Older persons’ expressed worries during nursing care at home: Do health complexity and nature of nursing care in the visit matter?

Lena Günterberg Heyn,Espen Andreas Brembo,Hilde Eide,Linda Hafskjold,Vibeke Sundling

doi:10.1016/j.pec.2021.07.019

Lena Günterberg Heyn, Espen Andreas Brembo + Show 3 more

Open Access

https://doi.org/10.1016/j.pec.2021.07.019

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Abstract

ObjectiveOlder persons receiving home care express more cues and concerns compared to other clinical contexts. Increased health condition complexity requires a corresponding increase in nursing competence. The aim of this study was to explore how complexity of older persons’ health and nature of the visit influenced their expressed worries. MethodsIn this cross-sectional explorative study, we analysed older persons’ expressed worries (n = 508) identified by the Verona Coding Definitions of Emotional Sequences (VR-CoDES) in 129 audio-recorded home care visits with older persons (≥65 years), collected in 3 city districts and 1 rural area in Norway. ResultsExpressed worries of 45 older persons were included in the analysis: 18 had low health complexity, 5 moderate and 22 high health complexity. The nature of the visit affected the number of expressed worries, health complexity did not. Most of the worries were expressed during basic nursing care visits and/or medication administration. ConclusionFindings suggest that home visit type may influence the older persons’ expressed worries. The complexity of the older persons’ health condition seems to have little impact on the expressed worries. Practice implicationsKnowledge about communication in different complexity of visits is important when planning care for older persons.

Highlights

The United Nation has declared 2021–2030 as the decade of healthy ageing [1], with a corresponding increase in health policies aimed at active ageing and enabling people to live at home for as long as possible
We explored whether the worries that older people expressed during nursing home care visits varied based on the patients’ health complexity or the nature of the nursing care in the home care visits
We found potentially important nuances in the emotional communication between nursing staff and older persons receiving home care

Summary

Introduction

The United Nation has declared 2021–2030 as the decade of healthy ageing [1], with a corresponding increase in health policies aimed at active ageing and enabling people to live at home for as long as possible. Shorter hospital stays and increased out patient and home care services seem to be the trend in many countries [2]. Nursing care in the home, which is an integral part of primary health care, is a health care service in which trained nursing staff provide care in the private home of the person in need. Highquality nursing care in the home is salient for supporting older persons’ needs. It is a prerequisite for allowing older persons to.

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