How trust was maintained in Scandinavia through the first crisis of modernity

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Home administration of needle injections for children with rheumatic diseases: A qualitative study on nurses’ perception of their educational role

Purpose - To explore nurses' perceptions of their educational role, pedagogical competence, and practice in teaching children with rheumatic diseases and their parents to manage subcutaneous injections at home. Design and methods - In this qualitative study, we used thematic analysis to analyze data from three focus groups with 14 nurses responsible for patient education at one pediatric ward and two outpatient clinics. Results - We identified three main themes capturing nurses' perceptions of their educational role: myriad expectations, awareness of own competence, and facilitation and prioritization of patient education. Nurses perceived patient education as an expected but challenging duty of their work. They described a lack of pedagogical competence, insecurity in managing parents' and children's fears and worries, and limited organizational structures guiding their educational role. Nurses who worked in outpatient clinics felt freer to individualize education compared to ward nurses. Conclusions - Nurses perceive their educational role as significant in enabling children and parents to manage subcutaneous injections at home; however, they require pedagogical competence integrated with daily practice to provide high-quality care. Short-term admissions require a different organization of patient education than before

Making a Difference: A Qualitative Study on Care and Priority Setting in Health Care

The focus of the study is the conflict between care and concern for particular patients, versus considerations that take impartial considerations of justice to be central to moral deliberations. To examine these questions we have conducted qualitative interviews with health professionals in Norwegian hospitals. We found a value norm that implicitly seemed to overrule all others, the norm of ‘making a difference for the patients’. We will examine what such a statement implies, aiming to shed some light over moral dilemmas interwoven in bedside rationing

Observed communication skills: how do they relate to the consultation content? A nation-wide study of graduate medical students seeing a standardized patient for a first-time consultation in a general practice setting

<p>Abstract</p> <p>Background</p> <p>In this study, we wanted to investigate the relationship between background variables, communication skills, and the bio-psychosocial content of a medical consultation in a general practice setting with a standardized patient.</p> <p>Methods</p> <p>Final-year medical school students (N = 111) carried out a consultation with an actor playing the role of a patient with a specific somatic complaint, psychosocial stressors, and concerns about cancer. Based on videotapes, communication skills and consultation content were scored separately.</p> <p>Results</p> <p>The mean level of overall communication skills had a significant impact upon the counts of psychosocial issues, the patient's concerns about cancer, and the information and planning parts of the consultation content being addressed. Gender and age had no influence upon the relationship between communication skills and consultation content.</p> <p>Conclusion</p> <p>Communication skills seem to be important for final-year students' competence in addressing sensitive psychosocial issues and patients' concerns as well as informing and planning with patients being representative for a fairly complex case in general practice. This result should be considered in the design and incorporation of communication skills training as part of the curriculum of medical schools.</p

Health education competence, self-management

Background: The health education competence of health professionals who deliver self-management programmes to those with long-term health challenges have been little reported and discussed in either Nordic or international research literature. Purpose: The purpose of the study is to provide a systematic literature review of studies describing key health education competencies. We included both quantitative and qualitative studies as well as a systematic literature review. Method: We conducted a systematic literature search in Medline, Embase, PsychInfo and Cinahl to identify various types of studies describing health education skills in self-management programmes. Results: The studies describe six competence areas considered essential for ensuring patients and service users good outcomes from self-management programmes. These areas are: knowledge and skills in group management, disease and diagnosis, communication, coping and coping strategies, education and personal qualities and attitudes. The quality of the studies varies. Conclusion: The studies emphasise that competence in health education is crucial for ensuring that patients and service users derive benefit from self-management programmes. We need more high-quality research together with efforts to improve the quality of health education training measures and the education of students, health professionals and service user representatives.publishedVersio

Conscientious objection to referrals for abortion: pragmatic solution or threat to women's rights?

Background Conscientious objection has spurred impassioned debate in many Western countries. Some Norwegian general practitioners (GPs) refuse to refer for abortion. Little is know about how the GPs carry out their refusals in practice, how they perceive their refusal to fit with their role as professionals, and how refusals impact patients. Empirical data can inform subsequent normative analysis. Methods Qualitative research interviews were conducted with seven GPs, all Christians. Transcripts were analysed using systematic text condensation. Results Informants displayed a marked ambivalence towards their own refusal practices. Five main topics emerged in the interviews: 1) carrying out conscientious objection in practice, 2) justification for conscientious objection, 3) challenges when relating to colleagues, 4) ambivalence and consistency, 5) effects on the doctor-patient relationship. Conclusions Norwegian GP conscientious objectors were given to consider both pros and cons when evaluating their refusal practices. They had settled on a practical compromise, the precise form of which would vary, and which was deemed an acceptable middle way between competing interests

Brukermedvirkning og mestring – emner i fremtidens legeutdanning?

Legeutdanningen har en lang tradisjon for å kvalifisere studenter for behandling av pasienter med akutt sykdom. I dag møter leger imidlertid flere og flere pasienter og brukere som må lære å leve med kronisk sykdom og langvarige helseutfordringer. Brukermedvirkning og sidestilt samarbeid mellom helsepersonell og brukere og pasienter har i mange år blitt løftet frem som en god måte å bidra til mestring. Vi har imidlertid lite kunnskap om hva og hvordan legestudenter lærer om brukermedvirkning og personer som har langvarige helseutfordringer. I denne artikkelen beskriver vi forskningslitteratur på området og peker på muligheter og utfordringer ved å introdusere brukermedvirkning og mestring som emner i fremtidens legeutdanning. Nøkkelord: langvarige helseutfordringer, pasientdeltagelse, legestudenter, medisinutdannin

Brukermedvirkning og mestring – emner i fremtidens legeutdanning?

Sammendrag Legeutdanningen har en lang tradisjon for å kvalifisere studenter for behandling av pasienter med akutt sykdom. I dag møter leger imidlertid flere og flere pasienter og brukere som må lære å leve med kronisk sykdom og langvarige helseutfordringer. Brukermedvirkning og sidestilt samarbeid mellom helsepersonell og brukere og pasienter har i mange år blitt løftet frem som en god måte å bidra til mestring. Vi har imidlertid lite kunnskap om hva og hvordan legestudenter lærer om brukermedvirkning og personer som har langvarige helseutfordringer. I denne artikkelen beskriver vi forskningslitteratur på området og peker på muligheter og utfordringer ved å introdusere brukermedvirkning og mestring som emner i fremtidens legeutdanning. Nøkkelord: langvarige helseutfordringer,pasientdeltagelse,legestudenter,medisinutdannin

Helsepedagogisk kompetanse, læring og mestring

Bakgrunn: Helsepedagogisk kompetanse hos fagpersoner som gir lærings- og mestringstilbud til personer med langvarige helseutfordringer, er i liten grad omtalt og diskutert, verken i nordisk eller i internasjonal forskningslitteratur. Hensikt: Hensikten med studien er å gi en systematisk litteraturoversikt over studier som beskriver sentral helsepedagogisk kompetanse. Vi inkluderte både kvantitative og kvalitative studier samt en systematisk litteraturoversikt. Metode: Vi gjorde et systematisk litteratursøk i Medline, Embase, PsychInfo og Cinahl etter ulike typer studier som beskriver helsepedagogisk kompetanse i lærings- og mestringstilbud. Resultat: Studiene beskriver seks kompetanseområder som viktige for at helsepersonell skal kunne gi pasienter og brukere et godt utbytte av lærings- og mestringstilbud. Disse kompetanseområdene er følgende: kunnskaper og ferdigheter knyttet til gruppeledelse, sykdom og diagnose, kommunikasjon, mestring og mestringsstrategier, pedagogikk samt personlige egenskaper og holdninger. Studiene er av varierende kvalitet. Konklusjon: Studiene fremhever at helsepedagogisk kompetanse er avgjørende for at pasienter og brukere skal kunne få utbytte av lærings- og mestringstilbud. Det er behov for mer forskning av høy kvalitet samt behov for å styrke kvaliteten ytterligere på helsepedagogiske opplæringstiltak og utdanning av studenter, fagpersoner og brukerrepresentanter