Background: Contact Nurses in Cancer Care (CNCCs) are well-positioned to address patients' concerns regarding sexual health, but many lack the tools and confidence to initiate such conversations. Aim: To explore how CNCCs perceive the use of the BETTER model as a new practice for integrating discussions of sexuality into cancer care. Methods: Data were collected from 37 CNCCs through video-recorded educational seminars, written reflections, and focus group interviews. A directed qualitative content analysis was conducted, guided by the four constructs of the Normalization Process Theory: coherence, cognitive participation, collective action, and reflexive monitoring. Results: The BETTER model was perceived as a valuable tool for initiating conversations about sexuality. The CNCCs highlighted the importance of personal reflection, peer support, and managerial backing. Time constraints and structural barriers were identified as key challenges to implementation. Many CNCCs viewed themselves as clinical champions, advocating for the sustained integration of the model into practice. Conclusion: Communication tools such as the BETTER model can enhance CNCCs' confidence and competence in addressing sexual health. Successful implementation requires organizational support and recognition of CNCCs' roles as facilitators of change. The Normalization Process Theory proved useful in understanding the implementation process, even across diverse clinical settings.

Introduction: Pain management for people with dementia is widely recognized as a challenge for healthcare personnel. Multifactorial and comprehensive person-centered care models that recognize individual abilities and resources are warranted but remain lacking in nursing homes. This study aimed to provide a comprehensive perspective on how pain management for people with dementia living in nursing homes can be conducted in a way that includes and supports their individual resources. Methods: We conducted eight group interviews with a total of 28 nurses providing care for people with dementia in nursing homes. The group interviews followed the four steps of the Nominal Group Technique: (1) Generating ideas, (2) Round Robin technique, (3) Group discussion and (4) Voting and ranking. A thematic framework with eight key themes was developed based on the ideas generated during the interviews. Ratings were compiled and presented thematically. The thematic framework subsequently served as the basis for analyzing the transcripts from the group discussions, providing an in-depth description of the identified themes. Results: A total of 112 ideas were generated, from which eight key themes were identified. The themes "mapping and assessment in the presence of clear pain expression" and "ensure appropriate competence" was ranked as most important. The mean feasibility of the idea's included in the themes was rated slightly lower than their relevance. The findings highlight the need for comprehensive pain management models addressing multiple dimensions simultaneously, grounded in professional competence and supported by relational and informational continuity.

Background: 

Healthcare personnel often report uncertainty about how to identify and alleviate pain in people with dementia. Up to 80% of nursing home residents with dementia are estimated to experience chronic pain. There is a lack of structured pain management interventions that focus on integrating and building upon the individual resources of people with dementia in the nursing home context. Although a prototype of such an intervention has been developed, further knowledge is needed regarding its functioning in clinical practice, relevance, and capacity to meet clinical needs. Stakeholders possess substantial field-specific knowledge. In this study, the prototype of the intervention is presented to stakeholders to increase the likelihood of a clinically relevant intervention and successful implementation.

Objectives: 

To describe stakeholders' perspectives of the prototype regarding intervention content and relevance, and implementation strategy.

Methods: 

Seven dyadic interviews were conducted with practice development nurses and first-line managers in nursing homes between May to June 2025 to describe their perspectives on the prototype. The transcripts were analyzed with a deductive framework analysis.

Results: 

The intervention was regarded as relevant and as having the potential to enhance healthcare personnel competence, structure pain management, and integrate residents' resources. However, successful implementation requires integration into existing practice models, and potential moderators were identified at both the organizational and individual levels.

Conclusions: 

This study presents an applied approach to collaborating with stakeholders in intervention development. The participants’ perspectives on activities, moderators and potential outcomes of the intervention provides essential knowledge for further refinement of the intervention and future evaluation.

Extensive research reports caregiver burden and unmet needs when caring for a home-dwelling family member at the end of life. Interventions are often decided by professionals and are less focused on family carers. There remains a gap in understanding family carers' preferences for support in their caregiving role. This integrative review summarises family carers' preferences for support when caring for a home-dwelling family member at the end of life. We examined what helps family carers cope and the impact of the organisation of end-of-life care on their experiences. Seven databases were searched between January 2011 and March 2024. Thirty-seven articles were included in this review. Data were thematically analysed. 'Care continuity' at the end-of-life features prominently and underpins four themes: (1) Family carers see themselves as a partner in care to ensure their loved one's needs were prioritised; (2) balancing the needs of their loved one alongside their caregiving responsibilities and attending to their own psychosocial needs was challenging; (3) timeliness of access to information, knowledge and appropriate services through the illness trajectory and shared decision-making were important in helping them cope; and (4) preparedness when death was imminent in terms of dealing with the dying process and support beyond bereavement. 'Care continuity' can be conceptualised as personal and relational continuity (at microlevel, it is about individuals building relationships with healthcare professionals through recognising their carer's role, access to contactable and knowledgeable staff and agreed care plan), informational continuity (micro- and mesolevel refer to effective transfer of information and knowledge between individuals and between services) and organisational continuity (mesolevel is about organised and coordinated care, early involvement of specialist palliative care and bereavement support). Health professionals should recognise that meeting the needs of family carers is inextricably linked to addressing the needs of their loved ones.

The literature on pain management for people with dementia in nursing homes places significant emphasis on the limitations dementia imposes on their ability to describe and express their pain. Little is known about how healthcare personnel can support and use the individual resources people with dementia have in pain management. Thus, this study aimed to explore pain management in people with dementia in nursing homes, focusing on the resources people with dementia have and how healthcare personnel can support and integrate these resources into their clinical practice. We applied an exploratory design with a focused ethnographic approach and collected data through participatory observations and field conversations, as well as notes from residents' medical charts. The study setting was a nursing home unit specializing in dementia care in a larger city in Norway. The study included residents with moderate- to severe stage dementia (n = 18) and nurses caring for them (n = 12). The data were analysed in line with qualitative content analysis. The analysis identified two categories: (a) Residents' pain narratives and (b) Nurses' interpretation and support. Within each category, several subcategories were identified. The categories are linked together in one overarching, latent theme describing how people with dementia express themselves in the moment and nurses integrate these moments into a coherent whole. Findings also indicate that people with dementia have individual resources and strengths that are important for pain management. With support from healthcare personnel, they can be active participants in pain management processes, in accordance with their individual abilities.

AimTo map and summarise research literature describing patient participation in hospital care for frail older persons and their next of kin.BackgroundPatient participation refers to the active involvement of patients in healthcare decision-making processes. An aging population and increased life expectancy have led to a growing number of older adults requiring hospital care, and engaging older patients in decision-making can be challenging due to the complexities of their health conditions. Thus, there is a need to deepen our understanding of patient participation, concerning frail older persons and their next of kin.DesignScoping review.MethodsA systematic search was conducted across four databases. Abstracts and titles were evaluated for relevance according to predetermined inclusion criteria. A total of 140 studies were read in full text, and 17 quality-appraised studies were selected for analysis.ResultsFive instruments for measuring participation were identified. Patient participation was mainly characterised as being informed, understanding provided information, conducting good communication and being given the opportunity to make decisions. Patients could adopt different participation strategies. Next of kin participation is characterised as being informed, communicating with healthcare staff and being involved in decision-making. Conditions facilitating participation are dependent on healthcare staff, environmental conditions and written information. Barriers to participation stem from staff attitudes, their lack of availability and approachability, unsatisfactory communication, patient shortcomings, substandard continuity of care, organisational routines and unsatisfactory physical environments.ConclusionOlder persons and their next of kin have reasonable demands for them to experience participation. Therefore, it should not be difficult for healthcare staff to meet patient expectations by ensuring patients and their next of kin receive understandable information and are given the opportunity to make their own decisions, and for organisations to create a climate where staff are available, approachable and empathetic so patients feel that they are participating in the planning and delivery of their care-in summary, to keep them in the loop.

Background Providing quality palliative care during a pandemic was challenging. Both specialist and communityhealthcare services cared for patients that faced life-threatening illness and who were influenced by the restrictionsof the COVID-19 pandemic. Little knowledge has yet been provided on how registered nurses (RNs) experiencedthe palliative care quality during the COVID-19 pandemic. The aim of this study was to explore RN’s experiences ofproviding palliative care quality during the COVID-19 pandemic. Methods This qualitative study had a descriptive design. Semi-structured individual interviews were conductedbetween November 2021 and January 2022 with 18 RNs who worked in intensive care units in hospitals, dementiacare or palliative care units in nursing homes in Norway during the pandemic. Data were analysed by using qualitativecontent analysis. The study was conducted and reported according to the COREQ’s checklist. Results Analysis of the data resulted in an overall theme: ‘Striving to achieve control’. This theme comprised sixcategories: (1) when the toolbox does not fit; (2) protective equipment—social distance and opportunities forcloseness; (3) unpredictable workday; (4) the right person to the right assignment at the right time; (5) presence andabsence of relatives and friends; and (6) situations that required creativity. RNs had various experiences regarding howthe quality of care was perceived; being worse, preserved, or in some cases even better than before the pandemic. Conclusions The provision of quality palliative care was experienced by RNs as challenging during the pandemic.The pandemic forced them to be creative and to strive for control to provide the best palliative care possible giventhe situation. The results of this study may contribute to important knowledge for leaders, policy makers and RNsto learn from the COVID-19 pandemic and planning for future pandemics or crises. Especially to optimise factorsperceived by RNs to be important for the palliative care quality, related to the specific situation and care context, toinclude the perspectives of those involved and take into consideration the time perspective of the pandemic.

Background: Pain is a common symptom in people with dementia living in nursing homes, but cognitive impairment, including language and communication difficulties, challenges pain assessment and the ability to self-report pain.Objectives: This study aimed to identify and summarize patterns, advances, and gaps in research literature describing pain assessment in people with dementia living in nursing homes.Design: We conducted a scoping review following Arksey and O'Malley's methodological framework.Methods: Systematic searches were conducted in CINAHL, Embase, MEDLINE, and PsycINFO. We included studies describing pain expressions in people with dementia and/or healthcare personnel assessment of pain in people with dementia, in a nursing home context. Charted data included demographics, methodological descriptions, ethical and quality assessment and relevant findings. Relevant findings were summarized using thematic analysis, and an overview of patterns, advances, and gaps in the research literature is presented.Results: Thirty-nine studies were included. The results describe three patterns: (1) pain awareness; (2) suspected pain and (3) pain mapping. Collectively, these patterns constitute a process of pain assessment, integrating pain expressions of people with dementia. Important perspectives on self-reporting are touched upon in several of the included studies, though direct descriptions of attempts to capture the residents' own experience of pain are sparse.Conclusion: This scoping review provides a comprehensive description of pain assessment in people with dementia living in nursing homes as a process in three steps. We identified several knowledge gaps in the understanding of this process and provide concrete recommendations for further research. The results underpin the importance of pain assessment approaches that incorporate the flexibility to meet residents' varying and potentially fluctuating ways of communicating pain.Trial registration: This scoping review is registered in the Open Science Framework (https://osf.io/8kaf5/).