Nurses´ and patients´ experiences of caring touch interventions in an emergency context

Detta är en avhandling från Stockholm : Karolinska Institutet, Dept of Neurobiology, Care Sciences and Society

Sammanfattning: The epistemological standpoint of this thesis is the theory of the lifeworld where the lived body is seen as a unity of body and soul. The overall aim of this thesis was to explore the experiences of caring touch interventions, such as tactile massage or healing touch, in an emergency care context, from the perspective of nurses and patients. The concept of ‘caring touch’ was used to capture the meaning, in order to explore the phenomenon of receiving and giving caring touch, and not the treatment per se. This thesis consists of four exploratory studies of which three are qualitative and one a mixed-methods study. The findings of study I indicate that tactile massage may help nurses and assistant nurses working in a short-term emergency ward to deal with a very stressful work environment and improve staff wellbeing. In study II, it is pointed out that admissions to short-term emergency ward for acute illness or disease is often associated with increased stress, anxiety and pain. Caring touch was offered to patients as a complement to usual nursing care. The patients’ lived experience indicated that caring touch resulted in an existential togetherness characterised by a non-verbal peacefulness, trust, consolation, safety, and a restoration of what it means to be a human being. Notably, some patients also expressed ambivalence toward caring touch. In study III, it is suggested that given the current high-tech healthcare system with overcrowded units and a shortage of nurses, including tactile massage as a caring tool may create a more holistic approach to caregiving, allowing nurses and assistant nurses to act with compassion for both the patient and themselves. In study IV, which is a longitudinal observational study, qualitative and quantitative perspectives are combined. Patients with minor or no physical injury after a motor vehicle accident were invited to an intervention with caring touch. Findings from individual interviews and questionnaires indicate that a caring touch intervention improve patients´ wellbeing, and sense of security and pain ratings over a period of six months after the accident. This thesis draw the attention to the potential of caring touch interventions in an emergency context with the overall conclusion that introducing caring touch interventions of tactile massage and healing touch in the short-term emergency ward context seem to benefit patient’s integrity, wellbeing, and sense of security. The caring touch interventions give nurses a tool to increase their patients’ and their own wellbeing in a stressful environment in general. Patients sustaining a motor vehicle accident with minor or no physical injury in particular, highly appreciated a follow-up to the hospital after discharge by the invitation to a caring touch intervention and this was also associated with reduced pain ratings.

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