Communication about physical activity to reduce vascular erectile dysfunction - A qualitative interview study among men in cardiac rehabilitation.

BACKGROUND: Physical activity, a core intervention in cardiac rehabilitation, can reduce vascular erectile dysfunction (ED). ED is a common sensitive problem for men with cardiac diseases, decreasing their quality of life. Cardiac health professionals rarely provide information about ED or its relation to physical activity. Developing health professionals' communicative component of the complex intervention 'Physical Activity to reduce Vascular Erectile Dysfunction' (PAVED) is important. Understanding the receiver needs is essential in designing a complex intervention. AIM: To elucidate men's perspectives on cardiac health professionals' communication about PAVED. ETHICAL ISSUES: An Institutional Data Protection Agency approved the study. METHODS: An interpretive data-driven thematic analysis was applied to individual, qualitative semi-structured interviews with 20 Danish men attending cardiac rehabilitation. RESULTS: The men wanted health professionals' communicating about ED, as it was perceived as a major problem diminishing masculinity and tabooed by health professionals. Men wanted help for self-help, which may be possible with the aid of competent health professionals' communication about how to prevent, reduce and cope with ED - including information about PAVED. The men wanted health professionals' communication about ED in various contexts: general information in groups, sexual counselling for individuals and couples and written material. STUDY LIMITATIONS: Recruitment was done from a Danish municipality's cardiac rehabilitation, and the transferability of the results may be limited to similar contexts. CONCLUSION: Erectile dysfunction was experienced as a major biopsychosocial problem for the men and their partners. The men had a need for health professionals' communication about sexuality, ED and information about PAVED as well as about prevention, reduction and management of ED. The men had a need for professional communication about sexual health.

To stay in touch - intensive care patients' interactions with nurses during mobilisation.

BACKGROUND: Minimal sedation has made it possible to communicate and cooperate with intensive care patients and mobilisation can start earlier during their stay in the intensive care unit. PURPOSE: To investigate the intensive care patient's reaction and interaction to mobilisation. METHOD: This study used focused ethnography combining observations, interviews and four scores for evaluating awareness, and pain levels were included: Richmond Agitation Sedation Scale Confusion Assessment Method For The Intensive Care Unit, Numeric Rating Scale and Critical Pain Observation Tool. Twelve patients were observed during mobilisation, with subsequent interviews of the involved nurses. FINDINGS: Nurses run the risk of overlooking the patient's reactions, such as pain, discomfort or needs during mobilisation. Nurses use several different ways of communicating to create contact with the patients. Patients with an impaired awareness level become more aware during mobilisation. CONCLUSIONS: If the nurse's attention is focused on the technical side of caregiving, there is a risk that she might overlook the patient's reactions and needs. If the nurse is aware of the risk of overlooking the patient's reactions, she may plan the mobilisation to ensure that the patient gets the necessary attention and is included in the process. In that way, the patient might avoid unnecessary discomfort and maintain trust and confidence in the nurse.

Visiting nurses' posthospital medication management in home health care: an ethnographic study.

BACKGROUND: Medication management is the most challenging component of a successful transition from hospital to home, a challenge of growing complexity as the number of older persons living with chronic conditions grows, along with increasingly specialised and accelerated hospital treatment plans. Thus, many patients are discharged with complex medication regimen instructions, accentuating the risk of medication errors that may cause readmission, adverse drug events and a need for further health care. AIM: The aim of this study was to explore visiting nurses' medication management in home health care after hospital discharge and to identify key elements in patient medication for improved patient safety. METHOD: Inspired by the ethnographic research cycle, participant observations and informal interviews were conducted at 12 initial visits by a nurse in a patient's home after hospital discharge. Data consisted of field notes and photographs from the patients' homes, medication lists and medical records. Field notes were analysed in four steps. FINDINGS: The analysis showed 12 stages in medication management in which nurses strove to adjust medication management to the patients' actual health status by mediating on knowledge of the patient, information to the patient and on rules and regulations and by establishing order in medication lists and medications in the home. CONCLUSION: The nurse-patient relationship, the integration of care and the context of care challenged patient safety in visiting nurses' medication management in patients' homes after hospital discharge. The implications for practice were the following: to ensure nurses' opportunities to continuously evolve their observation skills and skills in making sound clinical judgements; to establish interprofessional working processes which support the continuous assessment of patients' needs and the adjustment of care and treatment; to clarify expectations to nurses' responsibility and patients' privacy.

Sexuality in men after prostate cancer surgery: a qualitative interview study.

INTRODUCTION: Prostate cancer affects a growing number of men. Although erectile dysfunction is a well-known side effect, its impact on sex life and sexuality is under-researched. PURPOSE: The aim of this study was therefore to elucidate the effect of surgical treatment for prostate cancer on men's sexuality. METHODS: Data for the descriptive qualitative study were collected in interviews. The author applied a phenomenological-hermeneutic frame of understanding. RESULTS: Four themes appeared in the analysis of the interviews: lack of control, sense of self, intimate relations and redefining sexuality. CONCLUSION: Men experience erectile dysfunction as a negative influence on their sexuality with respect to their sex life, sense of self and intimate relations. The dysfunction is thus shown not only to affect sexual life but also to have repercussions for a range of aspects in male intimate life. A broader perspective should be applied in supporting the men's efforts towards improving their quality of life, for example through sexual counselling services performed by nurses.

How children handle life when their mother or father is seriously ill and dying.

AIMS AND OBJECTIVES: The aim of this study was to describe and understand how children handle their life when a mother or father is dying. METHODOLOGICAL DESIGN AND JUSTIFICATION: The research design was phenomenological hermeneutic. The phenomenological approach enabled us to capture the concrete everyday life of the children as it is understood and experienced by the children themselves. The hermeneutical approach offered the possibility of reaching an understanding of the children's experiences. RESEARCH METHODS: Seven children aged 11-17 years participated in the study. Data were collected using qualitative interviews and video diaries. ETHICAL CONSIDERATIONS: The researcher complied with ethical guidelines that apply to all researchers and followed ethical guidelines for nursing research in the Nordic Countries (Northern Nurses Federation). The children's names were changed, and the data were treated confidentially. FINDINGS: Analysis produced an overarching theme of death's waiting room, with following sub-themes: Relating to death, when death becomes even more clearly manifest and handling life in death's waiting room. STUDY LIMITATIONS: This study focuses on a limited explored area; children's lived life with a dying parent. The study limits itself to focusing on children's life world; by choosing this focus, we have not included the relational aspects that are essential aspects of children's lives. One might focus on these aspects in a second study to shed further light on the children's lives. CONCLUSION: When children live in a family with a dying mother or father, they find that their home is transformed from a safe base into death's waiting room. The children use a variety of ways to handle the confrontation with death. Avoiding talking to the children will not protect them from their thoughts about death.

Camera-assisted nursing observation of restless patients in an acute care setting, a multi-method feasibility study.

AIM: To evaluate the implementation, practicality and acceptability of camera-assisted observation of restless patients in the acute care ward. DESIGN: A multi-method feasibility study. METHODS: Data consisted of nurses' written records, a brief survey among all nurses and individual interviews with eight nurses. Data analysis encompassed numerical analyses as well as descriptive content analysis. FINDINGS: Camera-assisted observation was implemented by 44 patients from 60-95 years old, for 6 months. The practicality was enhanced by equipment that was easy to operate but the nurses were hampered by carrying the institutional mobile phone while caring for other patients. The intervention's acceptability depended on its potential for improved patient safety and the ability to adjust nursing care to meet the patients' needs as this could enhance feelings of confidence and control.

The Incidence of Sexual Dysfunction in Patients With Irritable Bowel Syndrome.

INTRODUCTION: Several studies have suggested that patients with irritable bowel syndrome (IBS) frequently have symptoms of sexual dysfunction. AIM: The current study aims to map the current knowledge about the burden of sexual dysfunction in patients with IBS. METHODS: A literature review was conducted on PubMed and EMBASE using the following search terms or combinations thereof: irritable bowel syndrome; functional colonic disease; sexual function; sexual health; sexual behavior; sexual dysfunction; dyspareunia; erectile dysfunction; quality of life; and questionnaire. MAIN OUTCOME MEASURE: Sexual dysfunction. RESULTS: 1,273 texts were found, 331 duplicates were removed, and 844 texts were excluded because they did not meet the inclusion criteria, leaving 98 full text articles. These were examined and it was found that 41 fulfilled the criteria. 4 questionnaires were found; Irritable Bowel Syndrome Quality of Life (IBS-QOL) questionnaire, the Irritable Bowel Syndrome - Quality of Life (IBSQOL) questionnaire, the Irritable Bowel Syndrome-36 question (IBS-36) questionnaire, and the Arizona Sexual Experience Scale. Subscores for sexual relations in IBS-QOL ranged from 37.7-100 (11.9) for patients with IBS and 82.2-100 (6.6) for controls. The IBSQOL and IBS-36 subscores for sexual relations ranged from 49.7-90.5 (9) to 3.9-5.4 (0.8) with no healthy controls for comparison. After interventions were implemented, there was an improvement in subscores (the IBS-QOL mean changed to 10.5%, IBSQOL mean changed to 3.8%, and the IBS-36 mean changed to 40%). The study using Arizona Sexual Experience Scale showed that 51% of patients with IBS had sexual dysfunction and also scored lower on the IBSQOL questionnaire. CONCLUSION: The information about sexual dysfunction in patients with IBS is sparse and emerges primarily from quality of life questionnaires. It seems as though patients with IBS have more sexual problems compared to controls, but further investigation regarding the extent and type of sexual dysfunction is needed. Sørensen J, Schantz Laursen B, Drewes AM, et al. The Incidence of Sexual Dysfunction in Patients With Irritable Bowel Syndrome. Sex Med 2019;7:371-383.