AIMS AND OBJECTIVES:Care home residents represent some of the frailest and most vulnerable members of society due to impaired physical and cognitive functions. In acute situations specifically, residents often rely heavily on others to speak and act on their behalf. This places significant demands on organizational preparedness within care homes and across sectors. However, the contextual and structural processes in these situations are underexplored, potentially overlooking important contextual and clinical processes to support person-centered care in acute situations. We sought to obtain a comprehensive understanding of the circumstances surrounding acute events among residents. METHODOLOGICAL DESIGN AND JUSTIFICATION:A qualitative study was performed with a phenomenological and hermeneutic approach. Field observations (180 h) were conducted in four care homes in one large Danish urban municipality between October 2024 and February 2025. Purposive sampling included care homes of different sizes and districts, and acute events were included based on a predefined definition. Data analysis was inspired by Paul Ricoeur's interpretation theory. ETHICAL ISSUES AND APPROVAL:This study is registered with the Danish Data Protection Agency (24/30952). FINDINGS:Based on 38 acute events, we identified three themes: (1) Care home staff have a crucial but challenged role, (2) Organizational structures in care homes shape the response, and (3) Care home residents rely on mutually dependent systems. Detection and management of acute events were strongly shaped by contextual factors, including staffing, resources, and intersectoral collaboration. CONCLUSIONS:Detection and management of acute events among residents are a systemic lottery, as resident care depends more on circumstances than personal needs and preferences. This misalignment produces a structural vulnerability that puts residents at risk of compromised autonomy and integrity in acute situations and undermines visions of person-centered care.
AIMS AND OBJECTIVES:To elucidate meanings of encountering ambulance staff when living in stigmatized neighbourhoods. METHODOLOGICAL DESIGN AND JUSTIFICATION:The study was conducted using a phenomenological hermeneutical approach based on narrative interviews. ETHICAL ISSUES AND APPROVAL:The study was approved by the Swedish Ethical Review Authority and conducted in accordance with the Declaration of Helsinki. RESEARCH METHODS:A phenomenological hermeneutical analysis was conducted. Interviews were performed with 18 persons living in stigmatized neighbourhoods who had lived experiences of encountering ambulance staff, either as relatives or as patients. RESULTS:These encounters carry meanings of being dependent on how the staff act in situations marked by fear, involving fear for one's own or a relative's health, or fear of being judged based on ethnicity, culture, or place of residence. STUDY LIMITATIONS:The participants shared similar demographic backgrounds, and recruitment through gatekeepers may have constrained the range of perspectives. As an interpretive method, the findings represent one possible understanding, and other interpretations may emerge from different backgrounds or theoretical lenses. CONCLUSIONS:Encounters with ambulance staff carried meanings of fear of being judged and of dependence, while ambulance staff's interpersonal actions could either reinforce or alleviate these meanings.
PURPOSE:The current study aims to explore parents' views on family care at a neonatal intensive care unit. METHODS:We conducted a qualitative exploratory study with a descriptive approach based on open-ended written narrative responses from the Danish version of EMpowerment of PArents in The Intensive Care-Neonatology questionnaire. The study was conducted at a Danish level IV NICU working with family-centred care and family integrated care. The data was analysed using inductive content analysis by Graneheim and Lundman. The Standards for Reporting Qualitative Research checklist was followed. MAIN FINDINGS:In total, 311/727 parents responded to the distributed questionnaire. Of those, 210 responded to the open-ended questions. While general expressions of satisfaction and praise were noted, the qualitative analysis focused on responses that included more elaborated comments. We generated two themes, Challenges in communication and recognition in NICU care and Balancing family needs and support systems in NICU. Communication with nurses and physicians included both positive experiences and areas for improvement, with some parents experiencing confusion and insecurity. Emotional support, privacy and the opportunity for bonding were often overlooked, leaving parents feeling excluded from the care process. Parents reported a lack of individualized care that considered their unique needs as a family. CONCLUSION:The findings underscore the need for improved communication, better parental involvement in care decisions, and more attention to emotional and relational support. Addressing these areas could enhance the overall neonatal experience and the needs of infants and their families, ultimately improving care quality and satisfaction.
BACKGROUND:Infective endocarditis requires long-term antibiotic treatment, often involving a lengthy hospitalisation. These extended stays frequently lead to patients experiencing feelings of isolation from their daily lives, which can result in loneliness and concerns for their families. Despite this, there is a notable gap in recent research regarding patients' experiences during long-term hospitalisation and treatment. AIM:This study aimed to explore the experiences of adult patients diagnosed with infective endocarditis during their long-term hospitalisation and treatment trajectory within a cardiac ward setting. METHODS:This qualitative study explored patients' lived experiences of long-term hospitalisation with infective endocarditis. Ten patients diagnosed with infective endocarditis were purposively sampled. Data were collected through semi-structured interviews and analysed using Braun and Clarke's thematic analysis framework. The COREQ guidelines were followed to ensure transparency. RESULTS:Three themes and six subthemes were identified: (1) Experiencing time in connection and isolation, with subthemes (a) perceptions of time and (b) moments of connection shape the day; (2) Fragmented care and a fragile sense of self, with subthemes (a) I am still a whole person and (b) bodily experience during treatment; and (3) Navigating uncertainty and seeking trust, with subthemes (a) no one can tell me when… and (b) seeking stability and trust. CONCLUSIONS:Patients with infective endocarditis experienced long-term hospitalisation as characterised by temporal uncertainty, social isolation despite regular family contact, fragmented attention to health needs beyond the infection, and disrupted continuity in relationships with healthcare professionals. Although patients did not always perceive themselves as acutely ill, continuous monitoring and prolonged intravenous antibiotic treatment restricted their everyday routines and social participation. These findings highlight the importance of relational continuity, communication, and attention to patients' psychosocial needs during long-term hospitalisation with infective endocarditis.
BACKGROUND:Nurses are pivotal in promoting self-care among patients with heart failure (HF), particularly by educating them on how to prevent potential complications and rehospitalisations. Meanwhile, optimal self-care in patients with heart failure is a positive predictor of improved physical and mental health, which are core domains of quality of life (QOL). This systematic review aims to identify available evidence on the effectiveness of nurse-led education on the QOL and self-care in patients with HF. METHODS:A detailed literature search was performed in six electronic databases (PubMed, Scopus, ScienceDirect, ProQuest and PsycNet) guided by the PRISMA guidelines to retrieve relevant articles published between 2015 and 2022. The results were checked for eligibility criteria, followed by performing quality appraisal and data synthesis. RESULTS:Overall, 19 articles were found to be eligible and relevant for the analysis. Descriptively, the interventions comprised different components, including self-care knowledge and skills, illness representation, cognitive behavioural intervention, motivation, social and emotional support, coping strategies, setting goals, problem-solving and action planning. The delivery methods were mainly face-to-face interaction, verbal education and the use of written materials, while follow-ups entailed telephone calls and home visits. Most nurse-led interventions, particularly those combining educational and psychological components, led to significant improvement in self-care and QOL. CONCLUSION:The findings imply that nurse-led interventions can be provided by utilising diverse methods to improve self-care and QOL among patients with HF. Further studies are required to ascertain the long-term effect and the most effective component of these educational interventions.
INTRODUCTION:Peer-perpetrated sexual violence is very common in young adult relationships. In Sweden, one in four young women has experienced sexual violence, and it is a leading cause of mental health issues among young women today. Knowledge about how recovery is enabled for young women with experience of peer-perpetrated sexual violence remains limited. The primary emphasis of caring is to support health and well-being and to contribute to recovery; therefore, understanding the meaning of how recovery is enabled is essential when caring for these young women. AIM:The aim of this study is to describe the meaning of enabling recovery as experienced by young women following peer-perpetrated sexual violence. METHODS:A reflective lifeworld research approach was applied in this phenomenological study. Twelve young women, aged 17 to 25 years, participated in lifeworld interviews exploring the meaning of enabling recovery following peer-perpetrated sexual violence. RESULTS:The essential meaning of enabling recovery is described as: "By unveiling the hidden, the movement of life reclaims existence." This is further described through the four constituents: Striking insight, A haven for rest, Existential safeness and Sharing one's story in a safe place. The enabling of recovery from peer-perpetrated sexual violence emerges as a dynamic movement that involves both physical and existential aspects. It emphasises that reclaiming one's existence requires a movement in life that strives to enhance well-being. Every element that contributes to this movement is interconnected, and no part can function in isolation from the others. CONCLUSIONS:This study provides an in-depth understanding of how recovery is enabled following peer-perpetrated sexual violence. It highlights the long-term impact on young women's health and well-being and emphasises the importance of a lifeworld-led, recovery-oriented caring approach that addresses both physical and existential dimensions. Enabling recovery is understood as an interconnected and dynamic process of meaning-making, where uncovering lived experiences and supporting existential safeness and stillness help young women to reclaim their existence.
OBJECTIVE:To validate the content of Primary Care Network Assessment Scale for Palliative Care Patients (ARCP) and to assess its clinical utility in patients with advanced cancer. METHODS:This methodological study was conducted in two phases. Phase 1 involved content validation by ten social work experts using the Content Validity Index (CVI). Phase 2 evaluated clinical utility in a cross-sectional study of 148 patients with advanced cancer receiving palliative care. Data included sociodemographic and clinical variables, global quality of life (EORTC QLQ-C15-PAL) and perceived social support (SSQ6). Multivariate logistic regression analyses were performed. RESULTS:The ARCP showed high content validity, with CVI values above 0.80 for relevance, clarity and vocabulary across all items. Clinically, 80% of patients were classified as having fully participatory caregiving networks; however, 42% relied on a single caregiver, indicating structural vulnerability despite high perceived support. Male sex (OR = 2.53; 95% CI: 1.02-4.34), being married (OR = 2.78; 95% CI: 1.06-7.29), better global quality of life (OR = 2.33; 95% CI: 1.08-2.57) and greater satisfaction with social support (OR = 5.41; 95% CI: 1.35-15.05) were independently associated with a fully participatory network. CONCLUSION:The ARCP demonstrated evidence of content validity and clinical utility for assessing caregiving network structure in palliative care.
AIM:To examine the challenges associated with transition processes in adult foster care for older adults from the perspective of foster caregivers. DESIGN:A qualitative design with semi-structured interviews was used to explore foster caregivers' experiences of care transitions and the meanings associated with these situations. ETHICAL CONSIDERATIONS:Permissions were obtained from a Finnish city, and ethical review was not required according to national guidelines. Participation was voluntary, informed consent was obtained, and confidentiality was ensured. METHODS:Data were collected through five semi-structured interviews with foster caregivers recruited via the Family Care Association. Interviews were conducted remotely, audio-recorded, transcribed verbatim, and analysed using inductive thematic analysis. RESULTS:The findings identified challenges across transition phases. In early stages, some older adults were placed in foster care despite having physical or cognitive impairments exceeding the model's capacity, complicating daily coping. Financial insecurity influenced decision-making and could contribute to the continuation of care beyond appropriate limits. In later stages, strong attachment relationships developed over time, making the ending of care emotionally demanding and affecting the entire foster care community. LIMITATIONS:The small sample size and single-country context may limit transferability, and the perspectives of older adults were not included. CONCLUSION:Transition processes in adult foster care involve tensions between residents' needs, care model limitations, structural conditions, and emotional demands. Clearer placement practices and stronger support structures are essential to improve care quality and caregiver wellbeing.
AIMS:This study aimed to identify and prioritize key strategies for improving a psychiatric home-based care programme, the Crisis Resolution and Home Treatment (CRHT) intervention in Catalonia, Spain. The objective was to incorporate the perspectives of service users, family caregivers and healthcare professionals to guide quality improvement efforts. METHODS:A modified Delphi method was used to reach consensus among stakeholders previously involved in a qualitative evaluation of the CRHT programme. The expert panel included 130 participants: 31 CRHT service users/caregivers and 99 healthcare professionals. Over three rounds of online surveys, participants rated 18 pre-identified improvement strategies across three dimensions: problem significance, change agency and feasibility of change. Service users and caregivers assessed only problem significance. Open-ended responses were also collected and analysed. FINDINGS:Consensus was reached in the third round, with five strategies prioritized: (1) training on CRHT referral and eligibility criteria, (2) standardized discharge and continuity of care protocols, (3) feedback loop between CRHT and referring professionals, (4) scheduling and communication of visiting hours, and (5) available updates for CRHT slots. These areas were rated highest in terms of feasibility and change agency, though not necessarily in problem significance. Notably, the same individuals who participated in the initial qualitative phase contributed to the prioritization process, ensuring continuity and relevance in stakeholder input. CONCLUSION:The study demonstrates the value of collaborative, consensus-based approaches to quality improvement in mental health care. Prioritized strategies reflect feasible and actionable areas for enhancing CRHT services. Involving service users, caregivers and professionals in both evaluation and decision-making processes strengthens the relevance, person-centredness and effectiveness of care. Implementation of these strategies is underway, with further improvements planned based on stakeholder feedback and continuous assessment.
OBJECTIVES:This study aimed to determine the effects of caregiver burden on the healthy lifestyle behaviours of people caring for patients with Alzheimer's disease. METHODS:The Caregiver Burden Inventory (CBI) and the Healthy Lifestyle Behaviour Scale-II (HLBS-II) were administered to caregivers of Alzheimer's disease patients who were admitted to the Neurology Department Dementia Outpatient Clinic of a university hospital in Ankara (n = 84). Independent sample t-test, one-way ANOVA, Pearson correlation and linear regression analysis were used in the study. RESULTS:A moderate, negative and statistically significant correlation was found between CBI and HLBS-II (r = -0.40; p < 0.001). The effect of CBI on HLBS-II was significant even in the presence of control variables (b = -0.29; p < 0.05). The increase in social burden (b = -0.92; p < 0.05) and developmental burden (b = -0.65; p = 0.053) of the CBI dimensions caused a decrease in healthy lifestyle behaviours. CONCLUSIONS:Effective home care for Alzheimer's patients requires caregivers to maintain their own good health. This study demonstrates that increased caregiver burden, particularly in social and developmental domains, negatively impacts their healthy lifestyle behaviours. Policies should focus on reducing this burden to enhance caregiver well-being and ensure sustainable home care.
AIMS AND OBJECTIVES:The mixed-method review aimed to synthesize research on how clinical nurse specialists' expertise develops from novice to expert and how this progression can be supported. METHODOLOGICAL DESIGN AND JUSTIFICATION:The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and was registered on PROSPERO. A mixed-methods approach was used to combine qualitative and quantitative data and enhance the robustness of the findings. RESEARCH METHODS:Literature search was conducted in CINAHL, PubMed and Scopus in September 2024. The selection and quality assessment of the studies were performed using JBI critical appraisal tools. The synthesis was based on qualitative and quantitative studies, using Benner's 'From Novice to Expert' model as a framework. ETHICAL ISSUES AND APPROVAL:Ethical approval was not required for this study. OUTCOME MEASURES:The main outcomes were stages of expertise development and factors supporting progression. RESULTS:Eleven articles were included for review. Becoming a clinical nurse specialist requires a basic nursing degree, clinical experience and a higher education degree. According to the results, expertise was seen to develop through three stages: novice, competent and expert, with the support of organizations, mentors, colleagues and multi-professional collaboration. Pursuing continuing education while gaining experience is essential to carry on the journey towards expertise. STUDY LIMITATIONS:The study screening process may have introduced selection bias, potentially leading to the omission of relevant articles. Additionally, selected articles on other interventions, such as service development, were excluded. However, they could have provided further insights into development. CONCLUSIONS:This review shows that developing CNS expertise from novice to expert requires education, clinical experience, and continuous professional support. Strengthening structures and collaboration enhances patient care, while further research on support strategies and competencies is needed.
PURPOSE:Research on suffering has been dominated by the healthcare, religious and philosophical perspectives which are based on a narrow perspective of individual subjectivity and well-being, with the social context largely neglected. This paper aims to complement this inadequacy by highlighting the unique contributions of Hegel's anthropological-philosophical perspective in bridging the gap between individual subjectivity, that is, personal experience, and the objective collective human entity, that is, the social reality, in the discussions on suffering. This in turn can generate concrete measures especially targeting at the concrete reality, that is, institutions, social structures and public policy. This is especially true for Caring Science because suffering and its alleviation are core notions in this discipline. METHOD:In this project, the conceptual, textual, and comparative analyses on the major and latest healthcare, philosophical and religious literature were conducted. The Hegelian perspective was proposed as the ideal foundation for research on suffering. It is because despite Hegel never explicitly accounted for suffering in any of his works, suffering surfaces in many occasions in his works describing Spirit's unfolding itself characterized by negation, contradiction and suffering. Given this, the Hegelian perspective offers abundant theoretical resources for re-conceptualizing suffering. FINDINGS:Evidence from Hegel's various works on different realms of life which include individual psychology, interpersonal relationships, family, and morality converges that suffering is caused by contradictions or gaps between individual subjectivity and the objective reality. Physical suffering is caused by diseases and mental disorders such as dementia, and are part of nature. CONCLUSION:The conclusion is that the Hegelian perspective can effectively serve as a conceptual bridge for the lack of consideration on the intimate links between individual subjectivity and the objective reality in extant research and discussions on suffering. The contributions of Hegel's philosophy lie in his closely-knitted nexus connecting human subjectivity and the objective reality operated by dialectic.
AIM:To synthesise the body of knowledge on the factors influencing caring behaviours among nurses working in hospital settings. DESIGN:Scoping review of original research articles. METHODS:This scoping review followed Arksey and O'Malley's five-stage framework and was reported in accordance with the PRISMA-ScR checklist. A comprehensive literature search was conducted across PubMed, CINAHL, Web of Science, Scopus, and Google Scholar in April 2025 for studies published between 2015 and 2025. Eligible studies were peer-reviewed original research that measured caring behaviour as an outcome among nurses working in hospital settings. RESULTS:A total of 34 original research articles included in this scoping review: 29 quantitative studies, three mixed method studies, and two qualitative studies. Factors influencing caring behaviour among nurses were varied across the studies. All the factors reported in the reviewed studies are aggregated into five main categories: (1) demographic factors, (2) work-related factors, (3) psychosocial factors, (4) ethical, moral, and professional factors, and (5) leadership and organisational factors. Among the demographic factors, age, education level, and income were positively associated with caring behaviours. Work-related factors influencing caring behaviours were job satisfaction, workload, and work environment. Psychosocial factors associated with caring behaviour include work-related stress, emotional intelligence, and resilience. Additionally, moral sensitivity, professional values, leadership, and organisational support were positive factors influencing care behaviour of nurses. CONCLUSION:This scoping review revealed multiple factors influencing caring behaviours among nurses. Healthcare providers and nurse leaders should consider these factors when developing strategies to promote caring behaviour in nursing practice. Future studies with qualitative inquiry would provide a comprehensive understanding of nurses' perspectives on caring behaviour.
INTRODUCTION:Receiving a cancer diagnosis is often experienced as a violent life turn, evoking existential suffering. To promote health and alleviate suffering, it is crucial to acknowledge and respond to patients' existential needs. However, nurses frequently lack the time and resources to address these needs, and when cancer care is reduced to merely treating the physical body, it may increase suffering and neglect the person as a whole. AIM:The aim of this study was to gain a deeper understanding of patients' existential suffering and what they need to alleviate suffering in cancer care. METHODS:A qualitative inductive design was used. The data consisted of in-depth interviews with 10 Finnish women with cancer or cancer survivors. A qualitative content analysis was conducted. FINDINGS:The study found three themes: (1) Inner experiences and need for human connection; (2) Encounters with healthcare professionals can either cause or alleviate patients' suffering; and (3) The organisation's impact on patient suffering. CONCLUSIONS:This study demonstrates that existential suffering in cancer care is shaped not only by the illness itself but also by care encounters and organisational conditions. Fragmented care and lack of continuity may intensify suffering, whereas compassionate, person-centred encounters can alleviate it. Addressing these issues may reduce patient suffering, enhance patient safety, support healthcare professionals, and contribute to a more sustainable healthcare system.
AIMS AND OBJECTIVES:This study aimed to assess caregiver burden and perceived social support among individuals providing care within the scope of home health services and to examine related sociodemographic factors. The relationship between caregiver burden and perceived social support was also explored. METHODOLOGICAL DESIGN AND JUSTIFICATION:A descriptive observational design targeting the entire population of caregivers registered with home health services in Şırnak Province was adopted. This design allowed for a comprehensive assessment of caregiving dynamics in their natural context. ETHICAL ISSUES AND APPROVAL:Ethical approval was obtained from Istanbul Medipol University Ethics Committee (Protocol No. 1315, 26/12/2024). Institutional permission was granted by the Şırnak Provincial Health Directorate. Informed verbal consent was obtained from all participants in line with the Declaration of Helsinki. RESEARCH METHODS, INSTRUMENTS AND/OR INTERVENTIONS; OUTCOME MEASURES: Data were collected through face-to-face interviews using a structured questionnaire. Caregiver burden and perceived social support were measured using the Zarit Caregiver Burden Scale (ZCBS) and the Multidimensional Scale of Perceived Social Support (MSPSS). Data analysis included descriptive statistics, non-parametric tests, and Spearman's correlation. RESULTS:Among 1022 caregivers, the mean ZCBS score was 41.24 ± 19.79, and the mean MSPSS score was 50.82 ± 17.48. Sociodemographic factors such as age, gender, education, residence, and caregiving characteristics were significantly associated with caregiver burden and perceived social support (p < 0.05). A positive correlation was found between caregiver burden and perceived social support (rs = 0.153, p < 0.01). STUDY LIMITATIONS:The descriptive nature limits causal inference. Self-reported data may introduce bias, and regional factors may affect generalisability. CONCLUSIONS:Caregivers within home health services experience high burden and moderate social support. These findings emphasise the need to enhance home healthcare quality, provide caregiver support programs, and increase access to training and counselling, especially in rural areas.
BACKGROUND:Loneliness, distinct from social isolation, is a subjective sense of social disconnection exacerbating a public health crisis among older adults. Affecting ~33% of community-dwelling individuals aged 50-80 years post-COVID-19, it rivals smoking in mortality risk and drives cognitive, cardiovascular, and mental health declines. This review synthesises evidence to inform clinical strategies. METHODS:A critical review of per-reviewed meta-analyses, RCTs, and prospective cohorts literature (2019-2025) was conducted for adults aged 50 years and above. Studies were selected using validated loneliness or social isolation measures, with quality appraised via AMSTAR-2, Cochrane RoB 2, and Newcastle-Ottawa Scale; 34 studies met eligibility criteria from an initial yield of 1,847 records. RESULTS:Prevalence of loneliness stands at 29% isolation by 2024, highest among those with poor health (53%-75%), unemployment (52%), solitary living, and ages 50-64. Loneliness elevates all-cause mortality (32%), dementia (50%-59%), cardiovascular events (29%-32%), depression (40%), and anxiety (35%). Mechanisms include increased inflammation (↑CRP, IL-6), HPA dysregulation, immune compromise, hippocampal atrophy, and behavioural lapses. Interventions like CBT/reminiscence therapy, multicomponent programs, animal therapy, exercise, and digital platforms have been shown to reduce loneliness, though primary care implementation lags due to screening/referral barriers. Tools such as the UCLA Loneliness Scale enable feasible assessment. CONCLUSIONS:Loneliness as a geriatric syndrome demands mandated screening, provider education, and reimbursement reforms. Coordinated healthcare-community efforts could avert substantial morbidity/mortality, addressing gaps in long-term outcomes and cost-effectiveness research.
BACKGROUND:This article introduces a reflexive methodological framework for evaluating the quality of hermeneutic research, grounded in interpretive epistemologies and a reinterpretation of Lincoln and Guba's classic trustworthiness criteria. While hermeneutic inquiry has become increasingly significant, few frameworks explicitly align quality evaluation with its ontological and epistemological foundations. Existing standards often reflect post-positivist ideals of neutrality and replicability, creating tension with the philosophical assumptions of hermeneutics. AIM:The aim of this article was to develop and present the DORR Framework, a hermeneutically grounded and philosophically coherent structure for assessing interpretive rigour in hermeneutic research as a whole. DESIGN:The framework synthesizes insights from philosophical hermeneutics caring science and qualitative methodology. Lincoln and Guba's trustworthiness criteria, credibility, transferability, dependability, and confirmability are reinterpreted through hermeneutic principles, resulting in four dimensions: Depth, Openness, Resonance, and Reflexivity. RESULTS:Each dimension is operationalised through reflective questions designed to support researchers in demonstrating interpretive depth, dialogical openness, contextual resonance, and reflexive accountability, while avoiding procedural reductionism. CONCLUSION:The DORR Framework offers a philosophically coherent yet practically applicable approach to evaluating hermeneutic inquiry. By fostering epistemological transparency, ethical integrity, and scholarly reflexivity, it equips researchers, supervisors, and reviewers with a means of assessing quality that is consistent with the philosophical and ethical foundations of caring science, including attentiveness to human dignity, suffering, and responsible knowledge development in health-related research.
AIM:To explore how patients and their relatives perceive and experience emergency care delivered at home by Mobile Emergency Teams (METs). DESIGN:An exploratory qualitative design was used to explore how patients and relatives experienced the care encounter. This approach was appropriate given the exploratory nature of the study. ETHICAL CONSIDERATIONS:The study was approved by the Swedish Ethical Review Authority (No: 2023-02186-01) and conducted in accordance with the Declaration of Helsinki. Participants provided informed consent, were assured of confidentiality, and were informed of their right to withdraw at any time. METHODS:The study was conducted in southwestern Sweden and included 20 semi-structured interviews with patients (n = 11), relatives (n = 4), and joint patient-relative interviews (n = 5) who had recently received care from METs. Interviews were audio-recorded and transcribed verbatim. Data were analyzed using Braun and Clarke's six-phase thematic analysis. RESULTS:The analysis generated two overarching themes: Embraced by a calming environment and A sense of safety and security. Participants described METs' arrival as a turning point that brought calm and clarity to emotionally intense situations. The teams' respectful approach, clear communication and structured assessments contributed to emotional reassurance. Receiving care at home, in a familiar environment and in the presence of loved ones, supported participants' sense of dignity, autonomy and control. However, some participants expressed uncertainty about what would happen after METs' departure, indicating a need for improved follow-up and continuity of care. LIMITATIONS:Findings are shaped by a specific Swedish context, joint interviews and purposive sampling, which may limit transferability. CONCLUSION:Emergency care at home was experienced as emotionally supportive and clinically competent. Attentiveness, clarity and a respectful presence were central to participants' sense of being thoroughly and considerately cared for.
BACKGROUND:Dignity care for older adults in China is gradually advancing, but there remains a lack of appropriate assessment tools. AIM:This study aimed to translate the 18-item Jacelon Attributed Dignity Scale into Chinese and evaluate its reliability and validity. METHODS:The original English version of the Jacelon Attributed Dignity Scale was translated into Chinese following Brislin's translation procedure. A convenience sample of 200 Chinese older adults was recruited. Item screening, internal consistency, test-retest reliability, content validity, construct validity and convergent validity were examined to establish the reliability and validity of the Chinese version of the scale. RESULTS:The Cronbach's α coefficient and test-retest correlation of the Chinese version of the Jacelon Attributed Dignity Scale were 0.959 and 0.891, respectively. The content validity index was 0.972. Confirmatory factor analysis supported the four-factor model (χ2/df = 2.431, p < 0.001; comparative fit index = 0.932; root mean square error of approximation = 0.085; Tucker-Lewis index = 0.920; standardised root mean square residual = 0.048). The scale demonstrated adequate reliability and convergent validity, as indicated by acceptable values of composite reliability (CR = 0.800-0.924) and average variance extracted (AVE = 0.515-0.710). CONCLUSION:The Chinese version of the Jacelon Attributed Dignity Scale exhibits good reliability and validity and can be utilised to assess the dignity of Chinese older adults.
