PURPOSE: Individuals with traumatic brachial plexus injuries (TBPI) may experience lifelong physical and psychosocial consequences. With or without surgical treatment, the rehabilitation is considered important. Physiotherapists and occupational therapists face challenges due to the scarcity of evidence-based rehabilitation protocols after TBPI. There is limited knowledge about patients' experiences with rehabilitation. This study aims to explore and describe patients' experiences of rehabilitation after a TBPI.

METHOD: Transcripts from five focus groups with 21 participants after TBPI and rehabilitation were coded and analysed with a qualitative content analysis. The discussion guide contained questions regarding experience of rehabilitation.

RESULTS: The analysis revealed one overarching theme: "A fight on your own", and three themes that include 1) Lack of tailored rehabilitation in a life-changing situation, 2) Crucial prerequisites for engagement in rehabilitation, and 3) Life will never be the same. The results highlighted the importance of healthcare professionals engaging with patients and advocates for comprehensive, person-centred rehabilitation programs across healthcare levels. Furthermore, participants value peer interaction, psychosocial support and up-to-date technology.

CONCLUSION: Patients struggle to access person-centred rehabilitation from engaged and knowledgeable occupational and physiotherapists. Addressing both psychosocial and physical aspects and daily activities is crucial.

Purpose There is growing interest in the potential of participatory research approaches to democratize research, empower participants and contribute to targeted health and social care. Participatory research approaches are emphasized in ethical and funding applications regarding patient and public involvement; however, less is known about their use in long-term care facilities for older adults. This meta-ethnography seeks to provide an increased understanding and novel conceptualization of participatory research approaches in long-term care facilities for older adults. Methods A meta-ethnography was used to synthesize qualitative literature on participatory research approaches in long-term care facilities for older adults. In total, 1,736 articles were screened at title and abstract level, 35 studies were eligible for full-text review and 10 articles were included. Results The following third-order constructs were identified as salient to the conceptualization and use of participatory research approaches in long-term care facilities for older adults: 1) participatory backdrops, 2) collaborative places, 3) seeking common ground and solidarity, 4) temporal considerations, and 5) empowerment, growth, and cultural and social change. Conclusion This meta-ethnography contributes a novel conceptualization and six recommendations to enhance the design and implementation of participatory research approaches as democratic spaces of exchange and collaboration for older adults.

BackgroundPhronesis is a way of knowing, implying wisdom, experiences, and reflections that guide our judgements. Phronesis, important for learning, is a neglected form of knowledge when applied to research.AimTo examine how phronesis is conceptualised and practiced in three research projects.MethodData from eight interviews with researchers involved in three research projects was generated. The interview material was analysed. A theoretical matrix of contemporary understanding of phronesis was applied to the material.ResultExamples of phronesis from three research projects in occupational therapy are presented according to categories of contemporary phronesis; acknowledging embodiment, embracing humility, using perceptiveness, and practicing reflexivity.SignificanceThis unique approach of analysing research projects contributes to the understanding of phronesis and its implications for research, providing valuable insights into the researchers' praxis in their respective projectsConclusionThere is a need for a greater recognition of phronesis as a dimension of knowledge within all types of research, and within the discipline. By not recognising phronesis as a legitimate form of knowledge, the discipline perpetuates a superiority of knowledge from episteme that dominates our ways of learning about the world around us and where the type of knowledge gleaned from phronesis is consequently marginalised.

In this article, we explore how pet robots come into being in a Danish nursing home for people with dementia, based on five months of ethnographic fieldwork. We argue that the researcher and the robot become an assembled temporary figure in the nursing home: the woman with the dog. We show how pet robots are characterized by their fluidity and can go from being mechanical robots to living animals in a matter of seconds during interactions with nursing home residents. The social robots are fragile technologies that disappear and cease to be used if people in the nursing home stop caring for them. Through relationships, the pet robots come into being together with other actors in the nursing home – a process that requires tinkering (Mol, Moser, and Pols 2010) and flexibility from those working with the robots. We argue that the woman with the dog can develop caring relations with the residents, but although there are hopes that pet robots are one of the technologies that can save a welfare state and care system under pressure, this is not something that can be done by the pet robots alone. Rather, the robots need care and tinkering to become embedded in the nursing home.

BACKGROUND: Participatory research approaches can potentially empower older adults and improve their quality of life and care. These include research designs, methods, and conceptual frameworks in collaboration with people directly involved and invested in the research and research outcomes. However, participatory research approaches have rarely been explored in long-term care facilities for older adults, such as nursing homes or residential care facilities. We aimed to provide increased understanding and recommendations about how participatory research approaches can be conceptualised and used in long-term care facilities for older adults.

METHODS: Inspired by Noblit and Hare (1988) and the seven phases of the eMERGe guidelines (2019), we performed a meta-ethnography (synthesis of qualitative research). We searched MEDLINE, CINAHL, ERIC, Sociological Abstracts, and Web of science in July 2021 and June 2022 for studies published between Jan 1, 2001, and June 27, 2022 (see appendix for search terms). We included peer-reviewed qualitative publications on participatory research approaches with older adults or staff in long-term care facilities, written in English. To promote rigour, a protocol was used with two authors independently screening the articles, reaching consensus through critical discussions with a third author, and using the Critical Appraisal Skills Programme (CASP) checklist. We extracted data regarding types of participatory research approaches and themes. This study is registered with PROSPERO, CRD42021275187.

FINDINGS: Ten of 1445 articles screened were included in the analysis. Using seven types of participatory research approaches, the included studies investigated experiences of approximately 153 residents and 99 staff from seven countries (Australia, Belgium, England, Guyana, Ireland, Sweden, and the Netherlands). We identified five themes, expressed as a conceptual model with recommendations: (1) participatory backdrop; (2) collaborative places; (3) seeking common ground and solidarity; (4) temporal considerations; and (5) empowerment, growth, and cultural change. We recommend researchers allow flexible time for the slow-paced progression and potentially unintended consequences of this emergent approach.

INTERPRETATION: This meta-ethnography provides an international and systematic synthesis of a diverse group of small-scale qualitative studies, which are, however, limited by insufficient reporting of participants' age, gender, or ethnicity. FUNDING: The Strategic Research Area in Health Care Science (SFO-V) at Karolinska Institutet and the Swedish Research Council for Health, Working Life and Welfare (FORTE).

This article brings methodological insight into in-situ drawings as representations of daily life with dementia. As part of ethnographic fieldwork in dementia care units in a nursing home, drawings were made on site by a researcher. We suggest that the ambiguity of in-situ drawings, and the ensuing possibilities to disambiguate them, is valuable. Inspired by Asdal and Moser’s (2012) concept of “contexting,” we experimented with arranging the drawings with fieldnotes, discussing them with staff members, as well as with configuring multiple drawings and fieldnotes in sequences. This led to reflexive engagements with the drawings, creating space for discussing concerns in research practices and care practices. Switching between different forms of contexting produced tensions, revealing that what was cared for through the practices of researchers, staff members, and residents, diverged. In this way, we argue that contexting in-situ drawings may intervene in ways of knowing, caring for, and living with dementia.

The physical environment plays an important role in how everyday life is shaped and experienced for persons living in nursing homes as well as for the residents' family and friends. Still, there is a scarcity of research exploring the perspectives of family members of residents regarding everyday life in common areas in nursing homes. In this study, we chose the term, 'a pleasant place', with the ambition of remaining open to various ideas and aspects that family members perceive as relevant when reasoning about the nursing home environment. The study aimed to explore how family members of nursing home residents reason in relation to pleasant places in nursing homes. Four focus group sessions were conducted with a total of 14 family members. Data were analysed using qualitative content analysis. The analysis resulted in four themes. 'A door ajar', highlighted the importance of a nursing home environment that provides potential opportunities for pleasurable everyday moments. 'Why does it have to be so ugly?', revealed how family members perceived institutional logics as guiding the design of the nursing homes, which were misaligned with the logics of a pleasant place. 'A place to care for?', emphasised the physical environment as an integrated aspect of care, in terms of being carefully arranged and used with sensitivity. Finally, 'allegiance to the place' showed that despite the family members' recognitions of shortcomings in the nursing home physical environments, their allegiance to the place provided a sense of the nursing home as a pleasant place. The study contributes knowledge regarding the perceived value of the design of the physical environment in nursing homes, particularly in common areas, as an integral aspect of care, and moves beyond the ideas of homelike and non-institutional nursing home environments.

Purpose

This study is an in-depth exploration of the unfolding experiences of five persons who developed dementia while still in paid work/employment, and of their significant others. Namely, we explore how they experienced the actions and decisions taken with respect to work, and what the consequences meant to them.

Methods

A qualitative longitudinal case study design with multiple cases was used, including five participants with dementia and significant others of their choice. Interviews were undertaken longitudinally and analysed with the Formal Data-Structure Analysis approach.

Results

The joint analysis resulted in two intertwined themes: 1) The significance and consequences of a dementia diagnosis: a double-edged trigger, and 2) Sensemaking and agency. The prevalent images of what dementia is, who can/cannot get it and what it will bring, were revealed as the critical aspects. Having the opportunity to make sense of what has happened and participate in decision-making, contributed decisively to the participants? experiences.

Conclusions

Findings illustrate how a dementia diagnosis is alien in work-life, but once diagnosed, it may trigger self-fulfiling expectations based upon stereotypical understanding of dementia. A shift is needed from a deficit-focused perspective, to viewing people with dementia as citizens capable of agency.

Background: Social participation can be described as engaging in activities that provide interaction with others, and support for social participation may reduce loneliness and improve health. However, there is limited knowledge about social participation in a home care context.

Aim: To explore the perceptions and experiences of community-dwelling older adults with regard to aspects related to social participation in a home care context.

Materials and methods: Seven home care recipients, aged 79-94 years, from two Swedish municipalities participated in semi-structured interviews. The interviews were analyzed using qualitative content analysis.

Results: The study identified the central theme, Personhood in aloneness and in affinity, as important in accomplishing satisfactory social participation. The results incorporated cultivating personal interests and navigating occupations, as well as having one's needs seen and experiencing mutuality in social encounters.

Conclusions: The study nuances existing knowledge about social participation among older home care recipients, and the findings strengthen the importance of framing a home care environment where recipients can cultivate personhood and be recognized as valuable individuals with relevant needs.

Significance: This study extends current understandings of the variety and richness of the social participation and occupational engagement enjoyed by older home care recipients, to be considered in research and practice.

The aim of this study was to contribute with knowledge about how a sense of home and belonging is enacted and can be supported in everyday life, with a particular focus on the relationships that connect everyday life and the environment in nursing home contexts. The concepts 'a sense of home' and 'belonging' were chosen with the ambition to grasp values grounded in experiences and everyday practices, with an openness for various aspects that can support an enjoyable life and comfort for nursing home residents. The study focused on communal areas, e.g. dining room, kitchen, corridors and gardens, that serve as arenas where nursing home residents' everyday lives expand beyond the private room. Ethnographic methods were applied to identify and explore situations where a sense of home and belonging were enacted in nursing homes that had been acknowledged as good examples of nursing home environments. Through the analytic process, four qualities were identified: (a) a cornerstone for stability and everydayness, (b) the beating heart, (c) spatial dynamics, and (d) magnetic places. Following from the chosen methodology, the findings provide a situated understanding of how communal areas in nursing homes can invite a sense of home and belonging for the residents.