Search

Aim: To gain insight into which elements of the interpersonal care relationship (IPCR) are perceived as occurring (less) frequently and as (not) disturbing from the perspective of hospitalized older patients. Design A cross‐sectional study in three Belgian hospitals. Methods: A convenience sample of patients aged 75 years or older admitted to a non‐geriatric ward were recruited between May 2017 and April 2019. The Interpersonal Geriatric care relationship (InteGer) tool was used to identify elements of the IPCR and was completed by the researchers through structured patient interviews. Results: The mean total scale score for frequency was 3.74 (SD 1.51) [range 0–12]. On subscale level, the highest mean score was in the accessibility and the lowest mean score in the humanization subscale. Statistically significant differences between the hypothesized and experienced disturbance were observed in 18 of the 30 items. Ten items score in the category 'no action needed' (not occurring, not disturbing), nine items in the category 'remain attentive for patient experiences' (occurring, not disturbing), 10 items in the category 'further analyses or monitoring needed' (not occurring, disturbing) and one item in the category 'urgent action needed' (occurring and disturbing). Conclusion: Participants report mostly positive experiences related to the four subscales of the InteGer, that is, humanization, attentiveness, interest and accessibility. Insights from this study provide important opportunities in the context of care optimization for each category with the main focus on items with high experienced disturbance. Impact The InteGer can be used for monitoring IPCR and formulating action points at ward and hospital level to further improve the IPCR and quality of care. [ABSTRACT FROM AUTHOR]

Suicide prevention and treatment opportunities often depend on interpersonal contact between patients and professionals. Presently, there is a lack of valid and reliable instruments to obtain the perspective of patients with suicidal ideation regarding their contact with professionals in mental health wards. This was a three‐stage study to develop and psychometrically evaluate a questionnaire: the Contact with Nurses from the perspective of Patients with Suicidal ideation (CoNuPaS). First, the construct was defined by a systematic review, qualitative study, and face validity among experts. Second, the content was validated through a Delphi procedure with professional experts (n = 14) and cognitive interviews with hospitalized patients (n = 12). Third, using a sample of adult patients with suicidal ideation in the past year (n = 405), the psychometric properties were assessed by an exploratory factor analysis, a test‐retest procedure, and the internal consistency. The CoNuPaS comprises 23 items and two subsections, to examine patients' perceptions of contact experiences with nurses (CoNuPaS‐experience) and what they find important in that contact (CoNuPaS‐importance). The subsections comprise four components: encountering a space to express suicidal thoughts and explore needs, being recognized as a unique and self‐determining individual, encountering nurses' availability/information‐sharing/transparency on expectations, and trusting nurses in communication about suicidality. Content validity scores were excellent (0.78–1.00); test‐retest intraclass correlation coefficient and internal consistency were >0.90. Thus, the CoNuPaS demonstrated good psychometric properties. The availability of a valid questionnaire to examine patient‐nurse contact in mental health wards is central to improving understanding of nurses' contributions to suicide prevention and suicidal ideation treatment. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Advanced Nursing (John Wiley & Sons, Inc.) is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Nurses play an important role in supporting patients in self‐managing their chronic conditions. However, it is uncertain how nurses define their success and what might create feelings of disillusionment. This exploratory qualitative study sought to understand the origin, meanings, and processes underlying nurses' feelings of success in supporting patients to self‐manage their life with a chronic illness. Semi‐structured interviews were held with 16 nurses who were purposively sampled. Data were iteratively collected and analyzed (November 2017–September 2018). The origin and meaning of nurses' feelings of success in supporting patients in self‐management converged around the intertwining of "maintaining and promoting health" as a primary goal in chronic care, while an "intrapersonal conflict" arises. Patients maintaining physical health by optimal medical management boost nurses' feelings of success, whereas patients dealing with sub‐optimally provoke "an intrapersonal conflict". When nurses observe unhealthy patient behavior, this is difficult to accept as it conflicts with their normative ideas of good care and health. Nurses' perception of success is refined by three interconnected processes, namely "keeping on track", "considering own role," and "protecting self". Nurses experienced and processed success differently depending on whether they interacted with patients from a more directive approach or an attuning approach. This study highlighted the fact that nurses expect compliance from patients, and thereby often feel empty‐handed. By adopting a broader perspective of what successful patient behavior is, nurses might be able to provide a more comprehensive meaning to their own success regarding the care of patients living with a chronic illness. [ABSTRACT FROM AUTHOR]

Aim: To uncover and understand the core elements of how nurses in psychiatric hospitals make contact with patients experiencing suicidal ideation. Design: A qualitative study based on the principles of grounded theory was performed. Methods: Nineteen nurses on wards of four psychiatric hospitals were interviewed between May 2017 – February 2018. The Qualitative Analysis Guide of Leuven was used to facilitate the constant comparison of data. Findings: Nurses make contact with patients experiencing suicidal ideation by "creating conditions for open and genuine communication" while maintaining a focus on "developing an accurate and meaningful picture of patients". These interconnected core elements represent nurses' attention to relational processes like building trust as well as their predominant focus on assessing suicide risk. Nurses put other emphases in their contacts with patients depending on whether their approach is guided more by checking and controlling suicide risk or by acknowledging and connecting (with) the person. Conclusion: The study enhances the conceptual understanding of how nurses on psychiatric wards can involve in compassionate and considerate contact and communication with patients experiencing suicidal ideation. These findings can be used to underpin the nurses' role in and contribution to suicide prevention. Impact: The core elements "creating conditions for open and genuine communication" while maintaining a focus on "developing an accurate and meaningful picture of patients" can inform policies for nursing practice and education that aim to preserve and improve the capacity of nurses to involve in compassionate and considerate contact and communication with patients experiencing suicidal ideation. [ABSTRACT FROM AUTHOR]

Aim The aim of this study was to gain insight into the influence of team members in how nurses perceive and address patients' transgressive behaviour. Background Aggression and transgressive behaviour in health care have been a focus of research over the past few decades. Most studies have focused on individual nurses' experiences with aggression and transgressive behaviour. Literature examining group dynamics in nursing teams and team members' interactions in handling patients' transgressive behaviour is scarce. Design Qualitative interview study. Methods Seven focus-group interviews and two individual interviews were carried out in 2014-2016. Twenty-four nurses were drawn from eight wards in three general hospitals. Interviews were analysed using the constant comparative method influenced by the grounded theory approach. Findings While elaborating how they perceived and addressed transgressive behaviour, nurses disclosed how interactions with team members occurred. Several patterns arose. Nurses talk to one another, excuse one another, fill in for one another, warn one another and protect and safeguard one another. In these patterns in reaction to patients' transgressive behaviour, implicit group norms transpire, causing nursing teams to acquire their specific identity 'as a group'. Consequently, these informal group norms in nursing teams impinge how nurses feel threatened by patients' potential transgressive behaviour; gain protection from the group of nurses and conform to informal ward rules. Conclusion The findings of this study can support intervention strategies aimed at supporting nurses and nursing teams in managing patient aggression and transgressive behaviour by identifying and explicating these group dynamics and team members' interactions. [ABSTRACT FROM AUTHOR]

Aim. To acquire insight into the onset and meaning of transgressive behaviour from the perspective of nurses. Background. Patient aggression towards healthcare providers occurs frequently. Nurses in particular are at risk of encountering aggressive or transgressive behaviour due to the nature, duration and intensity of relationships with patients. This study analysed nurse perspectives with regard to the onset and meaning of transgressive patient behaviour in a general hospital setting. Design. Qualitative research according to the grounded theory method. Methods. Data were collected in 2011 through individual interviews with 18 nurses who were selected using purposive and theoretical sampling. Findings. Findings revealed that various nurse-patient interactions can result in episodes of transgressive behaviour, depending on the interplay of determining and regulating factors which have been identified at the patient, nurse and ward level. Experiences of transgressive behaviour are influenced by degree of control nurses experience over the provision of care; the degree of patient acceptance of organizational and ward rules, the degree of gratitude and recognition expressed by the patient and the extent of patient regard for the nurse as a person. Factors affecting transgressive experiences were a trusting relationship between patient and nurse; the extent to which patient perspectives are understood; methods of managing transgressive behaviour; and the influence of the team, head nurse and ward culture and habits. Conclusions. The results of this study can support the development of nurses' coping ability and self-confidence to mitigate or prevent experiences of transgressive behaviour. [ABSTRACT FROM AUTHOR]

Aim. To gain insight in the onset and meaning of transgressive behaviour in care relationships with nurses, from the perspective of patients. Background. Aggression and transgressive behaviour in health care have been a focus of research over the last decades. Most studies describe staff experiences on patient aggression. Patient' perspectives on aggression and transgressive behaviour in interactions with nurses are rarely sought. Design. Qualitative interview study. Methods. Twenty patients were purposefully sampled from six wards of two general hospitals. Semi-structured interviews were carried out in 2011. Data were analysed using the constant comparative method influenced by the grounded theory approach. Findings. On elaborating on what constitutes experiences of transgressive behaviour, patients employ a framework of suppositions towards hospital care and nurse-patient relationships. This framework leads to implicit ideas on how competent professional caregivers will be and on how relationships with nurses will be characterized as normal human interactions. When these anticipated ideas are not met, patients feel obliged to address this discrepancy by adjusting their expectations or behaviour. Patients become more vigilant with regard to care given by nurses; search for own solutions; make excuses for nurses or reprioritize their expectations. Because of this adjustment, perceptions of transgressive behaviour are reinforced, mitigated or put into perspective. Conclusion. Patients adjust their behaviour based on what they experience in care relationships with nurses or the hospital care. It is crucial that patients feel free to discuss their assumptions or untoward needs and nurses learn to understand and reflect on those experiences. [ABSTRACT FROM AUTHOR]

The rising attention to participation and self-regulation in chronic care requires nurses to move towards an approach in which patients' perspectives and choices are central, and in which patients' competency is fostered. According to Self-Determination Theory, nurses can differ in the way they interact with patients living with a chronic illness. That is, they can interact in an autonomy-supportive, controlling, structuring or chaotic way. However, in practice, nurses often use these styles side by side depending on personal and situational demands. Rooted in Self-Determination Theory, this study sought to identify distinct profiles among nurses involving the co-occurrence of autonomy support, structure, control and chaos (aim 1), and to examine whether such profiles are meaningfully driven by nurse-related indicators (aim 2). A cross-sectional design with latent profile analysis. Data were collected using validated self-report questionnaires among nurses counselling chronically ill patients (N = 389). Latent profile analysis was performed to shed light on how nurses use different styles side by side; and subsequent MANCOVA testing was used to examine differences between the profiles in terms of nurse-related indicators. Four profiles could be identified, each characterised by a unique combination of differing degrees of autonomy support, structure, control and chaos. The profiles included a motivating profile (20.31%) characterised by the dominant presence of autonomy support and structure; a demotivating chaotic profile (17.74%) characterised by the dominant presence of chaos; an active profile (24.17%) where all styles were highly present; and an undifferentiated profile (37.79%) characterised by an average presence of all styles. These four profiles were meaningfully related to a set of nurse-related indicators. Multivariate analysis (Pillai's Trace test =.38, F (15, 756) = 7.28; p <.001; η2 =.13) indicated that job competency, job autonomy and high-quality motivation were most elevated in the motivating profile. Profiling has supported our understanding of the natural co-occurrence of more motivating and demotivating styles among nurses when counselling patients in self-managing their life with chronic illness. The pattern of retained profiles indicates that, for some nurses, it will be important to move away from controlling or chaotic interactions. Future intervention development should augment nurses' competence levels and high-quality motivation, with attention to reduce the pressure in nurses to act in a result-based manner. Profiling can also be valuable to better assign nurses to an employment in chronic care, and to support their personal professional growth. [ABSTRACT FROM AUTHOR]