Jessica Höglander

Background: Home Care Services for older adults vary widely across countries regarding how they are structured, organised, and funded. Contextual factors such as workload, staffing challenges, and variability in educational backgrounds may influence participation in communication training. Previous evaluations of the ACTION programme (A person-centred CommunicaTION programme for nursing assistants (NAs) in home care for older adults) have shown promising feasibility and acceptability, providing the basis for the current scaled-up evaluation. This study aimed to evaluate the impact of ACTION on NAs in Swedish home care, using a mixed-methods cluster design. Methods: This study used a convergent mixed-methods cluster quasi-experimental design Data were collected from both intervention and control groups using pre- and post-intervention surveys assessing person-centred care, empathy, job satisfaction, and communication self-efficacy. The intervention group also completed a programme evaluation with open-ended questions upon completing the training modules. Results: Quantitative results showed no statistically significant differences between groups after cluster-corrected analysis, while qualitative findings indicated increased awareness and reflection regarding communication. These findings highlight the importance of considering contextual factors and providing ongoing support when implementing person-centred communication interventions in elder care. The evaluation shows both strengths and methodological limitations. While some positive qualitative changes were observed, the findings emphasise the need to include the perspectives of older adults and their relatives in future research. Conclusions: While quantitative effects were limited, the training programme contributed to meaningful qualitative improvements in communication awareness. Longer follow up and larger samples are needed to determine measurable effects. Trial registration: ISRCTN64890826. Registered 10 January 2022, https://www.isrctn.com/ISRCTN64890826 .

Introduction: Newly graduated nurses (NGNs) encounter difficulties in their professional development and experience high stress during the transition into practice, which may contribute to early turnover. Providing structured transition support is essential for navigating the complexities of patient care and alleviating stress. Objective: To explore whether participation in a professional development programme (ProDeveloP) with a reflective component during the initial months of transition into practice is associated with NGNs’ perceived stress and professional development in terms of role clarity, task mastery, and social acceptance. Methods: A quantitative intervention study with a non-randomised design. The study was conducted in a region in mid-Sweden. A total of 66 NGNs participated in the study: a control group ( n  =  27) in 2022 and an intervention group ( n  =  39) in 2023. The intervention group comprised NGNs who participated in a ProDeveloP, which builds upon a previous introduction programme consisting of eight educational days. ProDeveloP introduced four additional focus areas – role clarity, task mastery, social acceptance, and recovery – and incorporated structured reflection through six facilitated dialogue group sessions. Data were collected through surveys and analysed statistically. Results: The intervention group, comprising NGNs who participated in ProDeveloP, had significantly lower perceived stress compared with the control group (Mann–Whitney U = 241.000, z = –3.311, p < .001), with a large effect size (Hedges’ g = .956, 95% CI [0.489, 1.575]). This difference remained statistically significant after adjusting for relevant covariates in a linear regression model. No significant differences were observed between the groups in relation to role clarity, task mastery, or social acceptance. Conclusion: Transition support employing a reflective approach, such as ProDeveloP, may lower perceived stress among NGNs during the early transition and can be crucial for ensuring a positive transition experience.

Background Home Care Services for older adults vary widely across countries regarding how they are structured, organised, and funded. The study presents an educational intervention called ACTION (a person-centred CommunicaTION programme for nurse assistants (NAs) in home care for older adults). The aim was to evaluate the impact of the person-centred communication educational intervention for nursing assistants in home care for older adults. Methods Data were collected from both intervention and control groups using pre- and post-intervention surveys assessing person-centred care, empathy, job satisfaction, and communication self-efficacy. The intervention group also completed a programme evaluation with open-ended questions upon completing the educational modules. Results NAs participating in the intervention reported increased awareness of the importance of communication and valued acquiring practical tools to enhance their interactions with older adults. While quantitative measures showed no significant differences between groups, qualitative feedback highlighted improvements in reflective practices and self-confidence in communication skills. The intervention did not yield significant quantitative outcomes, yet it prompted valuable qualitative changes in NAs’ communication awareness and practices. These findings highlight the importance of considering contextual factors and providing ongoing support when implementing person-centred communication interventions in elder care. The evaluation shows both strengths and methodological limitations. While some positive qualitative changes were observed, the findings emphasise the need to include the perspectives of older adults and their relatives in future research. Conclusions In summary, this study demonstrates that while quantitative improvements may be limited, qualitative insights reveal the meaningful impact of educational interventions on person-centred communication for nursing assistants. Continued attention to contextual challenges and ongoing support can further enhance the quality of care for older adults in home settings. Trial registration ISRCTN64890826. Registered 10 January 2022, https:// www. isrctn. com/ ISRCT N6489 0826

Background: Enhancing communication in everyday nursing conversations is essential for promoting person-centred care and preserving the dignity of older persons. This qualitative study was performed to gain an in-depth understanding of the nursing assistants’ person-centred communication skills and their communication style. The aim was to explore the communication styles of nursing assistants during home care visits to older persons. Methods: This deductive qualitative study was based on observational data gathered with audio recordings of naturally occurring communication between nursing assistants and older persons during home care visits. Data collection was part of an educational intervention study for in-home nursing assistants and took place from March to December 2022. Data were analysed with a method for deductive qualitative content analysis. The deductive analysis was guided by the framework developed by Bottorff and Morse, and the communication styles identified in the current study, doing more , doing with , doing for , and doing tasks. Findings: A total of 70 audio recording home care visits, including 39 nursing assistants and 37 older persons were included. Based on conversations during these visits, four distinct communication styles employed by NAs in their everyday interactions with older persons were described in depth with focus on communication patterns observed. The different styles included nuances of communication ranging from being more relational and collaborative to more task-oriented interactions. A pattern of doing too much was also observed. Conclusions: The communication styles used influenced the degree of person-centredness. Nurse assistants’ communication styles can vary during conversations and appear to reflect individual traits. The emotional demands of home care work may require more recognition and support from policymakers and managers. Strengthening person-centred communication and care for older persons requires both training and organizational support.

Background/Objectives: This study protocol outlines the implementation of a professional development programme (ProDeveloP) designed to support newly graduated nurses (NGNs). NGNs often experience inadequacy and face challenges in developing their professional competence. Healthcare organisations can ease this transition through introduction programmes. However, effective implementation strategies in local healthcare settings remain unclear. This study aims to develop, implement, and evaluate a programme that enhances role clarity, task mastery, social acceptance, stress reduction, and recovery, contributing to increased job satisfaction and retention. Methods: ProDeveloP will be implemented at a regional hospital in mid-Sweden. This study will include a convenience sample of 110 NGNs from both the previous and the new introduction programmes, 20 dialogue facilitators involved in the programme, and 10 managers responsible for NGNs participating in the programme. Data will be collected throughout the ProDeveloP using questionnaires, individual interviews, and focus groups. The data will be analysed using both qualitative and quantitative analyses. Conclusions: This study has the potential to improve NGNs’ work-related health, job satisfaction, and retention while contributing to competence development. By offering structured reflection, mentorship, and organisational support, this research project addresses knowledge gaps in understanding the long-term impacts of introduction programmes and structured reflection, contributing to evidence-based improvements in nursing practice and healthcare leadership. Clinical trial number: NCT06742047. Registered in ClinicalTrials.gov, 19 December 2024.

Background: In this study, the focus is on how to support the competence development needed for nursing assistants in home care. Home care services for older persons can be challenging concerning the nature of the interpersonal interaction and communication needed to care for and respond to the diverse needs of older people who seek to live well in our communities. This implies a need to offer more person-centred care (PCC) to older persons. However, there is a lack of knowledge on how to develop such competence. We, therefore, developed A Person-centred CommunicaTION (ACTION) programme, which is a web-based educational intervention aimed at supporting competence development for nursing assistants. The research objective is to evaluate the ACTION programme with respect to participants’ responses to and the effect of the intervention. Methods: A multicentre case–control study with pre- and post-assessments was designed. The ACTION programme will be implemented at home care units, in two different geographic areas in Sweden. A total of 300 nursing assistants will be recruited: 150 for the intervention group and 150 for the control group. We will evaluate the impact measures and the process. Pre- and post-assessments will be performed with data collected via a) audio recordings of communication, b) a questionnaire on self-efficacy communication skills, PCC, empathy and job satisfaction, c) user data, evaluation forms, field notes and observations, and d) interviews. The data will be analysed with descriptive and analytic statistics and/or qualitative methods for meanings. Discussion: This study has the potential to contribute to the evidence supporting competence development required to offer person-centred and quality home care to older persons and to meet upcoming needs for flexible and easily accessible competence development. Trial registration: ISRCTN64890826. Registered 10 January 2022, https://www.isrctn.com/ISRCTN64890826

Aim: To explore communication research in nursing by investigating the theoretical approaches, methods, content and perspectives in research on real‐time registered nurse (RN)–patient communication.Design: An integrative review of real‐time communication between RNs and patients.Data Sources: Empirical research papers were searched in PubMed, CINAHL Plus and Medline. The results from the database searches were supplemented with results from manual searches in reference lists.Review Methods: A total of 1369 articles published between January 1996 and December 2021 were screened, which resulted in the inclusion of 52 articles.Results: The integration of various theories, such as nursing or communication theories, is weak in most of the included studies. RN–patient communication appears to influence relationship building. Even when nurses strive to meet patients' needs, they often focus primarily on nursing routines and physical care. The topic of the communication varies depending on the situation and different communication styles are used. When a patient‐centred approach is adopted, the interpersonal communication becomes quite symmetrical, with complementary roles of nurses and patients. Within a more asymmetric communication context, nurses dominate communication, choose topics and function as instructors. How the nurses communicated subsequently influenced the patients' communication styles and strategies.Conclusion: Communication is multifaceted, contains different strategies and is important for building trust and facilitating patient‐centred care. The importance of RNs' communication for interaction and relationship‐building seems to be well established within research, but few studies focused on patients' communication with RNs.Impact: This integrative review gives an overview of the width and depth of observational studies on RN–patient communication research. The variety of studies indicates that this area is a less well‐grounded field of research. Future research is warranted to support nurses in their communication, especially regarding the exploration of patients' communication and desired communication skills in nurse–patient interactions.Patient or Public Contribution: No patient or public contribution was included in this integrative review.

The aim of this study was to explore the influence of characteristics of nurses and older people on emotional communication in home care settings. A generalized, linear, mixed model was used to analyze 188 audio‐recorded home care visits coded with Verona Coding Definitions of Emotional Sequences. The results showed that most emotional distress was expressed by older females or with female nurses. The elicitation of an expression of emotional distress was influenced by the nurses' native language and profession. Older women aged 65–84 years were given the most space for emotional expression. We found that emotional communication was primarily influenced by sex for nurses and older people, with an impact on the frequency of expressions of and responses to emotional distress. Expressions of emotional distress by older males were less common and could risk being missed in communication. The results have implications for students' and health professionals' education in increasing their knowledge of and attentiveness to the impacts of their and others' characteristics and stereotypes on emotional communication with older people.