Clinical decision-making processes among graduate nurses, specialist nurses and nurse practitioners A collaborative international study.

AIM: To explore clinical decision-making by comparing the processes used by three groups of nurses in the emergency departments of three hospitals: in Norway, Finland and Ireland. BACKGROUND: Clinical decision-making in an emergency department environment is a complex process often occurring in times of crisis. It is an important aspect contributing to the quality of care. However, empirical research is limited regarding the decision-making process in different nursing roles. METHODS: In accordance with the consolidated criteria for reporting qualitative research, a qualitative and observational study was conducted to explore clinical decision-making by comparing the processes used by three groups of nurses in the emergency departments of three hospitals: in Norway, Finland and Ireland. Six Registered Nurses, six Nurse Specialists and six Nurse Practitioners were observed. A total of 40 hours of observation was made at each setting according to a structured observation guideline, followed by clarifying questions. The data material was analysed by means of a qualitative manifest and latent content analysis. RESULTS: Three themes arose: acting in accordance with routines, previous experience and intuition; considering patient experience; and facilitating new alternatives based on critical thinking. The Registered Nurses mainly used the first approach, the Nurse Specialists used the first and the second approaches, and the Nurse Practitioners used all three approaches. CONCLUSIONS: The results highlight the differences in decision-making processes between these groups. Nurse Practitioners were the only group that facilitated and evaluated new alternatives using their clinical autonomy, such as stepping up and making independent and collaborative decision-making. IMPLICATION: The results can be used in countries developing advanced practice nursing education and defining their scope of practice to inform stakeholders.

When the time is right: Men's experiences of recovery in self-harm.

Previous research has mainly focused on self-harm among women, defining what it is, what functions it has, how to manage and prevent self-harm, and how to recover from it. A recent review of the literature on self-harm among men concluded that research need to consider both clinical and personal aspects of recovery and pointed out the need to explore recovery from men's point of view. This study aimed to describe men's experiences of recovery in self-harm. Data were collected in Sweden in 2020 using semi-structured interviews. Eleven men who had recovered in self-harm were interviewed. Interviews were analysed using an abductive approach to qualitative content analysis. The analysis involved the application of an established framework for personal recovery in mental illness: connectedness, hope, identity, meaning, and empowerment (CHIME). The analysis identified one main theme: when the time is right, and five sub-themes: finding support in others; trusting that change is possible; getting to know yourself; reaching a new understanding; and developing new strategies to manage life. While the cessation of self-harm might both be a sign of and contribute to recovery, it is not the defining feature of recovery. Mental health professionals should be persistent in providing person-centred, recovery-oriented care for men who self-harm. The CHIME framework can be applied in the context of men's recovery in self-harm. This study is reported in accordance with the COREQ guidelines.

The Professional Nurse Self-Assessment Scale II - Translation and cultural adaptation for Nordic countries.

BACKGROUND: It is important to map the clinical competence of newly graduated nurses in Nordic countries. The use of a common Nordic instrument could provide insights into nurses' levels of self-assessed clinical competence and perceptions of their need for professional development. AIM: To translate and culturally adapt the original Norwegian version of the Professional Nurse Self-Assessment Scale II (PROFFNurse SAS II) into (1) Danish, (2) Finnish and (3) Icelandic versions. METHOD: The PROFFNurse SAS II was translated and cross-culturally adapted. This translation was inspired by the process used in the Guidelines for Cross-Cultural Adaptation. RESULT: The translation and cultural adaptation processes employed the required steps and provided specific details. In addition, practical issues encountered during the translation process while translating and adapting instruments that may influence future translations were revealed. This study found that having a professional bilingual/bicultural agency translator was partly problematic in the process of translation and found that it is important to adjust the translations to each country's specific words used in nursing. CONCLUSION: Translating the PROFFNurse SAS II instrument into all Nordic languages enables us to use the instrument from a Nordic perspective and across various countries. This is important when comparing self-awareness and reflecting on nurses' clinical competencies. Professional development is central to valuing and developing clinical competence and allowing for the discovery of gaps in clinical competence.

Health care services for older people in COVID-19 pandemic times - A Nordic comparison.

OBJECTIVE: To explore the Nordic municipal health and care services' ability to promote principal goals within care for older people during the COVID-19 pandemic. DESIGN AND SETTING: Two surveys were conducted among managers of municipal health care services for older people in Denmark, Finland, Norway and Sweden; the first around 6 months into the pandemic (survey 1), and the second around 12 months later (survey 2). Data were analysed through descriptive statistics, and multiple regression (OLS). SUBJECTS: 1470 (survey 1, 2020) and 745 (survey 2, 2021) managers. 32% in home care, 51% in nursing homes, 17% combined. RESULTS: In all countries the pandemic seems to have had more negative impact on eldercare services' ability to promote an active and social life, than on the ability to promote or enhance older people's mental and physical health. The regression analysis indicates that different factors influence the ability to promote these goals. Managers within nursing homes reported reduced ability to promote mental and physical health and an active social life to a significantly lower degree than managers of home care. The effect of three prevention strategies (lock down, testing, and/or organisational change), were explored. Organisational change (reorganize staff and practice, restrict use of substitutes) tended to impact the units' ability to promote a social life in a positive direction, while lock down (areas, buffets etc) tended to impact both the ability to promote mental/physical health and a social life in a negative direction. CONCLUSION: Measures that can improve opportunities for an active and social life during a pandemic should have high priority, particularily within home care.

It is important to learn from how the COVID-19 outbreak in 2020 affected the municipal health and care services' ability to achieve principal goals within care for older people.The pandemic had a more negative impact on the services' ability to promote an active and social life, than on their ability to promote or enhance mental and physical health.Measures that can improve opportunities for an active and social life during a pandemic situation should have high priority, particularily within home-based care.

Structural and Psychological Empowerment of Learners Enrolled in Continuing Nursing Leadership Education in Finland: A Quasi-Experimental Longitudinal Study.

BACKGROUND: This study was conducted to assess structural and psychological empowerment among learners enrolled in a continuing leadership education program. Although the number of nurse leadership development interventions has increased, there is little evidence on how they influence leaders' empowerment. METHOD: A longitudinal study was employed, with learners (N = 85) enrolled in a continuing leadership education program as the participants. Data were collected in the beginning, at the end, and 8 months after the completion of the program using internationally validated instruments. Data were analyzed statistically. RESULTS: A total of 25 learners (29%) responded to the questionnaire at all three data collection points. The education significantly increased psychological and structural empowerment across all dimensions except formal power. These increased levels of empowerment were partially sustained at the 8-month follow-up time point. CONCLUSION: Continuing education seems to benefit nurse leaders, and the continuing nursing leadership education program was positively associated with learners' perceived empowerment. [J Contin Educ Nurs. 2023;54(10):462-471.].

Aging engineers' occupational self-efficacy-a mixed methods study.

Introduction: Engineers' work has become more complex with increased demands in today's changing working life. Self-efficacy is essential to successfully adapt to work-related changes and to cope with adverse job demands. However, less is known about aging engineers' occupational self-efficacy. Therefore, this study explores facilitators and barriers to aging engineers' occupational self-efficacy beliefs to continue working until expected retirement age. An additional purpose is to explore if any of the aspects described by the engineers are more prominent. Methods: The study design was exploratory, using mixed methods with a qualitative to quantitative approach. A total of 125 engineers, aged between 45 and 65 years, answered two open-ended survey questions about what positively and negatively affect their occupational self-efficacy beliefs to continue working. First, data was analyzed using an inductive manifest qualitative content analysis. Next, descriptive statistics were performed based on the results of the qualitative study. Results: The analyses revealed that health and working conditions that affect health were crucial facilitators and barriers for the aging engineers' occupational self-efficacy to continue working until expected retirement age. Furthermore, the engineers emphasized competence, motivation from meaningful tasks, family and leisure, and private economy. Discussion: The aging engineers' own health seems to be prominent in their self-efficacy regarding a full working life; consequently, support still needs to address issues affecting health.

'A perfect storm' or missed care? Focus group interviews with dementia care professionals on Advance Care Planning.

BACKGROUND: Dementia is one of the leading causes of dependency and disability among older people and currently the seventh leading cause of death among all diseases. In recent years, healthcare research in Advance Care Planning in dementia care has received increased attention. Advance Care Planning is a discussion process conducted in anticipation of future deterioration of a person's health condition. The purpose of the study was to investigate the views of dementia nurses and geriatricians on Advance Care Planning in dementia care. METHODS: The study design is a qualitative study using semi-structured focus group interviews with dementia care professionals in a region in Western Finland. A total of seventeen dementia care professionals participated. A modified version of the Qualitative Analysis Guide of Leuven was used for the data analysis. RESULTS: The data analysis identified one main theme and three sub-themes describing the views of dementia nurses and geriatricians on Advance Care Planning in dementia care. The main theme was the 'perfect storm' with sub-themes relating to the person with dementia, the care process, and the care professional. The unfavorable circumstances creating a 'perfect storm' are related to the nature of the illness and the associated stigma, to the unclarity in the suggested care path with inadequate guidelines for Advance Care Planning, and to the demands placed on dementia nurses and geriatricians, as well as to insufficient resources. CONCLUSIONS: Dementia nurses and geriatricians acknowledge the importance of advance directives and express a generally positive view of Advance Care Planning in dementia care. They also hold views on a number of factors which affect the conditions for conducting Advance Care Planning. The lack of Advance Care Planning in dementia care can be seen as a form of missed care caused by multiple forces coming together simultaneously.

The challenges of change processes for nurse leaders-a qualitative study of long-term leaders' experiences over 25 years.

AIM: This study aimed to map what experiences nurse leaders have encountered concerning the change work that political decisions and reforms have created within the healthcare sector in the last 25 years. DESIGN: A qualitative design with a narrative approach was used. METHODS: A qualitative study involved individual interviews of eight nurse managers from Norway and Finland with more than 25 years of experience working in specialist and primary healthcare fields. RESULTS: Two main categories were observed: experiences of organizational challenges and experiences of personnel-administrative challenges. The first main category included two subcategories: A: historical experience with culture and challenges in health services and B: historical experience with mergers and using welfare technology in health services. The second category included the following subcategories: A: historical experience of job satisfaction for leaders and employees and B experiences with interprofessional collaboration in health services.

Revealing a gap in the clinical competence of nursing staff in nursing homes: a cross-sectional study with the Ms. Olsen test.

BACKGROUND: Nursing staff, caring for frail older people in long-term care, needs to have a certain level of clinical competence to identify diseases at an early stage and to assess and provide good nursing care. In Finland, nursing care is based on evidence-based and high-quality nursing care. However, earlier inspections by the National Supervisory Authority for Welfare and Health showed many discrepancies between the nursing staff's clinical competence and adequate and continuous education. AIM: This study aimed to explore nursing staff, i.e. the clinical competence and decision-making skills of registered and practical nurses in nursing homes for older people in Finland and to analyse the association between nurses' clinical competence and fundamental background factors. METHODS: We conducted a cross-sectional study of 337 participants in 50 nursing homes in the western part of Finland, between December 2020 and January 2021. The instrument used was the validated Ms. Olsen test, an extraction of NOP-CET. Statistical analyses were conducted with descriptive statistics and correlations and a cut-off for clinical competence. RESULTS: This study with the Ms. Olsen test revealed that only one-fourth of the RNs and a third of the PNs passed the clinical competence test. In the self-evaluation, almost all participants evaluated themselves with good clinical competence. The Finnish Current Care Guidelines were used on a daily basis by 7.4% and weekly by 30%. Significant correlation was found between Swedish as a working language and mother tongue and the score for clinical competence. CONCLUSION: The clinical competence test, the Ms. Olsen test, was used in Finland for the first time to evaluate the nursing staffs´ clinical competence in nursing homes. We found gaps in the clinical competence in Finnish nursing homes, both for PNs and RNs. The result differed remarkably from their self-assessments and the staff did not use the national nursing guidelines as required to develop their nursing skills and knowledge. Gaps in the clinical competence have been identified and can be used to develop targeted continuous education.

Leader-member exchanges with leaders who have worked for 25 years in health institutions.

AIM: The aim is to investigate long-term leader experiences with leader- member exchanges (LMX) over 25 years. Leader-member exchanges focus on relational power and communication exchanges between leaders and employees when they communicate with each other or perform an action. DESIGN: This qualitative study is characterized by a phenomenological hermeneutical design and is based on the informants' interpretation and construction of meaning. METHOD: A qualitative study with eight interviews with supreme nurse leaders from the Norwegian and Finnish health care services. RESULT: The data analysis and interpretation show that relationships are built through trust, dialogue and confirmation and are affected by other contextual aspects such as the organizational size or workload and human factors such as safety, angst, and self-esteem. The informants fight for their subordinates. Interprofessional management and obtaining good relations with the doctors was challenging. No Patient or Public Contribution.

Nurse leaders' changing roles over 25 years: a qualitative study.

PURPOSE: The purpose of this study is to emphasise nurses' experiences of nurse leaders' changing roles over 25 years. DESIGN/METHODOLOGY/APPROACH: A qualitative study was performed with individual interviews of eight nurse managers. From Norway and Finland, all nurse managers with more than 25 years of experience and working in specialist health care and primary health care were included in the study. FINDINGS: These nurse managers have a lot of knowledge and resolved conflicts using improved methods and have experienced continuous change. The role of nurse manager ranges from bedside to exclusive administrative work. The organisations have become more extensive, and the staff has grown. These changes have led to many challenges and more complex organisations. RESEARCH LIMITATIONS/IMPLICATIONS: Nurse managers who have worked for over a 25-year period had useful experience and could handle many new challenges. They can change themselves and their organisation tasks over time and follow the development of society. ORIGINALITY/VALUE: Based on their experiences as novices at the beginning of their career, the informants demonstrate their development to the level of expert manager.

Which factors are associated with COVID-19 infection incidence in care services for older people in Nordic countries? A cross-sectional survey.

AIMS: To investigate the differences between Sweden, Denmark, Finland and Norway regarding residential/home care units' and frontline managers' background factors, the resources allocated and measures taken during the initial phases of the COVID-19 pandemic, and whether and how these differences were associated with COVID-19 among older people in residential/home units. METHODS: Register- and survey-based data. Responses from managers in municipal and private residential/home units. Number of municipal COVID-19 cases from national registries. Multilevel logistic multivariate regression analysis with presence of COVID-19 among older people in residential/home units as the outcome variable. RESULTS: The proportions of residential/home units with client COVID-19 cases, mid-March-April 2020 were Denmark 22.7%, Finland 9.0%, Norway 9.7% and Sweden 38.8%, most cases found in clusters. The proportions were similar among employees. Client likelihood of having COVID-19 was six-fold higher if the employees had COVID-19. Mean client cases per residential/home unit were Denmark 0.78, Finland 0.46, Norway 0.22 and Sweden 1.23. For the same municipal infection incidence class, Sweden's mean client infection levels were three-fold those of other countries. The regression analysis variables country, municipal COVID-19 incidence proportion, and care type were associated with client cases at p ⩽ .001. Compared with Denmark, the odds ratios (ORs) for Sweden, Norway and Finland were 1.86, 0.41 and 0.35 respectively. The variable difficulties in preventive testing had an OR of 1.56, p ⩽ .05. CONCLUSIONS: Municipal COVID-19 incidence, employee cases, and the lack of testing resources somewhat explained the confirmed COVID-19 cases among older people in residential/home units. A two- to five-fold unexplained inter-country difference in ORs in the multivariate analyses was notable. The level of protection of vulnerable older clients in municipal and private residential/home units differed between the included countries.

Advance care planning in dementia care: Wants, beliefs, and insight.

BACKGROUND: Advance care planning gives patients and their family members the possibility to consider and make decisions regarding future care and medical procedures. AIM: To explore the view of people in the early stage of dementia on planning for future care. RESEARCH DESIGN: The study is a qualitative interview study with a semistructured interview guide. The data were analyzed according to the Qualitative Analysis Guide of Leuven. PARTICIPANTS AND RESEARCH CONTEXT: Dementia nurses assisted in the recruiting of people with dementia for participation in the study. Study information was mailed to 95 people with early stage dementia. Ten people with dementia and eight caregiver spouses participated in the study. ETHICAL CONSIDERATIONS: People with dementia belong to a vulnerable patient group, and care was taken in the areas of informed consent and accessible information. FINDINGS: The views of people with dementia are characterized by a complex storyline involving tensions and movement within the themes of wants, beliefs, and levels of insight. Participants wanted to think about the future but also wanted to live in the here and now. DISCUSSION: High demands are placed on the advance care planning process for people with dementia and their family caregivers. A dignity-enhancing approach in dementia care emphasizes the dignity of and respect for this vulnerable and care-dependent patient group. CONCLUSION: The process of advance care planning in dementia care needs to go beyond person-centered care to a relationship-centered process. The illness trajectory and the impact on autonomy need to be taken into consideration.

Work motivation and occupational self-efficacy belief to continue working among ageing home care nurses: a mixed methods study.

BACKGROUND: It is important to support ageing home care nurses (HCNs) to remain in work for longer, since the need for home care services is increasing. Personal resources such as self-efficacy belief contribute to work ability, as does work motivation. Few studies have targeted the ageing workers' self-efficacy belief to manage their final working years. This study explores ageing HCNs' work motivation, and occupational self-efficacy, i.e. belief in one's capabilities, to continue working until expected retirement age. METHODS: The design of the study is exploratory using a mixed method with a qualitative to quantitative approach. A total of 234 HCNs answered four open-ended questions from a cross-sectional survey, regarding their work motivation and self-efficacy beliefs. First, data was analysed using manifest qualitative content analysis. Next, a quantitative analysis was performed based on the results of the qualitative study, and the categories that emerged were quantitatively ranked. RESULTS: The open-ended questions yielded 2339 utterances. The findings showed that several categories concurrently affected both work motivation and self-efficacy belief. When they were well-functioning, they positively affected both work motivation and self-efficacy belief, and when they were insufficient, they negatively affected either or both motivation and/or belief. Meaningfulness, job satisfaction, social support, and work environmental and organizational characteristics affected work motivation most. Perceived health highly affected the self-efficacy belief to continue working until expected retirement age, as well as meaningfulness of work, support from colleagues and home care managers, and work characteristics. CONCLUSIONS: Through highlighting the meaningfulness of work, and supporting the perceived health, the work community and leadership, both work motivation and self-efficacy belief to continue working might be facilitated among ageing HCNs. However, the still present draining workload must be handled.

Humanoid robots in the care of older persons: A scoping review.

The aim was to examine how humanoid robots have been used in the care of older persons and identify possible benefits and challenges associated with such use from older persons' points of view. The study was a scoping review based on Arksey and O'Malley's methodological framework. To identify peer-reviewed and non-peer-reviewed literature, a systematic search of the PubMed, Cinahl and Google Scholar electronic databases was conducted for studies published between 2013 and 2019. The PRISMA-ScR guidelines have served as a guideline. A total of 12 studies were included and resulted in four main categories related to how humanoid robots have been used in care of older persons (domain of use): Supports everyday life, Provides interaction, Facilitates cognitive training and Facilitates physical training. Potential for humanoid robots to be accepted as companions for older persons was seen, but technical issues, such as humanoid robots' slow response time or errors, emerged as key challenges. Older persons' perceived enjoyment of using a humanoid robot might also decrease over time. Validated measurements to estimate the effectiveness of using humanoid robots in the care of older persons are needed.

What is giving vitality to continue at work? A qualitative study of older health professionals' vitality sources.

BACKGROUND AND AIM: Vitality is described as 'life energy', 'inner strength' and 'inner health resource' and is the essence of health. Especially during the ageing process, it is of fundamental importance that an individual's health resources are strengthened to support work ability. The need for health services increases as the population ages and meanwhile the workforce in health care is also ageing. The aim of the study was to explore what is giving vitality to older workers in health care to continue at work until retirement age and maybe even an extended working life. INFORMANTS, METHODOLOGY AND METHODS: A qualitative interview study was conducted. A total of 15 people aged 59-65 participated in the study, all of them working in the health care sector. Five participants were administrative personnel and ten were nurses. One man and fourteen women took part in the study. Qualitative content analyses were used. FINDINGS: The results show that meaningful work, possibilities to use one's knowledge, relationships and work community are promoting vitality. Vitality is affected by work conditions, benefits, personal values and own health. CONCLUSION: Plans about continuing at work seem to depend on both external and internal reasons. Knowledge of what influences older employees' vitality resources makes it possible to improve their work situation so that vitality and work ability can be maintained by occupational health and employers despite the ageing process.

Men who self-harm-A scoping review of a complex phenomenon.

BACKGROUND: To understand and care for men who self-harm, it is important that healthcare professionals have understanding of how and why men self-harm, men's experiences of self-harm and what can be done to hinder or prevent self-harm. AIMS: The aim of this study was to synthesize the existing knowledge on men who self-harm, with a special emphasis on background, self-harming methods, experiences and reported therapeutic interventions and/or care approaches. DESIGN: Scoping review of internationally published and grey literature, based on a methodological framework by Arksey and O'Malley. DATA SOURCES: Systematic electronic database searches were conducted in CINAHL, MEDLINE (Ovid) and PsycINFO. From a total of 684 studies found, 24 studies met the inclusion criteria: full-text, published in English, peer-reviewed studies and grey literature including a focus on men who self-harm, men aged between 18 and 65 years, and published between 2010 and 2019. RESULTS: Men's self-harm was understood as being related to mental disorders, a means of affect regulation, a loss of self-control, and a means of interpersonal communication. Self-harm can be a positive or negative experience, and there is a wide variety in the methods that men use to self-harm: sharp objects, injection, ingestion, without aids or riskful behaviour. Few studies reported on therapeutic interventions and/or care approaches for men who self-harm. CONCLUSION: Men's self-harm should be understood as a complex, socially and culturally conditioned phenomenon and studied from a multitude of perspectives. IMPACT: This scoping review concludes that self-harm among men should be understood as a complex, socially and culturally conditioned phenomenon. To empower men and support their recovery from self-harm, a person-centred approach should be incorporated into research on the subject and practice.

Occupational self-efficacy and work engagement associated with work ability among an ageing work force: A cross-sectional study.

BACKGROUND: Occupational self-efficacy (OSE) is an appropriate adaption capability to react to continuous changes in work life today. While self-efficacy is an important component in work context, there is less knowledge regarding older workers' OSE. OBJECTIVE: This study examined the relationship between work ability, OSE and work engagement among a middle-aged workforce, and whether there were any differences between age groups and between professionals in different work context. METHODS: Data were collected by questionnaire, which included Work Ability Index (WAI), Occupational Self-Efficacy Scale, and Utrecht Work Engagement Scale. RESULTS: A total of 359 home care workers and engineers (response rate 43%) participated. The average age was 54 (SD±5.3) years, 69%were women. The results of logistic regression analyses revealed an association between WAI, OSE (OR 0.66; 95%CI 0.52 to 0.86) and work engagement (OR 0.61; 95%CI 0.47 to 0.78). Higher OSE and work engagement were related to higher work ability. No difference in OSE (5.9; ±0.8) between professional groups was seen, but the home care workers scored considerably higher work engagement (5.1; ±0.9) than the engineers (4.5; ±1.3). CONCLUSIONS: Improving OSE could be worthwhile to support work ability among middle-aged workers, despite dissimilarities in work context and educational level.

Implementation of advanced practice nursing for minor orthopedic injuries in the emergency care context: A non-inferiority study.

AIMS: To evaluate the implementation of advanced practice nursing for patients with minor orthopedic injuries, including comparison of outcomes in relation to advanced practice nurse versus standard (physician-led) care models. DESIGN: A non-inferiority study was performed in an emergency department in Norway, where advanced practice nursing is in an initial stage of implementation. The non-inferiority design was chosen to test whether the new advanced practice nursing model does not compromise quality of care compared to the standard care model already in use. METHODS: Patients with minor orthopedic injuries were assessed and treated by either advanced practice nursing or standard (physician-led) care models. Participating patients were assigned to the professional available at presentation. In the nursing model, registered nurses worked at an advanced level/applied advanced practice nursing following in-house-training. Senior orthopedic specialists evaluated the diagnostic and treatment accuracy in both models. Data were collected in a tool developed for this study, from May to October 2019. RESULTS: In total, 335 cases were included, of which 167 (49.9%) were assessed and treated in the nursing model. Overall, correct diagnosis was found in 97.3% (n = 326) of the cases, and correct treatment was found in 91.3% (n = 306) of the cases. In comparison of missed diagnosis between advanced practice nurse and the standard (physician-led) care model showed inconclusive results (risk ratio: 0.29, 95% CI: 0.06-1.36). In comparison of treatment outcomes, the results showed that the advanced practice nursing model was non-inferior (risk ratio: 0.45, 95% CI: 0.21-0.97). CONCLUSION: Advanced practice nursing care models can be used to diagnose and treat minor orthopedic injuries without compromising quality of care. Further implementation of the advanced practice nurse care model is encouraged.

"They Know Me and My Situation-Patients' and Spouses' Perceptions of Person-Centered Care in Hospital-at-Home Care".

Realization of person-centered care (PCC) is contextual. How is it perceived at hospital-at-home? Pairwise telephone interviews of patients (n = 27) and their spouses (n = 18) emerged in 4 themes. Care was found to be person-centered when both the principles and activities that underpin the concept PCC were realized.