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Kommunikasjon og afasi
Get PDFInnledning: Temaet i denne oppgaven er kommunikasjon i relasjon med pasienter med afasi. Afasi påvirker ens kommunikasjonsferdigheter. Dette kan føre til uønskede hendelser som lengre sykehusopphold og dårligere rehabiliteringsresultater. Hensikten med denne oppgaven er å identifisere sykepleieres erfaringer i kommunikasjon i relasjon med pasienter med afasi.
Metode: I denne oppgaven ble det utført et litteratursøk i den vitenskapelige databasen CINAHL. Søkeordene som ble brukt er basert på nøkkelord fra problemstillingen og problemstillingens avgrensninger. Søkeordene er «aphasia», «stroke-complications», «communication», og «nurse-patient relation”. Vi avgrenset søket til artikler publisert fra 2012-2022, engelsk eller skandinavisk spark. Det resulterte i 15 treff, hvorav fire ble inkludert i denne bacheloroppgaven basert på inklusjons- og eksklusjonskriterier. De fire utvalgte artikler er fagfellevurdert.
Resultat: Resultatene gir innsikt i sykepleieres erfaringer med kommunikasjon i relasjon med pasienter med afasi. Sentrale funn indikerer at sykepleiere erfarer utfordringer knyttet til kommunikasjon med pasienter med afasi, nemlig mangel på kunnskap og knapphet på tid. Sykepleiere opplever en utfordring ved inklusjon av pårørende, da de kan både lette og komplisere kommunikasjonen. Videre opplever sykepleiere at en effektiv kommunikasjon er mulig ved bruk av alternative kommunikasjonsmetoder som gester og kroppsspråk.
Diskusjon: Det er nødvendig å fokusere ikke bare på relasjonsbygging når det gjelder kommunikasjon med pasienter med afasi, men også på andre faktorer som for eksempel støttesystemet fra organisasjonen. Selv om sykepleiere kan ha kunnskap og være godt forberedt i kommunikasjonsprogrammet organisasjonen har valgt å implementere på avdelingen, utfordres de av andre faktorer som tidspress og arbeidsmiljøfaktorer. Å ta hensyn til disse bredere aspektene er avgjørende for å sikre vellykket kommunikasjon i relasjonen til pasienter med afasi.submittedVersio
Being a patient in the intensive care unit: a narrative approach to understanding patients’ experiences of being awake and on mechanical ventilation
Get PDFPurpose: Intensive care patients often struggle to communicate due to the technical equipment used for mechanical ventilation and their critical illness. The aim of the study was to achieve a deeper understanding of how mechanically ventilated intensive care patients construct meaning in the unpredictable trajectory of critical illness.
Methods: The study was a part of a larger study in which ten patients were video recorded while being in the intensive care. Five patients engaged in interviews about their experiences from the intensive care stay after being discharged and were offered the possibility to see themselves in the video recordings. A narrative, thematic analysis was applied to categorize the patients’ experiences from the intensive care.
Results: A pattern of shared experiences among intensive care patients were identified. Three main themes capture the patient’s experiences: 1) perceiving the intensive care stay as a life-changing turning point, 2) being dependent on and cared for by others, and 3) living with negative and positive ICU experiences.
Conclusion: The patients’ narratives revealed how being critically ill affected them, and how they understood their experiences in relation to themselves and their surroundings. The results can be used to pose important questions about our current clinical practice.publishedVersio
Health care service utilization and drug overdose death: A national nested case–control registry study
Get PDFBackground and Objectives: More knowledge is needed to identify and reach those at overdose risk with preventive measures. We examined past 12-month health service utilization, identified the most frequently utilized service, explored this utilization in more detail, and examined correlates of overdose death.
Methods: A population-based nested case–control registry study including all drug overdose deaths (1 January 2010 to 31 December 2018) in Norway through the Cause of Death Registry (n = 2388). The year-, age- and gender-matched controls included through a population registry (n = 21,465). Data cross-linked with population and patient registries. Multivariable conditional logistic regression analyses estimated the likelihood of overdose death.
Results: The cases (vs. controls) attended a higher median number of services (3 vs. 1). The General Practitioner (GP) was the most utilized service. The majority (55.7%) of cases had 11–50 encounters, while the majority (60.7%) of the controls had 1–5 encounters. No high school diploma, no employment, urban living, social welfare benefits/disability pension, single-person household, recent incarceration, multiple health service utilization and frequent GP encounters, as well psychological and certain physical diagnoses were correlates of overdose death among the GP attenders.
Discussion and Conclusions: The cases had utilized more services than the controls and the GP was the most frequently utilized service. In addition to low socioeconomic status, psychological and certain physical diagnoses were correlates of overdose death.
Scientific Significance: This is the first national case–control registry study to document the high utilization of multiple primary and secondary health care services before drug overdose death, as well as reasons for attendance and correlates of overdose death.publishedVersio
Physical activity behaviors and screen time in young childhood cancer survivors: the Physical Activity in Childhood Cancer Survivors Study
Get PDFPurpose: In childhood cancer survivors (CCS), high physical activity (PA) and low sedentary time may reduce risks of late-effects. PA behaviors and screen time, and how they relate to moderate-to-vigorous PA (MVPA) in CCS, are largely unknown. We examined PA behaviors and screen time, and their cross-sectional associations with MVPA.
Methods: CCS from any cancer diagnosis (≥ l year post-treatment), aged 9–16 years at study, were eligible in the international Physical Activity in Childhood Cancer Survivors (PACCS) study. PA behaviors (school transport, intensity-effort in physical education (“PE intensity”), leisure-time PA) and screen time were assessed by self-report, and MVPA by accelerometers (ActiGraph GT3X-BT). Multivariable linear regressions were used to assess associations between PA behaviors and screen time with MVPA.
Results: We included 481 CCS (48% girls, mean age 12.2 years). Passive school transport (prevalence 42%) was associated with 10% lower MVPA/day (β = 6.6 min, 95% CI 3.3–10.0), low PE intensity (prevalence 21%) with 16% lower MVPA/day (β = 10.2 min, 95% CI 6.0–14.3), and low leisure-time PA (prevalence 34%) with 15% lower MVPA/day (β = 9.4 min, 95% CI 1.0–17.7), compared to active school transport, high PE intensity and high leisure-time PA, respectively. High screen time was not associated with MVPA.
Conclusion: Interventions aiming to increase PA behaviors rather than reducing screen time may be more efficient in promoting a healthy lifestyle in CCS through increased MVPA. Encouraging active transport, high PE intensity, and high leisure-time PA seems important in survivorship care.
Implications for Cancer Survivors: Young CCS may benefit from engaging in active transport, high PE intensity, and high leisure-time PA.publishedVersio
Hvilke faktorer har betydning for smertekartlegging av pasienter med rusavhengighet på sykehus?
Get PDFInnledning: I denne oppgaven diskuteres det hvilke faktorer som har betydning for smertekartleggingen av pasienter med rusavhengighet på sykehus. Rusavhengighet er et utbredt problem, og personene som lider av dette er mer utsatt for ulike helseutfordringer. Pasientgruppen er derfor forventet å møte på sykehus.
Metode: Denne bacheloroppgaven er en generell litteraturstudie der problemstillingen besvares ved hjelp av forskningsartikler og faglitteratur. Det er valgt ut fire forskningsartikler som brukes i diskusjonsdelen til å besvare problemstillingen. Forskningsartiklene vi har brukt er funnet på Cinahl og Sykepleien Forskning.
Resultat: Forskningsartiklenes funn viser at sykepleier har manglende kunnskap og kompetanse om smertekartlegging og behandling. Funnene viser at manglende kunnskap og negative holdninger fører til mangelfull smertekartlegging. Pasientene står dermed i fare for å bli underbehandlet på sykehus. Pasientgruppen kan ha komplekse psykososiale behov. Sykepleierne i studiene opplevde det utfordrende å skape tillit og en relasjon til pasientene.
Diskusjon: Faktorene kunnskap, kompetanse, holdninger og evne til å utøve personsentrert sykepleie kan ha stor betydning for smertekartleggingen av pasienter med rusavhengighet. Mangel på kunnskap og kompetanse om smertekartlegging, kartleggingsverktøy og pasientgruppens utfordringer, kan ha en innvirkning på relasjonen mellom sykepleier og pasient. Videre diskuteres sammenhengen mellom negative holdninger og manglende kompetanse. Økt kunnskap og kompetanse er nødvendig for å sikre god smertekartlegging, og forhindre at pasientgruppen blir møtt med negative holdninger. Sykepleier må lytte og respektere pasientens smerteuttrykk. Slik kan pasientens verdighet, integritet og medbestemmelse bli ivaretatt. Ved å benytte Fundamentals of Care i sykepleieutøvelsen, kan det tenkes at kvaliteten på smertekartleggingen bedres. Sykepleier kan dermed sikre at egen utøvelse er personsentrert.submittedVersio
The Norwegian version of the nursing student mentors’ competence instrument (MCI): A psychometric validation study
Get PDFBackground: Nurse mentors require competence to mentor nursing students in clinical practice, including specific knowledge and skills. Evaluating mentor competence is crucial in developing and ensuring the high-quality mentoring of nursing students. The nursing student mentors’ competence instrument is one of the few valid instruments for assessing the competence of nurses as mentors.
Objectives: To translate the nursing student mentors’ competence instrument into Norwegian and evaluate its psychometric properties.
Design: The research employed a cross-sectional study design.
Settings: Data were collected from nurse mentors at nursing homes, hospitals, home nursing care and mental health care units in Norway from 2021 to 2022.
Participants: A total of 458 registered nurses with experience of mentoring nursing students participated in the study, of which data was used to conduct psychometric testing.
Methods: The nursing student mentors’ competence instrument was translated and evaluated in six steps: Forward translation, forward translation synthesis, backward translation, backward translation synthesis, cognitive debriefing and psychometric testing. The validity and reliability of the translated instrument were investigated using confirmatory factor analysis (CFA) and Cronbach's alpha.
Results: The translated instrument showed acceptability. The CFA goodness-of-fit indices showed acceptable model fit (χ2/df = 2.547, SRMR = 0.051, CFI = 0.919, RMSEA = 0.058), and the Cronbach's alpha values for the instrument's subscales ranged from 0.77 to 0.95.
Conclusions: The Norwegian version of the nursing student mentors’ competence instrument shows potential as a useful instrument for assessing current and required competencies of nurse mentors in clinical practice in nursing education.publishedVersio
Associations between nursing home care environment and unfinished nursing care explored. Secondary analysis of cross-sectional data
Get PDFUnderstanding unfinished nursing care and its relationship with modifiable care environment factors is crucial for the service delivery to long-term frail patients. This secondary analysis aimed to explore the associations between characteristics of the care environment and unfinished nursing care, as reported by nursing care workers in Norwegian nursing homes. Of 931 respondents (37% response rate) from 66 nursing homes, six care environment characteristics correlated with at least two types of unfinished nursing care. Resources and Multidisciplinary collaboration showed a positive association with all four unfinished care categories. Input and acknowledgement, Professional, or Interpersonal leadership were not associated to unfinished care. In summary, our findings suggest that nursing care workers reporting positive care environment descriptions also reported lower frequencies of unfinished nursing care. This study offers insights crucial for human resource management which ultimately can be used to improve patient outcomes in nursing homes.publishedVersio
Burnout among intensive care nurses, physicians and leaders during the COVID-19 pandemic: A national longitudinal study
Get PDFBackground: Burnout is frequent among intensive care unit (ICU) healthcare professionals and may result in medical errors and absenteeism. The COVID-19 pandemic caused additional strain during working hours and also affected off-duty life. The aims of this study were to survey burnout levels among ICU healthcare professionals during the first year of COVID-19, describe those who reported burnout, and analyse demographic and work-related factors associated with burnout.
Methods: This was a national prospective longitudinal cohort study of 484 nurses, physicians and leaders working in intensive care units with COVID-19 patients in Norway. Burnout was measured at 6- and 12-month follow-up, after a registration of baseline data during the first months of the COVID epidemic. The Copenhagen Burnout Inventory (CBI), was used (range 0–100), burnout caseness defined as CBI ≥50. Bi- and multivariable logistic regression analyses were performed to examine baseline demographic variables and work-related factors associated with burnout caseness at 12 months.
Results: At 6 months, the median CBI score was 17, increasing to 21 at 12 months (p = .037), with nurses accounting for most of the increase. Thirty-two per cent had an increase in score of more than 5, whereas 25% had a decrease of more than 5. Ten per cent reported caseness of burnout at 6 months and 14% at 12 months (n.s.). The participants with burnout caseness were of significantly lower age, had fewer years of experience, reported more previous anxiety and/or depression, more moral distress, less perceived hospital recognition, and more fear of infection in the bivariate analyses. Burnout was the single standing most reported type of psychological distress, and 24 out of 41 (59%) with burnout caseness also reported caseness of anxiety, depression and/or post-traumatic stress disorder (PTSD) symptoms. Multivariate analysis showed statistically significant associations of burnout caseness with fewer years of professional experience (p = .041) and borderline significance of perceived support by leader (p = .049).
Conclusion: In Norway, a minority of ICU nurses, physicians and leaders reported burnout 1 year into the pandemic. A majority of those with burnout reported anxiety, depression and/or PTSD symptoms combined. Burnout was associated with less years of professional experience.publishedVersio
Postgraduate Operating Room Nursing Students’ Experiences with Blended Learning Combining Digital Learning Paths and Basic Skills Training as Preparation for Internship: A Qualitative Study
Get PDFIntroduction: Numerous pedagogical practices ought to be contemplated for the acquisition of practical aptitudes imperative to postgraduate operating room nursing education. The employment of digital technologies has emerged as a strategic focus in higher education and learning paths exhibit potential as a digital approach in nursing education.
Objective: This study aimed to investigate the experiences of postgraduate OR nursing students who underwent a blended learning approach, which combines digital learning paths with skills training, and to explore how this approach prepares students to attain specific learning outcomes during their internship period.
Methods: This qualitative study employed a descriptive, exploratory design and utilized focus group interviews facilitated by an interview guide to gather qualitative data. A purposive sampling strategy was employed, and the collected data were analyzed using a systematic text condensation approach.
Results: The analysis of the data revealed two main categories and five subgroups. The first category, “Blended learning serves as adequate preparation for internship,” includes subgroups that highlight the advantages of diverse learning activities that aid in the development of a strong foundation in practical skills. The positive influence of peer collaboration fosters improved learning through social interaction, while the organization of the curriculum has a significant impact on students’ learning experiences. The second category, “The importance of skills training and behaving in an operating theater context,” consists of subgroups that emphasize the necessity of progressing from basic technical skills training to simulation pedagogy to ensure appropriate behavior in the operating room. Small group sizes, close monitoring, and assessment by educators contribute to effective learning.
Conclusion: The integration of digital learning paths with skills training fosters a problem-solving approach and encourages active and collaborative learning. Skills training in small groups, timely feedback, and coordination among subject managers to handle the students’ workload can create an optimal learning environment.publishedVersio
Sykepleieres erfaringer med palliasjon i hjemmet
Get PDFInnledning: Tema for bacheloroppgaven er palliasjon i hjemmet. En økende grad av eldre medfører et større behov for lindrende behandling og palliasjon. Det har blitt utviklet politiske føringer og nasjonale faglige retningslinjer for å løfte den palliative innsatsen i Norge, hvor sentrale målsettinger om økt tid i hjemmet for palliative pasienter har direkte føringer for sykepleieutøvelsen i hjemmetjenesten. Oppgavens hensikt er derfor å svare på følgende problemstilling: Hvilke faktorer erfarer sykepleiere som avgjørende for utøvelse av personsentrert sykepleie til palliative pasienter i hjemmet?
Metode: Oppgaven er en generell litteraturstudie med et kvalitativt design, basert på et strukturert søk i Cinahl. Emneordene er basert på nøkkelbegreper i problemstillingen og omfatter følgende; “palliative care”, “home health care”, “qualitative studies”, “professional competence” og “clinical competence”. Søket ble avgrenset til studier gjennomført i Vest-Europa, publisert de siste ti årene. Det resulterte i 10 treff, hvorav fire ble inkludert basert på inklusjon- og eksklusjonskriterier. Et tilleggssøk i Idunn ble utført for å sikre en overvekt av norsk kontekst. Dette resulterte i 21 treff hvorav én ble inkludert. Artiklene ble kvalitetsvurdert.
Resultat: Resultatene viser fire gjennomgående faktorer som er avgjørende for utøvelse av personsentrert palliativ pleie i hjemmet; en tidlig og god start av det palliative forløpet, samhandling og samarbeid med andre profesjoner og instanser, kompetanse og erfaringer innen palliasjon samt nødvendige ressurser.
Diskusjon: Resultatene i forskningen er diskutert opp mot teoretisk kunnskapsgrunnlag i oppgavens bakgrunnskapittel. Vi har benyttet rammeverket “Person-centred Practice Framework” av McCance og McCormack for å belyse faktorenes sammenheng med utøvelse av personsentrert sykepleie. Vi vurderer at de fremtredende faktorene er avgjørende for sykepleieres mulighet til å utøve personsentrert palliativ pleie i hjemmet, hvor kunnskap om dette kan bidra til sykepleieres mulighet til å håndtere utfordringene i klinisk praksis.submittedVersio