Background
Medication management in home care sits at a crucial intersection between patients’ needs and professional responsibility. It is shaped by the growing complexity of healthcare services delivered in people’s homes (1–3). Across countries, medication use has expanded in scope and intensity (4), a trend that is especially evident among older adults living with multimorbidity and polypharmacy (5). In this setting, home care nurses play a central role in ensuring safe medication management for older patients (4,6). In everyday practice, homecare nurses meet with patients daily, observe changes in health status, provide guidance, and identify risks associated with medication use (7). Since these encounters take place in the patient’s homes, relational and situational aspects add demands on nurses’ assessments and communication (8). The homecare nurses also face high workloads, time pressure, and increasing complexity with multiple interacting demands (7,9,10).
Reviews and empirical studies highlight the complexity of medication management for home-dwelling older adults and the structural conditions that shape nurses’ work. Research points to time pressure, fragmented information systems, inconsistent care, and growing dependence on digital tools as key challenges in medication management in homecare (3,7,11). However, research offers limited insight into how medication safety is enacted in day-to-day patient encounters (1). International initiatives highlight that communication, professional judgment, and cross-disciplinary collaboration are key to medication safety, yet there is little research on how homecare nurses can be effectively supported in these areas to ensure more person-centered approaches (4,8,11,12). Arts-based methods, including research-based theatre, remain rarely used in health services research (13), which continues to be dominated by conventional qualitative approaches (14,15). In contrast, theatre-based and other arts-based methods have been increasingly employed internationally in health professions education, with demonstrated benefits for communication, reflection, and empathy development (14). This study addresses a documented gap in Norwegian healthcare research, where arts‑based methodologies have so far been underrepresented in empirical health services research (16) despite their growing international evidence base (17,18).
The aim of this project
This project aims to strengthen nurses’ practice in home care services to ensure safer and more personalized medication use for older patients. This is done by exploring how nurses experience challenges in medication management and how applied theatre can empower and strengthen them in their interactions with older patients. Thereby increasing both parties’ autonomy.
At its core, this project is about people: the older adults living at home with complex medication needs; the nurses striving to support them under demanding conditions; and the shared moments of connection, tension, and meaning that occur in the space between them. It is also about the belief that interdisciplinary perspectives can illuminate aspects of care that might otherwise remain unseen—revealing the subtle, embodied elements of communication that shape not only safety and adherence, but also dignity, autonomy, and trust.
This project is part of the larger MedSafe-Old project, funded by the Norwegian Research Council. MedSafe-Old aims to facilitate sustainable, personalized, and safe medication use for older adults living at home.
Three studies
Using qualitative methods (19,20), the empirical data were generated through a three-part research project that engaged a dialogue with the nurses and their practice. The studies have been conducted in three municipalities in rural Norway to ensure that the data collection is relevant across sociocultural and structural frameworks. The project consisted of three substudies. Study I involved individual semistructured interviews with 14 nurses. Study II consisted of theatre workshops conducted with a total of 17 nurses (5-6 in each workshop) and 5–6 older patients or next of kin, who took part in the final part of the workshop as an active audience. I facilitated the nurses’ co-creation and performance of scenarios grounded in difficult medication-related encounters, enabling them to explore alternative actions and collectively reflect on strategies to improve their practice. Study III comprised focus group interviews with the workshop participants.
References
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