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Aims and objectives: To generate a standardised definition for fundamental care and identify the discrete elements that constitute such care. Background: There is poor conceptual clarity surrounding fundamental care. The Fundamentals of Care Framework aims to overcome this problem by outlining three core dimensions underpinning such care. Implementing the Framework requires a standardised definition for fundamental care that reflects the Framework's conceptual understanding, as well as agreement on the elements that comprise such care (i.e., patient needs, such as nutrition, and nurse actions, such as empathy). This study sought to achieve this consensus. Design: Modified Delphi study. Methods: Three phases: (i) engaging stakeholders via an interactive workshop; (ii) using workshop findings to develop a preliminary definition for, and identify the discrete elements that constitute, fundamental care; and (iii) gaining consensus on the definition and elements via a two‐round Delphi approach (Round 1 n = 38; Round 2 n = 28). Results: Delphi participants perceived both the definition and elements generated from the workshop as comprehensive, but beyond the scope of fundamental care. Participants questioned whether the definition should focus on patient needs and nurse actions, or more broadly on how fundamental care should be delivered (e.g., through a trusting nurse–patient relationship), and the outcomes of this care delivery. There were also mixed opinions whether the definition should be nursing specific. Conclusions: This study has initiated crucial dialogue around how fundamental care is conceptualised and defined. Future work should focus on further refinements of the definition and elements with a larger, international group of practising nurses and service users. Relevance to clinical practice: The definition and elements, through ongoing refinement, will contribute to a robust evidence base that will underpin policy development and the systematic and effective teaching, delivery, measurement and evaluation of fundamental care. [ABSTRACT FROM AUTHOR]

Aims and objectives To develop and test feasibility and acceptability of an interactive ICT platform integrated in a tablet for collecting and managing patient-reported concerns of older adults in home care. Background Using different ICT applications, for example interactive tablets for self-assessment of health and health issues based on health monitoring as well as other somatic and psychiatric monitoring systems may improve quality of life, staff and patient communication and feelings of being reassured. The European Commission hypothesises that introduction of ICT applications to the older population will enable improved health. However, evidence-based and user-based applications are scarce. Design The design is underpinned by the Medical Research Council's complex intervention evaluation framework. A mixed-method approach was used combining interviews with older adults and healthcare professionals, and logged quantitative data. Methods In cooperation with a health management company, a platform operated by an interactive application for reporting and managing health-related problems in real time was developed. Eight older adults receiving home care were recruited to test feasibility. They were equipped with the application and reported three times weekly over four weeks, and afterwards interviewed about their experiences. Three nurses caring for them were interviewed. The logged data were extracted as a coded file. Results The older adults reported as instructed, in total 107 reports (Mean 13). The most frequent concerns were pain, fatigue and dizziness. The older adults experienced the application as meaningful with overall positive effects as well as potential benefits for the nurses involved. Conclusions The overall findings in this study indicated high feasibility among older adults using the ICT platform. The study's results support further development of the platform, as well as tests in full-scale studies and in other populations. Relevance to clinical practice An ICT platform increased the older adults' perception of involvement and facilitated communication between the patient and nurses. [ABSTRACT FROM AUTHOR]

Aims and objectives The main aim of this study was to evaluate whether addressing the written questions of heart failure patients could individualise the education and increase patient satisfaction. A further aim was to describe the learning needs of patients with newly diagnosed heart failure. Background Despite well-designed patient education, daily problems and self-care sometimes seem difficult to manage for the patient with heart failure. The literature suggested that nurses should include individualised educational interventions. Design The study had an evaluative and descriptive design. Methods A mixed-method approach was used. A quasi-experimental method was used to compare patients in the control group ( n = 41), who received regular education at the nurse-led heart failure clinic, with patients in the intervention group ( n = 44), who received regular education but also education addressing questions they had written down at home before coming to the clinic. Two instruments were used to investigate, respectively, whether the intervention caused patients to experience a greater sense of involvement in their education and greater satisfaction. The patients' questions were subjected to manifest content analysis. Results There was no significant difference in satisfaction with the education between the control group and the intervention group. However, the intervention group did feel more strongly that the information they received was related to their personal situation. The patients' learning needs before education were categorised as: causes and meaning of illness, control and management of the disease, impact on daily living and future health. Conclusion Asking heart failure patients to write down their learning needs before the education increases their chances of receiving education based on their individual needs. Relevance to clinical practice The method is simple and cost-effective and could be a way to improve the patient education and facilitate person-centred care. [ABSTRACT FROM AUTHOR]

Aims and objectives To describe nursing students' experience of stress during clinical practice and evaluate the risk of stress in relation to the clinical setting characteristics and the organisation of the clinical education. Background Stress during clinical practice is well documented, but there is a lack of knowledge concerning whether the clinical setting characteristics and the organisation of the education make a difference. Design A cross-sectional study with evaluative design. Methods Data were collected by means of a numerical rating scale for the assessment of stress and questions about the clinical setting characteristics and the organisation of the education. One hundred and eighty-four students who had completed their final year on the nursing programme at three universities in Sweden were included. Results Nearly half of the students (43%) experienced high level of stress during clinical practice. Measured by decision in the tree analysis, the absolute risk of stress was 57% in students with placements in hospital departments, as compared to 13% in students with placements in other clinical settings. The risk of stress increased to 71% if the students with placement in a hospital took the national clinical final examination. Performance of practice in a hospital department overcrowded with patients was also associated with increased risk of stress. The organisation of supervision and number of students at the clinical placement had an effect on the experience of stress, but did not prove to be risk factors in the analysis. Conclusions The risk of stress in nursing students during their clinical practice differs depending on clinical setting characteristics. The taking of the national clinical final examination could be a source of stress, but this requires further investigation. Relevance to clinical practice It is important that supervisors are aware that students in hospital departments overcrowded with patients are at risk of stress and may have increased need of support. [ABSTRACT FROM AUTHOR]