Nursing students' movement toward becoming a professional caring nurse.

BACKGROUND: Previous research mainly focuses on how to support nursing students in caring for the patient and on educators' views of students' development as professional caring nurses. Against this background, it is important to further investigate nursing students' perspectives on what it means to become a professional caring nurse. RESEARCH AIM: This qualitative systematic review study aims to identify and synthesize nursing students' perceptions on the meaning of becoming a caring nurse. RESEARCH DESIGN AND DATA SOURCES: Systematic data searches were conducted by using the electronic databases MEDLINE (Ovid), CINAHL (EBSCO), Academic Search Premiere (EBSCO), and Philosopher`s Index. In total, 13 studies met the inclusion and quality criteria. The articles were analyzed by a systematic review and a thematic synthesis according to Thomas and Harden. ETHICAL CONSIDERATION: The study followed good ethical practice guidelines outlined in the Northern Nurses' Federation. FINDINGS: The analysis resulted in eight descriptive themes and finally in three analytical themes: Becoming is to get in touch with one's inner ethic or ethos, Becoming is a movement between courage, understanding, and being touched, and Becoming is strengthened through caring role models and a learning culture. CONCLUSIONS: Becoming a professional caring nurse is seen as an ongoing movement toward a deeper understanding of oneself and one's being and bearing. This movement is enabled when nursing students have a sense of self-awareness, courage to stand in their vulnerability, and reflect on their responsibility, caring attitude, and inner values and ethics. The force of becoming is that the attention is directed beyond self to care for and feel empathy for others in a caring manner. Becoming is released through a caring relationship, external confirmation, and good role models. A lack of external support in the movement can potentially prevent the students from becoming a professional caring nurse.

Health as a movement between suffering of life and meaning in life for men who have experienced transitions in life.

BACKGROUND AND AIM: Previous studies show that life transitions can have negative effects on men's lives and lead to health problems and meaninglessness in life. This study aims to deepen the understanding of men's health by exploring the movement between suffering of life and meaning in life when experienced life transitions. THEORETICAL FRAMEWORK: The study is anchored in Eriksson's caritative caring theory. Core concepts are health and the movement between suffering of life and meaning in life. METHODOLOGY AND METHODS: The methodology is hermeneutical, and the study has a qualitative research design. Fifteen men from Norway participated in in-depth interviews in 2021. The interviews were analysed using reflexive thematic analysis. RESULTS: Four themes emerged in relation to the suffering of life; enduring separation from community, shame at being useless as a human being, grief over what has been lost in life, and being powerless and vulnerable in the face of a hopeless struggle. Three themes emerged in relation to meaning in life; realising what is most important in one's life gives strength, decision to live one's life brings joy in life and a positive attitude towards life gives freedom and awakens a new spark for life. CONCLUSION: Suffering of life emerges as a separation from relationships and society and as a perceived uselessness as a human being losing faith, control and feeling like a burden erodes dignity and trigger feelings of shame, guilt and degradation. Suffering of life manifests as loss of drive and spark for life. Life has meaning through finding the good in oneself, coming to know and believe in oneself and seeing new possibilities which bring about a spark for life, gratitude, dignity and freedom. Health exists in the movement between suffering of life and meaning in life, in pausing, recognising vulnerability, prioritising and reorienting oneself.

The meaning of reflection for understanding caring and becoming a caring nurse.

BACKGROUND: Reflection is essential for students to learn and understand caring, their formation as human and caring beings, and their ability to meet patients in a caring way. Consequently, to facilitate nurse students' development into professionals, learning support is needed where the focus is on understanding caring and becoming caring nurses. AIM AND RESEARCH QUESTIONS: The exploratory study aim is to gain knowledge of the meaning of reflection in first-term nursing education, and how reflection grounded in caring theory can deepen the students' understanding of caring and their professional formation of becoming a caring nurse. METHOD: Data consisted of individual written reflections and were collected from 64 nursing students from Norway, who had completed their instruction in caring theories and participated in four reflection groups where they reflected on caring and becoming a caring nurse. A thematic analysis was used. FINDINGS: The results are based on the three main themes, Reflection provides an understanding of caring by developing a language for caring; Reflection provides an understanding of seeing the person behind the illness; and Reflection contributes to increased self-understanding and awareness of oneself as a caring nurse. CONCLUSIONS: Instruction in caring theories and participation in reflection groups, with reflection grounded in caring theory, has a key function in facilitating students' development of a language for caring in nursing and appropriation of caring theory. The appropriation of caring theory provides a foundation for the nurse students to see themselves within a broader perspective and is important for mutual support in the professional formation of becoming a caring nurse. The expected outcome of such integration is a nursing curriculum that progressively supports the development of nursing students professionally and personally in the formation of becoming a caring nurses.

Multi-professional ethical competence in healthcare - an ethical practice model.

INTRODUCTION: The starting point is that ethical competence is the basis for ethical healthcare practices and quality of care. Simultaneously, there is a need for research and development from a holistic multi-professional perspective. AIM: The aim is to create a proposed model for multi-professional ethical competence grounded in clarified meanings and dimensions of ethical competence studied from a multi-professional healthcare perspective. The research questions are, what is ethical competence from a multi-professional healthcare perspective and what strengthens a multi-professional ethical healthcare practice? RESEARCH DESIGN: The research has a qualitative approach and hermeneutic application research design. Two groups with six participants from clinical practice and two scientific researchers in each group met four times for dialogue. Thematic analysis was used as an analysis method. ETHICAL CONSIDERATIONS: The research is approved by the Declaration of Helsinki, the General Data Protection Regulations, and ethical permission was asked from the Norwegian Centre for Research Data (NSD). RESULTS: The proposed model for multi-professional ethical competence encompasses a three-dimensional ethical value base that is underpinned by: Ethical attitude - a personal desire to do good; Ethical basis - the best for the patient as a common goal and Ethical culture - common goals and values in the organization. Multi-professional ethical competence is strengthened by: Reflection - to see with new wondering eyes; Time for talk - interdisciplinary teamwork and Leadership - an ethical role model and support. DISCUSSION: Ethical competence has a strong link to the core of caring ethics and a deeper personal value base and attitude. Ethical competence involves the whole culture and is seen as a shared value base and a responsibility to do the best for the patient as a multi-professional team and organization. Ethical competence becomes active in healthcare practice by opening up for meaningful multi-professional talks and reflections.

Social, health care and rehabilitation educators' competence in professional education-Empirical testing of a model.

The social and health care educator's role in educating future professionals need to be stronger emphasised and deserves international recognition. The purpose of this study was to develop and test an empirical model of social and health care educators' competence in higher and professional education. The presented research employed a cross-sectional study design. Data were collected using HeSoEduCo-instrument from 28 educational institutions in Finland. The model was empirically tested with confirmatory factor analysis through Structural Equation Modelling that applied the Full Imputation Maximum Likelihood estimator. A total of 422 social and health care educators participated in the study. The empirical model of social and health care educators including eight competence areas: leadership and management, collaboration and societal, evidence-based practice, subject and curriculum, mentoring students in professional competence development, student-centred pedagogy, digital collaborative learning, and cultural and linguistic diversity. All of the connections between concepts of the empirical model were found to be statistically significant. There were strong connections between most of the identified competence concepts; however, two weak connections were found, namely, the link between competence in evidence-based practice and competence in subject and curriculum, along with the link between competence in digital collaborative learning and competence in student-centred pedagogy. The presented empirical model can help stakeholders identify which areas of social and health care educators' curricula should be further developed. The model is also relevant for improving continuous education, allowing educators to assess their competence levels and evaluating educators' performance at the organisational level.

"Living Between Two Different Worlds": Experiences of Leaving a High-Cost Religious Group.

The aim of this interdisciplinary study is to gain a comprehensive understanding of individuals' subjective experiences after leaving a high-cost religious group and how these experiences have affected their lives. In-depth interviews were done with 18 participants who had left different religious communities in Finland. The interviews were analysed through a thematic analysis. The results show that religious disaffiliation is a life change that may affect an individual's life in profound ways. Life after being a member of a high-cost group may involve experiences of fear, guilt, sorrow, pain, loss and even suffering on an existential level. These experiences can have serious implications for one's well-being and health. However, life after religious disaffiliation also includes many positive aspects, such as experiences of joy, freedom, relief, gratitude and empowerment.

Appropriation and application of caring science theory: Experiences of master education alumni in three Nordic countries.

BACKGROUND: A theoretical foundation in caring science is invaluable for nursing care because it enriches practice by providing explanations, clarity and direction. However, after graduation, students experience the frustration of not being able to sufficiently intertwine caring science theories in practice. Consequently, the integration of caring science theories in nursing education and practice is considered an essential focus area to reduce this theory-practice gap. AIM: This study aims to elucidate master alumni's experiences of appropriation and application of caring science after completing a master's education. METHODS: The data were collected by semi-structured interviews with 21 alumni from Finland, Sweden and Norway who had recently completed a master's degree with caring science as the major subject. A thematic analysis was used. FINDINGS: The analysis resulted in two main themes, both with three subthemes. Educator's bearing and a learning community are important for students' appropriation of caring science theories. Learning through reflection and the response of others evoke new paths of thought, and practice-related teaching promotes the intertwining and application of caring science theory in practice. The appropriated theory has significance to alumni by providing a guiding basis that strengthens alumni's professional bearing and way of being. The caring science theory guides alumni in providing nursing care with an increased ethical awareness and questioning approach that enables good patient care. Their professional identity and confidence in caring are also strengthened. CONCLUSION: Educators' bearing is of outermost importance for appropriation and application of caring science theory. It has a key function in facilitating students' understanding and intertwining of caring science theory and practice. Appropriated caring science theory provides authority and courage to practice nursing care. The appropriated theory promotes alumni's ethical awareness, confidence and a sense of pride in the profession.

Social, health and rehabilitation sector educators' competence in evidence-based practice: A cross-sectional study.

AIM: The purpose of the study was to identify and describe the characteristic profiles of evidence-based practice competence of educators in the social, health and rehabilitation sectors and to establish relevant background factors. DESIGN: This study was carried out as a descriptive cross-sectional study. METHODS: Data were collected from social, health and rehabilitation sector educators working in the 21 Finnish universities of applied sciences and seven vocational colleges (n = 422; N = 2,330). A self-assessment instrument measuring evidence-based practice competence was used. Competence profiles were formed using a K-cluster grouping analysis. RESULTS: Three distinct competence profiles were identified and delineated. Most educators feel that they can guide students' critical thinking and are able to seek and produce scientific knowledge. Evidence-based practice competence was explained by background factors such as year of graduation (for higher degree), level of education, job title, current employer and current field of work.

Continuing professional development among social- and health-care educators.

Future social- and health-care educators will be required to have versatile competence in educating professionals that reflects both the constantly changing health-care environment and delivery of high-quality patient care. Continuing professional development can be defined as a process that aims to increase educators' competence and well-being, along with the effectiveness of an organisation. This study aimed to describe educators' continuing professional development and clarify the contribution of continuing education. The research applied a qualitative approach as only limited information about social- and health-care educators' professional development currently exists.' Data were collected by group interviews of 35 experienced social- and health-care educators from six institutions of higher education and two vocational schools across Finland. An inductive content analysis yielded 39 subcategories, 11 categories and three main categories, namely, educators' approaches for developing professional competence, barriers to continuing education, and educators' continuing education needs. The educators reported that they maintain and develop their competence in versatile ways; for example, continuing professional development takes place through both formal continuing education and informal collaboration at daily work. Regarding barriers to continuing education, the educators most often cited the lack of planning and a lack of resources, for example, scheduling and financial factors. The continuing education needs of social- and health-care educators are highly individual and should not only reflect organisational goals. The fact that this study only included experienced educators can be considered a limitation, as a sample that also included novice educators may have yielded different perceptions of continuing education and professional development. The results of the research can be utilised when designing the continuing professional development of educators at the individual, group or organisational level.

A caring science study of creative writing and human becoming.

The previous research describes creative writing to have a potential for self-care and healing in relation to illness and mental health conditions. The aim of this article was to deepen the understanding of creative writing and human becoming, from a caring science perspective. A data material consisting of answers from an e-form and diaries was analysed with a thematic analysis. The result depicts two main themes and seven subthemes. The first main theme, Creative writing - an act of emotional reactions and release, shows that creative writing is an act where fears and emotional reactions are unveiled; it is a relieving valve for the writer and includes moments of liberating wordplay. The second main theme, Creative writing - a key to self-understanding and personal growth, shows that creative writing is a genuine conveying of oneself to others, to experience mercifulness within oneself, to keep up faith in oneself and hope for the future and to find a new order of values. Creative writing enhances human becoming and gives possibilities for human beings to find inner peace and balance in life.

Life has given me suffering and desire - A study of older men's lives after the loss of their life partners.

BACKGROUND AND AIM: All human beings have the need to feel connected with others. However, researchers have found that for those aged 80+, loneliness markedly increases and that such loneliness is often linked to life changes or the loss of a close relative. The loss of a life partner is considered to have a greater impact on men's identify, social engagement and management of life. The aim of this study was to deepen understanding of older (80+) men's life after the loss of their life partners. THEORETICAL FRAMEWORK: Caring science and Eriksson's theory of caritative caring form the theoretical base for the study and its interpretative framework. The central concepts are suffering of life and desire of life. INFORMANTS, METHODOLOGY AND METHODS: A total of five men aged 81-91 gave thereby consent for participation in the study. Emanating from hermeneutical methodology, qualitative deep interviews with a narrative approach were used to collect data. Thereafter, a six-step qualitative thematic analysis in accordance with Braun and Clarke was used to analyse the text. INTERPRETATION AND CONCLUSION: Four themes emerged: reconciliation with one's lived life, living in the present with uncertainty about the future, a reorientation in life including new living conditions and living with the hope of finding a new life partner and feeling loved. We found that loss can lead to suffering in life. The life can be filled with loneliness, emptiness, life weariness and an absence of desire, hope and longing. Yet there is a vitality in suffering that enables to find new meaning contexts and desire for life. Here, the fundamental choice underpinning the movement between life suffering and desire for life is comprised of reconciliation with one's lived life, living in the present, daily habits and routines, being seen, participation, love and thoughtfulness.

The core of Katie Eriksson's caritative caring theory - a qualitative study from a postdoctoral perspective.

BACKGROUND: For about 40 years, Katie Eriksson developed the caritative caring theory at Åbo Akademi University in Finland. However, a description regarding the most substantial concepts and the relationships between these is lacking and thus needs to be explored. AIMS: The aim of the study was twofold: to explore and describe central concepts in the development of caritative caring theory from a postdoctoral perspective and to uncover and explore the relationships between the concepts. METHODOLOGY: The design of the study was qualitative with a mixed method approach. The material was collected from a postdoctoral group (n = 38) mainly through electronic questionnaires. The texts were interpreted through manifest and latent content analysis. FINDINGS: The analyses generated five main categories including subcategories. The main categories were 'Caring' 'Ethos', 'Suffering' 'Health' and 'The human being'. The relation between the main concepts compiled as 'A tentative synthesis of the main concepts and the relationships between them'. CONCLUSION: This study contributes to an understanding of the most fundamental and valuable concepts in the development of caritative theory during its first 40 years according to postdoctoral researchers' perspectives. This study also displays that the concepts ethos and caring have the strongest relationship followed by that between caring and health, indicating the inner core of ethos and love within caring which bears the potential of enhancing the patient's well-being and health.

Social and health care educators' perceptions of competence in digital pedagogy: A qualitative descriptive study.

BACKGROUND: Digitalisation has made digital competence a necessity for those working in social and healthcare. A high degree of competence in digital pedagogy is required of educators to meet the challenge of educating future professionals who are themselves highly digitally competent. OBJECTIVES: The aim of this study was to describe the perceptions of competence in digital pedagogy that educators in social and healthcare have. DESIGN: A qualitative descriptive study. PARTICIPANTS: The participants were Finnish-speaking social and healthcare educators (n = 37) working at six Finnish universities of applied sciences (UAS). METHODS: Group interviews (n = 12) were conducted during spring 2018. Each group consisted of 2-5 educators, with a total of 37 educators. The data was analysed using an inductive content analysis. RESULTS: According to the interviewed educators, competence in digital pedagogy involved pedagogical, digital, and ethical skills and awareness. The educators were aware of the possibilities afforded by digital technology and had a positive view on how the technology could be utilised in education. However, the educators were concerned that technology might solely be utilised for the sake of digitalisation instead of being pedagogically preferable. CONCLUSIONS: In the future, the results of this study can be utilised while developing an instrument to evaluate the level of competence in digital pedagogy. Examining the perceptions of the educators will allows us to better understand the phenomena from the educators' point of view.

Digital Learning Interventions in Higher Education: A Scoping Review.

This scoping review was undertaken to synthesize and describe research related to digital learning interventions in higher education, focusing on technological outcomes. Five electronic databases were searched, and 86 articles were included in the review. The data related to positive and negative technological outcomes and authors' suggestions were analyzed using inductive content analysis. The articles represented six disciplines across six continents and included quantitative (n = 65), qualitative (n = 3), and mixed-methods (n = 18) intervention studies. For positive technological outcomes, digital formats of learning were considered effective and participatory forms of learning in a majority of the articles. The students appreciated individualized and self-paced learning, and the digital form increased their motivation to learn. Automatized technical solutions that enabled learning and teaching had several advantages, and digital learning was believed to save the resources of students, teachers, and organizations. For negative technological outcomes, the technical difficulties in using the digital devices or platforms were described the most, and a need for resources was identified. Feedback from teachers was considered important from positive and negative viewpoints. Authors' suggestions for future digital teaching and learning as well as related interventions consisted of various activities, resources, environments, and methods.

Health and social care educators' ethical competence.

BACKGROUND AND PURPOSE: Educators' ethical competence is of crucial importance for developing students' ethical thinking. Previous studies describe educators' ethical codes and principles. This article aims to widen the understanding of health- and social care educators' ethical competence in relation to core values and ethos. THEORETICAL BACKGROUND AND KEY CONCEPTS: The study is based on the didactics of caring science and theoretically links the concepts ethos and competence. METHODS: Data material was collected from nine educational units for healthcare and social service in Finland. In total 16 semi-structured focus group interviews with 48 participants were conducted. The interviews were analysed with a thematic analysis according to Braun and Clarke. ETHICAL CONSIDERATIONS: The study is approved by the Declaration of Helsinki, the legislation regarding personal data and the General Data Protection Regulation. The study received ethical permission from the University of Jyväskylä. Informed consent was obtained from all the educational units and participants in the study. FINDINGS: The findings are presented based on three general patterns, an ethical basic motive, an ethical bearing and ethical actions. Subthemes are Humane view of students as unique individuals with individual learning, Bearing of tactfulness and firmness, Bearing of perceptiveness and accessibility, Bearing of satisfaction and joy over student learning, Valuing bearing towards each oneself and colleagues, Ability to interact and flexibility, Collegiality and a supportive work community and Educators as role models and inspirators. CONCLUSION: Educators' personal and professional ethos is crucial to student learning, personal growth and ethical reasoning. Therefore, it is important to further develop educators' training regarding ethical competence.

Development and testing of an instrument (HeSoEduCo) for health and social care educators' competence in professional education.

BACKGROUND: Health and social care education is highly important for preparing future professionals for their future roles in sustainable health and social care. However, previous studies have emphasized that health and social care educators' competence is complex and poorly defined. Thus, there is a clear need for a psychometrically validated instrument to enable clarification and assessment of the required skills. OBJECTIVE: To develop and psychometrically validate an instrument (the HeSoEduCo) for assessing health and social care educators' competence in higher and professional education. DESIGN: Cross-sectional study. METHODS: A HeSoEduCo instrument, with items inviting 1-4 Likert scale responses, was developed, based on one systematic review and one qualitative study, then validated in terms of face, content and construct validity and internal consistency (Cronbach's alpha values). All health and social care educators based in all 21 universities of applied sciences in Finland and seven vocational colleges were subsequently invited to participate in a large-scale application of the instrument in fall 2018. In total, responses of 390 of these educators are analyzed here. RESULTS: The face and content validity of 71 newly developed items were assessed by experts in two evaluation rounds. The final content validity showed high scores for the instrument's relevance and clarity. Confirmatory factor analysis (to test construct validity) yielded eight factors (43-items remaining), defining the following competence areas of educators: evidence-based practice, digital collaborative learning, student-centered pedagogy, collaboration & societal, leadership & management, cultural & linguistic diversity, mentoring student into professional competence development and subject & curriculum. Cronbach's alpha values for the factors ranged from 0.70 to 0.89. CONCLUSION: The instrument can be used to obtain self-evaluations of educators' competence when assessing their general competence levels and help human resources departments and managers to identify suitable continuous education programs for their staff.

Qualitative study of social and healthcare educators' perceptions of their competence in education.

Competent educators are needed to ensure that social and healthcare professionals are effective and highly competent. However, there is too little evidence-based knowledge of current and required enhancements of educators' competences in this field. The aim of this study was to describe social and healthcare educators' perceptions of their competence in education. The study had a qualitative design, based on interviews with educators and rooted in critical realism. Forty-eight participants were recruited from seven universities of applied sciences and two vocational colleges in Finland, with the assistance of contact persons nominated by the institutions. The inclusion criterion for participation was employment by an educational institution as a part-time or full-time, social and/or healthcare educator. Data were collected in the period February-April 2018. The participants were interviewed in 16 focus groups with two to five participants per group. The acquired data were subjected to inductive content analysis, which yielded 506 open codes, 48 sub-categories, nine categories and one main category. The educators' competence was defined as a multidimensional construct, including categories of educators' competences in practicing as an educator, subject, ethics, pedagogy, management and organisation, innovation and development, collaboration, handling cultural and linguistic diversity, and continuous professional development. Educators recognised the need for developing competence in innovation to meet rapid changes in a competitive and increasingly global sociopolitical environment. Enhancement of adaptability to rapid changes was recognised as a necessity. The findings have social value in identifying requirements to improve social and healthcare educators' competence by helping educational leadership to improve educational standards, construct a continuous education framework and create national and/or international curricula for teacher education degree programs to enhance the quality of education. We also suggest that educational leadership needs to establish, maintain and strengthen collaborative strategies to provide effective, adaptable support systems, involving educators and students, in their working practices.

Competence areas of health science teachers - A systematic review of quantitative studies.

BACKGROUND: In the face of rapid digitalisation and ever-higher educational requirements for healthcare professionals, it is important that health science teachers possess the relevant core competences. The education of health science teachers varies internationally and there is no consensus about the minimum qualifications and experience they require. OBJECTIVE: The aim of this systematic review was to describe the health science teachers' competences and the factors related to it. DESIGN: Systematic review of original quantitative studies. DATA SOURCES: Four databases were selected from which to retrieve original studies: Cinahl (Ebsco), PubMed, Medic, Eri (ProQuest). REVIEW METHODS: The systematic review used PICOS inclusion criteria. Original peer-reviewed quantitative studies published between 1/2007 and 1/2018 were identified. Screening was conducted by two researchers separately reading the 1885 titles, 600 abstracts, and 63 full-texts that were identified, and then agreed between them. Critical appraisal was performed using the JBI MAStARI evaluation tool. The data was extracted and then analysed narratively. RESULTS: The core competences of health science teachers include areas of knowledge, skills and attitudes. Health science teachers evaluate their own competence as high. Only in relation to entrepreneurship and leadership knowledge was evaluated to be average. The most common factors influencing competence were teachers' title/position, healthcare experience, research activities, age, academic degree and for which type of organisation they work. CONCLUSION: It is important to identify the core competencies required by health science teachers in order to train highly competent healthcare professionals. Based on the findings of this systematic review we suggest that teachers should be encouraged to gain university education and actively participate in research, and that younger teachers should have opportunities to practice the relevant teaching skills to build competence.

Sustainability in care through an ethical practice model.

BACKGROUND: While sustainability is a key concept in many different domains today, it has not yet been sufficiently emphasized in the healthcare sector. Earlier research shows that ethical values and evidence-based care models create sustainability in care practice. OBJECTIVE: The aim of this study was to gain further understanding of the ethical values central to the realization of sustainability in care and to create an ethical practice model whereby these basic values can be made perceptible and active in care practice. RESEARCH DESIGN: Part of the ongoing "Ethical Sustainable Caring Cultures" research project, a hermeneutical application research design was employed in this study. PARTICIPANTS: Dialogues were used, where scientific researchers and co-researchers were given the opportunity to reflect on ethical values in relation to sustainability in care. FINDINGS: An ethical practice model with ethos as its core was created from the results of the dialogues. In the model, ethos is encircled by the ethical values central to sustainability: dignity, responsibility, respect, invitation, and vows. DISCUSSION: The model can be used as a starting point for ethical conversations that support carers' reflections on the ethical issues seen in day-to-day care work and the work community, allowing ethical values to become visible throughout the entire care culture. CONCLUSION: It is intended as a tool whereby carers can more deeply understand an organization's common basic values and what they entail in regard to sustainability in care.

Understanding and safeguarding patient dignity in intensive care.

BACKGROUND: Dignity has been highlighted in previous research as one of the most important ethical concerns in nursing care. According to Eriksson, dignified caring is related to treating the patient as a unique human being and respecting human value. Intensive care unit patients are vulnerable to threatened dignity, and maintaining dignity may be challenging as a consequence of critical illness. OBJECTIVES: The aim is to highlight how nurses in an intensive care setting understand patient dignity, what threatens patient dignity and how nurses can safeguard patient dignity. Research design and participants: Data materials were collected through a survey questionnaire which contained open questions about patient dignity, and the text was analysed using hermeneutic reading and text interpretation. Totally, 25 nurses employed in an intensive care unit in Finland participated in the study. Ethical considerations: The study follows the guidelines for good scientific practice by the Finnish Advisory Board on Research Integrity and the ethical principles according to the Declaration of Helsinki. FINDINGS: Findings revealed that nurses recognize the patients' absolute dignity by regarding them as unique human beings. The nurses also recognize the importance of shared humanity in preserving patient dignity. Intensive care patients' dignity is threatened by negative attitudes and when their integrity is not being protected. Dignity is also threatened when patients and nurses are not part of the patients' care and patient care decisions, when patients receive care against their will and because of the acute nature of intensive care.