The influence of prior work experience in aged care on nursing students' views on aged care nursing: A systematic review.

BACKGROUND: Nursing students' experiences during clinical training in aged care placements is a well-studied topic. However, there is less research on the connection between nursing students' prior experiences as assistants in nursing (AIN) and their perception of aged care nursing. AIM: The aim of this study was to identify and synthesize undergraduate nursing students' experiences as working as AIN in aged care settings. METHOD: A systematic review was carried out by searching the CINAHL, Scopus, Medline and Medic databases, supplemented by manual searches. The searches focused on peer-reviewed scientific empirical research articles published in English, with a 10-year date limitation. The data were analysed by the qualitative content method. RESULTS: The review identified 11 articles, which showed that nursing students' prior work experience shifts their perceptions of older adults' care. The findings were organized under four major themes. Through their employment as AIN, (1) nursing students' ability to reflect and develop skills needed in clinical work strengthened, (2) they became aware of the independent role of the nurse, (3) they feel part of the workplace community and (4) they recognized their feelings and views about aged care as a career. CONCLUSION: Students' work experience in aged care helps them to observe aged care settings as a unique set up and nursing comprehensively from the perspective of an older adult's care needs and they can observe the dynamics of a workplace community. They can see many positive features in working in aged care and assess their experience with positive descriptions.

Database nurse staffing indicators: explaining risks of staff job dissatisfaction in outpatient care.

AIM: To explore factors associated with nursing intensity, work environment intensity and nursing resources that may affect nurse job satisfaction and risk of dissatisfaction in outpatient care at one university hospital in Finland. BACKGROUND: Much research has been done to study how nursing intensity, work environment intensity and nursing resources are associated with nurse job satisfaction, but not in the context of outpatient care. METHODS: This research used a cross-sectional design. The data were collected from the hospital information systems of outpatient units (n = 12) in autumn 2010. RESULTS: Management style showed a statistically significant association with job satisfaction. The risk of dissatisfaction increased when nursing staff had no influence over the design of their jobs, when conflicts and contradictions were not addressed in the workplace and when feedback was not processed. CONCLUSIONS: Nursing intensity and work environment intensity had no effect on nurse job satisfaction. Nursing resources and patient satisfaction, on the other hand, were important to nurses' job satisfaction. IMPLICATIONS FOR NURSING MANAGEMENT: The results indicate that nursing management should involve nursing staff in the development of their jobs and the care delivery model.

Explaining patient satisfaction with outpatient care using data-based nurse staffing indicators.

OBJECTIVE: This article examines the associations of nursing intensity, work environment intensity, and nursing resources with patient satisfaction with outpatient care in a university hospital in Finland. BACKGROUND: While readily available in hospital information systems, data-based nurse staffing indicators have not been maximized in ambulatory nursing management and leadership. METHODS: Data were analyzed using descriptive and multivariate statistical methods. RESULTS: Patient satisfaction scores reached target levels at all measurements in 42% of the outpatient departments. The risk of low satisfaction scores was higher when patients received no information about their visits or their illness. Patient dissatisfaction increased linearly with the number of repeat visits. CONCLUSIONS: The patients were predominantly satisfied with the outpatient care. Better access to information improved patient satisfaction. Attention should be directed to the content of information in patient repeat visits.

Finnish nurse students' attitudes towards older adults and the teaching of gerontological nursing - A survey study.

BACKGROUND: Finland has one of the oldest populations in Europe. Gerontological nursing is unfortunately not appealing to nurse students. OBJECTIVES: This study aimed to examine nurse students' attitudes towards older adults and their suggestions about gerontological nursing course. DESIGN: A cross-sectional, descriptive study. SETTINGS: One university of applied sciences in Finland. PARTICIPANTS: A total sample of nurse students (n = 523). METHODS: Data were collected in 2015 using KAOP scale that included background questions and one open question. The data were analyzed statistically and thematized. The themes were then quantified as frequencies. RESULTS: The response rate was 47.5%. The mean age was 26.9 years. The results showed that students' attitudes were positive towards older adults. Factor analysis produced a four factor (characteristic value >1.0) model (explanation rate 44%, x2 118,770, df = 74 and p = .001). A four-factor model was however not justifiable, as only one variable loaded onto the fourth factor. The range of the communalities of the variables chosen for the factor analysis was between 0.37 and 0.99. There were seven such variables and their reliability was high (α = 0.71). The positive attitude was described by reciprocal understanding, social skills of older adults and older adults' ability to maintain their home and themselves. Of the suggestions for improving the teaching of gerontological nursing, 60% were related to the contents of teaching, 37% to didactic solutions and 3% to the capabilities of the teacher. CONCLUSIONS: Students consider older adults as individuals with their own personalities and many resources, a view that should not be lost after graduation. The study showed a demand for moving teaching away from classrooms to the real environments of older people's care. Using various methods such as lectures by experts by experience can make the topic more appealing.

Informal carers of older family members: how they manage and what support they receive from respite care.

AIMS: To describe informal carers' coping strategies and their experiences of the support provided by respite care. BACKGROUND: The target set in the Finnish national old age policy strategy is that 90% of the population over 75 should be able to live at home. A major source of support for older people and their families is respite care in an institution. DESIGN: Survey. METHODS: The data were collected among informal carers who regularly use respite care services (n = 143). Two structured questionnaires were used: the Carers' Assessment of Managing Index (Nolan et al. 1995) and an index developed by the researchers. RESULTS: Informal carers who provided care for younger individuals or people who needed less help had a better quality of life. Spouse carers and older informal carers were less satisfied with their quality of life than younger carers. Periods of respite care had a major influence on informal carers' quality of life: 93% said they felt invigorated. Care periods remained rather isolated episodes in the lives of the older patients in that there was hardly any discussion at the institution about the family's situation, the objectives of respite care, or about how the informal carer was coping. Altogether, 47% of the nurses remained fairly distant. The most useful coping strategies involved creating alternative perspectives in the caring relationship. CONCLUSIONS: The results strengthen the knowledge base of informal caregiving by showing how caregivers cope and what kind of support they need in their demanding caring role. RELEVANCE TO CLINICAL PRACTICE: Respite care nurses should invest greater effort in supporting informal carers. The service should be developed as an integral part of home care for older people. Nurses and informal carers should see each other as partners who share a common goal, i.e. the well-being of the entire family.

Women's views of caring for family members: use of respite care.

The purpose of this study was to describe the life situation of informal caregivers who regularly use respite services when caring for their older relative. The sample consisted of 17 wife and daughter caregivers who frequently relied on respite care to support coping at home. Data were analyzed by inductive content analysis. Spousal caregivers in a warm, loving relationship or who longed for their lost relationship with a husband experiencing a memory disorder did not identify themselves as informal caregivers, but principally as wives. Periods of respite invoked feelings of emptiness; on the other hand, they offered an opportunity for these caregivers to take care of their own health. The younger spouses also felt it was a relief to have time for their own interests. Caregivers who felt that being with the care recipient was an obligation described their relationship as mainly caregiving. In relationships focusing on organizing the daily routines, caregivers welcomed respite as a relief but experienced unexpected feelings of guilt. Those who felt imprisoned by the care recipient relied on respite to help them cope with a burdensome relationship, while waiting for their loved one's transfer into permanent institutional care. The results of the study challenge health care professionals to commit themselves to family-centered work, in which knowing the family's history and current life situation is key to providing high-quality services.

Nurses' perceptions of their relationships with informal carers in institutional respite care for older people.

The purpose of this study was to describe nurses' experiences of their collaboration and relationships with family members in institutional respite care for the elderly. The family has a particularly important role in respite care, which is an extension of care provided at home. However no published studies were found on this subject. The data were collected through qualitative interviews (N = 22). Content analysis of the nurses' descriptions of their collaboration with family members yielded four main categories as follows: (1) conscious ignoring, (2) attempting to understand the family's situation, (3) hinting at private family matters, and (4) being a friend. The results lend support to earlier findings which emphasize the complexity of relationships between nurses and family carers. A novel finding here is that these relationships may also develop into friendships. Greater emphasis must be placed on primary nursing so that the nurse and informal carer can build up a genuine relationship of trust. If periods of respite care are to help older people and their families to manage independently, it is imperative that nurses have the opportunity to visit their patients at home.