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Objective: To explore the relationships that emerge amongst caregivers of persons with dementia and stroke when caregivers use written messages as their communication tool in a closed information and communication technology (ICT)-based support group., Methods: An explorative design with a qualitative approach was used that applied systematic text condensation (STC) to analyse 173 written messages extracted from a web forum., Results: Empathetic, empowering and familiar relationships emerged amongst peers of older caregivers when the caregivers used written messages as their communication tool. The empathetic relationship was characterised by sincerity and openness when the caregivers shared emotions related to caregiving. The empowering relationship reflected a fellowship based on solidarity influenced by a sense of optimism and a willingness to share knowledge to support one another in overcoming challenges. In the familiar relationship, the caregivers were thoughtful and good-humoured with one another and displayed an attitude of consideration towards one another, as in an extended family., Practice Implication: The use of computer-mediated communication in health care service will change the context of establishing and maintaining interpersonal relationships. Therefore, greater knowledge regarding how the peers of caregivers interact with one another is vital so nurses may better support and educate ICT-based support groups.

Aims and Objectives: To explore the relationship between nurses and caregivers using a web camera and web forum as the communication methods., Background: In Norway and other European countries, there is an increased focus on ageing at home, which is aided by technology, as well as formal and informal care. The literature reveals that caregivers endure physical and mental burdens. With computer-mediated communication, such as telecare, it is possible for nurses to provide supportive care to caregivers in their homes., Design: An explorative design using qualitative content analysis., Method: Six nurses and nine caregivers with residential spouses suffering from stroke or dementia were interviewed two times over a six-month period., Results: The nurses responded dynamically to the information they received and helped to empower the individual caregivers and to strengthen the interpersonal relationships between the caregivers. While some participants thought that meeting in a virtual room was close and intimate, others wanted to maintain a certain distance. The participants' altered their roles as the masters and receivers of knowledge and experience; this variation was based on a relationship in which mutual respect for one another and an interest in learning from one another allowed them to work together as partners to demonstrate the system and to follow-up with new caregivers., Conclusions: The flexibility of the service allows the possibility of engaging in a close, or to some extent, a more distant relationship, depending on the participants' attitudes towards using this type of service., Relevance to Clinical Practice: Nurses can provide close care, support and information to caregivers who endeavour to master their everyday lives together with their sick spouses. The support seems to help the caregivers cope with their own physical and emotional problems., (© 2015 The Authors. Journal of Clinical Nursing published by John Wiley & Sons Ltd.)

Next of kin represent significant resources in the care for older patients. The aim of this study was to describe and illuminate the meaning of the next of kin's experiences during the transition of an older person with continuing care needs from hospital to home. The study has a phenomenological hermeneutic design. Individual, narrative interviews were conducted, and the data analysis was conducted in accordance with Lindseth and Norberg's phenomenological hermeneutic method. Two themes and four subthemes were identified and formulated. The first theme: "Balancing vulnerability and strength," encompassed the subthemes "enduring emotional stress" and "striving to maintain security and continuity." The second theme: "Coping with an altered everyday life," encompassed "dealing with changes" and "being in readiness." Our findings suggest that the next of kin in striving to maintain continuity and safety in the older person's transition process are both vulnerable individuals and significant agents. Thus, it is urgent that health care providers accommodate both their vulnerability and their abilities to act, and thereby make them feel valued as respected agents and human beings in the transition process.

Aims and Objectives: To describe and explore experiences of next of kin during the older persons' transition into long-term care., Background: Moving into long-term care is a challenge for both resident and next of kin. Next of kin experience transitions at the same time as they play significant parts in their family members' transition into long-term care placement., Design: Constructivist hermeneutical design., Methods: Ten next of kin to newly admitted eight residents were recruited by purposeful sampling and interviewed. Periodic participant observation periods following new residents on arrival day and the first week after admission and some written documentation were the backdrops to the interviews., Results: What happened prior to the long-term care placement as well as what happened in the initial period of transition influenced the experiences of next of kin. Characteristics of their experiences were: 'striving to handle the new situation', 'still feeling responsible', and 'maintaining dignity and continuity'., Conclusions: Next of kin were unprepared for the transition and had little support from staff. Staff lacked awareness about next of kin's transition experiences. Their involvement with next of kin was unpredictable, and this added to the burdens of next of kin in this period., Relevance to Clinical Practice: Knowledge about experiences of next of kin needs to be acknowledged among healthcare professionals. Health professionals need to pay attention to what happens across institutional borders within families as well as between staff and family members. Individual family members need support in this period of change., (© 2013 John Wiley & Sons Ltd.)

Background: Older persons in transition between hospital and home care services are in a particularly vulnerable situation and risk unfortunate consequences caused by organizational inefficiency. The purpose of the study reported here was to elucidate how home nursing leaders experience the administration of care to older people in transition from hospital to their own homes. Methods: A qualitative study design was used. Ten home nursing leaders in two municipalities in southern Norway participated in individual interviews. The interview texts were audio taped, transcribed verbatim and analyzed by use of a phenomenological-hermeneutic approach. Results: Three main themes and seven subthemes were deduced from the data. The first main theme was that the home nursing leaders felt challenged by the organization of home care services. Two subthemes were identified related to this. The first was that the leaders lacked involvement in the transitional process, and the second was that they were challenged by administration of care being decided at another level in the municipality. The second main theme found was that the leaders felt that they were acting in a shifting and unsettled context. Related to this, they had to adjust internal resources to external demands and expectations, and experienced lack of communication with significant others. The third main theme identified was that the leaders endeavored to deliver care in accordance with professional values. The two related subthemes were, first, that they provided for appropriate internal systems and routines, and, second, that they prioritized available professional competence, and made an effort to promote a professional culture. Conclusion: To meet the complex needs of the patients in a professional way, the home nursing leaders needed to be flexible and pragmatic in their administration of care. This involved utilizing available professional competence appropriately. The coordination and communication between the different organizational levels and units were pointed out as major factors requiring improvement. [ABSTRACT FROM AUTHOR]

Background: In Norway, changes in life expectancy have led to increased attention to older people who are ageing at home, by means of home care services, adapted technology and informal caregivers. The caring situation has become difficult for many caregivers. The use of telecare has now offered them the possibility to receive support at home. The purpose of this study was to explore how nurses provide support and care at a distance, using a web camera and a web forum in a closed telecare network for caregivers to persons suffering from stroke and dementia.Methods: The study had an explorative design with a qualitative approach. The data sources consisted of interviews with nurses and excerpts from posts in a closed telecare network. Content analysis was used to analyse the text from the interviews and the text from the web forum.Results: The main theme, "Balancing asymmetric and symmetric relationships" described nurses' relationship with caregiver. Two categories, "Balancing personal and professional qualities" and "Balancing caregivers' dependence versus independence" were identified. The first describing the tension in their dialogue, the second describing how nurses provided the caregivers with a sense of security as well as strengthening them to master their daily lives.Conclusions: The nurses provided long distance support and care for the caregivers, by using computer-meditated communication. This communication was characterized by closeness as well as empathy. To strengthen the caregivers' competence and independence, the nurses were easy accessible and provided virtual supervision and support. This study increases the knowledge about online dialogues and relationship between nurses and caregivers. It contributes to knowledge about balancing in the relationship, as well as knowledge about bridging the gap between technologies and nursing care as potential conflicting dimensions. Maintenance of ethical principles are therefore critical to be aware of. [ABSTRACT FROM AUTHOR]