Objective: Family can play a vital role in promoting the overall well-being of the critically ill patient. Despite this positive attribute, some nurses, for various reasons are hesitant to include family in patient care. The study explored family members and nurses' perspectives and experiences of family involvement in caring for patients in intensive care units. The objectives were to describe both nurses and family members' perspectives and experiences of family involvement in care. Methods: A descriptive exploratory qualitative study. Focus-group interviews were conducted using a purposeful sample of six family members of critically ill patients and six nurses from two intensive care units of a hospital in Bahrain. Results: A central finding was that overall critical care nurses were reluctant to involve family in care, despite the fact that generally family members were willing to participate in care. Themes that were common to both participant groups were that caring practices and active communication were central to quality patient care. Both groups agreed that kinship roles and relationships were pivotal to caring practices and enabled a sense of security and reassurance for family and patients. Despite the fact that nurses were aware that family knowledge of the patient made it possible for them to personalize patient care, they were reluctant to have open communication with family members and to include them in care. Instead they favored policy development to guide family involvement. Conclusions: Family members expressed the need to be part of caring practices. While the nurses acknowledged that family involvement in patient care benefited the patient they wanted policy guidelines to guide this participation in care. The findings suggest that role clarification of family members and clarification on the responsibilities of nurses are needed if family members are to be involved so that patient care adheres to international standards while maintaining cultural sensitivity to Islamic family values.
Despite the avoidance of death talk and nurses' lack of professional autonomy, they created awareness that death was imminent to family members and ensured that end of life care was given in a culturally sensitive manner and aligned to Islamic values.
The aim of this article is to explore the images of nursing that were presented in the media during the recent industrial action by nurses and midwives in the Republic of Ireland. Although both nurses and midwives took industrial strike action, the strike was referred to as 'the nurses' strike' and both nurses and midwives were generally referred to by the generic term 'nurses'. Data were gathered from the printed news media of The Irish Times over a period of one month--4 October to 4 November 1999--which included the nine days of the strike. Although we limited the source of our data to just one newspaper, the findings do provide an image of how nurses and nursing care are viewed by both health professionals and the public. This image appeared to give a higher value to masculine cultural codes and the performance of technical skills, whereas acts associated with feminine cultural codes of caring were considered of lower value.
Research has evidenced a marked increase in the prevalence of cancer among younger people with up to one in five, parenting children under the age of 18 years of age. When a parent is diagnosed with cancer they experience fears and anxieties as they attempt to simultaneously manage their role as parent, with the illness experience. Parents have expressed difficulties in knowing how to communicate appropriately with their children throughout the illness trajectory as they are primarily focused on protecting or shielding their children from knowledge of the illness. Understandably parents may become overwhelmed with significant parental stress impacting on their psychological wellbeing. This subsequently effects the well-being of the entire family unit, coupled with changes to routines, roles and responsibilities. This study was carried out to examine how a group psychosocial intervention Children's Lives Include Moments of Bravery (CLIMB®) helped young children to navigate parental cancer. A qualitative research design utilizing focus group methodology, artwork and individual interviews was used to generate data from 19 participants (parents, children and healthcare professionals). Three key themes emerged from the data, navigating the diagnosis, navigating emotions and changed routines, creating spaces to talk about cancer. The findings evidenced that attending CLIMB® was a positive experience for both children and parents. It gave the children the language and opportunity to express their fears and worries. CLIMB® equipped them with tools and skills to both express and manage their negative emotions, life skills that could be transferred to other challenging life events. All techniques that created spaces to talk and appeared to have a reassuring effect on the children. The parents appreciated the professional support that the structured intervention offered to them and helped them communicate more openly with their children. Creating spaces to talk about cancer reduces mistrust and tension between parents and children, when parental cancer occurs, and hopefully minimizes future psychological and social problems.
Objective: The aim of the study was to explore the lived experience of caregivers providing home care for terminally ill family members, with the objectives of describing their experiences of caring for relatives who are terminally ill with cancer and the needs of home caregiving in Bahrain. Methods: The study adopted a Heideggerian, hermeneutic phenomenological design, with a purposive sample of eight family caregivers. Data was generated through one to one, in-depth interviews and analyzed using Interpretative Phenomenological Analysis. Results: Three main themes emerged from the data: (1) the burden of care, (2) comforts, and (3) coping. The findings showed that the lived experience of home caregiving includes physical, emotional and financial burdens, combined with a lack of professional support. The collective experience was infused with intense emotions because of a lack of structured support, resulting in negative emotions that frequently affected the caregivers' well-being and their ability to care for the ill person. Nevertheless, caregivers tried to maintain care and comforts for their terminally ill relative in the home. They adopted the home environment, arranged resources to ease caring and provided psychological care. Caregivers utilized three coping mechanisms, faith, personal strategies and distribution of the care responsibilities among family members. Conclusions: Caregivers were not prepared for the commitment and burdens of home care when a family member is terminally ill. A recommendation from the study findings is that training be offered on nursing care before patients discharge. In addition, a reactivation of the palliative care clinic hotline service would support family caregivers. A further recommendation is that home nursing care and hospice services be established to improve homecare services for family caregivers in Bahrain.
Background: Heart failure (HF) is a worldwide chronic and progressive condition. HF symptoms affect an individual's life perspectives, and create dramatic changes in their everyday living routines. Qualitative studies showed that HF symptoms were associated with reported low quality of life, reduced physical activities, and altered social interactions and relationships. The aim of this study was to explore the experiences of men under the age of 65 diagnosed with HF living in the Kingdom of Bahrain. Methods: An interpretive phenomenological approach was used. In-depth, semi-structured interviews were conducted with six men under the age of 65 who were diagnosed with HF for a period of not less than a year. The interviews were conducted in Arabic, and then translated and transcribed into English. Smith's framework was drawn on for data analysis. Results: Three main themes emerged: the physical burden of the illness; the psychosocial aspects of the illness and living with HF. The findings showed that the physical symptoms shaped men's everyday work activities and also their resting and sleeping patterns. Participants expressed feelings of frustration, anger, and sadness following the diagnosis and recounted how their masculinity roles changed at home and in society. Families played a major role giving support to the men, who utilized different coping strategies, as lifestyle and behavioral modifications were adopted. Keeping faith and a belief in God, coupled with social support was a thread that connected all participants coping strategies. The authors recommend that educational programs for men who are diagnosed with HF and their families would help them cope with this chronic illness. Conclusions: Heart failure patients experience dramatic changes in their life. An understanding of the challenges they are facing in their daily living enables them, and those who care for them, both families and nurses, to creatively assist them live with the difficulties encountered with HF.
This study contributes to and engenders creative solutions on how best to ensure respectful, meaningful and effective communication with migrant patients and their families when receiving care in healthcare systems in resource-rich countries. People fleeing countries of origin are generally in need of humane, compassionate care due to strife in war-torn countries, civil conflict and social instability. Recently the United Nations expanded its definition of refugees to include people affected by natural disasters including climate change (Nicholas, 2019).In developed healthcare systems constrained by the principles of cost efficiency and local contextual conditions, it may be that respectful communications are difficult to implement in all clinical encounters, even with local population groups. Respectful meaningful communication takes time and the sensitive use of an expansive or 'thick' discourse when health decisions need to be made by patients and or family members (O'Neill, 2012). But when migrant populations who do not speak the language of the country are the focus of care, specific communication demands arise, particularly around health decisions.The authors of this research carried out a study in a paediatric unit in Switzerland, which treated 35 different nationalities in 2017, directing a critical lens on the issue of health decision making. Their research describes and shows how the nursing staff developed creative ways of communicating with migrant populations who present for treatment in their unit.It is interesting that Swiss legislation does not require researchers in healthcare to submit research projects for external institutional review when patients are not specifically included as participants. In this study, the head of the clinic and nurse manager acted as gatekeepers to protect the patient population and the staff who were asked to participate in the study. Nonetheless, the authors have detailed the procedures used to ensure ethical conduct with all the participants and have explicitly described how the differing data-generation methods of observation, short interviews and focus groups were operationalised in an ethical manner throughout the study.
Background: Different models of teaching and learning are used to produce competent skilled clinical nurses. Some are traditional clinical teaching methods while others are grounded in preceptorship principles of mentoring. Knowledge regarding student nurses' experiences of preceptorship and its meaning for them can enhance the understanding of stakeholders in academia and practice to the needs of senior nursing students' and can offer them guidance to construct a more efficient approach to clinical teaching. Objective: The aim of the study was to explore the lived experiences of senior student nurses of preceptorship, while on clinical placements , with the objectives of describing their experiences and their relations with preceptors and also to illustrate the factors that facilitated or hindered the clinical learning process. Methods: A phenomenological hermeneutical inquiry was utilized. Data collection was conducted using semi-structured interviews with ten purposively chosen senior nursing students. Smith's Interpretative Phenomenological Analysis (IPA) was used as a framework for data analysis. Results: Students' lived experiences of preceptorship were mainly positive. Three main themes were identified: (1) Role Model Identification; (2) Team Integration; (3) Interpersonal Professional and Structural Challenges. The findings showed that preceptor relationships shaped the acquisition of skills and knowledge of student nurses' during their clinical placements. Conclusions: The findings illustrate the importance of collaboration between the academy and practice in providing support for student nurses and their preceptors. In addition, careful selection, comprehensive training and rewards for preceptors can enhance and facilitate student nurses' learning.
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