Purpose: The purpose of this study was to analyze the concept of advanced care planning for patients with chronic heart failure.
Method: The analysis was conducted on 49 reports using the Rodgers’ evolutionary concept analysis.
Results: The following eight categories were extracted as attributes of advanced care planning: information that needs to be shared and discussed, exploring of humanity, foresee the end-of-life, promoting decision-making process, construction of system for seamless care, partnership, dialogue, and continuous and repetitive process. In addition, seven antecedents were extracted: social background, cultural background, background of medical personnel, timing of confirmation of intention by individual judgment, gap of heart failure perception, uncertainty of medical condition, treatment and care of heart failure, and lack of end-of-life care. Finally, five considerations were extracted: improvement of patient and family satisfaction, relief of total human suffering of patients and families, internal change of patient, realization of that patients’ way of life, and medical outcomes improvement.
Conclusion: Advanced care planning for chronic heart failure patients is defined as a process whereby, in preparation for the decline of the patients’ decision-making ability, patients, families and healthcare professional dialogue as they explore the patients’ humanity while looking at the disease processes specific to chronic heart failure, and continuously and repeatedly work together for the realization of the patients’ autonomous intentions and desired way of life.
This study aimed to understand the difficulty and learning needs of nurses caring for adolescent cancer patients. The participants consisted of two groups of nurses: 1. seven nurses with less than five years of nursing experience, and 2. eight nurses with more than five years of nursing experience. The research was conducted using group interview method. Results showed that, in Group 1, nurses had the following difficulties: “confusion regarding a sense of distance from elusive patients” and “having uncertainty on how to care for particular patients in the future”. Their learning needs were as follows: “knowledge of caring for adolescent cancer patients,” and “making up for one’s lack of experience by learning from others’ experiences and practices.” In Group 2, nurses had the following difficulties: “concern regarding forming relationships with patients developing autonomy” and “difficulty in staying close to patients who are losing hope”. Their learning needs were as follows: “knowledge of caring for adolescent cancer patients,” and knowledge of social support resources available to patients.” It was thought that in Group 1, nurses have lack of knowledge and lack of confidence in nursing practice due to the difficulty of accumulating care experience, and in Group 2, nurses have concerned about anxiety caused by past care experience.
Aim: This study aimed to describe the experience of proxy decision-making among mothers of infants born at the limits of viability in the medical context.
Methods: Data were collected through unstructured interviews and analyzed using phenomenological methods.
Results: The mother’s proxy decision-making experience was divided into two themes: “leaving subject” and “regaining subject.” The child was deprived of subject through being categorized by medical findings and the mother concealed her actual self by acting as the “mother” desired by the patient care team. However, as the mother developed her support by becoming involved in the world created by the patient care team, she gradually regained her child and her own subject within that world.
Conclusion: Offering support with a full view of motherhood limited the mother’s requests for support, but also provided an opportunity to change mother’s viewpoint over time. It was suggested that it is important for the patient care team to be introspective and consider those in need.
Aim: This study aimed to investigate the factors determining whether children in need of medical care are accepted into after-school daycare and child development support centers.
Method: The study design was a cross-sectional study. A survey questionnaire was distributed to 1556 after-school daycare offices and child development support centers between January and February 2019. Statistical analyses were performed using the χ2 test, Wilcoxon rank-sum test, and logistic regression.
Results: There were 292 responses (response rate: 20.7%), of which 249 were complete enough to be analyzed. Factors related to the acceptance of children requiring medical care include “paralleled with visiting nursing offices (odds ratio (OR) = 4.55),” “cooperation: knowing local resources specifically (OR = 1.18),” and “the number of nurses (OR = 14.94).”
Conclusion: According to this study, acceptance of children requiring medical care in after-school daycare and child development support centers was related to the arrangement of nurses and cooperation to support children with medical care in the community. Therefore, it is hoped that medical welfare cooperation and appropriate staffing will be promoted in the future.
Objective: This study was conducted to clarify the process of nurse dedication in nurse-patient relationships.
Methods: Semi-structured interviews were conducted with 12 nurses working in a general hospital and the results of the interviews were analyzed using the modified grounded theory approach.
Results: Nurses concentrated on “building relationships with patients living in the community,” focused on “showing consideration for patients’ feelings,” and were devoted to “responding to patients’ feelings.” In this process, nurses also experienced “nurses’ own emotional response,” but concentrated on “personalized care” through “maintaining a nurse-patient relationship.” Accordingly, nurses tried to dedicate themselves to fundamentally “focusing on the patient.” This process was perceived as ‘fluid dedication.’
Conclusions: Nurses should be capable of assessing what is happening to patients, reflect on what is happening in their own emotional response and in the patient–nurse relationship, and rededicate themselves to patients by providing nursing care that incorporates the “nurse’s own emotional response” instead of suppressing or discarding it as a personal problem that is not related to care, and by perceiving the “nurse’s own emotional response” within the conceptual framework of involvement in the patient–nurse relationship.
Purpose: To elucidate the most effective posture for female nurses to administer external chest compression to patients during transportation on a stretcher by comparing the quality of pressure on the chest.
Method: Using a human body model, 18 female nurses with more than five years of clinical experience administered external chest compression using three different styles: straddling chest compression (S-CC), in which a nurse assumes a position immediately over the patient; basic chest compression (B-CC), in which a nurse kneels on the floor beside a patient; and walking chest compression (W-CC), in which a nurse walks alongside a patient to administer external cardiac massage. The depth, rate and recoil of the compression were measured using a measurement application to evaluate the quality of the cardiac massage.
Results: Multiple comparisons revealed that S-CC and B-CC had a significantly higher compression depth than W-CC (p < .001). No significant differences were observed in terms of compression and recoil rates among the three styles. An analysis of the correlation between the quality of compression and the physique of the administrator showed no significant correlation when S-CC was used.
Conclusion: There is a possibility that S-CC is more effective than W-CC in terms of posture if a female nurse is to administer external chest compression while a patient is being transported on a stretcher.