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

Abstract

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.

“A becoming in the meeting”: the interpretations of competence in home care from the perspectives of older people and registered nurses – a meta-ethnography

“…Competence in home care dignity can best be described as the mutual acknowledgement of presence that happens in the meeting between a patient and a registered nurse. To the patients and registered nurses, acknowledgement, together with a basic interest in the human being in front of you (Hupkens et al, 2020 ), is what constitutes dignity as a competence. By acknowledging the whole person and being recognized as a fellow human being, both the registered nurses and the older people feel like care is provided to its fullest (Hupkens et al, 2020 ; Sæterstrand & Rudolfsson, 2019 ).…”

“…Another older person described this togetherness as a feeling of friendship: “ I just want to be human among other humans … There is one nurse who calls me her friend. That’s so nice ” (Hupkens et al, 2020 ). A registered nurse concluded that by saying, “ We try to get to know the patient by being there.…”

“… Aim : To explore and understand the views of clients and formal and informal caregivers about the experienced quality of home care for older people. Participants : Both RN’s (4) and older people (6) Setting : Dutch home care Method : A descriptive qualitative study using content analysis Themes : Familiar carers to provide personal care needs Having a connection Attentiveness Hupkens, S., Goumans, M., Derkx, P., & Hupkens et al ( 2020 ). Nurse’s attunement to patient’s meaning in life—a qualitative study of experiences of Dutch adults ageing in place.…”

“…Extant literature on health care competence focuses on practical caregiving, the ability to put educational knowledge into practice and experience (From et al, 2013 ; Hupkens et al, 2020 ; Karlstedt et al, 2015 ). According to the World Health Organization ( 2017 ), health in older age should not be defined by the absence of disease.…”

Nursing students' competence profiles in gerontological nursing—A cross‐sectional study

“…This study evaluates the gerontological nursing competence of Finnish nursing students based on the 11 competence areas defined in our previously validated GeroNursingCom instrument. These competence areas are: appreciative encounter and interaction with older persons (Holopainen et al, 2017), administration of medication to older persons (Karttunen et al, 2019), implementation of nutrition for older persons (Shlisky et al, 2017;WHO, 2003), implementation of a safe living environment for older persons (Nieboer & Cramm, 2018;Portegijs et al, 2017), supporting the functioning of older persons (Heath & Watson, 2006), end-of-life care (Smith, 2003), developing one's competences (Rizany et al, 2018), supporting the mental wellbeing of older persons (Hupkens et al, 2020), supporting the sexuality of older persons (Haesler et al, 2016), guiding the self-care of older persons (Imaginário et al, 2020) and responding to challenging situations (Suhonen et al, 2018).…”