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Background: Healthcare professionals' knowledge and attitudes may have an impact on older persons' nutritional status. Therefore, it is important to explore different healthcare professionals' perspectives on older persons' meals. Aim: The aim of this study was to describe healthcare professionals' understanding of and views on the mealtime experience of older persons in municipal care. Methods: Seven focus group discussions with various healthcare professionals (nurse assistants, registered nurses and occupational therapists) (n = 52) working in nursing homes and/or home care for older persons were conducted and analysed using interpretive description. The COREQ checklist was used for reporting the findings. Results: The results revealed a striving to create conditions for an appealing meal, regardless of profession. This overall theme, 'An appealing meal – creating conditions for older persons' mealtimes', consisted of four sub‐themes: 'Food is crucial', 'The mealtime as a social interaction', 'Identifying the individual older person's needs' and 'Integrating different perspectives of meal‐related situations among the team'. Conclusion: The findings show that the different professionals strive to prioritise meals in the everyday care of older persons, but at same time there is a lack of a common view on how to prioritise meal‐related issues. This indicates that the care may be fragmented, being based on each professional's duties and interpretation of responsibility for older persons' meals, rather than constituting comprehensive integrated person‐centred care provided by a multidisciplinary team. Relevance to clinical practice: To enhance older persons' mealtimes, we need to map how mealtimes are valued and implemented in clinical practice and approached in healthcare professionals' education. Education on older person's nutritional needs should be team‐based, and not focus on the perspective of a single profession. [ABSTRACT FROM AUTHOR]

Aim Background Design Methods Results Conclusion Implications for Profession and/or Patient Care Patient or Public Contribution Reporting Method To explore and compare the didactic approaches to practical skills learning at simulation centres in Scandinavian universities and university colleges.Academic simulation centres are an important arena for learning practical nursing skills which are essential to ensure competent performance regarding patient safety and quality of care. Knowledge of didactic approaches to enhance learning is essential in promoting the provision and retention of students' practical nursing skills. However, research on didactical approaches to practical nursing skills learning is lacking.A qualitative comparative design was used.During November and December 2019, interviews were conducted with a total of 37 simulation centre directors or assistant directors, each of whom possessed in‐depth knowledge of practical skills in teaching and learning. They represented bachelor nursing education in Denmark, Norway and Sweden. A qualitative deductive content analysis was conducted.The results revealed all five predetermined didactical components derived from the didactical relationship model. Twenty‐two corresponding categories that described a variation in didactic approaches to practical skills learning in Scandinavian nursing simulation centres were identified. The didactical components of Learning process revealed mostly similarities, Setting mostly differences and Assessment showed only differences in didactic approaches.Although various didactic approaches were described across the countries, no common approach was found. Nursing educational institutions are encouraged to cooperate in developing a shared understanding of how didactic approaches can enhance practical skills learning.Cross‐country comparisons of practical nursing skills learning in Scandinavian countries highlight the importance of educator awareness concerning the impact diverse didactic approaches may have on competent performance in nursing education. Competent performance is pivotal for ensuring patient safety and the provision of high‐quality care.No Patient or Public Contribution.This study followed the Consolidated Criteria for Reporting Qualitative Research reporting guidelines. [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]

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 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]

Aim and objectives To acquire knowledge regarding the contents to be implemented in an interactive information and communication technology-platform perceived to be relevant to health and self-care among older persons based on the literature, healthcare professionals and the older persons themselves. Background The growing ageing population places demands on the healthcare system to promote healthy ageing and to strengthen the older person's self-care ability. This requires innovative approaches to facilitate communication between the older person and healthcare professionals, and to increase the older person's participation in their care. An information and communication technology-platform could be used for this purpose, but the content needs to be relevant to both the older persons and the healthcare professionals. Design Descriptive qualitative design. Methods This study was based on three samplings: a scoping review of the literature ( n = 20 articles), interviews with healthcare professionals ( n = 5) and a secondary analysis of interviews with older persons ( n = 8) and nursing assistants ( n = 7). The data were analysed using qualitative content analysis. Results Four areas were identified to be of relevance to older persons' perceived health: frame of mind, having relationships and social activities, physical ability and concerns, and maintaining self-care. Self-care was described in the literature and by the healthcare professionals more than by the older persons. Conclusions The results show a concordance in the data samplings that give a clear indication of the areas relevant to older persons' health and self-care that can be integrated in an interactive information and communication technology-platform for use in regular daily care assessments. Descriptions of self-care were limited indicating a possible gap in knowledge that requires further research. Relevance to clinical practice Areas relevant to older persons' health and self-care could be used for regular assessment to support and promote healthy ageing. [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]

Aim and objectives To describe and compare nutritional status, pulmonary function, gender and marital status in patients with chronic obstructive pulmonary disease. Background Chronic obstructive pulmonary disease is a chronic illness that can lead to poor nutritional status due to an increased energy requirements related to laboured breathing. Inadequate nutritional intake has often been described in this patient group. Nutritional support for patients with chronic obstructive pulmonary disease who suffer from nutritional problems is essential, both for their sense of well-being and for their survival with chronic obstructive pulmonary disease. Design The study design was descriptive and comparative. Methods Quantitative data collection was carried out among 81 patients with chronic obstructive pulmonary disease (47 women and 34 men) with an average age of 65 years ( SD 3·5). The Mini Nutritional Assessment was used to assess nutritional status. Results Participants who lived alone had worse nutritional status than those who did not live alone, and female participants had worse nutritional status than their male counterparts. No significant correlation was found between pulmonary function and nutritional status. Conclusions This study contributes knowledge of a potential correlation between nutritional status, gender and marital status in patients with chronic obstructive pulmonary disease. Women with chronic obstructive pulmonary disease may be at an increased risk of malnutrition. Despite the previous results showing malnutrition and underweight to be common, the present study found that many of the participants were overweight, which may reflect a global health trend regardless of disease. Relevance to clinical practice Early identification of patients at risk of malnutrition is important. Registered nurses should be aware that patients with chronic obstructive pulmonary disease who are female or who live alone may be at an increased risk of nutritional problems. Patients with chronic obstructive pulmonary disease must be offered information and support for individually adapted measures at an early stage in order to avoid nutritional problems, regardless of under- and overweight. [ABSTRACT FROM AUTHOR]