Introduction:Health care systems for older people are becoming more complex and care for older people, in the transition between hospital and primary healthcare requires more systematic collaboration between nurses. This study describes nurses’ perceptions of their collaboration when working between hospital and primary healthcare within the older people care chain.Theory and methods:Using a qualitative approach, informed by grounded theory, six focus groups were conducted with a purposive sample of registered nurses (n = 28) from hospitals (n = 14) and primary healthcare (n = 14) during 2013. The data were analyzed using dimensional analysis.Findings:Four dimensions of collaboration were identified: 1) Context and Situation, 2) Conditions, 3) Processes and Interactions and 4) The Consequences of nurse-to-nurse collaboration within the older people care chain. These four dimensions were then conceptualized into a model of nurse-to-nurse collaboration.Discussion and conclusion:Improved collaboration is useful for the safe, timely and controlled transfer of older people between hospital and primary healthcare organizations and also in healthcare education. The findings in this study of nurse-to-nurse collaboration provides direction and opportunities to improve collaboration and subsequently, the continuity and integration in older people care in the transition between organizations.

Current healthcare changes make it a requirement for hospital and primary healthcare nurses to collaborate when working with adults to continue to meet the needs of patients. The findings of this study can be used to improve collaboration in practice and to devise research to improve collaboration between hospital and primary healthcare nurses.

The purpose of the review was to describe what kind of research has been conducted concerning relatives' participation in the care of cancer patients in hospital and how relatives have participated in the care. Data (n = 9) were identified through a manual search and by searching the electronic databases (n = 8) Cinahl, PubMed and Cochrane Library and analysed with deductive content analysis. According to the review, participation in the concrete care appeared as taking care of comprehensive care and the quality of care, helping with daily activities and helping the healthcare professionals. Emotional support appeared as protecting, supporting and visiting the patient and discussing with the patient. Participation in decision-making appeared as acting as an advocate for the patient, participating in the discussion concerning the decision-making and participating in the discussion concerning the decisions of end of life. According to the review, research concerning this topic seems to be rare. While hospital periods are shortening and homecare is increasing, the role of relatives as a supporter of the cancer patient is becoming even stronger. In the future, more research should be conducted how the patients experience participation and what are their wishes.

Background Nurse‐to‐nurse collaboration between nurses working in hospital and primary health care in the older people care chain is essential to ensure the continuity of care. The nature of good collaboration in this context is understood usually from the perspective of collaborating nurses. However, there seems to be a lack of research about this collaboration from the older patient's perspective who are at the centre of the collaboration. Aims and objectives To describe older patient's experiences of the collaboration between hospital and primary healthcare nurses delivering care to older people. Design A qualitative approach based on a descriptive phenomenological methodology was used. Methods Individual interviews were conducted using a purposeful sample of older patients (n = 18) who were cared for both in hospital and primary healthcare organisations. A qualitative data analysis method informed by Giorgi was used. Results The essence of the experience of nurse‐to‐nurse collaboration between hospital and primary health care was expressed as follows: the meaning of collaboration; the elements of collaboration valued; the visibility of collaboration; older patient involvement in collaboration; interaction within collaboration; and future expectations of collaboration. Conclusions Although nurse‐to‐nurse collaboration between hospital and primary health care was not often visible to older patients, they highlighted the importance of this collaboration to ensure the continuity of care. The participants would have liked to be part of the collaborating group, at the centre of care, cared for by motivated nurses who had a clear understanding of their patients’ health status. This study emphasises the need for improving collaboration between hospital and primary healthcare nurses by making it more visible and facilitating older patients’ participation. The results demonstrate the need to understand patient perspectives in the development of care and the services provided for older people.

Aims and objectives To examine the content and reported psychometric properties of instruments for assessing nurses’ palliative care knowledge and skills in specialised healthcare units. Background Knowledge of palliative care, and competence in the delivery of care, is essential. Assessment of competence is an important means of evaluating the knowledge and skills of practitioners in order to improve the quality of care provided for patients and their families. Design An integrative review. Methods A systematic literature search was conducted in November 2018 in five databases: CINAHL, PubMed (Medline), Cochrane, Scopus and Web of Science. The quality assessment was conducted using the Joanna Briggs Institute's (JBI) Checklist for Analytical Cross‐Sectional Studies. The data were analysed using content analysis. PRISMA guidelines were followed to ensure explicit reporting. Results Overall, 5,413 studies were identified and 23 met the inclusion criteria. Nurses’ knowledge and skills, as assessed by the instruments, were as follows: (a) care for the patient, (b) care for the patient's family and (c) professional requirements. Ten instruments were identified assessing nurses’ knowledge and skills through knowledge tests and skill evaluation self‐tests. The psychometric properties of the instruments were reported to varying degrees, mainly focusing on internal consistency and content validation. Conclusions Nurses’ knowledge and skills were seen to contribute to the holistic care of the patient and his or her family, and the possession of adequate information and skills is essential when dealing with death and dying. The instruments are commonly available and potentially reliable, although reliability must be determined with caution, so validation studies in other cultures are recommended. Relevance to clinical practice These results could be utilised to improve the quality of palliative care by evaluating the knowledge and skills of nursing staff or when considering the needs of palliative care education.

Aims and objectives To assess the level of nurse‐to‐nurse collaboration during the transfer of older people between hospital and primary health care and to evaluate the psychometric properties of the newly developed Nurse‐to‐Nurse Collaboration Between Sectors Instrument. Background Nurse‐to‐nurse collaboration is required when older people transfer between hospital and primary health care to enhance the safety and continuity of care to patients. There is a lack of evidence about the nature and level of this collaboration. Design A cross‐sectional survey design was used. This study adhered to the STROBE checklist. Methods A sample of 443 nurses (university hospital n = 240, primary health care n = 203) participated in the study from October 2017 to June 2018. Nurses completed the Nurse‐to‐Nurse Collaboration Between Sectors Instrument (86 items, 7–point Likert‐type scale), the Nurse‐Nurse Collaboration Scale and the Patient‐Centred Competency Scale. Results Nurses rated the overall level of nurse‐to‐nurse collaboration moderately high (mean=4.49, standard deviation=0.83, maximum 7.00). Nurses considered collaboration an important and confidential process, gaining older people's trust in their care. Lower scores were given to the agreement of mutual objectives, policies and guidelines in collaboration, opportunities for job rotation and interacting and networking during the collaboration process. The internal consistency reliability of the newly developed instrument was acceptable. Conclusions Nurses collaborate with competence and confidentiality during the transfer of older people between care settings. However, there is a need for more opportunities to collaborate, to obtain mutual agreement about objectives, policies and practices, and better understand other nurse's roles and responsibilities in collaboration. The reliability and validity of the Nurse‐to‐Nurse Collaboration Between Sectors Instrument were acceptable though the number and wording of items will be reviewed and further tested. Relevance to clinical practice Nurses need opportunities to collaborate, and there is a need to develop agreed objectives, practices, roles and responsibilities in this collaboration.

Patient-centredness in care is a core healthcare value and an effective healthcare delivery design requiring specific nurse competences. The aim of this study was to assess (1) the reliability, validity, and sensitivity of the Finnish version of the Patient-centred Care Competency (PCC) scale and (2) Finnish nurses’ self-assessed level of patient-centred care competency. The PCC was translated to Finnish (PCC-Fin) before data collection and analyses: descriptive statistics; Cronbach’s alpha coefficients; item analysis; exploratory and confirmatory factor analyses; inter-scale correlational analysis; and sensitivity. Cronbach’s alpha coefficients were acceptable, high for the total scale, and satisfactory for the four sub-scales. Item analysis supported the internal homogeneity of the items-to-total and inter-items within the sub-scales. Explorative factor analysis suggested a three-factor solution, but the confirmatory factor analysis confirmed the four-factor structure (Tucker–Lewis index (TLI) 0.92, goodness-of-fit index (GFI) 0.99, root mean square error of approximation (RMSEA) 0.065, standardized root mean square residual (SRMR) 0.045) with 61.2% explained variance. Analysis of the secondary data detected no differences in nurses’ self-evaluations of contextual competence, so the inter-scale correlations were high. The PCC-Fin was found to be a reliable and valid instrument for the measurement of nurses’ patient-centred care competence. Rasch model analysis would provide some further information about the item level functioning within the instrument.

Background Relatives’ participation in the care of patients with cancer in hospital is essential to both patients and relatives. Although the meaning of relatives’ participation has been recognized, knowledge about how patients experience this participation is rare. Aims To describe the experiences of patients with cancer of the realization of relatives’ participation in the hospital care. Materials & Methods A qualitative study with semi‐structured interviews of patients with cancer (n=21) were conducted. Data was analyzed using inductive thematic analysis. Results Three main themes were identified among patients’ experiences: Relative as part of the patient’s care, Relative supporting patient’s coping process, and Hospital enabling or preventing relatives’ participation. The relatives were available for patients in seeking information and in the decision‐making process. They helped with the daily needs of the patient, and supported patients emotionally and by managing everyday life at home. The behavior and attitudes of the healthcare professionals and the special nature of the hospital played a central role in the experiences. Conclusion The role of relatives is an important part of the coping process and care of patients with cancer in the hospital.