The theory of a co-creative process in advanced palliative home care nursing encounters: A qualitative deductive approach over time.
Elisabeth Bergdahl, Britt-Marie Ternestedt, Carina Berterö and 1 others
PMID 30534407WHAT IT FOUND
In palliative home care, nurses and families repeatedly revisited wishes, abilities and opportunities over weeks to reach patient vital goals.
Encounter length mattered less than pacing and continuity.
Key findings
01The five-step co-creative process was usable, but the three middle steps were revisited repeatedly rather than followed in a straight line.
02The length of each home care encounter did not have clear importance; instead, the number of encounters over time, sometimes over several weeks, was important.
03Nurses linked care tasks to patient vital goals, such as stopping parenteral nutrition, learning injections, or enabling daily walks.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only three cases were followed, so the findings describe a theory development exercise rather than a tested intervention. The nurses recruited the patients and relatives, so the encounters may have been ones the nurses already felt comfortable with. Patients had to be able to be followed for at least seven weeks and were not bedridden, so it may not apply to patients who are too ill or cannot continue. Only planned home care encounters were observed, not acute visits. The study did not measure whether the co-creative approach improved appetite, weight, pain, independence, or quality of life.
The easy way to misread this
Do not read this as evidence that co-creative care improved patients' appetite, weight, pain, independence, or quality of life. The paper developed a qualitative theory from carefully chosen cases and did not measure treatment effects.