AIM: The purpose of this study was to describe how nurses apply the components of family nursing conversations in their home healthcare practice.METHOD: A qualitative content analysis with a deductive approach was conducted. Home healthcare nurses conducted family nursing conversations with families from their practice. Families were selected based on three nursing diagnoses: risk of caregiver role strain, caregiver role strain or interrupted family processes. Nurses audio-recorded each conversation and completed a written reflection form afterwards. Transcripts of the audio-recorded conversations were analysed in Atlas.ti 8.0 to come to descriptions of how nurses applied each component. Nurses' reflections on their application were integrated in the descriptions.RESULTS: A total of 17 conversations were audio-recorded. The application of each component was described as well as nurses' reflections on their application. Nurses altered or omitted components due to their clinical judgment of families' needs in specific situations, due to needs for adjustment of components in the transfer from theory to practice or due to limited skill or self-confidence.CONCLUSION: All of the components were applied in a cohesive manner. Nurses' application of the components demonstrates that clinical judgment is important in applying them. Further training or experience may be required to optimise nurses' skill and self-confidence in applying the components. This study demonstrates the applicability of the family nursing conversations components in home health care, allowing exploration of the working mechanisms and benefits of family nursing conversations for families involved in long-term caregiving in future studies.
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AIM: The purpose of this study was to describe how nurses apply the components of family nursing conversations in their home healthcare practice.METHOD: A qualitative content analysis with a deductive approach was conducted. Home healthcare nurses conducted family nursing conversations with families from their practice. Families were selected based on three nursing diagnoses: risk of caregiver role strain, caregiver role strain or interrupted family processes. Nurses audio-recorded each conversation and completed a written reflection form afterwards. Transcripts of the audio-recorded conversations were analysed in Atlas.ti 8.0 to come to descriptions of how nurses applied each component. Nurses' reflections on their application were integrated in the descriptions.RESULTS: A total of 17 conversations were audio-recorded. The application of each component was described as well as nurses' reflections on their application. Nurses altered or omitted components due to their clinical judgment of families' needs in specific situations, due to needs for adjustment of components in the transfer from theory to practice or due to limited skill or self-confidence.CONCLUSION: All of the components were applied in a cohesive manner. Nurses' application of the components demonstrates that clinical judgment is important in applying them. Further training or experience may be required to optimise nurses' skill and self-confidence in applying the components. This study demonstrates the applicability of the family nursing conversations components in home health care, allowing exploration of the working mechanisms and benefits of family nursing conversations for families involved in long-term caregiving in future studies.
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Malnutrition is a serious and widespread health problem in community-dwelling older adults who receive care in hospital and at home. Hospital and home care nurses and nursing assistants have a key role in the delivery of high-quality multidisciplinary nutritional care. Nursing nutritional care in current practice, however, is still suboptimal, which impacts its quality and continuity. There appear to be at least two reasons for this. First, there is a lack of evidence for nutritional care interventions to be carried out by nurses. Second, there are several factors, that influence nurses’ and nursing assistants’ current behaviour, such as lack of knowledge, moderate awareness of the importance and neutral attitudes. This results in a lack of attention towards nutritional care. Therefore, there is a need to generate more evidence and to focus on targeting the factors that influence nurses’ and nursing assistants’ current behaviour to eventually promote behaviour change. To increase the likelihood of successfully changing their behaviour, an evidence-based educational intervention is appropriate. This might lead to enhancing nutritional care and positively impact nutritional status, health and well-being of community-dwelling older adults. The general objectives of this thesis are: 1) To understand the current state of evidence regarding nutrition-related interventions and factors that influence current behaviour in nutritional care for older adults provided by hospital and home care nurses and nursing assistants to prevent and treat malnutrition. 2) To develop an educational intervention for hospital and home care nurses and nursing assistants to promote behaviour change by affecting factors that influence current behaviour in nutritional care for older adults and to describe the intervention development and feasibility.
For English see below In dit project werkt het Lectoraat ICT-innovaties in de Zorg van hogeschool Windesheim samen met zorganisaties de ZorgZaak, De Stouwe, en IJsselheem en daarnaast Zorgcampus Noorderboog, Zorgtrainingscentrum Regio Zwolle, Patiëntenfederatie NPCF, VitaalThuis, ActiZ, Vilans, V&VN, Universiteit Twente en het Lectoraat Innoveren in de Ouderenzorg van Windesheim aan het in staat stellen van wijkverpleegkundigen om autonoom en doelmatig, op basis van klinisch redeneren, eHealth te indiceren en in te zetten bij cliënten. De aanleiding voor dit project wordt gevormd door de wijzigingen per 1 januari 2015 in de Zorgverzekeringswet. Wijkverpleegkundigen zijn sindsdien zelf verantwoordelijk voor de indicatiestelling en zorgtoewijzing voor verzorging en verpleging thuis: zij moeten bepalen welke zorg hun cliënten nodig hebben gezien hun individuele situaties, en hoe die zorg het best geleverd kan worden. Zorgverzekeraars leggen hierbij minimumeisen op, o.a. met betrekking tot de inzet van eHealth. Wijkverpleegkundigen hebben op dit moment echter niet of nauwelijks ervaring met het inzetten en toepassen van technologische toepassingen zoals eHealth. Vraagarticulatie leidde tot de volgende praktijkvraagstelling: 1. Hoe kunnen wijkverpleegkundigen worden voorzien in hun informatiebehoefte over eHealth? 2. Hoe kunnen wijkverpleegkundigen worden ondersteund in hun klinisch redeneren over het inzetten van eHealth bij hun cliënten? 3. Hoe kunnen wijkverpleegkundigen worden ondersteund bij het inzetten van eHealth in hun zorgproces? Het project levert hiertoe drie bijdragen: - De eerste bijdrage is een duurzaam geborgde keuzehulp (een app voor tablet of smartphone) waarmee wijkverpleegkundigen toegang hebben tot de benodigde informatie over eHealth-toepassingen en die aansluit bij de manier waarop wijkverpleegkundigen zorg indiceren (bijvoorbeeld door relaties te leggen tussen NIC-interventies en bijpassende eHealth-toepassingen). - Informatievoorziening is niet een afdoende antwoord op de handelingsverlegenheid van de wijkverpleegkundige omdat eHealth sterk in ontwikkeling is en blijft waardoor er altijd een discrepantie zal bestaan tussen de beschikbare en de benodigde informatie. . De tweede bijdrage van dit project is daarom kennis over (en inzicht in) het klinisch redeneren over de inzet van eHealth. Deze kennis wordt in het project doorvertaald naar een trainingsmodule die erop is gericht om het klinisch redeneren van wijkverpleegkundigen over het inzetten van eHealth en andere thuiszorgtechnologie bij hun cliënten te versterken. - De derde bijdrage van dit project omhelst inbedding van bovengenoemde resultaten in het verpleegkunde-onderwijs van onder meer Windesheim en in nascholingstrajecten voor wijkverpleegkundigen. Voor duurzame, bredere inbedding in het onderwijs wordt samengewerkt met regionale zorgonderwijsnetwerken. In this project the research group IT-innovations in Health Care of Windesheim University of Applied Sciences cooperates with care organisations de ZorgZaak, De Stouwe, and IJsselheem, and stakeholders Zorgcampus Noorderboog, Zorgtrainingscentrum Regio Zwolle, Patiëntenfederatie NPCF, VitaalThuis, ActiZ, Vilans, V&VN, University of Twente, and research group Innovation of Care of Older Adults of Windesheim to enable home care nurses to autonomously and adequately, based on clinical reasoning, allocate eHealth and implement it in patient care. The motivation behind this project lies in the alterations in the care insurance legislation per January 2015. Since then, home care nurses are responsible for the care allocation of all care at home: they determine which care their clients require, taking into account the individual situations, and how this care can best be delivered. Care insurance companies impose minimum requirements for this allocation of home care, among others concerning the implementation of eHealth. Home care nurses, however, have no or limited information about and experience with technical applications like eHealth. Articulation of the demands of home care nurses resulted in the following questions: 1. How can home care nurses be provided with information concerning eHealth? 2. How can home care nurses be supported in their clinical reasoning about the deployment of eHealth by their patients? 3. How can home care nurses be supported when deploying eHealth in their care process? This project contributes in three ways: " The first contribution is a sustainable selection tool (an app for tablet or smartphone) to be used by home care nurses to provide them with the required information about eHealth applications. This selection tool will work in accordance with how home care nurses allocate care, e.g. by relating NIC-interventions to matching eHealth applications. " Providing information is an insufficient, although necessary, answer to the demands of home care nurses because of continuously developing eHealth applications. Hence, the second contribution of this project is knowledge about (and insight in) the clinical reasoning about the deployment of eHealth. This knowledge will be converted into a training module aimed at strengthening the clinical reasoning about the deployment of eHealth by their patients. " The third contribution of this project concerns embedding the selection tool and the training module in regular education (among others at Windesheim) and in refresher courses for home care nurses. Cooperation with regional care education networks will ensure sustainable and broad embedding of both the selection tool and the training module.
The findings suggests that participation in music practices can significantly support caregivers' and nurses' contact with the people to whom they give care and the healthcare professionals' insights into the patients' and residents' personhood. Music can create experienced changes in the care environment through kairotic moments of connectivity and intimacy of the musical interaction. The music sessions support and reinforce the person-centred values of care delivery.The meaning of participatory music practices for the well-being and learning of healthcare professionals working with ageing patients and nursing home residents.
Personal factors, team factors, and organizational factors have a strong influence on the adoption of technology used by, for instance, nurses in homecare. This part of the research portfolio in Point of Care Diagnostics regards the adoption of diagnostic technology in the health care domain.
