Unregulated care providers' engagement in palliative care to older clients and their families in the home setting: a mixed methods study.

BACKGROUND: Unregulated care providers (UCPs) are at the forefront of direct client care in the community. Their services are required to meet the demand for home-based palliative care from a growing older population, yet understanding of UCPs involvement in care is limited. The study aimed to identify the types and frequencies of tasks performed by UCPs in home-based palliative care to older clients (> 65 years) and their families and to describe UCPs' engagement in care, and barriers and facilitators to their work. METHODS: A mixed method approach was used comprising a quantitative retrospective chart review of UCPs' tasks (n = 66), qualitative content analysis of progress notes from clients' charts (n = 85), and thematic analyses of in-depth interviews with UCPs (n = 10). RESULTS: A thematic structure was derived from analyses and integration of data from the chart review and interviews. The themes reflect the physical, affective, and relational aspects of UCPs involvement in the care of clients and families at the end of life. The findings indicate that although a significant proportion (63%) of the 13, 558 UCP tasks identified were directed toward meeting clients' physical care needs, their presence in the home, made UCPs an important source of information on the client's condition; observing and appraising the situation. Further, the nature of their work and frequent interactions with clients and families also presented opportunities for UCPs to provide emotional support; a role UCPs felt was integral to their work. CONCLUSIONS: The study highlights the challenging nature of palliative care to older clients and their families whose needs are often complicated, situated within the unique environment of home care where supervision of UCPs is at a distance. Challenges and facilitators to UCPs' work in this context are discussed with recommendations to support UCPs in their roles.

Emotional intelligence in professional nursing practice: A concept review using Rodgers's evolutionary analysis approach.

BACKGROUND: Knowledge around emotional intelligence originated in the 1990s from research regarding thoughts, emotions and abilities. The concept of emotional intelligence has evolved over the last 25 years; however, the understanding and use is still unclear. Despite this, emotional intelligence has been a widely-considered concept within professions such as business, management, education, and within the last 10 years has gained traction within nursing practice. AIMS AND OBJECTIVES: The aim of this concept review is to clarify the understanding of the concept emotional intelligence, what attributes signify emotional intelligence, what are its antecedents, consequences, related terms and implications to advance nursing practice. METHOD: A computerized search was guided by Rodger's evolutional concept analysis. Data courses included: CINAHL, PyschINFO, Scopus, EMBASE and ProQuest, focusing on articles published in Canada and the United Stated during 1990-2017. RESULTS: A total of 23 articles from various bodies of disciplines were included in this integrative concept review. The analysis reveals that there are many inconsistencies regarding the description of emotional intelligence, however, four common attributes were discovered: self-awareness, self-management, social awareness and social/relationship management. These attributes facilitate the emotional well-being among advance practice nurses and enhances the ability to practice in a way that will benefit patients, families, colleagues and advance practice nurses as working professionals and as individuals. CONCLUSION: The integration of emotional intelligence is supported within several disciplines as there is consensus on the impact that emotional intelligence has on job satisfaction, stress level, burnout and helps to facilitate a positive environment. Explicit to advance practice nursing, emotional intelligence is a concept that may be central to nursing practice as it has the potential to impact the quality of patient care and outcomes, decision-making, critical thinking and overall the well-being of practicing nurses.