Fagutviklingssykepleieren som brobygger mellom forskning og klinisk praksis

Bakgrunn: Forskning og teknologi er i økende grad blitt en del av vår hverdag, som medfører at kunnskap får en mer abstrakt og symbolsk form. Det stilles derved særegne krav til faglig oppdatering blant sykepleiere. Hensikt: Studiens hensikt er å få innsikt i hva som kjennetegner fagutviklingssykepleierens formidlende og tilretteleggende virksomhet mellom forskning og klinisk praksis. Metode: Studien er eksplorerende, og er utført som ledd i oppfølging av funn i ProLearn studien ved Universitetet i Oslo. Fem fagutviklingssykepleiere fra to ulike sykehus ble forespurt, og det ble utført kvalitative intervjuer med utgangspunkt i en intervjuguide. Analysen hadde likhetstrekk med en hermeneutisk prosess, hvor forskningsspørsmålet var utgangspunkt for en gjentagende gjennomlesning av et helhetlig datamateriale mot en mer fortolkende fremstilling. Resultater: Studien tyder på at fagutviklingssykepleieren har en viktig rolle som brobygger mellom forskning og klinisk praksis. Ved å tilrettelegge infrastrukturer for læring prøver våre informanter både å stimulere til et dynamisk forhold til kunnskap, og fremme kunnskapsbasering av det daglige arbeidet. Konklusjon: Til tross for et sterkt engasjement og ansvar for kunnskap, er det knyttet store pedagogiske og administrative utfordringer til fagutviklingssykepleierens rolle.Title: The Advanced Nurse Practitioner: Bridging the gap between research and clinical practice Background: Nurses are required to keep up to date with professional demands, which implies the increased importance of science and technology as abstract and symbolic forms of knowledge. Objectives: The aim of the study is to gain insight into how Advanced Nurse Practitioners perform their jobs in a way that minimizes the gap between research and clinical practice. Methods: This article discusses an explorative follow-up study on findings from the ProLearn study conducted by the University of Oslo. Five Advanced Nurse Practitioners from two hospitals were interviewed on the basis of an interview guide. The research questions were the basis for a hermeneutic interpretation of the data that lead from description and conceptualizing, to a more comprehensive understanding. Results: The findings indicate that the Advanced Nurse Practitioner holds an important role as a mediator between the fields of research and clinical practice. By organizing infrastructures for learning, our informants try to both stimulate a dynamic relationship towards knowledge, and promote that the daily work is based on knowledge. Conclusion: Despite a strong commitment to and responsibility for knowledge, Advanced Nurse Practitioners face huge pedagogical and administrative challenges. Key words: nurses, clinical nursing research, evidence based medicine, information service

Negotiating Goals: Exploring the Dialogue Between Professionals and Patients in Team-Meetings

The aim of this study is to explore the negotiation of goals in team meetings with patients within a specialized rehabilitation context: What characterizes the dialogue between professionals and patients in goal meetings? Despite agreement in the literature that the patients’ perspectives and participation are significant in goal setting processes, there seem to be few studies on characteristics of the dialogue in such meetings with patients. The data derived from audio-recorded observations of three team meetings with various health care professionals and patients within rehabilitation services. The method can be characterized as a theme-oriented discourse analysis, which is a qualitative method for analyzing how language constructs professional practice. The analysis identifies two main themes: 1. Reviewing goals: from standardized readings to everyday language. 2. Setting meaningful goals. The article discusses characteristics of the patients´ participation in the dialogue, and how professionals de-emphasize inherent power inequalities in the negotiation of goals

Diminishing pain stigma: patient perceptions of encounters with interprofessional teams in biopsychosocial pain rehabilitation

Purpose To explore how patients in biopsychosocial pain rehabilitation perceive encounters with interprofessional teams. The focus of this article is to explore how interactions can perpetuate or diminish chronic pain stigma. Material and methods An ethnographic approach was applied to the study. Participant observation of interprofessional encounters and clinical encounters in a pain rehabilitation ward was undertaken in 2016 (19 weeks). Interviews with 12 professionals and seven patients were conducted. Data were analysed in an abductive process using thematic analysis. Results The patients perceived their encounters with interprofessional teams as supportive, with implications for pain stigma. This is presented as two themes: (1) being seen as credible, involving patients being believed in and a concept of being overactive at the expense of their own health, and (2) being helped to see their situation in a new light, which involves enthusiasm about changing and challenging views in a process with professionals who were supportive and united across professions. Conclusion Interprofessional biopsychosocial pain rehabilitation may be an intervention that can diminish internalised stigma in patients suffering from chronic pain. The study contributes to increased understanding of patient perceptions of positive encounters with professionals during a learning process in rehabilitation and of the imbued influence on power relations. This appears to be fundamental to diminishing pain stigma, as the occurrence of stigma is dependent on differences in power.publishedVersio

Helsesøstres utfordringer for å fremme elevenes psykiske helse

Challenges school nurses have to promote students’ mental healthThe school is an important arena for promoting students' mental health. Prevalence of mental health problems among young people is of concern, and focusing on prevention efforts in schools has been considered to be important. The purpose of this qualitative study was to gain further insight into how collaboration between school nurses and teachers can promote students' mental health. This article is based on four interviews with school nurses from secondary and high school. The school nurses highlighted the importance of establishing themselves as visible partners for teachers, while at the same time providing low threshold for services to students. Factors like lack of time and the location of the school nurse’s office, created tension and influenced their work. Much of the work concerning students' mental health was experienced as "fire fighting", while they instead wanted to emphasize health promotion and primary prevention efforts on class and group levels

Personal factors associated with health-related quality of life in persons with morbid obesity on treatment waiting lists in Norway

Purpose To explore relationships of socio-demographic variables, health behaviours, environmental characteristics and personal factors, with physical and mental health variables in persons with morbid obesity, and to compare their health-related quality of life (HRQoL) scores with scores from the general population. Methods A cross-sectional correlation study design was used. Data were collected by self-reported questionnaire from adult patients within the first 2 days of commencement of a mandatory educational course. Of 185 course attendees, 142 (76.8%) volunteered to participate in the study. Valid responses on all items were recorded for 128 participants. HRQoL was measured with the Short Form 12v2 from which physical (PCS) and mental component summary (MCS) scores were computed. Other standardized instruments measured regular physical activity, social support, self-esteem, sense of coherence, self-efficacy and coping style. Results Respondents scored lower on all the HRQoL subdomains compared with norms. Linear regression analyses showed that personal factors that included self-esteem, self-efficacy, sense of coherence and coping style explained 3.6% of the variance in PCS scores and 41.6% in MCS scores. Conclusion Personal factors such as self-esteem, sense of coherence and a high approaching coping style are strongly related to mental health in obese persons

Praksisveilederes erfaring med lokale læreplaner for sykepleierstudenter

Several studies have shown that nurse mentors experience the education's learning outcomes as generally defined. An R&D-related collaborative project was therefore launched. Part 1 involved the development of a local curriculum in collaboration with nurse mentors. Part 2 involved a systematic evaluation study focusing on the use of local curricula. The aim was to investigate the importance of local curricula as a tool for clarifying learning outcomes in clinical studies. The study is qualitative with an exploratory and descriptive design based on four focus group interviews with nurse mentors from different levels of the bachelor's education. The analysis process was based on thematic analysis. The findings were: Varying experiences with implementation of local curriculumClarify current learning situationsVarying use in assessment situationsThe nurse mentors experienced the description of learning situations as relevant and recognizable. The local curricula was a good tool in the process assessment of the students.Flere studier har vist at praksisveiledere i sykepleierutdanningen opplever utdanningens læringsutbyttebeskrivelser som lite konkrete. Det ble derfor iverksatt et FoU-relatert samarbeidsprosjekt inndelt i to deler. Del 1 innebar utvikling av lokale læreplaner i samarbeid med praksisveiledere. Del 2 innebar en systematisk evalueringsstudie med fokus på bruken av lokale læreplaner. Hensikten var å undersøke hvilken betydning lokale læreplaner har som redskap for tydeliggjøring av læringsutbytter i praksisstudier. Forskningsspørsmål: Hvordan erfarer praksisveiledere bruken av lokale læreplaner? Studien er kvalitativ med et utforskende og beskrivende design basert på fire fokusgruppeintervju med praksisveiledere fra ulike nivå i bachelorutdanningen i sykepleie. Analyseprosessen tok utgangspunkt i tematisk innholdsanalyse, som resulterte i tre hovedtema: 1.Varierende erfaringer med implementering av lokal læreplan, 2.Tydeliggjør aktuelle læresituasjoner. 3.Varierende bruk i vurderingssituasjoner. Studien konkluderer med at praksisveilederne erfarte beskrivelsen av læresituasjoner som relevante og gjenkjennbare i forhold til eget praksissted, og at planen var et godt redskap i prosessvurderingen av studentene

Primary Hyperparathyroidism Influences the Expression of Inflammatory and Metabolic Genes in Adipose Tissue

Background: Primary hyperparathyroidism (PHPT) is characterised by increased production of parathyroid hormone (PTH) resulting in elevated serum calcium levels. The influence on bone metabolism with altered bone resorption is the most studied clinical condition in PHPT. In addition to this, patients with PHPT are at increased risk of non-skeletal diseases, such as impaired insulin sensitivity, arterial hypertension and increased risk of death by cardiovascular diseases (CVD), possibly mediated by a chronic low-grade inflammation. The aim of this study was to investigate whether adipose tissue reflects the low-grade inflammation observed in PHPT patients. Methodology/Principal Findings: Subcutaneous fat tissue from the neck was sampled from 16 non-obese patients with PHPT and from 16 patients operated for benign thyroid diseases, serving as weight-matched controls. RNA was extracted and global gene expression was analysed with Illumina BeadArray Technology. We found 608 differentially expressed genes (q-value,0.05), of which 347 were up-regulated and 261 were down-regulated. Gene ontology analysis showed that PHPT patients expressed increased levels of genes involved in immunity and defense (e.g. matrix metallopeptidase 9, S100 calcium binding protein A8 and A9, CD14, folate receptor 2), and reduced levels of genes involved in metabolic processes. Analysis of transcription factor binding sites present in the differentially expressed genes corroborated the up-regulation of inflammatory processes. Conclusions/Significance: Our findings demonstrate that PHPT strongly influences gene regulation in fat tissue, which may result in altered adipose tissue function and release of pathogenic factors that increase the risk of CVD

Personal factors associated with health-related quality of life in persons with morbid obesity on treatment waiting lists in Norway

Purpose To explore relationships of socio-demographic variables, health behaviours, environmental characteristics and personal factors, with physical and mental health variables in persons with morbid obesity, and to compare their health-related quality of life (HRQoL) scores with scores from the general population. Methods A cross-sectional correlation study design was used. Data were collected by self-reported questionnaire from adult patients within the first 2 days of commencement of a mandatory educational course. Of 185 course attendees, 142 (76.8%) volunteered to participate in the study. Valid responses on all items were recorded for 128 participants. HRQoL was measured with the Short Form 12v2 from which physical (PCS) and mental component summary (MCS) scores were computed. Other standardized instruments measured regular physical activity, social support, self-esteem, sense of coherence, self-efficacy and coping style. Results Respondents scored lower on all the HRQoL subdomains compared with norms. Linear regression analyses showed that personal factors that included self-esteem, self-efficacy, sense of coherence and coping style explained 3.6% of the variance in PCS scores and 41.6% in MCS scores. Conclusion Personal factors such as self-esteem, sense of coherence and a high approaching coping style are strongly related to mental health in obese persons

Why do nurses utilize textual knowledge sources at work?

Aim. The aim of this paper is to shed light on why nurses utilize textual knowledge sources in a hospital workplace setting. The paper focuses on the following research question: Why do nurses utilize textual knowledge sources at work? Background. Knowledge utilization implies that nurses rely on knowledge sources that are regulated at a more general level. Knowledge utilization may be triggered by uncertainty or novelty in task requirements. Methods. The data derives from 10 semi-structured in-depth interviews with nurses, conducted during spring-05. Six of them also kept logs for two days during two weeks during the fall semester of 2005. In addition, a focus group interview with three of the nurses was conducted in the spring semester of 2006. Findings. The reasons for using textual knowledge sources seem to crystallize into three interrelated themes: 1. To fill in gaps of knowledge needed to understand or solve problems at hand 2. To verify and enhance skills 3. A desire to strengthen their professional repertoire Conclusion. The reason for knowledge-utilization seems to encompass both instrumental and conceptual purposes. This area is in need of further exploration

Why do nurses utilize textual knowledge sources at work?

Aim. The aim of this paper is to shed light on why nurses utilize textual knowledge sources in a hospital workplace setting. The paper focuses on the following research question: Why do nurses utilize textual knowledge sources at work? Background. Knowledge utilization implies that nurses rely on knowledge sources that are regulated at a more general level. Knowledge utilization may be triggered by uncertainty or novelty in task requirements. Methods. The data derives from 10 semi-structured in-depth interviews with nurses, conducted during spring-05. Six of them also kept logs for two days during two weeks during the fall semester of 2005. In addition, a focus group interview with three of the nurses was conducted in the spring semester of 2006. Findings. The reasons for using textual knowledge sources seem to crystallize into three interrelated themes: 1. To fill in gaps of knowledge needed to understand or solve problems at hand 2. To verify and enhance skills 3. A desire to strengthen their professional repertoire Conclusion. The reason for knowledge-utilization seems to encompass both instrumental and conceptual purposes. This area is in need of further exploration