Nurses' and pharmacists' learning experiences from participating in interprofessional medication reviews for elderly in primary health care - a qualitative study.

BACKGROUND: Traditionally, drug prescription and follow up have been the sole responsibility of physicians. However, interprofessional medication reviews (IMRs) have been developed to prevent drug discrepancies and patient harm especially for elderly patients with polypharmacy and multimorbidity. What participating nurses and pharmacists learn from each other during IMR is poorly studied. The aim of this study was to investigate nurses' and pharmacists' perceived learning experience after participating in IMRs in primary health care for up to two years. METHODS: A qualitative study with semi-structured focus group interviews and telephone interviews with nurses and pharmacists with experience from IMRs in nursing homes and home based services. The data was analysed thematically by using systematic text condensation. RESULTS: Thirteen nurses and four pharmacists were interviewed. They described some challenges concerning how to ensure participation of all three professions and how to get thorough information about the patient. As expected, both professions talked of an increased awareness with time of the benefit of working as a team and the perception of contributing to better and more individual care. The nurses' perception of the pharmacist changed from being a controller of drug management routines towards being a source of pharmacotherapy knowledge and a discussant partner of appropriate drug therapy in the elderly. The pharmacists became more aware of the nurses' crucial role of providing clinical information about the patient to enable individual advice. Increasingly the nurses learned to link the patient's symptoms of effect and side effect to the drugs prescribed. CONCLUSIONS: Although experiencing challenges in conducting IMRs, the nurses and pharmacists had learning experiences they said improved both their own practice and the quality of drug management. There are some challenges concerning how to ensure participation of all three professions and how to get thorough information about the patient.

Bereaved family members' perspectives on suffering among older rural cancer patients in palliative home nursing care: A qualitative study.

Little is known about experiences with receiving home nursing care when old, living in a rural area, and suffering from end-stage cancer. The aim of this study was thus to investigate bereaved family members' perceptions of suffering by their older relatives when receiving palliative home nursing care. Qualitative semi-structured interviews were conducted with 10 family members, in Norway during autumn 2015, and directed content analysis guided by Katie Eriksson's theoretical framework on human suffering was performed upon the data. The two main categories identified reflected expressions of both suffering and well-being. Expressions of suffering were related to illness, to care and to life and supported the theory. Expressions of well-being were related to other people (e.g. familiar people and nurses), to home and to activity. The results indicate a need to review and possibly expand the perspective of what should motivate care. Nursing and palliative care that become purely disease and symptom-focused may end up with giving up and divert the attention to social and cultural factors that may contribute to well-being when cure is not the goal.

Strength of noise effects on memory as a function of noise source and age.

The objectives in this paper were to analyse noise effects on episodic and semantic memory performance in different age groups, and to see whether age interacted with noise in their effects on memory. Data were taken from three separate previous experiments, that were performed with the same design, procedure and dependent measures with participants from four age groups (13-14, 18-20, 35-45 and 55-65 years). Participants were randomly assigned to one of three conditions: (a) meaningful irrelevant speech, (b) road traffic noise, and (c) quiet. The results showed effects of both noise sources on a majority of the dependent measures, both when taken alone and aggregated according to the nature of the material to be memorised. However, the noise effects for episodic memory tasks were stronger than for semantic memory tasks. Further, in the reading comprehension task, cued recall and recognition were more impaired by meaningful irrelevant speech than by road traffic noise. Contrary to predictions, there was no interaction between noise and age group, indicating that the obtained noise effects were not related to the capacity to perform the task. The results from the three experiments taken together throw more light on the relative effects of road traffic noise and meaningful irrelevant speech on memory performance in different age groups.