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BakgroundWorldwide, older people were more severely affected during the COVID-19 pandemic than others. In Sweden, those living in residential care facilities had the highest mortality rate, followed by those receiving home care services. The Swedish and international literature on the working environment for assistant nurses and care aides during the pandemic shows an increase in stress, anxiety, depression and post-traumatic stress syndromes. Care organisations were badly prepared to prevent the virus from spreading and to protect the staff from stress. In order to be better prepared for possible future pandemics, the health and well-being of the staff, the care of older people and the experiences of the staff both during and after a pandemic are important aspects to take into account. Therefore, this study aims to describe the experiences of assistant nurses and care aides working in the care of older people during the COVID-19 pandemic in Sweden, their working conditions and the impact all this had on their lives.MethodologyThe study has a qualitative, descriptive design. The data was collected in four focus group interviews with 21 participants and analysed using qualitative content analysis.ResultsThe results revealed the theme, Being used for the greater good while fighting on the frontline, which was then divided into three categories: portrayed as a risk for older people, not being valued and being burnt out. The worsening working conditions that the pandemic contributed to resulted in a high degree of stress and risk of burnout, with staff members both wanting to and actually leaving their employment. After the pandemic they felt forgotten again and left to cope in an even worse situation than before.ConclusionsThe pandemic had a major effect on assistant nurses and care aides in terms of their working environment and their private lives. To be better prepared for future pandemics or disasters, organisations with responsibility for the care of older people will need to ensure that their staff have the necessary competencies and that there is adequate staffing in place. This also means that adequate government funding and multiple interventions will be needed.

Nursing students require resilience to navigate the complexities of clinical practice. This characteristic is essential for managing demanding workloads, unpredictable patient situations, and emotional stressors while maintaining performance and well-being. Fostering resilience helps students develop the capacity to adapt to adversity, overcome setbacks, and remain committed to providing high-quality patient care. This qualitative study explores the challenges and supports influencing nursing students’ resilience during clinical education. Interviews with 28 Thai nursing students revealed two key themes: the “experience of vulnerability” and the “experience of meaningfulness”. The sub-themes of vulnerability included “navigating uncertainty”, “transcending professional struggles”, and “being exposed to diverse encounters”. The sub-themes of meaningfulness focused on restoring strength through social interactions and engaging in positive transformation. This study highlights the need for comprehensive support systems that address personal and professional vulnerabilities. Integrating caring theory principles could further enhance resilience by emphasizing compassionate care and fostering student empathy. This suggests that instructors and stakeholders can significantly impact student well-being by creating supportive environments built on collaboration, empathy, and mentorship, all of which are aligned with caring theory.

Resilience aids nursing students in dealing with adversities during their nursing education. This study examined the relationship between nursing students’ resilience and relevant variables in the context of clinical education. Methods: A cross-sectional study was conducted to collect data from 319 undergraduate nursing students in Northeast Thailand. The Connor–Davidson Resilience Scale, the Multidimensional Scale of Perceived Social Support, the Learning Experience Scale or the Personal Responsibility Orientation to Self-Direction in Learning Scale, and the Stressors in Nursing Students scale were administered. A multiple regression analysis was performed for factors presumed to be associated with resilience. Results reported that Thai nursing students’ average resilience score was 71.79 ± 16.33. Multiple regression analysis indicated factors associated with resilience, in which social support (β = 0.354, p < 0.001, 95%CI: 0.240 to 0.469) and self-directed learning (β = 0.787, p < 0.001, 95%CI: 0.606 to 0.968) showed a positive association, while stress (β = −0.083, p = 0.025, 95%CI: −0.083 to −0.006) had a negative association. The final model accounted for 43.4% of the variance in the resilience score. In conclusion, self-directed learning, social support, and perceived stress among nursing students during clinical education are associated with their resilience.

Introduction: During the COVID-19 pandemic, older people in Sweden's residential care facilities and home care services experienced high mortality rates. Prior to the pandemic, the care of older people in Sweden was challenged by organisational and regulatory changes, an ageing population and insufficient increases in staff numbers. These issues led to high staff turnover, increased workloads, stress, burnout and a perceived inability to provide satisfactory care. The pandemic brought about increased job strain, stress, anxiety, depression and post-traumatic stress disorder among the staff who cared for older people. The aim of this study was therefore to focus on assistant nurses and care aides' experiences of their work environments when caring for older people during the pandemic in Sweden. Methods: The data were collected through four focus groups interviews and analysed using qualitative content analysis. Results: The results showed that the care staff had to navigate organisational and ethical challenges in poor and unsafe work environments. They lacked supportive leadership in their respective organisations, were neither valued, seen nor heard and were treated as ‘plain doers’. During the pandemic, they were unable to protect or communicate easily with the older people in their care, which had harsh consequences. Conclusion: According to the participants, the pandemic left them, their working conditions and this part of the care system in a worse situation than before the pandemic. The pandemic thus revealed more unsustainable and unethical working conditions for the staff than before it, including the vulnerability of the older people in their care. Implications for Practice: The findings highlights the need of policies that ensure adequate training and instruction on medical issues, for managers responsible for overseeing the care of older people. There are also a need of provision of sufficient support for care staff and health care professionals during crises. The findings also underscore the need of feasible and efficient strategies do disseminate care information and address the psychosocial needs of older people. 

BackgroundFor persons with dementia, receptive music may reduce negative expressions and increase positive ones. Caregiver singing (CS) is an intervention aimed at facilitating care situations and involves caregivers singing for or together with persons with dementia during care activities. In the literature, CS is commonly addressed as a music activity rather than a care intervention. The aim was to describe caregivers' experiences of the reactions of persons with dementia when using CS and receptive music in dementia care.MethodThe data comprised three focus group interviews with 12 professional caregivers in dementia care, analysed using qualitative content analysis.Resultsthe analysis resulted in two themes: "CS increases interaction and builds companionship" and "Receptive music soothes, awakens memories and reflects the person's self".ConclusionBoth CS and receptive music was shown to have positive influences, and while the results were sometimes intertwined, CS was shown to better facilitate problematic care situations.

 Background:  In Sweden, older people in residential care had the highest mortality rates, followed by those who received home care, during the coronavirus disease 2019 (COVID-19) pandemic. Staff working in the care of older people assumed responsibility for preventing the spread of the virus despite lacking the prerequisites and training. This study aimed to investigate the psychosocial work environment during the COVID-19 pandemic among staff in the care of older people and examine the factors associated with staff's perceptions of the clarity of instructions and the ability to follow them.

 Methods:  A cross-sectional study design was employed using a web survey. The staff's perceptions of their psychosocial environment were analysed using descriptive statistics. The association between organisational and individual factors, as well as the degree of clarity of the instructions and the staff's ability to follow them, were assessed using multivariate (ordinal) regression analysis.

 Results:  The main findings show that perceptions of the clarity and adaptability of the instructions were primarily correlated with organisational factors, as higher responses (positive) for the subscales focusing on role clarity, support and encouragement in leadership at work were associated with the belief that the instructions were clear. Similarly, those indicating high job demands and high individual learning demands were less likely to report that the instructions were clear. Regarding adaptability, high scores for demands on learning and psychological demands were correlated with lower adaptability, while high scores for role clarity, encouraging leadership and social support, were associated with higher adaptability.

 Conclusions:  High job demands and individual learning demands were demonstrated to decrease the staff's understanding and adoption of instructions. These findings are significant on an organisational level since the work environment must be prepared for potential future pandemics to promote quality improvement and generally increase patient safety and staff health.

AimTo explore communication research in nursing by investigating the theoretical approaches, methods, content and perspectives in research on real-time registered nurse (RN)-patient communication. DesignAn integrative review of real-time communication between RNs and patients. Data SourcesEmpirical research papers were searched in PubMed, CINAHL Plus and Medline. The results from the database searches were supplemented with results from manual searches in reference lists. Review MethodsA total of 1369 articles published between January 1996 and December 2021 were screened, which resulted in the inclusion of 52 articles. ResultsThe integration of various theories, such as nursing or communication theories, is weak in most of the included studies. RN-patient communication appears to influence relationship building. Even when nurses strive to meet patients' needs, they often focus primarily on nursing routines and physical care. The topic of the communication varies depending on the situation and different communication styles are used. When a patient-centred approach is adopted, the interpersonal communication becomes quite symmetrical, with complementary roles of nurses and patients. Within a more asymmetric communication context, nurses dominate communication, choose topics and function as instructors. How the nurses communicated subsequently influenced the patients' communication styles and strategies. ConclusionCommunication is multifaceted, contains different strategies and is important for building trust and facilitating patient-centred care. The importance of RNs' communication for interaction and relationship-building seems to be well established within research, but few studies focused on patients' communication with RNs. ImpactThis integrative review gives an overview of the width and depth of observational studies on RN-patient communication research. The variety of studies indicates that this area is a less well-grounded field of research. Future research is warranted to support nurses in their communication, especially regarding the exploration of patients' communication and desired communication skills in nurse-patient interactions. Patient or Public ContributionNo patient or public contribution was included in this integrative review.

The COVID-19 pandemic has dominated the global media since 2020. To a large extent, it isvia the news media that the public has learned about the risks, levels of danger, governmentalregulations and mandatory actions. This article highlights the subject positions constructedby the Swedish news media from January 2020 to February 2021 in reports about thepandemic. The result shows that citizens can be active-passive or solitary solidarity, thesepositions appeal to individual accountability, thus potentially shaping and fostering citizensin line with the Swedish government’s wider response to the pandemic. The news media’simages are of self-regulated citizens who govern and discipline themselves and othersaccording to the current discourses, all of which simultaneously evoke fear, togethernessand hope. The ideological dilemmas for citizens are whether to be active-passive or, ifnecessary, switch to the solitary solidarity subject position.