Nordic Journal of Nursing Research

Knowledge about care providers’ experiences of working in residential care of older people during times of downsizing and reorganisation is scarce, and it is not known whether/how their conscience is influenced by such changes. The aim was to describe care providers’ experiences of working in private residential care for older people during downsizing and reorganisation, focusing on troubled conscience. This study adopted a qualitative descriptive design based on interviews with seven care providers. A qualitative content analysis was used. The overall understanding was revealed as perceiving oneself as pinioned in between current circumstances to provide care and what one’s conscience conveyed. Care providers perceived: deteriorating working conditions as exhausting, downsizing and reorganisation as triggering one’s conscience when collaborating, troubled conscience when downsizing and reorganisation decrease the quality of care, and good management as crucial during downsizing and reorganisation. The results highlight that adequate communication strategies, well-functioning leadership and opportunities to know together and share what one’s conscience tells are aspects that need consideration.

Building trustworthy relationships that promote equal participation is a fundamental feature of daily living in dementia care. Creating a social community is thus a key component of quality of life for residents in dementia special care units. The aim of this study was to explore healthcare personnel’s experiences of enhancing social community in common spaces in dementia special care units. A qualitative descriptive design consisted of four focus-group interviews with 15 healthcare personnel. The transcribed interviews were analyzed inductively using qualitative content analysis. The findings revealed that healthcare personnel’s experiences of enhancing social community in common spaces were related to three main themes, expressed as dilemmas between knowing versus not knowing each other, safety versus unsafety and presence versus absence. Our analysis indicates that to enhance social community, it is essential for healthcare personnel to be able to create different forms of proximity to residents: physical, narrative and moral. Moreover, the meaning and role of ‘proximity’ in dementia care should be further explored as organizational context influences spatial-structural practices and may disrupt proximity in dementia care.

In meetings with healthcare professionals, transgender people are often met with ignorance. The meetings tend to focus more on the person’s gender identity rather than reasons for the contact and therefore may be perceived as being offensive to that person. The aim of the study was to describe transgender people’s experiences in their meetings with healthcare professionals. Fourteen transgender persons were interviewed in this descriptive qualitative study. The semi-structured interviews were audiotaped. Data were collected during January–February 2015 and analysed using content analysis. Three themes were identified: ‘Experience of treatment by healthcare professionals’, ‘Expectations of meeting with healthcare professionals’ and ‘Consequences of meetings with healthcare professionals’. Findings revealed that healthcare professionals do not always respect the patient’s gender identity. This could lead to their avoiding contact with healthcare services. More education/training of healthcare personnel for the treatment of transgender people seeking care is requested.

When children are seriously ill, being able to be cared for at home with the family is valuable, but community nurses are often not trained to care for children. The aim of this study was therefore to describe community nurses’ perceptions of caring for seriously ill children at home. A content analysis was conducted of 11 semi-structured interviews with nurses. One theme, obligation to care, was found, followed by three categories: making an impact, feeling confident, and emotional processing. In conclusion, we found collaboration with paediatric staff in the hospital is important for community nurses in order to gain confidence, which would optimise care at home for seriously ill children and their families.

The aim of this study was to explore attitudes towards research among a subgroup of Swedish nurses specializing in ophthalmic care and to compare the results with the findings of a similar study from 2001. A cross-sectional survey was conducted with a convenience sample of 250 Swedish nurses. A factor analysis was performed on the responses to a web-based questionnaire to discern the factors underlying the ophthalmic nurses’ attitudes. Responses to open-ended questions were analysed using content analysis. A five-factor solution accounted for 47% of the cumulative variance, with Cronbach’s alpha values ranging from 0.56 to 0.8. The responses to the open-ended questions indicated that among the nurses interested in conducting research, lack of time was the most prominent cause for not doing so, whereas older age and time constraints were the most important factors for those who were not interested in research, largely consistent with previous studies. Furthermore, the nurses mentioned frustration and bad experiences related to conducting research during their education programmes. Overall, however, the participating ophthalmic nurses were more reluctant to engage in research, perhaps because of their significantly older age compared to a previous study cohort. The results reveal new information implying that further qualitative studies would be beneficial to the planning of nursing education and to the integration of nurses in clinical scientific work.

Thirteen carers were interviewed about their ethical reasoning when using a common staff approach to restricting smoking for a psychiatric in-patient. A constructed case structure and a vignette method were used in the interviews, and manifest content analysis of the texts exposed five ethical positions adopted by the carers: ‘best for the person’, ‘best for the patient’, ‘best for others involved with the person/patient’, ‘best for me as a carer’, and ‘best according to rules and regulations’. A second manifest content analysis of language showed terms that expressed value judgments in regard to the carers’ personal experiences. Some carers argued at first from one ethical position, but when the question was changed, they argued from an opposite ethical position. Results may be understood in light of dialog philosophy; ethical reasoning during use of a common staff approach tends to focus either on relations with others or with oneself.

Ischemic heart disease (IHD) is a major cause of death for women worldwide, and thus it is important to focus on lifestyle changes to reduce the impact of the disease on women’s everyday lives. Nine women were interviewed using an explorative approach to describe women’s lifestyle changes after being diagnosed with IHD. Three major themes emerged; ‘Heart disease: A life-changing event’, ‘Social life – both inhibiting and promoting lifestyle changes’ and ‘Maintaining changes: An ongoing challenge and a conscious choice’. Ischemic heart disease caused anxiety, and the women strived to find meaning in life after diagnosis. Family had a great impact on the lifestyle changes made and the social aspect of exercise was highlighted as important. Time since onset of disease affected the effort to make lifestyle changes, showing that changes were easier to make immediately after onset but difficult to maintain over time.