Dealing with troubled conscience in municipal care of older people

2013 ◽  
Vol 20 (3) ◽  
pp. 300-311 ◽  
Author(s):  
Eva Ericson-Lidman ◽  
Gunilla Strandberg
Keyword(s):  
Content Analysis ◽  
Quality Of Care ◽  
Older People ◽  
Healthcare Personnel ◽  
Care Providers ◽  
Thematic Content Analysis ◽  
Thematic Content ◽  
Daily Work

Troubled conscience may jeopardize the health of healthcare personnel and, hence, the quality of care provided. Learning more about how personnel deal with their troubled conscience therefore seems important. The aim of this study was to describe personnel’s experiences of how they deal with troubled conscience generated in their daily work in municipal care of older people. Interviews were conducted with 20 care providers and analysed with a thematic content analysis. The findings show that in order to deal with troubled conscience, personnel dialogued with themselves and with others. They took measures in a direction they perceived to be correct, and they expressed a need for distancing and re-energizing. It is of importance to share situations that generate troubled conscience in order to find ways to deal with them. Reconsidering one’s ways of dealing with troubled conscience may give care providers an opportunity to reach consensus within themselves.

scholarly journals Views of Canadian Patients on or Nearing Dialysis and Their Caregivers: A Thematic Analysis

2014 ◽  
Vol 1 ◽  
pp. 4 ◽  
Author(s):  
Lianne Barnieh ◽  
Kathryn King-Shier ◽  
Brenda Hemmelgarn ◽  
Andreas Laupacis ◽  
Liam Manns ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
Content Analysis ◽  
Financial Support ◽  
Convenience Sample ◽  
Thematic Content Analysis ◽  
Thematic Content ◽  
Psychosocial Wellbeing ◽  
Appropriate Care

Background: Quality of life of patients receiving dialysis has been rated as poor. Objective: To synthesize the views of Canadian patients on or nearing dialysis, and those who care for them. Design: Secondary analysis of a survey, distributed through dialysis centres, social media and the Kidney Foundation of Canada. Setting: Pan-Canadian convenience sample. Participants: Patients, their caregivers and health-care providers. Measurements: Text responses to open-ended questions on topics relevant to end-stage renal disease. Methods: Statements related to needs, beliefs or feelings were identified, and were analysed by thematic content analysis. Results: A total of 544 relevant statements from 189 respondents were included for the thematic content analysis. Four descriptive themes were identified through the content analysis: gaining knowledge, maintaining quality of life, sustaining psychosocial wellbeing and ensuring appropriate care. Respondents primarily identified a need for more information, better communication, increased psychosocial and financial support for patients and their families and a strong desire to maintain their previous lifestyle. Limitations: Convenience sample; questions were originally asked with a different intent (to identify patient-important research issues). Conclusions: Patients on or nearing dialysis and their caregivers identified four major themes, gaining knowledge, maintaining quality of life, sustaining psychosocial wellbeing and ensuring appropriate care, several of which could be addressed by the health care system without requiring significant resources. These include the development of patient materials and resources, or sharing of existing resources across Canadian renal programs, along with adopting better communication strategies. Other concerns, such as the need for increased psychosocial and financial support, require consideration by health care funders.

scholarly journals Sadness, despair and anger when a patient dies alone from COVID-19: A thematic content analysis of Twitter data from bereaved family members and friends

2021 ◽  
pp. 026921632110170
Author(s):  
Lucy E Selman ◽  
Charlotte Chamberlain ◽  
Ryann Sowden ◽  
Davina Chao ◽  
Daniel Selman ◽  
...  
Keyword(s):  
Public Health ◽  
Content Analysis ◽  
End Of Life ◽  
English Language ◽  
Qualitative Content Analysis ◽  
Care Providers ◽  
Thematic Content Analysis ◽  
Thematic Content ◽  
Twitter Data ◽  
Health And Social Care

Background: To inform clinical practice and policy, it is essential to understand the lived experience of health and social care policies, including restricted visitation policies towards the end of life. Aim: To explore the views and experiences of Twitter social media users who reported that a relative, friend or acquaintance died of COVID-19 without a family member/friend present. Design: Qualitative content analysis of English-language tweets. Data sources: Twitter data collected 7–20th April 2020. A bespoke software system harvested selected publicly-available tweets from the Twitter application programming interface. After filtering we hand-screened tweets to include only those referring to a relative, friend or acquaintance who died alone of COVID-19. Data were analysed using thematic content analysis. Results: 9328 tweets were hand-screened; 196 were included. Twitter users expressed sadness, despair, hopelessness and anger about their experience and loss. Saying goodbye via video-conferencing technology was viewed ambivalently. Clinicians’ presence during a death was little consolation. Anger, frustration and blame were directed at governments’ inaction/policies or the public. The sadness of not being able to say goodbye as wished was compounded by lack of social support and disrupted after-death rituals. Users expressed a sense of political neglect/mistreatment alongside calls for action. They also used the platform to reinforce public health messages, express condolences and pay tribute. Conclusion: Twitter was used for collective mourning and support and to promote public health messaging. End-of-life care providers should facilitate and optimise contact with loved ones, even when strict visitation policies are necessary, and provide proactive bereavement support.

Fall Prevention Program Characteristics and Experiences of Older Adults and Program Providers in Canada: A Thematic Content Analysis

2019 ◽  
Vol 39 (10) ◽  
pp. 1124-1133 ◽  
Author(s):  
Humna Malik ◽  
Briana Virag ◽  
Fiona Fick ◽  
Paulette V. Hunter ◽  
Sharon Kaasalainen ◽  
...  
Keyword(s):  
Older Adults ◽  
Content Analysis ◽  
Health Care Providers ◽  
Fall Prevention ◽  
Prevention Programs ◽  
Care Providers ◽  
Structured Interviews ◽  
Thematic Content Analysis ◽  
Thematic Content ◽  
Accessible Information

Objectives: To document the characteristics of fall prevention programs in specific regions in two Canadian provinces and to explore older adults’ and program providers’ experiences with these programs. Methods: Semi-structured interviews were conducted with 16 program providers/managers from 12 different programs. Ten semi-structured focus groups were conducted with 59 older adults. Data were analyzed using thematic content analysis. Results: Older adults reported functional and social benefits. Program providers identified barriers to program success, including cognitive impairment, frailty, and lack of motivation. The need for general attitudinal changes toward older adults’ needs and broader community changes were identified as important by the older adults. Discussion: Easily accessible information about fall prevention programs for older adults and no-cost, ongoing initiatives were critical. Health care providers play keys roles in disseminating information, facilitating referrals, and advocating for initiatives that best meet the needs of older adults in their communities.

Using a developed participatory action research process in practice to help care providers deal with troubled conscience in residential care of older people

2016 ◽  
Vol 16 (2) ◽  
pp. 190-206 ◽  
Author(s):  
Eva Ericson-Lidman ◽  
Gunilla Strandberg
Keyword(s):  
Quality Of Care ◽  
Action Research ◽  
Older People ◽  
Participatory Action Research ◽  
Residential Care ◽  
Research Process ◽  
Care Providers ◽  
Participatory Action ◽  
Care For Older People

Stress of conscience seriously influence the quality of care and the wellbeing of the care providers in care for older people. It is therefore of great importance to take measures to address, and relieve but preferably prevent stress related to troubled conscience. In our participatory action research studies, we have used troubled conscience as a driving force to relieve care providers’ burden and to increase quality of care. The aim with this paper is to present our experiences of using a further developed participatory action research process in practice to deal with care providers' troubled conscience in residential care for older people. The contribution to participatory action research practice in our studies is a support to the participatory action research process through using a modified model of problem processing, an approach which we found fruitful. In the paper, we describe our experiences and discuss them in relation to relevant literature and theory. Our experiences are that in participatory action research it is crucial to build a trusting relationship and striving to create a fruitful dialogue between the researchers and the participants. In our studies, we found that participatory action research is an easy approach to adapt as a problem-solving process in clinical practice and in nursing research.

The reciprocity of the quality of care providers' occupational life of and the quality of care: A cycle model

2013 ◽  
Author(s):  
Marco Ferrara ◽  
Sara Viotti ◽  
Daniela Converso ◽  
Valentina Trotta ◽  
Gloria Guidetti ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Care Providers ◽  
Cycle Model ◽  
Occupational Life

scholarly journals Understanding the Link between Family Caregiver Quality of Life and the Care Provided to Older People With Dementia

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 153-154
Author(s):  
Afeez Hazzan
Keyword(s):  
Quality Of Life ◽  
Quality Of Care ◽  
Older People ◽  
Family Caregivers ◽  
Family Caregiver ◽  
Well Being ◽  
The United States ◽  
People With Dementia ◽  
The Impact

Abstract Dementia is one of the most rapidly growing diseases in the United States. In 2018, the direct costs to American society of caring for older people with dementia was approximately $277 billion. Primary informal caregivers are mainly responsible for the care of older people with dementia including Alzheimer’s disease. Caregivers perform a myriad of duties ranging from shopping for their loved ones’ groceries, helping with medications, and managing finances. The caregiving role becomes more demanding as the disease progresses over time, and studies have shown that the quality-of-life (QoL) experienced by caregivers of older adults who have dementia is lower than the QoL of caregivers for older people who do not have dementia. To the best of our knowledge, there has been no research conducted to investigate whether lower caregiver QoL affects the level or quality of care that caregivers provide to persons with dementia. In the current study, we interviewed family caregivers living in Rochester, New York to inquire about their quality of life and the care provided to older people living with dementia. Further, caregivers completed the 36-item Short Form Health Survey (SF-36) as well as a draft questionnaire for measuring the quality of care provided to older people living with dementia. Both quantitative and qualitative findings from this study reveals important relationships between family caregiver QoL and the care provided, including the impact of social support and financial well-being. The study findings could have significant impact, particularly for the provision of much needed support for family caregivers.

scholarly journals Care-seeking and managing diabetes in rural Bangladesh: a mixed methods study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hannah Maria Jennings ◽  
Joanna Morrison ◽  
Kohenour Akter ◽  
Hassan Haghparast-Bidgoli ◽  
Carina King ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Health Care Providers ◽  
Low Income ◽  
Diabetes Management ◽  
Local Health ◽  
Care Seeking ◽  
Care Providers ◽  
Structured Interviews ◽  
Rural Bangladesh

Abstract Background Type 2 diabetes mellitus poses a major health challenge worldwide and in low-income countries such as Bangladesh, however little is known about the care-seeking of people with diabetes. We sought to understand the factors that affect care-seeking and diabetes management in rural Bangladesh in order to make recommendations as to how care could be better delivered. Methods Survey data from a community-based random sample of 12,047 adults aged 30 years and above identified 292 individuals with a self-reported prior diagnosis of diabetes. Data on health seeking practices regarding testing, medical advice, medication and use of non-allopathic medicine were gathered from these 292 individuals. Qualitative semi-structured interviews and focus group discussions with people with diabetes and semi-structured interviews with health workers explored care-seeking behaviour, management of diabetes and perceptions on quality of care. We explore quality of care using the WHO model with the following domains: safe, effective, patient-centred, timely, equitable and efficient. Results People with diabetes who are aware of their diabetic status do seek care but access, particularly to specialist diabetes services, is hindered by costs, time, crowded conditions and distance. Locally available services, while more accessible, lack infrastructure and expertise. Women are less likely to be diagnosed with diabetes and attend specialist services. Furthermore costs of care and dissatisfaction with health care providers affect medication adherence. Conclusion People with diabetes often make a trade-off between seeking locally available accessible care and specialised care which is more difficult to access. It is vital that health services respond to the needs of patients by building the capacity of local health providers and consider practical ways of supporting diabetes care. Trial registration ISRCTN41083256. Registered on 30/03/2016.

scholarly journals Need to Intervene: An Exploratory Study of Nurses’ Experiences With Patienthood

2021 ◽  
Vol 8 ◽  
pp. 237437352199884
Author(s):  
Marian A O Cohen ◽  
Jim McQuaid ◽  
Ruth Remington
Keyword(s):  
Patient Satisfaction ◽  
Quality Of Care ◽  
Healthcare System ◽  
Family Caregiver ◽  
Exploratory Study ◽  
Medical Personnel ◽  
Healthcare Personnel ◽  
Coordination Of Care ◽  
Professional Perspective

Much has been written about the patient experience, but there is little information about experiences of providers as patients. Since lay patients and providers have differing perspectives and expectations, it is important to identify those elements shared by those in each group and those that diverge. This study identified experiences of nurses as being a patient or a family caregiver of a patient as well as identified assessments of the healthcare system by nurses. An exploratory study using a self-administered electronic questionnaire with a group of registered nurses was conducted. Assessments of the system by responders were positive when addressing quality of care, interactions among healthcare personnel, and interactions with patients. However, when discussing their experiences as patient, nurses reported they encountered problems with coordination of care, responses of medical personnel, attention to details of care, and responses to their attempts to become more involved. Results confirm issues raised by patients who are not medical experts in patient satisfaction studies. Adding a professional perspective highlights where problems with the healthcare system lie.

scholarly journals Quality of Care Provided by Family Caregivers of Older People With Dementia: Measurement and Interpretations

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 152-152
Author(s):  
Afeez Hazzan
Keyword(s):  
Quality Of Care ◽  
Older People ◽  
Family Caregivers ◽  
Family Caregiver ◽  
Primary Reason ◽  
People With Dementia ◽  
High Level ◽  
The Impact ◽  
The Relationship

Abstract Family caregivers of older people living with dementia are relatives, friends, or neighbors who provide assistance related to this condition, but who are unpaid for the services they provide. Although caregiving could be personally rewarding, many caregivers report a high level of strain. Compared to caregivers of older adults who do not have dementia, family caregivers of older people living with dementia report lower quality-of-life (QoL). In a published systematic review examining the relationship between family caregiver QoL and the quality of care provided, only one study was found to be somewhat relevant. The study suggested that the primary reason for an absence of research into the link between family caregiver QoL and quality of care was the absence of a questionnaire for measuring quality of care in dementia. Therefore, any attempt to investigate the impact of caregiver QoL on the care provided to older people with dementia must first address the lack of an instrument to measure quality of care. To address this issue, we interviewed approximately 20 family caregivers in order to elicit feedback on measurements and interpretation of the quality of care provided by family caregivers of older people living with dementia. Content analysis of the interview transcripts revealed that the quality of relationships with family, caregiver availability to provide or supervise care, and availability of paid or volunteer help are important for the quality of care provided. These results have important implications, particularly for the development of an instrument to measure quality of care in dementia.

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