This paper aims to contribute to the knowledge about open, co-produced meeting centres for people with dementia, from their own perspective. Services that support people who are newly diagnosed with dementia are often insufficient. Co-produced services have the potential to address the need of people with dementia to be useful and productive, while reducing the stigma. In this study, we applied a qualitative design. Data were collected at a meeting centre for people with newly diagnosed dementia, and consisted of fieldwork (13 days for about two hours at a time), written materials, and semi-structured interviews (mean length 30 minutes) with five attendees with dementia and two staff persons. The analysis was inspired by situational analysis. The findings showed that the meeting centre provided a place for human encounters, a break from everyday life, and a place to share knowledge and develop new skills. Further, challenges were described. Co-production consisted of the attendees being encouraged to take part in the planning of activities, learning from each other and providing mutual support. The study adds to previous knowledge about co-produced services for people with dementia. Future studies can clarify how co-production can be developed in services for people with newly diagnosed dementia in countries and regions where there is a dearth of this kind of support.

Background: Patients’ health and wellbeing are promoted when nurses successfully conceptualize caring in clinical practice. Measuring caring behaviors can advance knowledge about caring and has potential to improve caring practices and the outcomes of care. The Caring Behaviors Inventory-24 (CBI-24) is an empirical instrument for measuring caring, developed to determine perceptions of caring among patients and nurses. Since the instrument was not available in Swedish, the aim of this study was therefore to translate into Swedish and cross-culturally adapt CBI-24 for a Swedish healthcare context, and to psychometrically analyze the Swedish version of CBI-24.

Methods: The study used a traditional forward and back translation process in six stages: (1) two simultaneous translations by bilingual experts; (2) expert review committee synthesis; (3) blind back translation; (4) expert review committee deliberations; (5) pre-testing with cognitive interviews, and (6) psychometric evaluations. 

Results: The translation process was systematically conducted and entailed discussions regarding semantic, idiomatic, experiential and conceptual equivalence. The cognitive interviews generated thoughts and reflections, which resulted in adjusting three items of the CBI-24 SWE. For psychometric analyses, 234 persons answered the questionnaire. Results indicated acceptable overall model fit in the χ2-value for the confirmatory factor analysis, while for the heuristic goodness-of-fit indices, the comparative fit index (CFI) and the standardized mean square residual (SMSR) indicated good model fits, and the root mean square error approximation (RMSEA) indicated an acceptable fit. 

Conclusions: CBI-24 SWE has been shown to be a psychometrically acceptable instrument for use in Swedish research contexts. Further studies regarding the clinical usefulness of the instrument may be in order. In particular, CBI-24 SWE should be evaluated among nurses in rural areas.

BACKGROUND: Homelessness is an increasing problem worldwide, and the origins of homelessness in high-income countries are multifaceted. Due to stigma and discrimination, persons in homelessness delay seeking health care, resulting in avoidable illness and death. The Attitudes Towards Homelessness Inventory (ATHI) was developed to cover multiple dimensions of attitudes toward persons in homelessness and to detect changes in multiple segments of populations. It has, however, not previously been translated to Swedish.

AIMS: The aim of the present study was to translate, cross-culturally adapt, and psychometrically test the ATHI for use in a Swedish healthcare context.

METHODS: The project used a traditional forward- and back-translation process in six stages: (1) two simultaneous translations by bilingual experts; (2) expert review committee synthesis; (3) blind back-translation; (4) expert review committee deliberations; (5) pre-testing with cognitive interviews including registered nurses (n = 5), nursing students (n = 5), and women in homelessness (n = 5); and (6) psychometric evaluations. The final ATHI questionnaire was answered by 228 registered nurses and nursing students in the year 2019.

RESULTS: The translation process was systematically conducted and entailed discussions regarding semantic, idiomatic, experiential, and conceptual equivalence. Confirmatory factor analysis was used to examine if the collected data fitted the hypothesized four-factor structure of the ATHI. Overall, it was found that the model had an acceptable fit and that the Swedish version of ATHI may be used in a Swedish healthcare context.

LINKING EVIDENCE TO ACTION: The ATHI has been shown to be a psychometrically acceptable research instrument for use in a Swedish healthcare context. The systematic and rigorous process applied in this study, including experts with diverse competencies in translation proceedings and testing, improved the reliability and validity of the final Swedish version of the ATHI. The instrument may be used to investigate attitudes toward women in homelessness among nursing students and RNs in Sweden.

The aim of this study was to describe from a staff perspective what promotes a positive atmosphere in a nursing home for people with dementia. A nursing home renowned for its positive atmosphere and quality of care was chosen for our research. The study has a qualitative descriptive design using a modified grounded theory. Eight members of staff were interviewed. The analysis consisted of open, axial and selective coding and constant comparison between each narrative. The core category was ‘A safe haven for everyone’, with three categories; ‘Relating to people with dementia’, ‘Relating to work’ and ‘Relating to each other’. A shared set of values embraced by all staff was the foundation in the nursing home and supported the atmosphere and quality of care. The positive atmosphere had been founded on mutual trust between manager and staff, lending staff the freedom to be creative in their work, and ensuring that the residents with dementia were cared for in the best possible way.

The aim of this article is to present a communication skills training curriculum for nursing students, based upon phenomenology. Research shows that nurses have difficulty prioritizing dialogue with patients, due to lack of time, organizational and cultural factors. Like other health care professionals, nurses may also have difficulties communicating with patients due to personal fears and shortcomings. The communication training curriculum based upon phenomenology aims at systematically training students to stay focused upon patients' and relatives' narratives, allowing them to reflect upon and better understand their current situation. This approach to communication is applicable in any clinical situation where it important to provide space for the patients' experiences. The philosophical principles guiding the training are presented here as well as the practical steps in the program. Finally, the approach is compared to other common communication methods used in nursing (motivational interviewing, caring conversations, empathy training). The authors hope that the article will highlight the nurses’ role as dialogue partner as well as emphasize the importance of communication skills training in nursing education. This approach can be refined, tested and modified in future research and may serve as an inspirational model for creating a generic communicative competence for nurses.

Living with dementia disease (DD) can include difficulties describing experiences of everyday lives, which can lead to withdrawal, social isolation or existential homelessness. Persons with DD living in nursing homes are mainly dependent on the nurses for establishing and maintaining relationships with those around them. It can be challenging for nurses to understand what a person with DD is trying to express and to make themselves understood in turn. The validation method is intended to facilitate communication with persons with DD, but to our knowledge, there have been no qualitative studies of how this influences persons’ communication. This study aimed to illuminate the actions and reactions of persons with DD living in nursing homes in one-to-one conversations with nurses during 1 year of validation method training, as observed in videotapes. Four persons with DD were involved in videotaped conversations with four nurses who were participating in a validation method training programme. Videotapes with at least 5 months between the first and last recording were analysed and compared qualitatively. The findings are presented in four categories that were identified to various degrees in conversations at the beginning and at the end of the programme: being uninterested in or unable to answer questions, talking about more than one topic of conversation at the same time, trying to talk about what is on one’s mind and speaking more freely about what is on one’s mind. In the videotaped conversations at the end of the programme, the persons had the opportunity to use their remaining communication abilities. This may have been related to the development of the nurses’ communication skills during the training programme, and so it is possible that persons with DD could benefit from communicating with nurses trained in the validation method.

Background: Training nursing staff in communication skills can impact on the quality of care for residents with dementia and contributes to nurses' job satisfaction. Changing attitudes and practices takes time and energy and can affect the entire nursing staff, not just the nurses directly involved in a training programme. Therefore, it seems important to study nurses' experiences of a training programme and any influence of the programme on work climate among the entire nursing staff.

Aims and objectives: To explore nurses' experiences of a 1-year validation method training programme conducted in a nursing home for residents with dementia and to describe ratings of work climate before and after the programme.

Design: A mixed-methods approach.

Methods: Twelve nurses participated in the training and were interviewed afterwards. These individual interviews were tape-recorded and transcribed, then analysed using qualitative content analysis. The Creative Climate Questionnaire was administered before (n = 53) and after (n = 56) the programme to the entire nursing staff in the participating nursing home wards and analysed with descriptive statistics.

Results: Analysis of the interviews resulted in four categories: being under extra strain, sharing experiences, improving confidence in care situations and feeling uncertain about continuing the validation method. The results of the questionnaire on work climate showed higher mean values in the assessment after the programme had ended.

Conclusion: The training strengthened the participating nurses in caring for residents with dementia, but posed an extra strain on them. These nurses also described an extra strain on the entire nursing staff that was not reflected in the results from the questionnaire. The work climate at the nursing home wards might have made it easier to conduct this extensive training programme.

Implications for practice: Training in the validation method could develop nurses' communication skills and improve their handling of complex care situations.

Communication difficulties among residents with dementia disease living in nursing homes may complicate care situations. These residents can have difficulties describing how they experience their everyday lives, which can lead to withdrawal, social isolation, or feelings of homelessness. Research indicates that nurses involved in dementia care experience communication as difficult and challenging. The validation method developed by Feil is held to facilitate communication through emphatic and confirmatory approaches. Scientific reviews show insufficient evidence for recommending the use of the method, in spite of this the method is used in dementia care. Evaluations of the validation method have primarily focused on the residents’ perspective, and reports on nurses’ experiences of the validation method are sparse. The overall aim for this thesis was to evaluate Feils’ validation method by describing nurses’ experiences and skills in communication observed during implementation of a training programme. Twelve nurses participated in the validation method training programme that included 10 days of theoretical training with supervision about once a month, and practical training integrated in everyday work. During practical training nurses had conversation with 3 residents each 2-3 times a week, and videotaped one conversation per month. Methods: The design is based on naturalistic scientific approach. Data were collected with interviews (I, II) and a questionnaire (II) before and after the programme, and videotaped conversations during the programme (III, IV). An interview was conducted as a comparison with nurses from another nursing home, who had long experiences of using the validation method (I). The result showed that nurses improved their communication and had closer relationships with residents with dementia disease after validation method training, in accordance with nurses with long experiences (I). The training strengthened the nurses, but also posed an extra strain on them. Even though the nurses described an extra strain on the entire nursing staff, this was not reflected in the results from the questionnaire about the work climate (II). Videotaped one-to-one conversations between nurses and residents showed that the nurses developed their approaches and communication skills, although to different degrees. An overall pattern revealed nurses’ movements within and between various paths when improving their communication skills (III). The findings were in congruence with the nurses described experiences (I). In videotaped conversations from the end of the programme, the residents had the possibilities to use their remaining communication abilities and to communicate what was currently on their mind (IV). This may be related to the development of the nurses’ communication skills during the programme. Conclusions of this thesis were that the nurses developed their skills in caring approach and communication when communicating with residents with dementia disease, which gave these residents possibilities to communicate according to their abilities. In order to integrate new knowledge about communication the results showed that it was necessary to combine theoretical and practical training with supervision and reflection. To provide nursing staff with this type of training could be seen as an investment for nursing homes, an opportunity to increase job satisfaction for nurses and to increase social community for residents.