Being met as a person and not as a diagnosis - Meanings of healthcare encounters for women with chronic obstructive pulmonary disease stage III or IV.

Our study seeks to elucidate meanings of healthcare encounters for women with chronic obstructive pulmonary disease stage III or IV. We conducted 12 narrative interviews which were analyzed using phenomenological hermeneutic interpretation. Our analysis revealed one theme; being met as a person and not as a diagnosis with three subthemes: getting sufficient time and feeling involved in care; fulfillment of personal needs; and experiencing disrespect and injustice. We found that meanings of healthcare encounters center on the expectation of being seen as a person. Feeling disrespected and injust leaves women unsupported and could pose serious health risks.

A reflexive thematic analysis of ambulance nurses' experience of facilitating child-centered care.

INTRODUCTION: Ambulance nurses' (ANs) feel less confident treating children. According to the United Nations Convention on Child Rights, there is a provision to safeguard children's rights. Child-Centered Care (CCC) strives to lift children's voices in healthcare. AIM: To describe ambulance nurses' experiences of facilitating child-friendly care. METHOD: A qualitative approach with Reflexive Thematic Analysis was performed on seventeen individual semi-structured interviews. RESULT: One overarching theme, caring with the child in center, and three themes were developed: adapting to follow the child's lead, being reliable by balancing the trust, stepping back and supporting. DISCUSSION: The ANs' communication with the children was honest and straightforward. Letting the child and the parents perform the care together reduced the child's anxiety. Guided participation was used by ANs, expanding the child's initiative. CONCLUSION: The ANs work according to CCC, but unknowingly. It is important and beneficial to elevate the CCC to a conscious level. The ANs could refer to CCC in training new colleagues, reflecting on cases, and incorporating the Child Act in their work.

The Experiences of Close Relatives to Women with Chronic Obstructive Pulmonary Disease Stages III or IV: A Qualitative Study.

Chronic obstructive pulmonary disease stage III or IV is a progressive and incurable disease. The hallmark of the disease is breathlessness, and it is graded into four different stages, from mild to severe. Living with chronic obstructive pulmonary disease impacts almost every aspect of everyday life for an affected person. As the illness progresses to stages III and IV, the need for support from close relatives increases. The aim of this study was to explore and describe the experiences of close relatives of women with chronic obstructive pulmonary disease stage III or IV and it used qualitative content analysis of individual, semi-structured interviews. Close relatives (n = 9) were interviewed about their experience of being close to a woman with chronic obstructive pulmonary disease stage III or IV. They experienced stress and uncertainty in an unpredictable everyday life. Close relatives supported the women both practically and emotionally and they called for tailored information about the illness, considering it as an essential tool for support. The results highlighted that healthy close relatives had difficulty in understanding the experience of living with chronic obstructive pulmonary, as they take the simple fact of breathing for granted most of the time.

Striving for moments of easier breathing despite being trapped in breathlessness: meanings of feeling well for women with chronic obstructive pulmonary disease stage III or IV.

BACKGROUND: Living with chronic obstructive pulmonary disease stage III or IV means living an everyday life, severely restricted by breathlessness. AIM: The aim of this study was to elucidate meanings of feeling well for women with chronic obstructive pulmonary disease stage III or IV. METHOD: The study has used a phenomenological hermeneutical design. Individual narrative interviews were conducted with 14 women with chronic obstructive pulmonary disease at stages III or IV. RESULTS: The results revealed one theme: striving for moments of easier breathing despite being trapped in breathlessness with four subthemes: acting in rhythm with breathing, taking care of oneself, taking advantage of better moments, and being in togetherness in everyday life. CONCLUSION: This study shows that women with chronic obstructive pulmonary disease at stages III or IV strived for moments of feeling well despite living with a severe illness. Feeling well meant that when connected to nature, they felt alive, free, and less trapped in breathlessness, which provided a sense of being unconscious of their breathing rhythm. They could do what healthy people tend to take for granted during everyday life. To feel well, the women found it important to receive tailored support from their close relatives.

Experiences of transitions in daily life for parents of children with type 1 diabetes: An interpretive description.

In this study, we aimed to explore and describe the experiences of parents whose children have been diagnosed with type 1 diabetes (T1D) and the transitions of daily life. T1D is a long-term illness, and parents of children with T1D often become informal caregivers and face many challenges in their daily lives. A qualitative study design, in line with interpretive description, was used, and a sample of 10 parents of children with T1D participated in individual interviews. The COnsolidated criteria for REporting Qualitative Research (COREQ) checklist was used. The interviews were analyzed using interpretive descriptions. The analysis resulted in one main theme: "The realization of having taken 'daily life' for granted and having to accept a new reality," with six themes showing different transitions in the parents' daily lives, including transitions in daily life patterns, parenthood, in relationships with family and friends, relationships with school personnel, relationships with healthcare personnel, and in knowledge and learning about the illness. Parents experienced multifaceted changes that affected their lives, as shown by the six identified transitions. Being the parent of a child with T1D implies a new reality with complex, irreversible life changes that may be unknown and unspoken to healthcare professionals and society. Healthcare systems, school personnel, and society at large need to improve their knowledge regarding parents' situations to better support them in embracing a new reality for themselves and their children long after the onset of T1D.

An emotional journey when encountering children in prehospital care: Experiences from ambulance nurses.

BACKGROUND: Care encounters with children are a challenging and important task, but opportunities for such encounters are rarely available. Therefore, ambulance nurses (ANs) face difficulties in gaining experience in properly handling children, which can lead to stress for the ANs. A deeper understanding of ANs' emotions through the course of the care encounter is needed. AIM: To describe how ambulance nurses' feel and manage their emotions before, during and after a care encounter with a child. METHODS: A qualitative approach was adopted, with content analysis being performed on seventeen individual interviews. FINDINGS: Three themes were identified: Feeling worried and insecure, Emotional surge, and Mixed feelings of satisfaction and concern. CONCLUSION: The ANs experienced a range of emotions during a care encounter with children as they had little experience with it. More training and education in paediatric care could benefit ANs. The ANs use professionalism during care encounters to create a calm and secure atmosphere for families. Their will to bring about a safe journey for the child and family through the care encounter supersedes their nervousness. Reflection after a care encounter could strengthen their confidence in their professional role and reduce emotional distress in future encounters.

Functioning and Disability in Community-Living People with Perceived Cognitive Impairment or Dementia: A Mixed Methods Study using the World Health Organization Disability Assessment Schedule.

OBJECTIVE: To explore how community-living people with perceived cognitive impairment or dementia and their next-of-kin perceive functioning and disability in major life domains. METHODS: Individual interviews guided by the World Health Organization Disability Assessment Schedule (WHODAS 2.0) were conducted with 26 people with perceived cognitive impairment or dementia (age range 38-87 years) and 26 next-of-kin. Qualitative content analysis- and International Classification of Functioning, Disability, and Health (ICF) linking methods were used to analyse the transcripts. The perceived degree of disability in daily functioning was calculated and compared between people with perceived cognitive impairment or dementia and next-of-kin, using a Mann-Whitney U test. RESULTS: A total of 38 of 47 (81%) established ICF categories corresponding to WHODAS items and 38 additional International Classification of Functioning, Disability, and Health (ICF) categories describing participants perceived cognitive and physical impairments, activity limitations and participation restrictions in interaction with the environmental factors were confirmed from the transcripts. The perceived disability of people with perceived cognitive impairment or dementia was scored higher by next-of-kin (48%) than by people with perceived cognitive impairment or dementia (16%, p < 0.0001). CONCLUSION: Interviews provided a comprehensive picture of participants' perceived activity limitations and participation restrictions in the life domains cognition, mobility, self-care, getting along, life activities, and participation. For a better understanding of the impact of cognitive impairment on people's daily lives, inclusion of the perspective of the next-of-kin and the factors that hinder or facilitate daily living in the community setting is necessary.

Primary Healthcare Nurses' Views on Digital Healthcare Communication and Continuity of Care: A Deductive and Inductive Content Analysis.

Primary healthcare in the Western world faces significant functional challenges, resulting in the implementation of digital communication tools. Nurses are key professionals in primary care and focusing on the impact of digital communication and continuity of care in primary care organisations is important. This qualitative descriptive study explores digital communication and continuity of care from primary healthcare nurses' perspective. Data from individual semi-structured interviews with 12 nurses were collected; deductive and inductive content analyses were performed. Three descriptive categories emerged from the deductive (digital communication as interpersonal, information, and management continuities) and inductive ('digital care does not suit everyone', 'new technology is contextually intertwined with daily work', and 'patient-positive aspects of digital information') phases. Additionally, a structural risk of obscuration of patients' needs by the contextual conditions emerged. To ensure digital communication-aligned continuity of care, compatible information technology systems should be developed. Allowing nurses to provide high-quality care based on their own values would enhance person-centred patient care.