Meaning in life of older adults in daily care: A qualitative analysis of participant observations of home nursing visits

Hupkens, Susan; Goumans, Marleen; Derkx, P.H.J.M.; Oldersma, Annechien; Schutter, Trudy; Machielse, Anja

doi:10.1111/jan.14027

Cited by 19 publications

(24 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Compared to those conditions, nurses' role may be modest yet remains important. The role of nurses is especially promising because home nurses have many opportunities during daily care to attune to patients' MiL [51]. We therefore confirm that nurses have an important supportive role, as described in other papers [24][25][26], but our study adds that this role should be considered in the context of many other influencing circumstances.…”

Section: Responsibilitysupporting

confidence: 88%

Nurse’s attunement to patient’s meaning in life - a qualitative study of experiences of Dutch adults ageing in place

et al. 2020

Self Cite

View full text Add to dashboard Cite

Background: Meaning in life (MiL) is considered to be an important part of health and is associated with many positive outcomes in older adults, such as quality of life and longevity. As health promotors, nurses may take patients' MiL into account in the care process. There is a knowledge gap in terms of what constitutes good care in relation to older patients' MiL, and what the benefits may be for patients when nursing is attuned to this aspect. The purpose of this study was to explore the experiences of home nursing older adults in relation to nurses' attunement to MiL. Methods: Gadamerian hermeneutic phenomenological design with semi-structured interviews. Participants were 24 aged home nursing patients. A framework of care ethical evaluation was used in the analysis. Multiple dialogues enhanced understanding. Results: Patients did not expect nurses' regard for their MiL. They rather expected 'normal contact' and adequate physical care. Nurses showed that they were open to patients' MiL by being interested in the patient as a person and by being attentive to specific and hidden needs. Participants explained that the nurse's behaviour upon arrival set the tone: they knew immediately if there was room for MiL or not. All participants had positive and negative experiences with nurses' behaviour in relation to MiL. Valued nursing care included maintaining a long, kind and reciprocal relationship; doing what was needed; and skilled personalised care. Participants mentioned 'special ones': nurses who attuned to them in a special way and did more than expected. Benefits of care that was attuned to patients' MiL were: experiencing a cheerful moment, feeling secure, feeling like a valuable person and having a good day. Older adults also stressed that consideration for MiL helps identify what is important in healthcare. Conclusion: Aged homecare patients value nurses' attunement to their MiL positively. Although patients regard MiL mostly as their own quest, nurses play a modest yet important role. Managers and educators should support nurses' investment in reciprocal nurse-patient relationships.

show abstract

Section: Responsibilitysupporting

confidence: 88%

Nurse’s attunement to patient’s meaning in life - a qualitative study of experiences of Dutch adults ageing in place

et al. 2020

Self Cite

View full text Add to dashboard Cite

show abstract

“…Compared to those conditions, nurses' role may be modest yet remains important. The role of nurses is especially promising because home nurses have many opportunities during daily care to attune to patients' MiL(49). We therefore confirm that nurses have an important supportive role, as described in other papers(24)(25)(26), but our study adds that this role should beconsidered in the context of many other influencing circumstances.…”

supporting

confidence: 88%

Nurses’ attunement to patients’ meaning in life – A qualitative study of experiences of Dutch adults ageing in place

Hupkens

Goumans

Derkx

et al. 2020

Preprint

Self Cite

View full text Add to dashboard Cite

Background Meaning in life (MiL) is considered to be an important part of health and is associated with many positive outcomes in older adults, such as quality of life and longevity. As health promotors, nurses may take patients’ MiL into account in the care process. There is a knowledge gap in terms of what constitutes good care in relation to older patients’ MiL, and what the benefits may be for patients when nursing is attuned to this aspect. The purpose of this study was to explore the experiences of home nursing older adults in relation to nurses’ attunement to MiL. Methods Gadamerian hermeneutic phenomenological design with semi-structured interviews. Participants were 24 aged home nursing patients. A framework of care ethical evaluation was used in the analysis. Multiple dialogues enhanced understanding. Results Patients did not expect nurses’ regard for their MiL. They rather expected ‘normal contact’ and adequate physical care. Nurses showed that they were open to patients’ MiL by being interested in the patient as a person and by being attentive to specific and hidden needs. Participants explained that the nurse’s behaviour upon arrival set the tone: they knew immediately if there was room for MiL or not. All participants had positive and negative experiences with nurses’ behaviour in relation to MiL. Valued nursing care included maintaining a long, kind and reciprocal relationship; doing what was needed; and skilled personalised care. Participants mentioned ‘special ones’: nurses attuned to them in a special way who did more than expected. Benefits of care that was attuned to patients’ MiL were experiencing a cheerful moment, feeling secure, feeling like a valuable person and having a good day. Older adults also stressed that consideration for MiL helps identify what is important in healthcare. Conclusion Aged homecare patients value nurses’ attunement to their MiL positively. Although patients regard MiL mostly as their own quest, nurses play a modest yet important role. Managers and educators should support nurses’ investment in reciprocal nurse-patient relationships.

show abstract

“…They feel fragile due to their chronicity and old age, in accordance with the literature identifying the elements of fragility in a long illness and lifespan (Skilbeck et al, 2018). In addition, fragility is underpinned by a sense of realism regarding the aging process (van Leeuwen et al, 2019; Skilbeck et al, 2018), which is not anxiety about death or avoidance of the future, but rather an acceptance of one's status (Hupkens et al, 2019). This sense of fragility, even if it manifests at discharge, constantly affects the lives of chronic patients (Hupkens et al, 2019; Skilbeck et al, 2018).…”

Section: Discussionmentioning

confidence: 99%

“…In addition, fragility is underpinned by a sense of realism regarding the aging process (van Leeuwen et al, 2019; Skilbeck et al, 2018), which is not anxiety about death or avoidance of the future, but rather an acceptance of one's status (Hupkens et al, 2019). This sense of fragility, even if it manifests at discharge, constantly affects the lives of chronic patients (Hupkens et al, 2019; Skilbeck et al, 2018). It is closely linked with continuous changes in life, where periods of general decline intersect with periods of relative stability (van Leeuwen et al, 2019; Skilbeck et al, 2018), and patients constantly look for a balance between their chronic condition and daily routine management (Hupkens et al, 2019; van Leeuwen et al, 2019).…”

Section: Discussionmentioning

confidence: 99%

“…This sense of fragility, even if it manifests at discharge, constantly affects the lives of chronic patients (Hupkens et al, 2019; Skilbeck et al, 2018). It is closely linked with continuous changes in life, where periods of general decline intersect with periods of relative stability (van Leeuwen et al, 2019; Skilbeck et al, 2018), and patients constantly look for a balance between their chronic condition and daily routine management (Hupkens et al, 2019; van Leeuwen et al, 2019). Looking for a balance in their health status is expressed in the main category ‘ need for support ’, which reveals that patients require support to regain health and autonomy to meet their fundamental needs such as eating, rest, safety and spirituality (Henderson & Nite, 1978).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

“The light at the end of the tunnel”. Discharge experience of older patients with chronic diseases: A multi‐centre qualitative study

Facchinetti

Albanesi

Piredda

et al. 2021

Journal of Advanced Nursing

View full text Add to dashboard Cite

Aim To explore the experiences of being discharged from hospital of older patients with chronic diseases at time of discharge. Design Multi‐centre descriptive qualitative study. Methods Semi‐structured interviews were conducted with older patients with chronic diseases discharged from two Italian university hospitals, between March 2017 and October 2019. The interviews were audio‐recorded, transcribed verbatim and analysed using inductive content analysis. Several strategies were used to ensure the credibility, dependability, confirmability, authenticity and transferability of the findings. The study was reported in accordance with Standards for Reporting Qualitative Research and Consolidated criteria for reporting qualitative research. Results Sixty‐five patients participated in the study. Six main categories emerged: feelings, need for information, time of fragility, need for support, need for trusting relationships, and home as a caring place. Conclusion Older patients with chronic diseases are patients who require quality discharge planning with a patient‐centred care vision. Healthcare professionals should intervene more extensively and deeply in the discharge process, balancing the patients' perception of their needs against organizational priorities and the wish to return home with that of not being abandoned. Impact Discharge from hospital remains an area of concern as older people have varying degrees of met and unmet needs during and following hospital discharge. Discharge is characterized by conflicting feelings of patients, who need information and support of healthcare professionals through trusting and continuous relationships. Understanding the experience of discharge is essential to support older patients with chronic diseases, considering that discharge from hospital is not an end point of care but a stage of the process involving care transition. The reframing of discharge as another transition point is crucial for healthcare professionals, who will be responsible for making their patients fit for discharge by preparing them to manage their chronic condition at home.

show abstract

Meaning in life of older adults in daily care: A qualitative analysis of participant observations of home nursing visits

Cited by 19 publications

References 12 publications

Nurse’s attunement to patient’s meaning in life - a qualitative study of experiences of Dutch adults ageing in place

Nurse’s attunement to patient’s meaning in life - a qualitative study of experiences of Dutch adults ageing in place

Nurses’ attunement to patients’ meaning in life – A qualitative study of experiences of Dutch adults ageing in place

“The light at the end of the tunnel”. Discharge experience of older patients with chronic diseases: A multi‐centre qualitative study

Contact Info

Product

Resources

About