The aim of this study is to propose a model of the benefits and working mechanisms of family nursing conversations in home healthcare from the perspective of participating patients and their family members. Family nursing conversations in this study are intended to optimise family functioning, improve collaboration between family and professional caregivers and ultimately prevent or reduce overburden of family caregivers. In a qualitative grounded theory design, data were collected in 2017 using intensive interviewing with participants of family nursing conversations in home healthcare. A total of 26 participants (9 patients and 17 family members) from 11 families participated in a family nursing conversation and the study. Seven nurses who received extensive education in family nursing conversations conducted them as part of their daily practice. Interviews occurred 4-6 weeks after the family nursing conversation. The model that was constructed in close collaboration with the families consists of three parts. The first part outlines working mechanisms of the conversation itself according to participants, i.e. structured and open communication about the care situation and the presence of all of the people who are involved. The second part consists of the benefits that participants experienced during and immediately after the conversation - an increased sense of overview and improved contact among the people involved - and the related working mechanisms. The last part consists of benefits that emerged in the weeks after the conversation - reduced caregiver burden and improved quality of care - and the related working mechanisms. Insight into the benefits and working mechanisms of family nursing conversations may assist healthcare professionals in their application of the intervention and provides directions for outcomes and processes to include in future studies.
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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05/31/2020Background: Caregiving by family members of elderly with chronic conditions is currently intensifying in the context of an aging population and health care reform in the Netherlands. It is essential that nurses have attention for supporting roles of family caregivers of older patients and address family caregiving aspects on behalf of the continuity of care. This study aims to explore what aspects of family caregiving were addressed during planned discussions between nurses, patients and family caregivers in the hospital.Methods: Qualitative descriptive research was conducted using non-participant observation and audio-recordings of planned discussions between nurses, older patients and their family caregivers as they took place in the hospital.Through purposive sampling eligible patients (≥ 65 years) with one or more chronic conditions were included. These patients were admitted to the hospital for diagnostics or due to consequences of their chronic illness.Retrospective chart review was done to obtain patient characteristics. Data were collected in November/December 2013 and April/May 2014 in four hospitals. Qualitative content analysis was performed using the inductive approachin order to gain insight into addressed aspects of family caregiving.Results: A total of 62 patients (mean age (SD) 76 years (7.2), 52% male) were included in the study, resulting in 146 planned discussions (62 admission and discharge discussions and 22 family meetings). Three themes were identifiedregarding addressed aspects of family caregiving. Two themes referred to aspects addressing the patients’ social network, and included ‘social network structure’ and ‘social network support’. One theme referred to aspectsaddressing coordination of care issues involving family caregiving, referred to as ‘coordination of care’.Conclusions: During discussions nurses mostly addressed practical information on the patients’ social network structure. When specific family caregiving support was addressed, information was limited and nurses did not seem toexplore the nature of the family support. Patients discharge and after care needs were addressed occasionally as aspects of coordination of care. Current nursing policies could be evaluated on nursing and family oriented theories.Implications for education could include mirroring study findings with nurses in a group discussion to enhance their awareness on family caregiving aspects.
Promoting entrepreneurship is an enabler of smart, sustainable and inclusive growth and it is one objective EU regions have pursued since the EC included it into 2020 Strategy. Entrepreneurship development has economic and social benefits, since it is not only a driving force for job creation, competitiveness and growth; it also contributes to personal fulfillment and to achieve social objectives. That is why the EU encourages entrepreneurial initiatives and to unlock the growth potential of businesses and citizens. However, only a 37% of Europeans (Eurobarometer 2012) would like to be self-employed. The Entrepreneurship Action Plan adopted by the EC in 2013 to reignite Europe’s entrepreneurial spirit includes initiatives for educating young people on entrepreneurship. To ensure that EU economy remains globally competitive, young generations of Europeans need to be inspired to develop their entrepreneurial mindset. EU 2020 Action Plan argues that young people benefitting of a specialised entrepreneurial education are more likely to start-up a business and to better tackle challenges in their professional career and life in general. Hence, there is good reason to ensure better quality of entrepreneurial education. Most approaches in recent years have focused on improving the skills or competences youngsters should obtain only within the education system. However, an integrated approach is needed, where the school, their friends, family and the social environment, shall play each one a relevant role, contributing to generate a more adequate atmosphere to boost their entrepreneurial mindsets, intrapreneurial attitudes and innovation capacities. This project will identify and exchange – through a quadruple helix approach- good practices for creating friendlier entrepreneurial ecosystems and actions to boost entrepreneurship in young people mindsets. The good practices and lessons learnt will be transferred into Action Plans to be included in regional policies.
