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Health literacy has become increasingly important in healthcare and education. The aim is to provide an overview of school nurses' activities to increase health literacy in schools, and to analyse their conceptual understanding of health literacy.
This mixed-methods study consists of an online survey (n = 65), two focus group interviews (n = 16) and non-participatory observations with school nurses in Germany (n = 5), and expert interviews with interest-holders (n = 10). School nurses' health literacy-related activities, conceptual health literacy understanding, and critical health literacy (measured by the Critical Health Competence Test) were assessed. Quantitative data were analysed descriptively, and the qualitative data by content analysis. Quantitative and qualitative findings were integrated and triangulated using a convergent design.
School nurses address health literacy among students and their relatives through counselling, teaching support, and acute care. Their services are primarily based on a functional health literacy understanding. Experts view schools as key settings for health literacy, led by school nurses.
School nurses use real-life oriented, low-threshold activities to address health literacy and empower students. School nurses' critical health literacy and evidence-based practice could be improved.
School nurses represent a valuable resource to address health literacy in German schools, in line with international approaches. These interventions should be expanded.
This study followed the criteria for Good Reporting of A Mixed Methods Study (GRAMMS), the consolidated criteria for reporting qualitative research (COREQ) and the Checklist for Reporting Results of Internet E-Surveys (CHERRIES).
No direct patient or public contribution.
To develop a care-bundle of non-pharmacological strategies with the potential to prevent constipation in people with dementia in Residential Aged Care (RAC).
Mixed-methods intervention development study using Modified Delphi and co-design, informed by evidence, current constipation prevention practices and stakeholder collaboration to define best practice.
The draft bundle was developed using evidence from a scoping review, consultations with aged care professionals and staff at two RAC homes and field observations. It was then refined through expert and lived-experience panels via an online Modified Delphi survey (rating relevance, acceptability and feasibility) and a face-to-face workshop to finalise items for the constipation prevention care-bundle.
Health data, interviews, observations, surveys and workshops.
The draft care-bundle comprised 24 items; 13 reached ≥ 78% agreement in the Modified Delphi, including dietitian consultation, adequate fibre, individualised hydration and toileting plans, beverage cart, constipation risk assessment, privacy during toileting, dementia-friendly signage, toileting positioning, contrasting toilet seat, electronic alerts, staff education and resident/family information.
An evidence-informed and co-designed care-bundle was co-developed with potential to prevent constipation in residents with dementia.
This research has implications for nursing practice by offering an alternative to reliance on pharmacological strategies for preventing constipation in people with dementia.
This co-designed and evidence-informed care-bundle has potential to reduce the incidence of constipation among the growing population with dementia. To ensure sustained use, it was co-designed with stakeholders to be fit-for-purpose.
There were no reporting guidelines for this co-design study identified.
End-users, including frontline staff and older people receiving care, as well as carers of people with dementia, were engaged in the co-design as equal partners in the constipation prevention care-bundle development process.
To explore how receiving gerontological nurse telephone support assisted caregivers of older adults to provide care after hospital discharge.
Informal caregivers are vital to the recovery of older patients after hospital discharge, but often feel under-prepared and unsupported. The need to strengthen caregiver support is becoming increasingly important due to the growing population of older adults and their needs for hospital services. This secondary analysis of a randomized controlled trial examined how nurse telephone support assisted caregivers in their caring role at the time of hospital discharge.
A qualitative descriptive study. A purposive sample of informal caregivers (n = 47) who had received nurse telephone support was recruited. In-depth semi-structured interviews were conducted with participants at six (March 21–January 23) and 12 months (August 2021–June 2023) after the older adult's discharge. The nurses used a problem-solving approach to provide support. Transcripts were analysed inductively using content narrative analysis.
Two themes emerged: (i) mastery and skills to care; (ii) empowerment to care. Caregiver mastery was developed through nurses providing tailored support that assisted caregivers to develop a structured approach to problem-solving, apply problem-solving to their personal circumstances, increase capacity and skills, and manage workload more effectively. Empowerment resulted from nurses creating a nurturing environment where caregivers developed a positive inner dialogue, increased confidence and capacity to foster a positive relationship with the care recipient and valued themselves. Synthesizing these themes via a concept map explained how nurse support assisted caregivers of older adults become more prepared to care and increase self-efficacy.
Nurse telephone support can facilitate caregivers of older adults discharged from hospital to undertake problem-solving that is effective for their individual circumstances and empower them to care. Telephone calls enabled nurses to provide timely, tailored support for caregivers of older adults after hospital discharge.
Nurses can provide expert, professional guidance via telephone to support caregivers be more prepared to care when older adults are discharged from hospital. This support should extend beyond instructions related to the care recipients' immediate needs and include the provision of knowledge and coaching to support a structured approach to problem-solving. Allocating dedicated time for hospital nurses to deliver caregiver support should be considered an integral component of person-centred care. This research strengthens the evidence for the valuable contribution that nurses can make to improving hospital discharge services.
This study was reported using the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist.
The research team includes consumer investigator (HL) who provided input throughout the research, including design, procedures, data analysis and manuscript authorship.
Trial Registration: Australian New Zealand Clinical Trials Registry Identifier: ACTRN12620000060943
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