Caring in Ambulance Encounters With Older Patients With Complex Care Needs: A Phenomenographic Study.
Scandinavian journal of caring sciences · 2026-01-02 · Qualitative study
Abstract
BACKGROUND: Although caring is a core concept in nursing, its meaning is not uniform, and perceptions may vary across care settings. In ambulance care, encounters with older patients with complex care needs present challenges that may shape how caring is understood and practiced. Guided by a lifeworld-led caring perspective, this study explores how caring is perceived and enacted in this specific clinical context. AIM: This study aims to describe variations in nurses' perceptions of caring in ambulance encounters with older patients with complex care needs. METHODS: This qualitative study employed a phenomenographic approach to identify variations in nurses' perceptions of caring in ambulance encounters with older patients with complex needs. Semi-structured interviews with 16 nurses in ambulance care from two regions in Sweden were analysed using a phenomenographic method. ETHICAL CONSIDERATIONS: Ethical approval was granted by the Swedish Ethical Review Authority. All participants provided informed consent to participate. RESULTS: The outcome space comprised three qualitatively different ways in which nurses perceived caring: 'Caring as balancing symptoms and medical care', 'Caring as negotiating responsibility', and 'Caring as responding to an ethical demand'. CONCLUSIONS: Caring in ambulance encounters with older patients with complex care needs is perceived as a multidimensional and contextually situated practice that integrates clinical, relational, and ethical dimensions. While caring was often expressed in terms of balancing symptoms and medical interventions, it also involved moral sensitivity, relational engagement, and professional responsibility. These findings contribute to a deeper understanding of caring as a lifeworld-led and ethically grounded practice in ambulance care, with implications for education, reflective practice, and policy development.
Tags
Ambulance & prehospital nurses · Clinician perspective · Ethics · Older adults