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.

BackgroundNursing practice in long-term care, must support the delivery of safe and evidence-based care, especially for older people with functional ability limitations and frailty, with the competency, knowledge and structured working modes such practice requires. Understanding, detecting and preventing these conditions is important in a context where care is given to a significant number of older people with complex care needs. Our aim was to map published literature on how functional ability limitations and frailty among older people (65 and above) in home-and facility-based care (i.e. long-term care) were described by key stakeholders, and to identify models of care (MoCs) targeting these conditions.MethodsWe followed Arksey and O'Malley's methodological steps and the PRISMA-ScR reporting guidelines. The PubMed, CINAHL and PsycInfo databases were used to identify papers published between June 2002 and June 2022. The search was updated in May 2024. A descriptive analysis was conducted where the identified patterns were organised and categorised with the support of the Pattern, Advances, Gaps, Evidence for practice and research Recommendations framework (PAGER).ResultsA total of 18,875 unique records were identified. Of these, 26 papers were included. The findings implied a discrepancy between the older people's subjective- and the nurses' more objective, 'matter-of-fact' perspective. The older people described both conditions in terms of identity loss and an emotional struggle to remain independent. They also highlighted the importance of positive connotations in relation to their efforts to adapt and accommodate the situation to the conditions. Nursing practice targeting the conditions were predominantly described as being reactive, based on their experiences and guided by 'intuition'. The identified MoCs mainly targeted functional ability limitations while focusing on educating nurses.ConclusionA point of saturation seems to have been reached regarding research focusing on older people's descriptions of frailty in home-based care. The same cannot be said about older people's or nurses' descriptions concerning functional ability limitations or MoCs. Intervention studies focusing on nursing practice and the development of MoCs that target these conditions preferably in a home-based care context could substantially benefit the development of knowledge within nursing and nursing practice.Trial registration: Open Science Frameworkhttps://doi.org/10.17605/OSF.IO/FNHSA.

Purpose: Sexuality and body image are closely related to health-related quality of life (HRQoL), but these factors are less investigated in patients treated for lymphoma. Therefore, the aim of this study was to describe and explore the associations between sexuality, body image, comorbidities and HRQoL in patients treated for diffuse large B-cell lymphoma. Methods: A cross-sectional study with 257 patients (25% response rate) was conducted in 2019 using measures for sexuality, HRQoL and body image and data from the Swedish National Quality Registry for Leukemia–Subregistry for Lymphoma. Results: The participants had a mean HRQoL of 69.75 on a 1 to 100 scale, and the functional scales ranged from 68.50 for Role to 80.82 for Social functioning. The symptoms ranged from 5.56 for nausea and vomiting to 37.73 for fatigue. Regarding body image, the participants scored a total of 14.47 (reference values 10–40). The total score for Sexual adjustment was 3.02 (fair), and for the subscales Sexual Interest 2.63 (low), Sexual Relation 2.72 (low), Sexual Function 3.62 (high) and Sexual Satisfaction 3.50 (high). HRQoL was positively associated with Sexual Relation; however, negative body image and comorbidities showed negative associations. The model explains 39.6% of the variation in HRQoL. Conclusion: The positive impact of sexual relationships on HRQoL was highlighted, which emphasised the unfavourable effect of negative body image and comorbidities on HRQoL for lymphoma patients. Cancer nurses should address these topics with patients to improve their long-term well-being.

IntroductionFirst-line managers in Swedish communities have responsibility for that care to older people is provided, staffing is sufficient and the budget is balanced in their unit. It is a struggle with limited resources due to a growing population in need of care. This can lead to missed nursing care. The aim was to describe first-line managers<acute accent> perceptions of missed nursing care in community health care for older people.MethodsA qualitative design with a phenomenographic approach, interviewing 24 first-line managers. Ethics approval for the study was received from the Research Ethics Committee at Karlstad University (Dnr HNT 2020/566).ResultsThe results are shown in six descriptive categories containing 15 perceptions. The descriptive categories are 'occurrence of missed nursing care', 'becoming aware of missed nursing care', 'reasons for missed nursing care', 'missed nursing care has consequences for the older persons', 'missed nursing care has consequences for the staff' and 'taking action to decrease missed nursing care'.ConclusionsIt is important for first-line managers to become aware of the existence and reasons for missed nursing, as it has consequences for older people and staff. Managers need to take missed nursing care seriously in order to work with improvements for maintaining good quality of care and patient safety.

There is a lack of clinical placements for bachelor nursing students (BNS). Due to this, stringent educational models for clinical practice need to be developed. The aim was to describe bachelor nursing students’ and main preceptors’ experiences of the clinical learning environment during peer learning. This mixed method study was based on a joint project between the Karlstad University and the Region Värmland, Sweden, where peer learning was launched in two geriatric clinical education wards. A total of 23 bachelor nursing student and four main preceptors participated. The data were collected in parallel, qualitative data through focus group interviews and reflective journals, and quantitative data with the CLES + T scale between November 2017 and February 2018. A directed content analysis of all results was performed. The COREQ Checklist was used. The student–patient and the student–main preceptor relationships were important for the students’ development. The students described the educational atmosphere as comfortable and safe and that the staff were knowledgeable about them. Peer learning with close interaction between patients and all staff can create authenticity, which in turn drives the BNSs’ professional development. All staff should be involved in the supervision of the students and include them as members of the nursing team.

AimThe aim of the study was to translate, adapt and validate the instrument Basel Extent of Rationing of Nursing Care for Nursing Homes and Home Care for use in the Swedish community health care context. DesignA cross-sectional study. Data were collected from October 2019 to January 2020, and the questionnaire was sent to Registered Nurses, Enrolled Nurses and assistant nurses. MethodsThe study was performed in four phases: (1) translation, (2) adaptation of the Basel Extent of Rationing of Nursing Care for Nursing Homes and Home Care to the Swedish context, (3) content validity testing, and (4) evaluation of psychometric properties. The collected data resulted in 611 responses. Explorative factor analysis was performed to explore the interrelationship, and Cronbach's alpha was used to evaluate the internal consistency. ResultsExplorative factor analysis presented six factors/subscales: (1) fundamental care, (2) timely needed-based care, (3) dignity and support, (4) ensuring respectful treatment, (5) social activities, and (6) documentation, planning and reporting. The Cronbach's alpha for the components showed values between 0.7 and 0.9. ConclusionThe analyses indicate an instrument to be usable for Enrolled Nurses and nurse assistants in community health care. Additional tests, can contribute to refining the content of the items and further test reliability and validity of the instrument. No patient or public contributionAs this is a study of translation and validation of the instrument Basel Extent of Rationing of Nursing Care for Nursing Homes and Home Care.

Aim: To examine the extent and nature of missed nursing care in elderly care in community healthcare contexts from the perspective of healthcare staff, and to identify instruments used to measure missed nursing care and the content of these instruments. Design: Scoping review. Methods: Searches were conducted in the CINAHL, PubMed, Scopus and Google Scholar databases in March 2020. The selection process followed the PRISMA flow diagram. Results: Sixteen research papers were found from nine countries. The instruments used in the studies were Basel Extent of Rationing of Nursing Care for nursing homes (BERNCA-NH), modified MISSCARE survey and study-specific instruments or items. The item content differed, as did the number of items, which was between one and 44. The studies reported values for missed nursing care, as well as described reasons for and/or the relation between missed nursing care and organization, working climate and patient outcomes.

INTRODUCTION: Older people receiving healthcare in long-term care contexts (eg, home healthcare, sheltered housing and nursing home contexts) are especially vulnerable to developing frailty and functional decline. Considering the negative effects associated with these conditions and the possibility of preventing them from progressing, it is vital that nurses possess a broad knowledge base related to them. Particularly as prevention related to these conditions lies well within their remit. Such knowledge could guide the development of effective models of care, ensuring continuity and, hence, quality of care. Our objective will be to review published literature on existing models of care targeting frailty and/or functional decline and how these conditions are described by older people themselves, significant others and nurses in relation to long-term care. METHODS AND ANALYSIS: The scoping review will be conducted in accordance with Arksey and O’Malley’s methodological framework. Recent methodological developments will be considered. PubMed, CINAHL and PsycINFO will be searched. Eligibility criteria will be peer-reviewed papers and written in English. All types of study designs will be eligible and included papers will be quality and ethically assessed. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)-Protocol checklist for protocols and the PRISMA for Scoping Reviews checklist were followed in this paper. ETHICS AND DISSEMINATION: As the study outlined in this protocol is a scoping review, no ethics approval was needed for this protocol nor for the upcoming study. The findings will be published in an open-access, peer-reviewed journal. Additionally, the findings will guide a research project following the Medical Research Council’s framework for developing and evaluating complex interventions. Thus, supporting us in developing a model of care related to the detection and prevention of frailty and/or functional decline among older people in a long-term care context. 

Background With an ageing population, there is an increasing need for care, both as home care and in nursing homes. However, some needed care is not carried out for different reasons, which can affect patient safety. The aim of the study was to describe prevalence, type, and reasons for missed nursing care in home care and nursing homes, from nurses' perspective. Methods A cross sectional design with quantitative and qualitative approach. A Swedish version of Basel Extent of Rationing of Nursing Care for nursing homes and 15 study specific questions were answered by 624 registered nurses, enrolled nurses, or nurse assistants. Both descriptive and analytical, independent-samples t-test, analyses were used. Qualitative content analysis was used for the open-ended question. Results The care activity most often missed in home care was: 'set up or update care plans' (41.8%), and in nursing homes: 'scheduled group activity' (22.8%). Reasons for missed nursing care were lack of preparedness for unexpected situations, obstacles in a deficient work environment, unsatisfactory planning in the organisation, and/or shortcomings related to the individual. Conclusion Not all care activities needed are performed, due to reasons such as lack of time or organisational issues. Missed nursing care can lead to adverse events and affect patient safety. It is important to be aware of missed nursing care and the reasons for it, which gives a possibility to initiate quality improvement work to ensure patient safety.