ABSTRACT Introduction Research indicates that shame may undermine self‐worth, particularly in societies marked by high demands for self‐realization and individual responsibility, where failures are often internalized. Shame is a pervasive and potentially harmful affect, closely linked to self‐evaluation, mental health and societal expectations, yet its lived and existential dimensions remain insufficiently explored. In this study, shame is understood in relation to life‐suffering, an ontological dimension of suffering that touches the whole human being when dignity, belonging, life understanding and possibilities of being are challenged. Aim The study aims to deepen the understanding of shame as it is experienced and expressed, using life‐suffering as a theoretical framework. Method Hermeneutical reading of classic texts was used as the methodological framework and research method. Two contemporary novels written by Marie Aubert and Helga Flatland were selected as material for reading and interpretation. Findings The findings highlight shame as an interplay between desire and self‐disqualification, embodied shame and the vanishing self, shame arising from the sense of being different, shame as a generalized sense of not being enough as a human being, the shame of wanting to stand out, shame as unmet expectations and the sense of living the wrong life, and shame as the breaking point that opens new possibilities and dreams. Conclusion Shame, as a lived and dynamic force intertwined with life suffering, shapes human beings' understanding of self, human worth, belonging, relationships and capacity to act. Being seen, acknowledged and received by others in ways that affirm human dignity and restore vitality and agency. Rather than needing to be eliminated, shame may be borne, reconciled with and transformed through experiences of meaning, recognition and connection. In this way, existential vulnerability emerges not only as a source of suffering but also as an opening toward renewed meaning, hope and courage to live.
ABSTRACT Aim The aim of this study is to describe how nurses assess interventions to promote patients' sleep on hospital wards. Desing The study was a cross‐sectional survey, and it was conducted among nurses in Finnish specialist healthcare in 2022. Methods Out of 482 eligible participants in the sampling frame, 129 nurses returned a completed questionnaire. The open‐ended question was answered by 36 participants. Data were analysed using statistical methods and inductive content analysis. Results In general, participants assessed that they perform well in sleep‐promoting activities in a hospital ward. Participants gave the highest assessment to supporting patients' mental and emotional well‐being. Minimising disturbance related to nursing interventions got the lowest scores. Based on the open‐ended questions, respondents described that the realisation of patients' sleep support in the hospital related to the care environment, patient placement within the ward, resources available for nursing interventions, sleep‐supporting aids, care culture and training related to supporting patients' sleep. Conclusion Nurses assess that they are implementing patient sleep‐promotion interventions well. Nurses realise patients' sleep promotion as a part of their daily activities. Nurses can promote patient's sleep with small activities, as long as the organisation takes care of the nurses' skills and ensures practical interventions so that the patient gets enough rest during the treatment period.
ABSTRACT Introduction A burn patient requiring admission to a Burn Unit undergoes a challenging treatment process whose physical, emotional and social consequences can result in self‐care deficits. In this regard, Orem's Self‐Care Deficit Nursing Theory (SCDNT) is utilized to frame and systematize nursing interventions according to the identification of the care needs of the hospitalized burn patient. Aim This study aimed to identify and synthesize the care needs of burn patients during hospitalization, using Orem's Self‐Care Deficit Nursing Theory as a theoretical framework. Methodology A meta‐synthesis was conducted in accordance with the guidelines of the Joanna Briggs Institute (JBI) and PRISMA. The search was carried out across four databases, resulting in the inclusion of 10 primary studies with adult participants. The analysis of the articles led to the identification of four categories through thematic synthesis, which were mapped onto Orem's self‐care deficit nursing theory. Results Four main categories of care needs were identified: I. Physical and Self‐Care Needs (pain, skin integrity, functional recovery); II. Emotional Distress and Adaptation to Illness (fear, anxiety); III. Therapeutic Relationship and Humanized Care (empathic communication, privacy); and IV. Social Support and Continuity of Care (family involvement, post‐discharge support). This categorization allowed for an articulation with Orem's theory through the transition between compensatory nursing systems (acute phase) and supportive‐educative systems (hospitalization phase and immediately prior to clinical discharge). Conclusion The physical and psychological trauma associated with a burn injury requires a multifaceted intervention by the nursing team. These professionals, within a logic of transition between compensatory and supportive‐educative systems, must develop interventions not only at the level of burn pathophysiology (pain, hemodynamic instability, and functional rehabilitation) but also regarding the integration of significant others into the patient's care dynamics, as well as establishing a therapeutic relationship capable of yielding gains after clinical discharge.
ABSTRACT Aims and Objectives This study aims to describe the current practices for involving relatives of hospitalised patients. Methodological Design and Justification A descriptive qualitative design using a combination of field observations and semi‐structured individual interviews with hospitalised patients, relatives and healthcare professionals was applied as part of the first phase of a multiphase Participatory Action Research project. The Consolidated Criteria for Reporting Qualitative Research (COREQ) guided the reporting. Ethical Issues and Approval The study adhered to the Helsinki Declaration and Nordic ethical guidelines for nursing research. All participants provided informed consent. Outcome Measures and Findings Three overarching themes emerged: different strategies and approaches for interaction between relatives and healthcare providers, various roles and positions of relatives and enablers and barriers for involvement of relatives. Study Limitations The study is limited by a small number of interviewed patients and relatives (all spouses) which may limit the transferability of findings to other types of relatives, such as adult children, as well as to close friends and similar relations, who may have different roles and expectations. Conclusions Involvement of relatives in hospital care is a complex balancing act, shaped by professional attitudes and the evolving expectations of patients and relatives. Our findings reveal that relatives occupy shifting roles and may require support themselves, with both organisational and personal factors influencing their involvement. Consequently, recognising the diverse roles and support needs of relatives is essential for preventing misunderstandings and for person‐ and family‐centred care.
ABSTRACT Introduction Providing home‐based care to children with type 1 diabetes (T1D) places healthcare professionals (HCPs) in complex and demanding practice contexts. Outside the clinic, HCPs must adapt their expertise to families' everyday lives, navigate shifting roles and manage emotional and relational challenges, particularly when working with vulnerable families. These situations often involve competing priorities, social constraints and complex family dynamics that challenge conventional care approaches and require additional competencies and support. Despite this, HCPs' perspectives remain underexplored. Therefore, this study aims to explore how HCPs experience, interpret and respond to the challenges and needs that arise when delivering diabetes care in the homes of children with T1D and their families in vulnerable positions. Methods A qualitative study with a phenomenological‐hermeneutical approach inspired by Paul Ricoeur's philosophy of interpretation and narrative was conducted using 75 h of field observations and two focus group interviews with 14 HCPs. Data were analysed through naïve reading, structural analysis and critical interpretation. Results Home‐based diabetes care was experienced as an ongoing process of learning and development, involving the expansion of competencies and the renegotiation of professional roles. Expert knowledge as the foundation for care provided stability but required adaptation to family contexts. Interpersonal work and emotional challenges involved building trust, managing relationships and coping with emotional strain and uncertainty. New and unfamiliar issues included encountering complex psychosocial problems, ethical dilemmas and role ambiguity, often beyond HCPs' expertise. Together, these dimensions illustrate how home‐based care demands flexibility, emotional engagement and broader competencies, while increasing the need for supervision, peer support and organisational guidance. Conclusions Home‐based T1D care in vulnerable families is experienced as a complex, evolving practice requiring adaptable clinical and relational competencies, emotional engagement and role flexibility. Increased psychosocial demands highlight the need for structured education, supervision, organisational support and strengthened multidisciplinary and intersectoral collaboration.
