Navigating healthcare systems: A qualitative study on socially marginalised patients' experiences of hospital transition and support by social nurses.

BACKGROUND: Socially marginalised patients face many challenges related to their health condition and often have several contacts with healthcare and social service workers. The Danish social nursing initiative, whose nurses have experience and knowledge about marginalisation, aims to support socially marginalised patients during hospital admission and through hospital transitions. However, there is limited knowledge about the hospital transitions of patients being supported by a social nurse. OBJECTIVES: The objectives of this study were to explore (1) the perspectives of socially marginalised patients on the transition from hospital to home and (2) how these patients experience the importance of social nursing on patient trajectories after hospital discharge. METHODS: A qualitative study with a phenomenological and hermeneutic approach was performed at a large hospital in southern Denmark. Adult patients who had contact with a social nurse during hospital admission were purposely sampled. Data were collected between January 2023 and March 2023. Initial patient interviews were conducted during hospital admission with a second interview 7-22 days after discharge. Systematic text condensation was used for the analysis, and Nvivo 12 supported data storage and coding. ETHICAL APPROVAL: The study is registered with the Danish Data Protection Agency (22/47509). Informed consent was given by the participants. RESULTS: Sixteen patients participated in the study. The participants experienced major challenges in their transitions from the hospital, which were generally related to their interactions with many different social and healthcare services. While the social nurses supported the patients and helped facilitate care during hospital admission and after discharge, the participants identified transitional care gaps related to multidisciplinary cooperation and standardised care options. CONCLUSIONS: This study identifies challenges related to the hospital transition of socially marginalised patients, which indicates a gap in healthcare services. Future research should focus on improving interprofessional collaboration with socially marginalised patients across healthcare services.

Receiving person-centred care in a hospital-A qualitative study of socially marginalised patients' experiences of social nursing.

BACKGROUND: Socially marginalised people are at a substantially increased risk of diseases and typically have several contacts with the healthcare system. Health professionals at hospitals often lack the knowledge, skills, confidence, and time to provide relevant care for socially marginalised patients. Danish hospitals have implemented a social nursing initiative consisting of social nurses with specialised knowledge about marginalisation to support socially marginalised patients. Limited research into patients' perceptions of social nursing has been undertaken. OBJECTIVE: To explore patients' experiences with the in-hospital social nursing initiative. DESIGN: A qualitative study was conducted using a phenomenological hermeneutical approach. SETTING: Odense University Hospital, Denmark. PARTICIPANTS: Patients aged 18 years and older who had been in contact with a social nurse during hospital admission were purposely sampled. Data saturation was reached when 15 participants were recruited. METHODS: In-depth patient interviews were conducted from November 2021 to April 2022 using a semi-structured interview guide. The interviews were transcribed verbatim and analysed using systematic text condensation. NVivo 12 software was employed for the analysis. Patient representatives were involved to validate the analysis and interpretations. RESULTS: Three themes were identified: (1) an equal and trusting relationship, (2) receiving person-centred care, and (3) coherence in the patient trajectory. The results show that when patients have established a relationship with a social nurse, they are willing to let her into their lives and share personal information. Patients also experience person-centred care and coherence in their trajectory when a social nurse participated in their treatment and care. CONCLUSION: The findings indicate that the social nursing initiative bridges the gap between socially marginalised patients and healthcare services.

Interpreters' experiences of participating in an introduction course in the healthcare sector. An ethnographic field observation study.

AIM: We aimed to explore how interpreters experienced being part of a special designed health introduction course and to obtain their perspectives on the learning process. The overall aim was to improve health care to patients with language barriers. DESIGN: With a hermeneutic phenomenological approach, we used participant observations as a method for collecting data. METHOD: The teaching methods used were case-based learning, role-play and active involvement including dialogs, discussions and critical reflections. The interpreters were divided into teams of 10-15 interpreters. Over the duration of 6 weeks, teaching sessions were conducted, with 3 hr/week planned. RESULTS: The findings emphasize the importance of providing the interpreters with education, supervision and a work environment where they can confidentially share and get competent feedback on their experiences and linguistic skills, in order to ensure patients get the correct information in their native language.

Cultural Competences Gained Through an Education Program as Ethnic Patient Coordinator: A Qualitative Study.

INTRODUCTION: Studies have shown that health care professionals lack cultural knowledge and cultural competences in the care of patients with a minority background. The aim of this study was to explore whether a cultural teaching program, the so-called ethnic patient coordinator program, had an impact on health professionals' self-perceived clinical competences in the encounter with the minority patient. METHODOLOGY: The study was designed as a qualitative study using participant observation and semistructured interviews with a practice-led research approach. In total, 30 health professionals participated in the program. RESULTS/DISCUSSION: The coordinators described that they had learned to focus systematically on reducing language barriers and to overcome prejudices. Their new competences not only had a direct influence on patient-related practical skills but also affected the practice culture and their colleagues' approach to vulnerable patients with a minority background. Conclusion/Implication: The presence of an ethnic patient coordinator team may give rise to a more migrant-friendly and culturally competent hospital.