Diakonal profil i perioden 1960-2006 : En dokumentanalyse av Diakonissehjemmets høgskole, Haraldsplass, sykepleierutdanningen

I denne historiske dokumentanalysen har jeg gått igjennom brosjyrer, skoleplaner, undervisningsoversikter, fagplaner, studiehåndbøker og andre dokumenter som har vært i bruk ved Diakonissehjemmets høgskole, Haraldsplass fra 1960 og frem til 2006. Jeg har kartlagt hvordan den diakonale profilen har kommet til uttrykk gjennom disse dokumentene i denne tidsepoken. Materialet forteller hvordan den diakonale målsetningen skriftlig har vært formulert, uttrykt, ivaretatt, påvirket og endret, og til en viss grad også hvilke faktorer som har bidratt til dette. Med utgangspunkt i en klargjøring av begrepene diakoni, sykepleie, omsorg og kall, diskuteres funnene i lys av organisasjonsteori, integrasjonsteori og læreplanteori. Empirien viser at Diakonissehjemmets høgskoles konfesjonelle profil er konsistent og uforandret, til tross for at de diakonale fagene har vært utsatt for en betydelig reduksjon. Høgskolen har endret sin målgruppeprofil, etter at særvilkårene med krav om kristen bekjennelse ble fjernet i 1996. Studentmassen er nå sammensatt av kristne og ikke kristne studenter. Den enkeltes personlige tro ser ut til å ha blitt mer privatisert, mens ansvaret for diakonioppdraget har gått fra å være den enkelte students ansvar til å bli mer et ansvar for institusjonen som sådan. Disse forholdene representerer ekstra utfordringer i forhold til å ivareta og formidle det diakonale innholdet i utdanningen. Når det gjelder tjenesteprofil; hva høgskolen utdanner til, oppgaver, fagfelt og hvem som skal hjelpes, så er også denne betydelig endret. Kontakten med menighetene er borte. Den diakonale målsetningen skal nå være med som et gjennomgående perspektiv i alle fagmoduler. Det kan se ut som at det har funnet sted en generell sekularisering av diakonioppdraget i utdanningen, som følge av den sykepleiefaglige utviklingen spesielt, men også som følge av det offentliges påvirkninger av høgskolesystemet generelt, med likedanning gjennom ulike reformer. Diakoni kan sies å være tro virksom i tjeneste, og utfordrer spesielt til ivaretakelse av nødstilte i samfunnet. Dagens utdanning gir en forsiktig oppfordring om ”en særlig oppmerksomhet mot menigheter og diakonale institusjoner”. Spørsmålet er hvorvidt det diakonale oppdragets utfordring; om å utdanne til omsorg for de mest nødstilte i samfunnet, blir ivaretatt godt nok i dagens utdanning. I spenningen mellom det å være en privat diakonal institusjon og det å skulle sammenveves med det offentlige høgskolesystemet kan det se ut som at sykepleierutdanningen ved Diakonissehjemmets høgskole svikter diakonioppdraget. Dette dilemmaet er like aktuelt i dag som det var ved opptakten til etableringen av utdanningen tidlig på 1900 tallet. SUMMARY This study is a historical analysis of documents created and used at the Bergen Deaconess University College. In order to find how the diaconal profile of the University College has been expressed through written materials during the period 1960-2006, the files at both the University College and the National Archives in Bergen have been reviewed. Different types of written material have been studied, including brochures, education schedules and student guides. From the different sources, it is possible to describe how the diaconal purpose of the University College have been expressed, formulated, taken care of, influenced and possibly changed over the years, and to a certain extent what has contributed to this development. Firstly, the terms deaconry, nursing, care and calling have been clarified, and then the results are being discussed with respect to these terms. Furthermore, the results are discussed in relation to theories of organization, integration and curriculum. The study shows that the confessional profile of the Bergen Deaconess University College is consistent and unchanged, despite the fact that class hours in diaconal subjects have been significantly reduced over the period studied. Bergen Deaconess University College today aims towards other student populations than in the earlier part of the period studied. This is especially evident after 1996, when the schools` strictly confessional admission policy was abolished. Today the student body comprises confessional as well as non confessional admission, which presents the University College with challenges in maintaining and expressing the diaconal aspects of the education. Personal faith seems to be more private than earlier, whilst carrying out the deaconry mission seems to have become more an institutional responsibility. The service profile (i.e. what challenges and jobs the University College educates the students for), has changed during the period. Contact with the congregations is no longer existing. The deaconry perspective is now supposed to be taken care of in each study module. It looks as if there has been a general secularisation of the deaconry mission in the education. This may be viewed as a consequence of developments in nursing education in particular, and of politically induced changes in college education in general, through various reforms intended to create greater uniformity in higher education., Deaconry might be said to be living the faith through service, and challenges especially care for the weakest in society. Today’s studyprogram conveys a modest request for “a special attention towards congregations and diaconal institutions”. The question is whether or not the special task of deaconry, to educate for care for the weakest in society, is accounted for in today’s education. In the tension between being a private diaconal institution and becoming increasingly integrated into a public educational system, it might look as if it is the weakest and poorest in our modern society that are let down. This ideological dilemma is just as acute today as was when the Bergen Deaconess University College was established almost 90 years ago

Quality of life in home-dwelling cancer patients aged 80 years and older: a systematic review

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativeco mmons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the dataObjective: Quality of Life (QoL) in elderly cancer patients is a topic that has been little explored. This systematic review aims to identify, assess, and report the literature on QoL in home-dwelling cancer patients aged 80 years and older and what QoL instruments have been used. Methods: We systematically searched the databases of Medline, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), PsykINFO, Scopus, Epistemonikos and Cinahl to identify studies of any design measuring QoL among home-dwelling cancer patients aged 80 years and older. We screened the titles and abstracts according to a predefned set of inclusion criteria. Data were systematically extracted into a predesigned data charting form, and descriptively analyzed. The included studies were assessed according to the Critical Appraisal Skills Programme (CASP) checklists, and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement (PRISMA) checklist was used to ensure rigor in conducting our investigations and reporting our fndings. This systematic review was registered in PROSPERO (CRD42021240170). Results: We included three studies that specifcally analyze QoL outcomes in the subgroup of home-dwelling cancer patients aged 80 years and older, with a total of 833 participants having various cancer diagnoses. 193 of the participants included in these three studies were aged 80 years or more. Diferent generic and cancer-specifc QoL instruments as well as diferent aims and outcomes were studied. All three studies used a diagnosis-specifc instrument, but none of them used an age-specifc instrument. Despite heterogeneity in cancer diagnoses, instruments used, and outcomes studied, QoL in home-dwelling cancer patients aged over 80 years old seems to be correlated with age, physical function, comorbidity, living alone, needing at-home care services, being in a poor fnancial situation and having a small social network. Conclusion: Our systematic review revealed only three studies exploring QoL and its determinants in the specifc subgroup of home-dwelling cancer patients aged 80 years and over. A gap in the knowledge base has been identifed. Future studies of this increasingly important and challenging patient group must be emphasized. Subgroup analyses by age must be performed, and valid age and diagnosis specifc QoL instruments must be used to generate evidence in this segment of the population.publishedVersio

Quality of life among cancer inpatients 80 years and older: a systematic review

Objective The aim of this systematic review was to summarize and assess the literature on quality of life (QoL) among cancer patients 80 years and older admitted to hospitals and what QoL instruments have been used. Methods We searched systematically in Medline, Embase and Cinahl. Eligibility criteria included studies with any design measuring QoL among cancer patients 80 years and older hospitalized for treatment (surgery, chemotherapy or radiation therapy). Exclusion criteria: studies not available in English, French, German or Spanish. We screened the titles and abstracts according to a predefined set of inclusion criteria. All the included studies were assessed according to the Critical Appraisal Skills Programme checklists, and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement checklist was used to ensure rigor in conducting and reporting. This systematic review was registered in PROSPERO (CRD42017058290). Results We included 17 studies with 2005 participants with various cancer diagnoses and Classification of Malignant Tumors stages (TNM). The included studies used a range of different QoL instruments and had different aims and outcomes. Both cancer-specific and generic instruments were used. Only one of the 17 studies used an age-specific instrument. All the studies included patients 80 years and older in their cohort, but none specifically analyzed QoL outcomes in this particular subgroup. Based on findings in the age-heterogeneous population (age range 20–100 years), QoL seems to be correlated with the type of diagnosed carcinoma, length of stay, depression and severe symptom burden. Conclusion We were unable to find any research directly exploring QoL and its determinants among cancer patients 80 years and older since none of the included studies presented specific analysis of data in this particular age subgroup. This finding represents a major gap in the knowledge base in this patient group. Based on this finding, we strongly recommend future studies that include this increasingly important and challenging patient group to use valid age- and diagnosis-specific QoL instruments.publishedVersio

Health-related Quality of Life, Distress and Psychosocial Factors in Head and Neck and Renal Cancer Patients. Quality of Life in HNSCC and RCC patients

Cancer represents a major health challenge worldwide, and affects a substantial proportion of the human population. Studies of cancer treatment has traditionally assessed endpoints such as overall survival and progression free survival. In order to better understand and evaluate the overall impact of the disease and its treatment, researchers eventually also included evaluation of health related quality of life (HRQoL) after cancer treatment. Knowledge of patient’s HRQoL and what affects cancer patients' psychological adaptation to treatment and survival has become increasingly important considering the growing number of cancer patients who survive. In this thesis, we have studied the relationship between HRQoL and psychosocial factors such as personality, choice of coping, and distress (GHQ) in patients treated for Head and Neck Squamous Cell Carcinoma (HNSCC). Except for distress, we have studied the same factors in patients treated for Renal Cell Carcinoma (RCC). We have also examined the importance of comorbidity, some aspects of cancer biology and other treatment-related factors. HNSCC and RCC occurs about equally as frequently in Norway. The two cancer diagnosis groups have an approximately equal risk of recurrence and death. The big difference between the two patient groups is according to the conditions of treatment. HNSCC patients often receive an extensive treatment consisting of radiation therapy, chemotherapy and surgery, which may lead to sequelae of a potentially great impact on daily functioning. RCC patients are normally treated with one surgical procedure only. The groups are therefore interesting to compare in terms of what determines the perceived HRQoL. Is it the cancer prevalence, treatment related factors, risk of recurrence and death, sequelae -or other more personality-related qualities that are decisive. In HNSCC patients, we found that presence of the personality trait neuroticism and use of avoidance- coping, were both associated with and predicts increased distress with much the same pattern as for HRQoL. Furthermore we suggested that distress may possibly be regarded a HRQoL variable in HNSCC patients. The personality trait of neuroticism showed up to 30% common variance with HRQoL. Large extent of primary tumor (T- stage), predicted increased distress in HNSCC patients. Utilized coping strategy was also important, partly as mediator between personality and HRQoL, and associated to HRQoL. Distress was found to be stable when measured over a four-year follow-up period in the HNSCC patient group.In our sample of RCC patients we made similar findings. Almost all HRQoLindices were significantly negatively correlated with the personality trait neuroticism and to use of avoidance- coping. RCC patients treated with a flank incision and to some extent with open abdomen approach, reported impaired HRQoL in several indexes, while those treated with minimal- invasive surgery, reported HRQoL in line with the general population. In some areas, the flank treated RCC patients reported a decreased HRQoL compared to a group of laryngectomized HNSCC patients. Considering the patients HRQoL, selection of surgical access in nephron- sparing surgery (NSS) should be viewed in the light of this finding. Comorbidity and particularly whether the patient had diabetes or were on lung medication or not, seems to be associated with impaired HRQoL in patients surgically treated for RCC. The “European Organization for Research and Treatment of Cancer” (EORTC) has developed several general and disease-specific quality of life questionnaires for cancer patients, but a disease-specific questionnaire for RCC patients have so far been lacking. We have therefore developed an EORTC-compatible RCC-specific quality of life questionnaire. Our proposed form adds important disease-specific information about RCC- patients' HRQoL. By adding four general questions about pain, mobility and social functioning, our form also has the potential as a stand- alone HRQoL questionnaire that can be clinically used among surgically treated RCC patients. Surprisingly similar patterns of self-reported HRQoL and distress (only in head/neck cancer patients) on the one hand, and personality and coping on the other side, between the head/neck and renal cancer patients were found in this study. For both groups, it appears that the relationship between psychosocial factors and HRQOL is three to four times as strong as the correlation between sequelae of treatment and reported HRQOL. Comorbidity was associated with lower self-reported HRQoL

Personality and educational level determine self-reported health-related quality-of-life and distress in patients with renal tumors awaiting radical surgery

Objective: Data on preoperative distress and health-related quality-of-life (HRQoL) is lacking for patients with newly diagnosed renal tumors. This study aims to compare HRQoL within this group with the general population and to study the relationship between distress, HRQoL, personality, coping, and patient/tumor-related factors. Materials and methods: Between January 2011 and June 2014, 153 patients (100 males/53 females), scheduled for surgery were prospectively included. Distress was determined by the General Health Questionnaire (GHQ), HRQoL by EORTC-QLQ-C30 questionnaire, personality by Eysenck Personality Inventory and coping by COPE questionnaire. HRQoL-data from an age and gender matched Norwegian reference population was used for comparison. Results: The study patients had significantly poorer HRQoL than the reference population. GHQ and HRQoL sum scores had a common variance (CV = r2) of 29–35%. In regression models, the measured variables accounted for 33% of the variance for the GHQ score. Significant predictors of the measured variance were neuroticism (18%), education level (3%) and avoidant coping (2%). Similarly, the measured variables accounted for 33–44% of the variance for the HRQoL sum scores. For all HRQoL sum scores, neuroticism predicted 17–28%, while education predicted 4–11% of the measured variance. Large tumor size, comorbidity, performance status and CRP predicted 2–7% of individual sum scores. Conclusions: For both preoperative distress and HRQoL, personality traits such as neuroticism and education level were the most important predictors. Tumor-related factors and other preexisting conditions seemed to be of lesser importance. Thus, preoperatively screening of psychological factors could be helpful to identify those at risk of poor outcomes

Baccalaureate Nursing Students’ Reflections on Professional Development Within the Nursing Leadership Role When Participating in Student-run Teams: A Qualitative Content Analysis of Student’s Reflection Notes

Introduction: Studies show that nursing education institutions do not sufficiently prepare newly graduated nurses for the challenges they face when it comes to the leadership role. The direct relationship between leadership and quality of care makes it imperative to explore what contributes to prepare undergraduate nursing students to be effective future leaders. Objective: To explore how second-year nursing students experience development of nursing leadership competence when participating in student-run teams (SRTs). Methods: We used a qualitative approach with a descriptive, exploratory design to examine 37 reflective notes with a scope of 1000 words each, written while undertaking leadership training in 14 medical and surgical wards. An inductive, qualitative content analysis inspired by Lindgren et al. was used to give meaning and content to the students’ experiences. Results: One overarching theme emerged when analyzing the reflective notes; nursing leadership skills are developed in a safe authentic clinical environment. This main theme evolved from an interpretation of three subthemes: (1) Discovery and recognition of the leadership role contributed to development of nursing identity, (2) Being challenged and given responsibility in the SRT contributed to development of nursing leadership skills, (3) The way nursing services are organized affects the quality of care and satisfaction in one’s own work situation. Conclusion: SRTs can be a way of organizing clinical placement studies to strengthen nursing students’ competence in the nursing leadership role and may counteract the reality shock when transitioning from the student role to the professional role.publishedVersio

Quality of life in home-dwelling cancer patients aged 80 years and older: a systematic review

Objective Quality of Life (QoL) in elderly cancer patients is a topic that has been little explored. This systematic review aims to identify, assess, and report the literature on QoL in home-dwelling cancer patients aged 80 years and older and what QoL instruments have been used. Methods We systematically searched the databases of Medline, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), PsykINFO, Scopus, Epistemonikos and Cinahl to identify studies of any design measuring QoL among home-dwelling cancer patients aged 80 years and older. We screened the titles and abstracts according to a predefined set of inclusion criteria. Data were systematically extracted into a predesigned data charting form, and descriptively analyzed. The included studies were assessed according to the Critical Appraisal Skills Programme (CASP) checklists, and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement (PRISMA) checklist was used to ensure rigor in conducting our investigations and reporting our findings. This systematic review was registered in PROSPERO (CRD42021240170). Results We included three studies that specifically analyze QoL outcomes in the subgroup of home-dwelling cancer patients aged 80 years and older, with a total of 833 participants having various cancer diagnoses. 193 of the participants included in these three studies were aged 80 years or more. Different generic and cancer-specific QoL instruments as well as different aims and outcomes were studied. All three studies used a diagnosis-specific instrument, but none of them used an age-specific instrument. Despite heterogeneity in cancer diagnoses, instruments used, and outcomes studied, QoL in home-dwelling cancer patients aged over 80 years old seems to be correlated with age, physical function, comorbidity, living alone, needing at-home care services, being in a poor financial situation and having a small social network. Conclusion Our systematic review revealed only three studies exploring QoL and its determinants in the specific subgroup of home-dwelling cancer patients aged 80 years and over. A gap in the knowledge base has been identified. Future studies of this increasingly important and challenging patient group must be emphasized. Subgroup analyses by age must be performed, and valid age and diagnosis specific QoL instruments must be used to generate evidence in this segment of the population.publishedVersio

sj-docx-1-son-10.1177_23779608221130604 - Supplemental material for Baccalaureate Nursing Students’ Reflections on Professional Development Within the Nursing Leadership Role When Participating in Student-run Teams: A Qualitative Content Analysis of Student’s Reflection Notes

Supplemental material, sj-docx-1-son-10.1177_23779608221130604 for Baccalaureate Nursing Students’ Reflections on Professional Development Within the Nursing Leadership Role When Participating in Student-run Teams: A Qualitative Content Analysis of Student’s Reflection Notes by Marit Hegg Reime, Karin Bell, Bente Albrigtsen and Elisabeth Grov Beisland in SAGE Open Nursing</p

It is possible for nursing students to achieve the learning objectives in their hospital clinical training at the outpatient clinic? Experiences from the students

AMEE (An International Association for medical Education) congress. Barcelona, 28. august - 30. august, 2016The aim of this project was to explore if the outpatient clinics can be an appropriate learning context for supervised clinical training, and furthermore to evaluate nursing students achieved learning outcome. Twelve outpatient clinics and students from three colleges were involved: 38 nursing students completed training for 12 weeks divided between outpatient clinic (6 weeks) and ward (6 weeks) and 13 students had their entire training in outpatient clinics for 6-8 weeks. A questionnaire was used to collect experiences just after completed training; 39 students responded (N = 51) .publishedVersio