Life situation of older people living with severe mental illness - A scoping review.

An increasing number of older people with severe mental illness (SMI) poses additional challenges to healthcare and social services. This scoping review aimed to investigate the life situation of older people living with severe mental illness and identify the research gaps in the existing literature. The current review followed the methodological framework for conducting scoping reviews by Arksey and O'Malley, consisting of five main stages: (1) identifying the research question (2) identifying relevant studies, (3) selecting the studies, (4) charting the data, and (5) collating, summarising, and reporting the results. An optional sixth stage, a consultation exercise, has also been used in this study: The scoping review was conducted in accordance with the PRISMA extension for scoping reviews PRISMA-ScR, and the databases PsychINFO Scopus, Cinahl, Web of Science and PubMed were used. A total of 24 studies were included in the review. The thematic analysis focused on: (1) the perspective of older people with SMI, (2) the perspective of healthcare professionals supporting older people with SMI, and (3) the perspective of informal carers supporting older people with SMI. The results describe the life situation of older people living with SMI, especially in relation to the older peoples' experiences of suffering and well-being. The staff and the informal carers need adequate knowledge to provide support to the older people with SMI. To gain greater knowledge about the life situation and support needed by older people with SMI, we strongly advocate additional research focusing on their own experiences.

The perspectives of patients, nursing students and supervisors on "the caring-learning space" - a synthesis of and further abstracton of previous studies.

The aim was to describe and gain a greater understanding of the phenomenon "caring-learning space" based on the perspectives of patients, nursing students, and supervisors in clinical practice contexts.A general structure of the phenomenon "caring-learning space" was created based on essential structures from five empirical studies. The analysis is based on a reflective lifeworld research approach (RLR).The "caring-learning" space shows itself in terms of interpersonal relationships between patients, students, supervisors, and other actors in the care environment. It is first when the learning space is accepted as a part of caring, that a "caring-learning space" is created. A flexibility and a receptivity are seen where the learning is allowed to become visible and be integrated in the caring processes when caring and learning to interact.A caring-learning space is established by the patient being the focal point, but also a co-creator in caring as well as learning regardless of her/his health status. This entails that the "caring-learning space" exists when patients, students, supervisors and other healthcare professionals interact based on their ability and role in the space.

Digital Engagement of Older Adults: Scoping Review.

BACKGROUND: Digital technologies facilitate everyday life, social connectedness, aging at home, well-being, and dignified care. However, older adults are disproportionately excluded from these benefits. Equal digital opportunities, access, and meaningful engagement require an understanding of older adults' experience across different stages of the technological engagement life cycle from nonuse and initial adoption to sustained use, factors influencing their decisions, and how the experience changes over time. OBJECTIVE: Our objectives were to identify the extent and breadth of existing literature on older adults' perspective on digital engagement and summarize the barriers to and facilitators for technological nonuse, initial adoption, and sustained digital technology engagement. METHODS: We used the Arksey and O'Malley framework for the scoping review process. We searched MEDLINE, PsycINFO, CINAHL, Web of Science, and ACM digital library for primary studies published between 2005 and 2021. The inclusion and exclusion criteria were developed based on the Joanna Briggs Institute (participants, content, and context) framework. Studies that investigated the digital engagement experience as well as barriers to and facilitators of older adults' digital technology engagement were included. The characteristics of the study, types of digital technology, and digital engagement levels were analyzed descriptively. Content analysis was used to generate tentative elements using a congruent theme, and barriers and facilitators were mapped over the capability, opportunity, and motivation behavior change model (COM-B) and the theoretical domain framework. The findings were reported in accordance with the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews). RESULTS: In total, 96 publications were eligible for the final charting and synthesis. Most of the studies were published over the past 5 years, investigated the initial adoption stage of digital engagement, and focused on everyday technologies. The most cited barriers and facilitators across the engagement stages from each COM-B component were capability (eg, physical and psychological changes and lack of skill), opportunity (eg, technological features, environmental context, and resources), and motivation (eg, optimism from perceived usefulness and beliefs about capability). CONCLUSIONS: The COM-B model and theoretical domain framework provide a guide for identifying multiple and intertwined barriers and facilitators at each stage of digital engagement. There are limited studies looking into the whole spectrum of older adults' digital technology experience; in particular, studies on technological nonuse and sustained use stages are rare. Future research and practice should focus on tailored interventions accounting for the barriers to older adults' digital engagement and addressing capabilities, motivation, and opportunities; affordable, usable, and useful digital technologies, which address the changes and capability requirements of older adults and are cocreated with a value framework; and lifelong learning and empowerment to develop older adults' knowledge and skills to cope with digital technology development. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/25616.

The Digital Engagement of Older People: Systematic Scoping Review Protocol.

BACKGROUND: There is an ongoing negative narrative about aging that portrays older people as a socioeconomic burden on society. However, increased longevity and good health will allow older adults to contribute meaningfully to society and maximize their well-being. As such, a paradigm shift toward healthy and successful aging can be potentially facilitated by the growing digital technology use for mainstream (day-to-day activities) and assisted living (health and social care). Despite the rising digital engagement trend, digital inequality between the age groups persists. OBJECTIVE: The aims of this scoping review are to identify the extent and breadth of existing literature of older people's perspectives on digital engagement and summarize the barriers and facilitators for technological nonuse, initial adoption, and sustained digital technology engagement. METHODS: This review will be based on the Arksey and O'Malley framework for scoping reviews. The 6-stage framework includes: identifying research questions, identifying relevant studies, study selection, charting the data, summarizing and reporting the results, and a consultation exercise. Published literature will be searched on primary electronic databases such as the Association of Computing Machinery, Web of Science, MEDLINE, PsycINFO, CINAHL, and ScienceDirect. Common grey literature sources will complement the database search on the topic. A two-stage (title/abstract and full article) screening will be conducted to obtain eligible studies for final inclusion. A standardized data extraction tool will be used to extract variables such as the profile of the study population, technologies under investigation, stage of digital engagement, and the barriers and facilitators. Identified and eligible studies will be analyzed using a quantitative (ie, frequency analysis) and qualitative (ie, content analysis) approach suitable for comparing and evaluating literature to provide an evaluation of the current state of the older person's digital engagement. Inclusion will be based on the Joanna Briggs Institute-recommended participant, concept, and context framework. Articles on older people (65 years and older), on digital technology engagement, and from a global context will be included in our review. RESULTS: The results of this review are expected in July 2021. CONCLUSIONS: The findings from this review will identify the extent and nature of empirical evidence on how older people digitally engage and the associated barriers and facilitators. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/25616.

Norovirus outbreaks in german refugee camps in 2015.

Purpose Refugees often live in confined housing conditions with shared kitchen and sanitary facilities, rendering susceptible to communicable diseases. We here describe the outbreak, spread and self-limiting nature of a norovirus outbreak in a German refugee camp in the winter of 2015. Methods During a norovirus outbreak, data on clinical symptoms, nationality and living conditions was obtained in a refugee camp in northern Germany in the winter of 2015. Furthermore secondary data on norovirus outbreaks in 2015 was assessed. Results Amongst n = 982 refugees, n = 36 patients (3.7 %) presented with acute norovirus gastroenteritis. The vast majority of cases were children, only the first patient was admitted to the hospital. Intensified hygiene measures were implemented on day 2 of the outbreak, but new cases peaked on day 21 and occurred until one month after the first case. Different cultural backgrounds, eating habits and hygiene standards amongst the refugees made it particularly challenging to implement stringent isolation and hygiene measures. Despite these predisposing factors, only minor norovirus outbreaks were reported in refugee camps in 2015. Conclusion Adults refugees had a low attack rate of symptomatic norovirus infection, while small children are at high risk. Infection spreads despite hygiene measures and camp sites and staff should be prepared for the particular challenges of such situations with a particular focus on cultural-background specific implementation of hygiene measures.

The learning space-interpersonal interactions between nursing students, patients, and supervisors at developing and learning care units.

PURPOSE: Previous research shows that the learning space is significant for students' learning in pairs in clinical practice but does not explain the meaning of the phenomenon. The aim of this study is thus to explain and understand the learning space that occurs in the interaction between the patients, the pairs of nursing students, and the supervisors on a developing and learning care unit in Sweden. METHOD: The study has been carried out with a Reflective Lifeworld Research (RLR) approach founded on hermeneutics. A total of 39 informants, consisting of 16 patients, five pairs of students (10 students), and 13 supervisors, were observed and interviewed. RESULTS: The results reveal that an interpersonal linkage between the patients, the students, and the supervisors is created within the learning space. A learning space, based on respect towards each other, creates the prerequisite for beneficial and supportive interactions that contribute to a deeper relationship. CONCLUSION: The phenomenon is complex due to its expandable nature and due to the fact that the learning space cannot be isolated from the surrounding environment. In order to exploit the potential of the learning space it is of importance to understand and consider the learning space as a whole.

The experiences of supporting learning in pairs of nursing students in clinical practice.

The purpose of this study is to describe how supervisors experience supporting nursing students' learning in pairs on a Developing and Learning Care Unit in Sweden. The present study has been carried out with a Reflective Lifeworld Research (RLR) approach founded on phenomenology. A total of 25 lifeworld interviews were conducted with supervisors who had supervised pairs of students. The findings reveal how supervisors support students' learning in pairs through a reflective approach creating learning space in the encounter with patients, students and supervisors. Supervisors experience a movement that resembles balancing between providing support in learning together and individual learning. The findings also highlight the challenge in supporting both the pairs of students and being present in the reality of caring. In conclusion, the learning space has the potential of creating a relative level of independency in the interaction between pairs of students and their supervisor when the supervisor strives towards a reflective approach.