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Background: Most health systems are insufficiently prepared to promote the participation of chronically ill patients in their care. Strong primary health care (PHC) strengthens patients' resources and thus promotes their participation. The tasks of providing continuous care to people with chronic diseases and promoting self‐management are the responsibility of PHC nurses. Recent research assessing enablers of or barriers to nurses' efforts to support patients' participation has mostly not considered the special situation of patients with chronic diseases or focused on the PHC setting. Objective: To investigate enablers of and barriers to PHC nurses' efforts to promote the participation of chronically ill patients in their care. Methods: We interviewed 34 practicing PHC nurses and 23 key informants with advanced knowledge of PHC nursing practice in Brazil, Germany and Spain. The data was analyzed using thematic coding. Results: We identified four categories of barriers and enablers. (1) Establishing bonds with patients: Interviewees emphasized that understanding patients' views and behaviours is important for PHC nurses. (2) Cooperation with relatives and families: Good relationships with families are fundamental, however conflicts within families could challenge PHC nurses efforts to strengthen participation. (3) Communication and cooperation within PHC teams: PHC nurses see Cooperative team structures as a potential enabler, while the dominance of a 'biomedical' approach to patient care is seen as a barrier. (4) Work environment: Interviewees agreed that increased workload is a barrier to patient participation. Discussion and Conclusions: Supporting patient participation should be acknowledged as an important responsibility for nurses by general practitioners and PHC planners. PHC nurses should be trained in communicative competence when discussing participation with chronically ill patients. Interprofessional education could strengthen other professionals' understanding of patient participation as a nursing task. Patient or Public Contribution: This study is part of a research project associated with the research network 'forges: User‐oriented care: Promotion of health in the context of chronic diseases and care dependency'. The study's focus and provisional results were discussed continuously with partners in health and social care practice and presented to and discussed with the public at two conferences in which patient representatives, professionals and researchers participated. [ABSTRACT FROM AUTHOR]

Purpose: To describe the process of delivery of pediatric palliative care from the perspective of a pediatric interdisciplinary team and the children's parents. Methods: A qualitative descriptive case study was conducted. Purposeful sampling took place within a specialized pediatric palliative care Unit in Madrid (Spain), located at the Niño Jesus Hospital. The study participants included a specialized pediatric palliative care team from Madrid's pediatric palliative care program, other professional teams involved in interdisciplinary care and parents of children under pediatric palliative care. Data were collected via semi-structured interviews, focus groups and researchers' field notes. A thematic analysis was performed. Results: This study included 28 participants (20 women, 8 men), of whom 18 were professionals who belonged to the pediatric palliative care interdisciplinary team, 4 professionals were from other units that collaborated with the pediatric palliative care, and 6 were parents (5 women, 1 man). The mean age of the pediatric palliative care members was 38.2 years (SD ± 7.9), that of the collaborating professionals was 40.5 (SD ± 6.8), and that of the parents was 44.2 (SD ± 5.4). Two main themes emerged: a) Pediatric palliative care has a distinct identity, associated with life. It represents the provision of special care in highly complex children, in the context of the home, far from the hospital environment; b) The team is key: its interdisciplinary organization provides a more comprehensive view of the child and their family, fosters communication among professionals, and improves coordination with other services involved in the care of children. The mindset shift experienced by ID-PPC professionals towards a palliative approach makes them more sensitive to the needs of their patients and leads them to develop specific skills in areas such as communication, decision-making, and adaptability that were identified as differentiating aspects of pediatric palliative care. Conclusions: Describing pediatric palliative care from the professional and parental perspective helps to establish realistic and comprehensive goals for the care of children and their parents. The findings of this study may help with the establishment of a pediatric palliative care team, as a necessary organizational change in a health care system that cares for children with complex and life-threatening conditions. Promoting training in pediatric palliative care, prioritizing more horizontal organizations, providing tools and spaces for coordination and communication between professionals from different services, together with the creation of a position of case coordinator in the care process of children could enhance the understanding of pediatric palliative care services. [ABSTRACT FROM AUTHOR]

Background: Health and social care systems face difficulties in managing multimorbidity, disease burden and complex needs in long‐term conditions such as Parkinson's disease. Objective: This study aimed to develop a European understanding of how health and social care professionals can collaborate with stakeholders from different organizations and sectors to enhance the management of Parkinson's disease in a community setting by identifying the existing gaps in this process and how people with Parkinson's disease and their family carers could benefit from these partnerships. Methods: A mixed‐methods sequential study was conducted in Denmark, Norway, Spain and the United Kingdom. The findings from the qualitative phase are presented. Individual semistructured interviews were analysed using Braun's and Clarke's thematic analysis. A meta‐ethnography approach was used to analyse and synthesize cross‐national findings. Results: A total of 41 healthcare professionals and 39 stakeholders from different disciplines and sectors were interviewed in the four countries. The participants acknowledged a lack of awareness of available resources and poor communication between the different support systems in the management of Parkinson's disease. To promote multiagency collaborations, the participants highlighted the need to organize services along the Parkinson's disease journey, patient involvement and strategic involvement of carers in organizing resources and Parkinson's disease care pathways. According to the participants, the benefits from multiagency partnerships could lead to an enhanced continuity of care and specialized knowledge, mobilization of resources in the community, personalized support and improved access to services. Conclusions: Policymakers are called upon to create formal structures that facilitate multisectoral collaborations to promote an integrated system of care for the management of Parkinson's disease in the community. To address this challenge, we propose five strategies showing how organizations can work together to optimize the use of resources and enhance the management of Parkinson's disease throughout the illness trajectory. Patient or Public Contribution: Patient and Public Involvement groups made up of stakeholders, healthcare professionals, patients with Parkinson's disease and family carers participated in the design of the study, the development of the interview guides and the validation of the findings. [ABSTRACT FROM AUTHOR]

Objective: To know the nurses' perception of the factors that influence the safe administration of medications in the work context of the General University Hospital of Elda (Alicante), Spain. Method: This is a qualitative phenomenological study through interviews semi-structured in which 15 nurses chosen by deliberate sampling participated. Results: The participants expressed concern about the performance of the medication administration procedures, which made it possible to perceive safety as the greatest concern in the study unit. A main category called "knowing" was established, which encompasses all the reflections about the nurse's performance during the medication administration process. The following subcategories are developed from this main category: work overload, insufficient training, distractions, and communication and information failures. Conclusion: Knowing the nurses' perception of the factors that influence the safe administration of medications could facilitate the use of instruments to standardize and reduce variability in the safe administration of medications. As well as improving conditions in work environments and not favoring social, personal and professional stigmatization due to care error. [ABSTRACT FROM AUTHOR]

Introduction: Pseudoscience's use fallacious arguments to expand in society. Different groups of professionals are being analyzed in order to identify, characterize and eventually undermine these major communicative patterns. Objective: To analyze the Spanish healthcare professionals' perception of pseudoscience. Methodology: A qualitative approach was used, consisting of in-depth interviews and questionnaires. Data was analyzed using an inductive analysis with the intention to identify the main patterns present in the subjects. Results: Interviewees defined pseudoscience as those practices lacking any scientific method and created by false specialists. The spiritual character of pseudoscience, together with the exploitation of the placebo effect, its disguise of natural and innocuous, and the emotional support of the preceptors of the false therapies are highlighted as the main causes of its spread. Conclusions: 1) For pseudoscience's prevention, healthcare professionals should be supported by coordinated strategies from the authorities; 2) the decline in public investment in the care services can be one of the causes of its expansion; 3) in the post-truth context, the emotional and spiritual arguments acquire a greater authority than the scientific ones, thus provoking a loss of confidence of the epistemological scientific framework [ABSTRACT FROM AUTHOR]

Background: The working conditions of emergency department professionals and the technification of healthcare have had a negative impact on the healthcare professional-patient relationship, dehumanizing it. Objective: This qualitative study explored nurses' perspectives about the humanization of healthcare in Spanish emergency departments. Methodology: A qualitative design, centred on the opinions of 11 nurses working in the emergency department was applied via semi-structured interviews. Data were analysed using the content analysis technique. Results: Two main themes were identified: The dimensions of humanized healthcare and implementing humanized healthcare at emergency departments, as well as five subthemes. Conclusion: Recommendations are put forward to strengthen initiatives for implementing integrated models of healthcare assistance. The implementation of holistic, patient and family-oriented healthcare is essential to guaranteeing humanized healthcare at the emergency department. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to establish the factors that induce nursing professionals to present engagement with their work environment. Method: Qualitative study, using the communicative methodology, with nursing professionals from public and private centers in the city of Huesca. The statements were collected through communicative stories and discussion groups. Result: The methodology used has allowed the establishment of a set of engagement promotion measures in the studied environment. These measures are framed in the three main categories analyzed: the systemic or structural variables, the subject-oriented variables, and those that refer to the relationships between the subjects. Conclusion: Knowledge of the situation regarding engagement among professionals, and the issues that encourage or hinder its appearance, is essential in establishing measures that contribute to its development. The use of qualitative techniques has allowed for the discovery of situations that would have gone unnoticed. After analyzing the interviews and the discussion groups, the following were present: an important lack of recognition that the participants experience, and that contribute, in their opinion, to the appearance of burnout syndrome, and, the lack of cohesion as a collective. [ABSTRACT FROM AUTHOR]

Background: Few empirical studies have been conducted on the continuity of rehabilitation services, despite the fact that it may affect clinical outcomes, patient satisfaction, the perception of quality, and safety. Objectives: The aim of this study was to explore experiences and perceptions of inpatients receiving physical rehabilitation in an acute care hospital and how these experiences may have led to perceived gaps in the continuity of rehabilitation care. Method: Using qualitative research methods, fifteen semi-structured interviews were conducted with patients who received physical rehabilitation during hospital stay in an acute care hospital in Murcia, Spain. Interviews were transcribed verbatim, analyzed, and grouped into predetermined and emergent codes. Results: Patients described three main themes in continuity of care: informational, management, and relational continuity. Several factors were described as influencing the perceived gaps in these three types of continuity. Informational continuity was influenced by the transfer of information among care providers. Relational continuity was influenced by patient-therapist relations and consistency on the part of the provider. Management continuity was influenced by consistency of care between providers and the involvement of patients in their own care. Conclusion: The participants in this study identified several gaps in three types of continuity of care (informational, management, and relational). Inpatients often perceive their experiences of rehabilitation as being disconnected or incoherent over time. [ABSTRACT FROM AUTHOR]

In this article we present the project we are carrying out in the 2010-2012 period (FIS: PS09/01449). This study is the continuation of the investigation we started in 2007 with the financing of the Consejeria de Salud of the Junta de Andalucia (the Andalusian Government Health Office) (PI424-2007) in which we analyze the Intercultural Communicative Competence of the Nursing professionals dealing with Muslim patients from the point of view of the professionals themselves. Now we aim at evaluating the Intercultural Communicative Competence of the Nursing professionals from the point of view of the Muslim immigrant users-patients. Objective: To know how the patients receiving the care value the Intercultural Communicative Competence of the nurses and nursing assistants. Methodology: Qualitative study, in-depth interviews and discussion groups as a data collecting strategy. Informants: men and women of Muslim tradition who have been hospitalized in one of the Public Hospitals of the province of Almería (Spain). Conclusion: Being aware of the perceived deficiencies will enable us to elaborate a series of suggestions-proposals for intervention aimed at improving the health care and attention offered to this collective of population. [ABSTRACT FROM AUTHOR]

The aim of this study is to describe the experience of children in their interactions with nursing professionals while in hospital. It is a qualitative study supported by the critical incident technique. Data was collected through participant observation and semi-structured interviews with thirty hospitalized children and teenagers between 8 and 14 years old. The results showed that children positively valued nursing care at the hospital and recognized that interactions with nursing staff included social and emotional factors. It is concluded that communication established with children plays a fundamental role to comprehend their experiences while in hospital. Therefore, nurses need to evaluate their strategies and relational skills used to interact with children at the hospital. [ABSTRACT FROM AUTHOR]

This research tries to approach the interaction between doctor and sick people, the speech of both actors and its products, in an environment that is constituted by the Healthcare Center, the biocenosis that occupies it, trained by doctors, auxiliary, nurses, pediatricians, social worker of nursing and administrative officers, watchmen - drivers, and patients. This research is basically an ethnography of a Healthcare Center of Andalusia, where we have studied the interaction doctor - patient, all that surrounds that interaction, and the product called Primary Care Histories (PCH), giving a special attention to the speeches of doctor and patient; working with participant observation, interviews and the emptying and review of the PCH. Between the results, we must emphasize that the PCH lightly gathers the speech of the patient and that the doctors do not follow the procedures of medical records production. [ABSTRACT FROM AUTHOR]