Sanne Angel

Using Scandinavian literature reporting patient experiences of intensive care as a case, the aim of this qualitative systematic review was to explore if humanising was addressed in the descriptions of patient experiences and, if so, what words and theoretical perspectives were used to underpin the results. A comprehensive search of qualitative studies published between 1 January 2016 and 12 December 2024 was conducted in Embase, CINAHL, MEDLINE, Scopus, and Web of Science. Twenty-nine studies reporting patient ICU experiences were included and analysed using thematic synthesis following Thomas and Harden. The review adhered to the Enhancing Transparency in Reporting the Synthesis of Qualitative Research checklist. The terms humanisation and de-humanisation were not explicitly used, but the studies engaged with these concepts by corroborating the three themes that defined humanising ICU in this study: (1) feeling recognised as a human being when experiencing connectedness with healthcare professionals, (2) feeling connected with themselves and the situation when experiencing safety and well-being, and (3) feeling connected with significant persons and life outside the ICU. In addition, our analysis identified a further theme: (4) experiencing capacity to influence the situation when able to express themselves. Humanising intensive care involves ethical and caring engagement with the patient, helping them feel connected, experience well-being, and influence their situation. Although Scandinavian literature has not directly studied humanisation, it has focused on understanding patients’ experiences and addressing the ontology of critical illness. As such, humanising ICU aligns well with Scandinavian nursing traditions. Implications for clinical practice: ICU staff should actively listen to patients and encourage them to express needs and preferences, create a safe and calm environment that supports well-being, and maintain communication with patients and families to promote a humanising approach to intensive care.

Formålet med studiet er at undersøge hvad der særligt har betydning for forældre til børn med kronisk sygdom, som oplever gentagne indlæggelser sammen med deres barn.

Introduction: The power of action research to create change by anchoring research results in practice was challenged in an action research project at a specialized rehabilitation unit for persons with acquired spinal cord injury. Despite the co-researchers' new insights, approaches, and actions supporting patient participation, it was not possible to change the basic conditions for the practicing of nursing. We aimed to raise awareness of the mechanisms that govern barriers by exploring these barriers as experienced by nurses in their effort to change their practice to improve patient participation.Method: We used Fairclough's critical discourse analysis drawing on Foucault's practical systems; ethics (identity, relation to oneself), power (action, relation to others), and knowledge (representation, aspects of the world), which he combines with discourse-analytical concepts.Results: Our discourse analysis of the empirical data at micro-level uncovers the nature of barriers to change in practice. In addition, our analysis at macro-level unveils how these practices are embedded in larger historical, societal, and institutional discourses. This identified two current discourses: a biomedical discourse and a biopsychosocial discourse. In the light of these two discourses, the nurses at micro-level saw themselves as strong agents for the best rehabilitation by acting in accordance with the biopsychosocial discourse. But they were unable to find the time and space to do so due to tasks, structures, and practices specified by an organization dominated by the biomedical discourse.

Background: Critical illness and the intensive care unit can be a terrifying experience to patients and relatives and they may experience the extreme life‐saving measures as dehumanizing. Humanizing intensive care is often described as holism or dignity, but these abstract concepts provide little bodily resonance to what a humanized attitude is in concrete situations.Objective: To explore what contributes to patients' and relatives' experience of intensive care as humanized or dehumanized.Design: Thematic synthesis.Materials: Findings from 15 qualitative papers describing patients' and/or relatives' perceptions of humanizing or dehumanizing care.Methods: A systematic literature search of PubMed, CINAHL, Scopus and EMBASE from 1 January 1999 to 20 August 2022 identified 16 qualitative, empirical papers describing patients' and relatives' experiences of humanizing or dehumanizing intensive care, which were assessed using Critical Appraisal Skills Programme Qualitative Checklist, 15 papers were included and analysed using Thematic Synthesis and Ricoeur's model of the text.Findings: Intensive care was humanized when patients felt connected with healthcare professionals, with themselves by experiencing safety and well‐being and with their loved ones. Intensive care was humanized to relatives when the patient was cared for as a unique person, when they were allowed to stay connected to the patient and when they felt cared for in the critical situation.Conclusion: Patients and relatives experienced intensive care as humanized when healthcare professionals expressed genuine attention and supported them through their caring actions and when healthcare professionals supported patients' and relatives' opportunities to stay connected in the disrupted situation of critical illness. When healthcare professionals offered a connection to the patients and relatives, this helped them hold on and find meaning.Patient or Public Contribution: No patient and public contribution.

Working at nights as a nurse seems to become ever busier due to an increasing level of duties and stressful working conditions. The aim of the study is to explore nurses’ experience of living and working through the night time. Data were collected through interviews with 19 nurses. The analysis was based on a phenomenological method. The nurses establishing a good link between the evening and the day shift; facilitating rest and sleep; being tired but ready for the unexpected; relieving pain, frustration and sombre thoughts; needing an ally to avoid feeling alone and vulnerable; and coping with unforeseen acute situations. Nurses experience a stressful work and struggle against fatigue and a need for prolonged alertness caused anxiety and fear of making patient care errors. The nurses rely on close collaboration to increase their ability to handle difficult situations. Keywords hospital, night shift, nurse, patient safety, phenomenology, workforce

The mental health of the general population is decreasing. This happens in spite of a growing focus on mental health both from a clinical perspective and from a life crisis perspective. Mental illness may be of biological, biochemical, psychological, ...