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Background Nurses are trained to establish a trusting relationship with patients to create an environment promoting patients’ quality of life. However, in tech-heavy care settings, such as haemodialysis units, dehumanising practices may emerge and take root for various reasons to the potential detriment of both patients and nurses. For patients, this may lead to a deterioration of quality of life and, ultimately, of health status. For nurses, it may cause a deterioration of the work environment and, in turn, of quality of working life. Based on Watson’s Theory of Human Caring, we developed a brief educational intervention for haemodialysis nurses to strengthen their humanistic practice in the aim of improving the nurse-patient relationship and nurse quality of working life.. The intervention was tested by way of an experimental design. Methods One hundred and one haemodialysis nurses, recruited in ten hospitals in French-speaking Switzerland, were randomised into an experimental group that received the intervention and a control group. The nurse-patient relationship was measured with the Caring Nurse-Patient Interaction Scale (EIIP-70) and nurse quality of life at work was measured with the Quality of Work Life Questionnaire at four time points: pre-intervention, intervention completion, and six-month and one-year follow-ups. Random intercept regression analysis was used to evaluate change over time in the two variables under study. Results The intervention appeared to reinforce nurse attitudes and behaviours geared to a more humanistic practice. The effect seemed to fade over time but, 1 year post-intervention, six dimensions of the nurse-patient relationship (hope, sensibility, helping relationship, expression of emotions, problem solving, teaching) scored above baseline. Nurse quality of working life, too, seemed positively impacted. The cultural dimension of nurse quality of working life, that is, the degree to which everyday work activities attune with personal and cultural values, seemed positively impacted, as well, with improvement stable throughout the year following the intervention. Conclusions Results support a positive effect of the intervention over both the short term and the medium-to-long term. A brief intervention of the sort may constitute an effective means to improve the nurse-patient relationship by preventing or reducing dehumanising practices. Trial registration NCT03283891.

IntroductionHemodialysis (HD) patients experience numerous physical and psychological symptoms on a daily basis. These symptoms have a heavy impact on their quality of life, which is a key indicator of their survival in the short term. Numerous empirical studies have shown that the quality of the nurse-patient relationship (NPR) is essential in promoting positive outcomes for patients. When patients receive caring, their autonomy and independence grows, their sense of hope increases, their quality of life improves, and their sense of satisfaction with nursing care received rises. Inversely, the presence of dehumanizing practices in hemodialysis settings can contribute to delay healing for patients. In light of the importance of the quality of the relationship between nurses and HD patients and of the benefits to be had from a quality relationship, an educational intervention based on Watson's Theory of Human Caring was delivered to HD nurses.ObjectiveThe purpose of this study was to explore qualitatively the perceptions of nurses working with HD patients in French-speaking Switzerland regarding changes to their clinical practice after receiving an educational intervention intended to reinforce caring attitudes and behaviors towards patients.MethodsThe method used was that of consensual qualitative research (CQR). Sixteen semi-structured interviews were conducted with hemodialysis nurses post-intervention.ResultsThe results evidence a transformation of clinical nursing practice illustrated by three core ideas: (1) caring practice was reinforced; (2) new practices emerged; and (3) some limitations appeared.ConclusionIn these times of global pandemic where the issue of the humanization of nursing care is front and center, this professional development activity helped reinforce caring-based practice. This practice needs to be developed within the various care units in order to guarantee and promote quality of care and patient safety.

A French-language humanistic educational intervention aimed at strengthening nurses’ caring attitudes and behaviors was first developed in Quebec, with rehabilitation nurses, and then used in Switzerland, with hemodialysis nurses. In both projects, phenomenological interviews explored the feasibility, acceptability, and benefits of this intervention. This article presents the results of a secondary analysis of both datasets regarding its convergence and divergence. A strong thematic convergence underlined that nurses adopted a shared language with respect to caring and reinforced their humanistic clinical practices. Consequently, such intervention could prove itself useful in fostering a more humanist nursing practice within today challenging healthcare system.

Background: Chronic kidney disease (CKD) is a fast-growing cause of morbidity and mortality worldwide. Patients suffering from CKD almost always develop end-stage renal disease (ESRD) that is often treated with haemodialysis (HD). In this context, the quality of the nurse-patient relationship (NPR) plays a major role in supporting the quality of life (QoL) of HD patients. This study examined the relationship between quality of nurse behaviours and attitudes as perceived by HD patients and QoL of these patients.Methods: The study used a cross-sectional correlational design. The sample consisted of 140 patients recruited in 10 HD units in French-speaking Switzerland. The Caring Nurse-Patient Interaction Scale (CNPI-70) was used to assess the NPR, and the French version of the WHOQOL-Bref was used to evaluate different dimensions of QoL. Random-intercept linear regressions adjusted for sociodemographic characteristics were used to study the relationship between patient-perceived quality of nurse caring attitudes and behaviours and patient QoL.Results: Patients reported a high frequency of caring attitudes and behaviours from their attending nurses, except relative to the dimension of spirituality. All the dimensions of patient QoL were positively influenced by the caring factor composing the CNPI-70. In particular, nurse attention to patient dignity when providing support for basic human needs seemed to be a major factor in patient QoL.Conclusions: Quality of NPR is essential to improving patient QoL. Interventions need to be developed to support quality of NPR.

Humanistic nursing practice constitutes the cornerstone of the nursing profession. However, according to some authors, such practice tends to fade over time in favour of non-humanistic behaviours. To contrast this tendency, an educational intervention (EI) based on Watson’s Theory of Human Caring was developed and tested in two pilot studies involving, respectively, rehabilitation nurses in Quebec (Canada) and haemodialysis (HD) nurses in Switzerland. In light of the positive results obtained in these, another study is being undertaken to examine more in depth the EI’s effects on both HD nurses and patients in French Switzerland. The EI is expected to have positive effects on quality of nurse-patient relationship (NPR), team cohesion, nurse quality of working life (QoWL), and patient quality of life (QoL). The study described in this protocol will use a mixed-method cluster randomised controlled trial design. For the quantitative component, nurse and patient data will be collected through questionnaires. The accessible population of 135 nurses and 430 patients will be clustered into 10 HD units. These units will be randomised into an experimental group (EG) and a waiting-list control group (WLCG). Measurements will be taken at baseline (pre-intervention) and repeatedly over time (post-intervention): immediately at EI completion and six and 12 months thereafter. For the qualitative portion of the study, 18 semi-structured interviews will be conducted with EG nurses picked at random two months after EI completion to explore perceived changes in nurse humanistic practice. Qualitative data will be analysed through the relational caring inquiry method, a phenomenological approach. Descriptive and inferential statistics will be computed from the quantitative data. The study described in this protocol will determine if and how the proposed EI promotes humanistic nursing practice and how this practice affects quality of NPR, nurse QoWL, and patient QoL. Moreover, it will lay the groundwork for offering the EI to nurses in other healthcare sectors. This clinical study was registered with ClinicalTrials.gov [ NCT03283891 , 14/09/2017].

A mixed-design pilot study was undertaken to examine the feasibility, acceptability, and preliminary effects of an educational intervention based on the theory of human caring delivered to hemodialysis (HD) nurses in Switzerland. Participants were 9 nurses and 22 patients undergoing HD. Results showed that the proposed intervention had a high level of feasibility and acceptability. Following the intervention, participating nurses consolidated their caring attitudes/behaviours toward patients undergoing HD. The patients, for their part, perceived significant changes in the nurses' caring attitudes/behaviours following the intervention. Further research is needed to examine its effects on a larger population of nurses and patients.

An educational intervention was developed based on Watson's theory of human caring and dispensed to hemodialysis (HD) nurses in Nyon, Switzerland. HD patients point out that human contact with nurses can become therapeutic when characterized by caring. Research has documented the importance of the contribution of such caring practice to the rehabilitation of patients living with a chronic illness. This initiative supports the relevance of exploring humanistic caring practice in order to contribute to the rehabilitation of HD patients. The article presents the principal stages of the theoretical development of the educational intervention.

« Etre avec » la personne soignee s’avere un phenomene primordial pour la profession infirmiere en raison de la nature relationnelle du role infirmier. Il se situe d’ailleurs au cœur meme de la philosophie du caring, laquelle correspond, selon plusieurs auteurs, a l’essence meme des soins infirmiers. Ayant comme perspective disciplinaire, la philosophie du Human Caring de Watson, cette etude phenomenologique a explore, aupres d’infirmieres (n=17) œuvrant en contexte de readaptation, la signification de l’experience d’« etre avec » la personne soignee, de meme que leur perception de la contribution de cette experience a la readaptation de la personne. Trois entrevues realisees pour chaque participant, totalisant 51 entrevues, ont ete analysees a l’aide de la methode phenomenologique intitulee « Relational Caring Inquiry » developpee par Cara (1997). Le processus d’analyse des donnees a permis l’emergence de cinq eidos-themes. Parmi ceux-ci, quatre se rapportent a la signification de l’experience d’« etre avec » la personne soignee, a savoir : l’importance des valeurs humanistes au centre du soin, l’investissement de l’infirmiere et de la personne soignee, les dimensions reciproque et relationnelle du soin et, l’experience de soin irremplacable d’une complexite contextuelle. Le cinquieme et dernier eidos-theme, rehaussement de l’harmonie corps-âme-esprit chez la personne soignee et l’infirmiere, devoile la perception des participantes quant a la contribution therapeutique de l’experience d’« etre avec » la personne soignee a la readaptation de cette derniere. Ces resultats ont favorise l’emergence de la signification du phenomene a l’etude soit, « une rencontre humaine profonde, therapeutique et transformatrice ».De l’ensemble des resultats decoulent des retombees novatrices et des propositions des piste d’interventions pouvant servir de guide au renouvellement de la pratique clinique de l’infirmiere en readaptation, de meme que pour la formation et la recherche infirmiere.

Essentiellement basee sur des valeurs humanistes de respect, de collaboration et d’unicite plutot que sur l’objectivation, le controle et la categorisation de la personne soignee, l’intervention des professionnels inspiree de l’approche du « caring » se fera dans le respect inconteste de la dignite humaine de la personne et de sa famille. Si nous considerons que le caring est au cœur des soins infirmiers et qu’il represente son essence, les infirmieres devront alors faire un effort conscient afin de preserver cette approche humaniste et relationnelle du soin dans leur pratique clinique (Cara, 2004b ; O’Reilly, 2008, Watson, 2002). Pour se faire, les theories du caring, comme celle de Jean Watson, s’averent indispensables. Inspire de l’article de formation continue de Cara (2003), cette presente reflexion se veut pragmatique et vise la comprehension des elements essentiels de la theorie du Human Caring de Watson, par le biais d’un exemple de pratique reflexive dans le cadre d’une situation clinique de readaptation.

Health care professionals are increasingly called upon to work collaboratively. This commentary discusses our experience at the Summer Institute on Interdisciplinary Health Research, which aimed to increase the capacity of future Canadian researchers to work with health professionals from other disciplines. We discuss, in particular, our small group experience--the challenges we faced, and how we were able to resolve the internal conflicts that occurred. We also discuss the conditions necessary to engage in interdisciplinary work and offer suggestions to improve future initiatives to build interdisciplinary research capacity.