Tidsskrift for omsorgsforskning, 2026

Crisis development in frail home-dwelling patients: A process analysis of clinical records

Abstract

Abstract:
Background: New knowledge about the process leading to crises among community-dwelling frail patients, such as acute hospital admissions, may contribute to improved understanding, prevention, and new approaches to future crises. The aim of this study was to explore the development of crises among frail patients as documented in the patient records by home care services and general practitioners.

Methods: This study comprised a qualitative process analysis of documents from electronic patient records systems retrieved from home care services and general practitioners in ten municipalities in Norway for 20 patients.

Findings: The analysis showed that the structure of the examined patient records influences the ability to disclose the processes leading to crises. Events within the crisis process were often described without addressing the underlying reasons for their occurrence. Furthermore, the development of a crisis was found to follow individual and complex pathways for each patient.

Forfattere

Janne Myhre, Sverre Bergh, Ingvild Hjorth Feiring, Lisbeth Dyrendal Høgset Lisbeth, Øyvind Kirkevold og Bjørn Lichtwarck

Tilgang til artikkelen

Palliative and Supportive Care, 2026

Ensuring a good death: Priorities and concerns of healthcare personnel across healthcare settings

Abstract

Abstract

Objectives: The primary objective of healthcare personnel involved in end-of-life care is to ensure a good and dignified death. However, end-of-life care is delivered across various healthcare settings. This qualitative study aimed to identify the priorities and concerns related to end-of-life care shared by healthcare personnel working in hospitals, nursing homes, and municipal home care.

Methods: Twenty-two healthcare personnel from across Norway participated in virtual focus group interviews. Participants represented 3 distinct healthcare settings and had diverse professional backgrounds. Each interview was audio-recorded and transcribed verbatim. Qualitative content analysis was conducted and informed by theory on professional competence.

Results: The analysis demonstrated that ensuring a good death was a shared focus among participants. Across settings, they expressed aligned priorities and concerns regarding end-of-life care. They likened their role to that of a pilot boat skipper, guiding the end-of-life process with a clear focus on: 1) offering support and information, 2) providing symptom relief, and 3) ensuring a presence at the bedside. Each of these themes highlights a key priority in end-of-life care across healthcare settings, along with its associated concerns.

Significance of results: This study demonstrates that healthcare personnel across hospitals, nursing homes, and municipal home care share core priorities of what constitutes a good and dignified death. The findings challenge setting-specific assumptions in end-of-life care and support an emphasis on shared core competencies in education and practice. Overall, the study contributes to a more unified understanding of end-of-life care by highlighting foundational care values that transcend organizational boundaries and professional backgrounds, thereby supporting policies that promote continuity and coherence across care environments.

Forfattere

Siren Eriksen, Anne Marie Mork Rokstad, Elisabeth Wiken Telenius, Kariann Krohne

Tilgang til artikkelen