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Background: Pharmacologic management of mental health illnesses in patients receiving dialysis is complex and lacking data. Objective: Our objective was to synthesize published data for the treatment of depression, bipolar and related disorders, schizophrenia or psychotic disorders, and anxiety disorders in adults receiving hemodialysis or peritoneal dialysis. Methods: We undertook a scoping review, searching the following databases: Medline, Embase, CINAHL, PsycINFO, Cochrane Library, Scopus, and Web of Science. Data on patients who received only short‐term dialysis, a kidney transplant, or non‐pharmacologic treatments were excluded. Results: Seventy‐three articles were included: 41 focused on depression, 16 on bipolar disorder, 13 on schizophrenia and psychotic disorders, 1 on anxiety disorders, and 2 addressing multiple mental health illnesses. The majority of depression studies reported on selective serotonin reuptake inhibitors (SSRIs) as a treatment. Sertraline had the most supporting data with use of doses from 25 to 200 mg daily. Among the remaining SSRIs, escitalopram, citalopram, and fluoxetine were studied in controlled trials, whereas paroxetine and fluvoxamine were described in smaller reports and observational trials. There are limited published data on other classes of antidepressants and on pharmacological management of anxiety. Data on treatment for patients with bipolar disorder or schizophrenia and related disorders are limited to case reports. Conclusion: Over half of the studies included were case reports, thus limiting conclusions. More robust data are required to establish effect sizes of pharmacological treatments prior to providing specific recommendations for their use in treating mental health illnesses in patients receiving dialysis. [ABSTRACT FROM AUTHOR]

Implementing evidence-based innovations into care practice is a complex, slow and haphazard process. Dissemination and implementation (DI) research seeks to understand and optimize that process, to close gaps between research and practice and to improve quality of care. While there is a growing body of international DI research, little is known about the number and types of DI research studies and the DI topics studied in German-speaking nursing settings. This scoping review therefore evaluates the state of nursing-related DI research in German-speaking countries, discusses these results in light of the international state of DI research and provides directions for future research. We searched international databases (Web of Knowledge including Medline, CINAHL, PsycInfo, and GeroLit), German library meta-search engines, six German-language key trade journals, and reference lists of included articles. In total, 186 references representing 140 research projects were included in our review. Quality appraisal used five validated checklists. Methodological quality of the included studies was generally low. A total of 92 studies assessed the effects of DI strategies, 67 studied DI barriers and facilitators, 64 evaluated the impact or characteristics of DI processes, and 5 reported on the development or validation of DI research tools. None of the included studies focussed on methodological questions of DI research or on development and testing of DI theories and models. Future nursing-related DI research in German-speaking countries should particularly focus on these latter topics. Taking into account the international state of DI research will be especially crucial for those research activities.

During the coronavirus disease 2019 pandemic, public health has issued three interrelated dominant narratives through social media and news outlets: First, to care for others, we must keep physically distant; second, we live in the same world and experience the same pandemic; and third, we will return to normal at some point. These narratives create complexities as they collide with the authors' everyday lives as nurses, educators, and women. This collision creates three paradoxes for us: (a) learning to care by creating physical distance, (b) a sense of togetherness erases inequities, and (c) returning to normal is possible. To inquire into these three paradoxes, we draw on our experiences with Ingrid, an older adult who requires in‐home physical care, and Matthew, a man with multiple disabilities including severe oral dyspraxia and developmental delays. We outline how narrative care is a counterstory to the dominant narratives and enables us to find ways to live our lives within the paradoxes. Narrative care allows us, through attention to embodiment, liminality, and imagination, to create forward looking stories. Understanding narrative care within these paradoxes allows us to offer more complex understandings of the ways narrative care can be embodied in our, and others', lives. [ABSTRACT FROM AUTHOR]

For us, narrative care is grounded in pragmatist philosophy and focused on experience. Narrative care is not merely about acknowledging or listening to people's experiences, but draws attention to practical consequences. We conceptualize care itself as an intrinsically narrative endeavour. In this article, we build on Lugones' understanding of playfulness, particularly to her call to remain attentive to a sense of uncertainty, and an openness to surprise. Playfulness cultivates a generative sense of curiosity that relies on a close attentiveness not only to the other, but to who we each are within relational spaces. Generative curiosity is only possible if we remain playful as we engage and think with experiences and if we remain responsive to the other. Through playfulness, we resist dominant narratives and hold open relational spaces that create opportunities of retelling and reliving our experiences. Drawing on our work alongside older adults, as well as people who work in long‐term care, we show the possibilities of playfulness in the co‐composition of stories across time. By intentionally integrating playfulness, narrative care can be seen as an intervention, as well as a human activity, across diverse social contexts, places and times. [ABSTRACT FROM AUTHOR]

The metaphor of "world traveling" has been taken up by researchers engaged in narrative inquiry. This metaphor provides a reference point throughout the research process for navigating relational processes. In this article, we unpack how the metaphor of "world travelling" shapes the writing of research texts in narrative inquiry and the meaning making inherent in shared texts. We draw on a narrative inquiry focused on the experiences of men who are homeless in Japan, as well as a narrative inquiry focused on precariously housed women who are pregnant or engaged with early parenting and who use illicit substances. As we work with Lugones's ideas, we see it is critical to engage in a collaborative process that is marked by a playful exchange of ideas and that pushes us to identify connections with others. At the same time, we work to create meaning; we need to challenge racial, social, political, and economic boundaries and social differences in ways that allow researchers and participants to locate themselves in relation to others. Engaging in this manner shows openness to multiple ways of sense making and to creating texts where expectations are broken. Representation requires the development of texts where we can "exercise double vision" and "create and cement relational identities." These spaces of openness and multiplicity are always in motion and are marked by a sense of "dwelling," "world travelling," and "playfulness." [ABSTRACT FROM AUTHOR]

In the past decades, narrative practices have been developed, and care has been conceptualized as being narrative in nature. More recently, narrative care has been developing both as a practice and a field of study. It is necessary to make the theoretical foundations of narrative care visible to avoid the risk of narrowly defining narrative care as a matter of storytelling and listening. In this article, we develop an understanding of narrative care grounded in early feminist pragmatist philosophy, with a focus on social and political activism and experience. Pragmatism holds the possibilities to open spaces for realities that are constantly in flux and for emergent situations that must be considered across time, diverse places and social contexts. With the aid of Vera's stories about her relationship with Tammy, we demonstrate the importance of recognizing that realities are multiple, complex and uncertain. Furthermore, we discuss how the stronghold of formula stories and issues of power, positioning and inequities, restrict people's possibilities to be, become and co-author their stories. We also argue that the playfulness, imagination and world travelling of narrative care are in line with early feminist pragmatism, which draws on a wide and diverse range of experiences. Jane Addams linked democracy to dialogue, joint experiences and social equality. This calls for the development of ethical frameworks grounded in care that are more specifically focused on relational ethics and a commitment to dialogical and relational democracy and the prioritization of community. [ABSTRACT FROM AUTHOR]

We tested the feasibility of a nursing intervention (DEMIAN) in routine care and its effects on care providers' job satisfaction, motivation, and work strain. This cluster-randomized trial was conducted in 20 German long-term care facilities. We randomly assigned 20 facilities to an intervention group (84 care providers, 42 residents with dementia) or a control group (96 care providers, 42 residents with dementia). Intervention group providers received two training days on the intervention; 68 providers attended both training days. Sixty two providers completed both baseline and follow-up questionnaires. Trained providers created individualized mini-intervention plans for participating residents. Control group residents received 'usual care'. Intervention group providers stated that the intervention was feasible and helped them improve emotional well-being of residents with dementia. We found significantly decreased time pressure and decreased job dissatisfaction for intervention group providers. DEMIAN is an effective and pragmatic contribution to implementing person-centred care in long-term care, with positive effects on providers' working conditions. [ABSTRACT FROM AUTHOR]

In Germany, the use of life story work as an approach to care in nursing homes has not been implemented successfully. Using Grounded Theory, we explored care staff's understandings of life story work when caring for persons with dementia. Thirty-six staff from seven nursing homes participated in semi-structured interviews or group discussions. In this paper we discuss new aspects and theoretical connections between understandings and practices of life story work. For some participants, obtaining 'true facts' about a resident's course of life was considered the most important topic. Others highlighted the importance of narratives as well as embodied stories told by persons with dementia, as aspects that generated emotionally meaningful situations. Delivering sound life story work can be challenging for care staff working with persons with dementia. To enhance care in nursing homes, the importance of life story work needs to be further developed. [ABSTRACT FROM AUTHOR]

Aims and objectives: We will provide insights in the theoretical background and key concepts of a Narrative Care approach, such as narrative cultures, narrative curiosity, narrative co‐composition and narrative reflective practice. Background: Care understood as narrative practice underscores the importance of experiences and how these shape identities. Important to the quality of care in institutional care settings is the ability of care providers to cope with complexities and uncertainties in older adults' stories, which can be realised by attending to ways that foster and co‐compose evolving and forward‐looking narratives. Recognising these ongoing co‐compositions means that persons living in institutional care settings and care providers live, tell, retell and relive their experiences. A change in the current institutional culture is necessary to implement care as narrative practice. To support such a change, approaches are needed that foster a focus on experiences and relationships and make relational ethics central to care. Methods: The proposed Narrative Care approach is the result of an iterative development process involving a literature review, interviews with, and observations of, care providers, dialogues with an advisory committee, and consultation with experts. Main contributions: The proposed Narrative Care approach aims to help care providers (a) to recognise the importance of curiosity in a person's verbal and embodied narratives—especially for those living with dementia; (b) to take note of individual experiences in all of their complexity and uncertainty; (c) to respect these narratives; (d) to open up spaces to co‐compose new narratives; and (e) to allow care providers to engage in narrative reflective practices that shape who they are and are becoming. Conclusion: The introduced approach responds to the need of implementing strategies to think and work narratively in institutional care settings. Implications for practice: Narrative Care has the potential to reshape task‐oriented, technical notions of care. Concepts such as embodied narratives, relational ethics, narrative co‐composition and narrative reflective practice must be integrated in the education of all care providers. [ABSTRACT FROM AUTHOR]

Given the rapidly expanding older adult population, finding health care approaches that support older adults to age in their choice of place, with an accompanying philosophical re-orientation of health services, is becoming more urgent. We studied the Home Care Home First - Quick Response Project to understand how clients over age 75 and their family caregivers perceived the enhanced community-based services delivered through Home First. Using interpretive description as the methodological design, we explored the experiences of eight older adults and 11 family caregivers; all older adults were enrolled in Home First due to a significant change in their health status. We identified four themes: growing older in chosen places with support, philosophy of care, processes of Home First, and the significance of Home First for clients. Overall, clients and family caregivers responded positively to the Home First services. Clients valued their independence and growing older in places they had specifically chosen.

We tested the feasibility of a nursing intervention (DEMIAN) in routine care and its effects on care providers' job satisfaction, motivation, and work strain. This cluster-randomized trial was conducted in 20 German long-term care facilities. We randomly assigned 20 facilities to an intervention group (84 care providers, 42 residents with dementia) or a control group (96 care providers, 42 residents with dementia). Intervention group providers received two training days on the intervention; 68 providers attended both training days. Sixty two providers completed both baseline and follow-up questionnaires. Trained providers created individualized mini-intervention plans for participating residents. Control group residents received 'usual care'. Intervention group providers stated that the intervention was feasible and helped them improve emotional well-being of residents with dementia. We found significantly decreased time pressure and decreased job dissatisfaction for intervention group providers. DEMIAN is an effective and pragmatic contribution to implementing person-centred care in long-term care, with positive effects on providers' working conditions.