Background: Transmural palliative care interventions aim to identify older persons with palliative care needs and timely provide advance care planning, symptom management, and coordination of care. Nurses can have an important role in these interventions; however, their expertise is currently underused. A new transmural care pathway with a central role for the community care registered nurse in advance care planning aims to contribute to the quality of palliative care for older persons. Objective: To examine the perspectives of community nurses on the feasibility of a new transmural care pathway for advance care planning for older persons. Design: A qualitative study design using semi-structured interviews. Setting(s): Interviews were performed with community nurses of three participating homecare organizations in the Netherlands between March and May 2023. Participants: 19 community nurses. Methods: A topic guide was based on (1) challenges in advance care planning identified from the literature and (2) concepts that are important in assessing the feasibility of complex healthcare interventions provided by the Normalisation Process Theory framework. A combined inductive and deductive thematic analysis was performed. Results: Four themes were identified: views on the transmural care pathway, community nurses’ needs to fulfil their role, key points regarding implementation, and evaluation of the new practice. In general, community nurses were positive about the feasibility of the new practice as it provided a more structured work process that could facilitate interprofessional collaboration and improve the quality of palliative care. Overall, the feasibility of the new practice, from community nurses perspective, was determined by (1) clear roles and responsibilities in the transmural care pathway, (2) standardized registration of advance care planning, and (3) close involvement of community nurses in the whole implementation process. Conclusions: We highlighted important factors, from the perspectives of community nurses, that need to be considered in the implementation of a new transmural care pathway for advance care planning. A clear division of roles and responsibilities, standardized registration of advance care planning, and involvement of community nurses during the whole implementation process were mentioned as important enabling factors. This knowledge might contribute to successful implementation of a transmural care pathway that aims to enhance the quality of palliative care for older persons. Tweetable abstract: Community nurses’ perspectives on the feasibility of a transmural care pathway for advance care planning for older persons.
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Aims. The aim of this study is to gain insight into the level of emotional intelligence of mental health nurses in the Netherlands. Background. The focus in research on emotional intelligence to date has been on a variety of professionals. However, little is known about emotional intelligence in mental health nurses. Method. The emotional intelligence of 98 Dutch nurses caring for psychiatric patients is reported. Data were collected with the Bar-On Emotional Quotient Inventory within a cross-sectional research design. Results. The mean level of emotional intelligence of this sample of professionals is statistically significant higher than the emotional intelligence of the general population. Female nurses score significantly higher than men on the subscales Empathy, Social Responsibility, Interpersonal Relationship, Emotional Self-awareness, Self-Actualisation and Assertiveness. No correlations are found between years of experience and age on the one hand and emotional intelligence on the other hand. Conclusions. The results of this study show that nurses in psychiatric care indeed score above average in the emotional intelligence required to cope with the amount of emotional labour involved in daily mental health practice. Relevance to clinical practice. The ascertained large range in emotional intelligence scores among the mental health nurses challenges us to investigate possible implications which higher or lower emotional intelligence levels may have on the quality of care. For instance, a possible relation between the level of emotional intelligence and the quality of the therapeutic nurse–patient relationship or the relation between the level of emotional intelligence and the manner of coping with situations characterised by a great amount of emotional labour (such as caring for patients who self-harm or are suicidal).
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Accessible Summary What is known on the subject? • Mentalizing is the capacity to understand both one‘s own and other people‘s behaviour in terms of mental states, such as, for example, desires, feelings and beliefs. • The mentalizing capacities of healthcare professionals help to establish effective therapeutic relationships and, in turn, lead to better patient outcomes. What this paper adds to existing knowledge? • The personal factors positively associated with the mentalizing capacities of healthcare professionals are being female, greater work experience and having a more secure attachment style. Psychosocial factors are having personal experience with psychotherapy, burnout, and in the case of female students, being able to identify with the female psychotherapist role model during training. There is limited evidence that training programmes can improve mentalizing capacities. • Although the mentalization field is gaining importance and research is expanding, the implications for mental health nursing have not been previously reviewed. Mental health nurses are underrepresented in research on the mentalizing capacities of healthcare professionals. This is significant given that mental health nurses work closest to patients and thus are more often confronted with patients‘ behaviour compared to other health care professionals, and constitute a large part of the workforce in mental healthcare for patients with mental illness. What are the implications for practice? • Given the importance of mentalizing capacity of both the patient and the nurse for a constructive working relationship, it is important that mental health nurses are trained in the basic principles of mentalization. Mental health nurses should be able to recognize situations where patients‘ lack of ability to mentalize creates difficulties in the interaction. They should also be able to recognize their own difficulties with mentalizing and be sensitive to the communicative implications this may have.
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