No place like home - Or is there? Extended transformational potential of nursing homes during vital conjunctures.

AIMS AND OBJECTIVES: The purpose of this study is to explore how the concept of 'feeling at home' manifests in nursing home environments and influences the transformational potential of such homes-servicescapes where customers experience vital conjunctures. BACKGROUND: Recent research on places highlights the potential of service venues as places that can promote well-being. Nursing homes bridge the concepts of 'home' and a service with transformational aspirations. Moving to a nursing home can be regarded as a vital conjuncture, yet despite the resultant mixed emotions, nursing homes can generate positive changes and meaningful relations. DESIGN; METHODS: A qualitative field study with ethnographic features was conducted in two Finnish nursing homes. The data consist of observations and 64 semi-structured interviews. COREQ guidelines were followed. RESULTS: 'Feeling at home' is built on: (1) artefacts and surroundings, (2) functions and activities and (3) relationality and atmosphere. A home-like experience related to each category is important in enabling customers to feel at home, thus assisting in dealing with the vital conjuncture, but the transformative power of nursing homes is linked most closely to respectful, kind attendance of the others and a positive atmosphere. CONCLUSIONS: The roles of nurses and a homely servicescape are essential in dealing with residents' vital conjunctures, whether those residents employ resistance or adjustment coping methods. Positive transformations that evoke residents' re-balancing and well-being are enabled in nursing homes that support residents' important relationships, identity, safety and self-efficacy. This positive transformation also aids family members with their associated vital conjunctures, thus multiplying the service's transformational potential. PATIENT OR PUBLIC CONTRIBUTION: Service users and caregivers were involved in the design and conduct of the data in this study. RELEVANCE TO CLINICAL PRACTICE: Creating a homely atmosphere in nursing homes fosters not only residents' but also family members' re-balancing and well-being.

Itinerários terapêuticos, cuidados e atendimento na construção de ideias sobre maternidade e infância no contexto da Zika / Itinerarios terapéuticos, cuidados y atención en la construcción de ideas sobre maternidad e infancia en el contexto del Zika / Therapeutic paths, care and assistance in the construction of ideas about maternity and childhood in the context of the Zika virus

Com pesquisa de campo etnográfico, seguimos itinerários terapêuticos de cuidadoras de filhos com Síndrome Congênita do Zika para compreender como diferentes contextos (descoberta, casa, unidades de saúde, assistência social, associações) contribuem para formar noções sobre maternidade e infância. O conceito de "conjunturas vitais" em ritos de passagem geracionais singulariza experiências que levam a estabilizações e/ou caminhos invertidos na passagem entre etapas. A construção prática e simbólica de maternidade e infância oscila entre uma multiplicidade de significados marcados pela obrigatoriedade de mulheres se empenharem na tarefa de cuidar, vivendo sofrimento e sacralização do cuidado, numa realidade cotidiana que amarra suas vidas a buscas de explicações causais e respostas terapêuticas diversas sem mudanças geracionais marcadas. Quem trilha esses itinerários terapêuticos constrói uma imagem multifacetada de si mesma em relação, direta ou indiretamente, à maternidade, à infância e à filiação biológica e social.(AU)

Con investigación de campo etnográfico seguimos itinerarios terapéuticos de cuidadoras de hijos con Síndrome congénito del zika para comprender cómo diferentes contextos (descubrimiento, casa, unidades de salud, asistencia social, asociaciones) contribuyen para formar nociones sobre maternidad e infancia. El concepto de "coyunturas vitales" en ritos de pasaje generacionales singulariza experiencias que llevan a estabilizaciones y/o caminos invertidos en el paso entre etapas. La construcción práctica y simbólica de maternidad e infancia oscila entre una multiplicidad de significados marcados por la obligatoriedad de que las mujeres se empeñen en la tarea de cuidar, viviendo el sufrimiento y la sacralización del cuidado, en una realidad cotidiana que amarra sus vidas a búsquedas de explicaciones causales y respuestas terapéuticas diversas sin cambios generacionales marcados. Quien recorre estos itinerarios terapéuticos construye una imagen multi-facetada de sí misma en relación, directa o indirectamente, a la maternidad, a la infancia y a la filiación biológica y social.(AU)

Based on an ethnographic field research, we followed the therapeutic paths of caregivers of children with the Zika congenital syndrome in order to understand the way different contexts (discovery, household, health units, social work, associations) contribute to creating notions about maternity and childhood. The concept of "vital conjunctures" in generational rites of passage singularizes experiences that lead to stabilization and/or inverted paths in the passage between stages. The practical and symbolic construction of maternity and childhood oscillates among a multiplicity of meanings marked by the obligatoriness of women to strive in the task of caring and experiencing suffering and care sacralization, in a daily reality that ties their lives to searches for causal explanations and diverse therapeutic answers without marked generational changes. Those who take these therapeutic paths build a multifaceted image of themselves in a direct or indirect relationship to maternity, childhood and their social and biological affiliation.(AU)