questionnaire and a comparison with previous studies. Results and conclusions. The replicating part of the study are mainly in accordance with Strang et al. (2002) and lead to the conclusions that holistic care (i) is desirable, (ii) should include spiritual needs of the patients and (iii) is not yet realized in Swedish health care. The identified influencing factors are relevant in a Swedish nursing context. The factors influencing the largest number of indicators of attitudes to spiritual care are 'non-organized religiousness' and 'degree of comfort while providing spiritual care'. Other influencing factors are: 'belief in God', 'belief in life after death', 'organized religiousness', 'profession', and 'the perceived degree of education in spiritual care'. Relevance to clinical practice. Knowledge of attitudes towards spiritual care among nursing staff and factors influencing these attitudes will improve the possibilities of meeting the spiritual needs of patients. [ABSTRACT FROM AUTHOR]

Background: Caring has been seen as a nursing term/concept, including all the aspects that are used to deliver nursing care to patients. Sometimes caring has been conceptualized as a relational expression of human concern and as a collection of human activities that assists others. Aim: This study is to identify and describe the nature of the concept 'caring' from the novice student nurse's perspective. Methods: A total of 127 Swedish novice student nurses wrote comments in essay form to the question: 'what is your image of the concept caring?' Data were analysed using qualitative content analysis, with the use of the theoretical framework: 'doing' and 'being'. Findings: Three categories of caring were identified as 'doing; 'being' and 'professionalism'. The phenomena of caring and the caring process could be illustrated as including hand (doing), heart (being) and brain (professionalism). Conclusions: It is now time to make care more visible as a principle of practice and of moral action. This could be explicit in a clear professional framework and incorporated more fully into nursing education programmes. Caring is to take care of the entire human being physically, emotionally and intellectually. Nurses need to use hand, heart and brain in order to fulfil their commitments. [ABSTRACT FROM AUTHOR]