Opening Pandora’s box: A meta-ethnography about alcohol use in pregnancy from midwives’ and other healthcare providers’ perspectives

Introduction: Alcohol consumption has increased in recent years, including among women of childbearing age. A woman’s alcohol intake during pregnancy is linked to complications and injuries in the newborn, and the risk of the child being harmed by the mother’s alcohol use increases in proportion to the amount of alcohol she consumes. This meta-ethnography aims to explore midwives’ and other healthcare providers’ experiences of screening pregnant women for alcohol use in pregnancy and counselling them on the subject. Methods: A systematic literature search in CINAHL, Maternity & Infant Care, MEDLINE, and Scopus was conducted in August 2021 and updated in January 2023. The CASP checklist was used to assess the included articles and meta-ethnography was used to synthesize the data. Results: Fourteen qualitative studies were included. In the synthesis, we use the metaphor of Pandora’s box to deepen our understanding of the topic. We found that some healthcare providers tiptoe around the box, not wanting to face the consequences and responsibilities of asking women about their alcohol use. Others refuse or are reluctant to open the box because they lack knowledge about screening and counselling. Some eventually open the box, understanding the importance of establishing a trusting relationship to address alcohol use and seeing the need for knowledge and screening tools. Conclusions: Healthcare education has the important task of ensuring that healthcare personnel have sufficient evidence-based knowledge about alcohol use in pregnancy. In the future, a health-promoting, tailored approach offering women in pre-pregnancy and early pregnancy sufficient evidence-based information should be implemented.publishedVersio

Family carers' experiences of attending a multicomponent psychosocial intervention program for carers and persons with dementia

Background: Psychosocial interventions for persons with dementia and their primary family carers are promising approaches to reducing the challenges associated with care, but, obtaining significant outcomes may be difficult. Even though carers in general are satisfied with such interventions, few studies have evaluated the interventions by means of qualitative methods. Aim: The objective of the study reported here was to investigate family carers’ experiences of a multicomponent psychosocial intervention program, and also to offer advice on how to develop the intervention program. Methods: Content analyses were taken from individual qualitative interviews conducted in 2012 with 20 carers (aged 50–82 years) who participated in a psychosocial intervention program that included education, individual and family counseling, and parallel group sessions for carers and persons with dementia. Results: Two main categories emerged: 1) benefits of the intervention program, which sets out the informants’ experiences for the benefits of participation, described in the subcategories “importance of content and group organization” and “importance of social support”; and 2) missing content in the intervention program, which details the informants’ suggestions for future interventions, contained in the subcategories “need for extended content” and “need for new group organization”. Conclusion: The carers found the interventions useful. The importance of even earlier and more flexible interventions for the family carers, the extended family, and the persons with dementia was underscored.publishedVersio

Lydhør identitetsstøtte i samtaler med personer med demens: En studie av intervjuer i en femårig narrativ forløpsstudie

Responsive identity support in conversations with people with dementia: A study of interviews in a five-years narrative longitudinal study A narrative longitudinal study depends on trust and a positive relationship between the interviewer and the participant to encourage the participant’s continued participation. In reported studies, the methodological part is usually too short to present the complexities in dialogues over time. We therefore have analyzed the interview processes with younger people with dementia, relating the interactions to central concepts associated with identity. The aim was to explore the methodological interview approach used in a longitudinal study, focusing on supporting identity and self-esteem. We used the concept of responsive identity to illuminate our findings. In addition, we demonstrate how the interview dialogues can support identity and self-esteem of the participants. The core of this approach is that the interviewee, living with dementia, should be seen, confirmed and supported to preserve the person`s self and dignity. Dialogue with responsive identity support is a fruitful research method in dementia research. This approach can be generalized to person-centred communication in health and caring relationships

The meaning of dignity for older adults : A meta-synthesis

Dignified care is a central issue in the nursing care of older adults. Nurses are expected to treat older adults with dignity, and older adults wish to be treated in a dignified manner. Researchers have recommended investigating the concept of dignity based on specific contexts and population groups. This meta-synthesis study aims to explore the understandings of dignity from the perspective of older adults in the Nordic countries. Synthesising findings from qualitative studies on older adults? experiences of dignity has provided important insight into what can be essential for dignified care in a Nordic context. The importance of visibility and recognition for the experience of dignity is an overarching theme in all the studies. The participants? descriptions mostly implicated an existence dominated by a lack of recognition. The older adults do not feel valued as people or for their contribution to society and strive to tone down their illnesses in an attempt to become more visible and acknowledged as people. Toning down their illnesses and masking their needs can protect their independence. At the same time, becoming less visible can leave them without a voice. The metaphorical phrase protected and exposed by a cloak of invisibility is used to express the authors? overall interpretation of the findings. Lack of recognition and being socially invisible is a genuine threat to older adults? dignity.Peer reviewe

Hvorfor velger ikke flere menn jordmoryrket? En kvalitativ studie med mannlige sykepleierstudenter

Background: Many professions are gender divided. In Norway, there are only 22 male educated midwives out of 6711. Aim: To gain knowledge of male nursing students’ views of the reasons why few men become midwives. Method: This qualitative study collected data through focus-group interviews and individual interviews with male nursing students. Results: Three themes emerged from the analysis: midwifery is an unnatural career choice for men; men have little knowledge of the midwifery profession; to experience of demands and uncertainty associated with the education and profession. These themes included seven sub-themes. Conclusion: Midwifery as a career choice is constrained by the societal view of this career, which is considered a feminine occupation. The ‘midwife’ title can deter males from studying midwifery. Access to male role models is an important prerequisite for recruiting men, and it can be difficult for them to enter midwifery education and to obtain permanent employment after graduation. These results may contribute to less interest of the profession.Bakgrunn: Mange yrkesvalg påvirkes av kjønn. I jordmorfaget er det 22 menn av totalt 6711 utdannede jordmødre i Norge. Mål: Å få kunnskap om mannlige sykepleierstudenters synspunkter på hvorfor så få menn blir jordmødre. Metode: Studien innhentet data gjennom fokusgruppeintervjuer og individuelle intervjuer med mannlige sykepleierstudenter. Datamaterialet ble analysert med systematisk tekstkondensering. Resultater: Tre hovedtemaer ble avdekket i analysen: et unaturlig yrkesvalg for menn, menn har liten kjennskap til jordmorfaget og å oppleve krav og usikkerhet knyttet til utdanningen og yrket. Hovedtemaene dekket syv undertemaer. Konklusjon: Deltakerne mente at yrket var knyttet til femininitet og var et yrke forbeholdt kvinner, samt at «jordmor» ikke er en kjønnsnøytral tittel. Noe som kan redusere interessen for faget. Tilgang til informasjon om yrket, samt mannlige rollemodeller ble også påpekt som viktig for å rekruttere menn. Usikkerhet knyttet til å bli tatt opp i utdanningen, og framtidig arbeidsmuligheter ble understreket. Disse resultatene kan bidra til å redusere interessen for faget

Døden i livet

"There is a widely held notion that death is not particularly visible in our culture; death is something we do not talk about. The premise for Døden i livet has been to challenge this preconception from a variety of perspectives and disciplines. The authors argue that death is present in our lives in many ways. We see it and experience it in our physical surroundings, for example in the various arrangements we make to remind ourselves of the dead. We hear or read about it in speeches, poems, music lyrics, psalms, obituaries, biographies, picture books, novels and newspapers. We talk about death in conversations with each other, in characterizing the dead and in clinical language about illness and death. We reveal our understanding of death through visual forms such as newspaper images, illustrations in books and in the imagery and metaphors we employ when we describe it. Døden i livet is a mult-disciplinary, scientific anthology consisting of 12 peer-reviewed chapters geared towards scholars and students interested in broader appreciation of how death is present in our culture. The chapters are written by researchers working in such diverse fields as health, pedagogics, idea history, religion, literature studies, linguistics and rhetoric.

Prevalence and Determinants of Diagnosed Dementia: A Registry Linkage Study Linking Diagnosis of Dementia in the Population-Based HUNT Study to Registry Diagnosis of Dementia in Primary Care and Hospitals in Norway

BACKGROUND: A timely diagnosis of dementia can be beneficial for providing good support, treatment, and care, but the diagnostic rate remains unknown and is probably low. OBJECTIVE: To determine the dementia diagnostic rate and to describe factors associated with diagnosed dementia. METHODS: This registry linkage study linked information on research-based study diagnoses of all-cause dementia and subtypes of dementias, Alzheimer's disease, and related dementias, in 1,525 participants from a cross-sectional population-based study (HUNT4 70+) to dementia registry diagnoses in both primary-care and hospital registries. Factors associated with dementia were analyzed with multiple logistic regression. RESULTS: Among those with research-based dementia study diagnoses in HUNT4 70+, 35.6% had a dementia registry diagnosis in the health registries. The diagnostic rate in registry diagnoses was 19.8% among home-dwellers and 66.0% among nursing home residents. Of those with a study diagnosis of Alzheimer's disease, 35.8% (95% confidence interval (CI) 32.6-39.0) had a registry diagnosis; for those with a study diagnosis of vascular dementia, the rate was 25.8% (95% CI 19.2-33.3) and for Lewy body dementias and frontotemporal dementia, the diagnosis rate was 63.0% (95% CI 48.7-75.7) and 60.0% (95% CI 43.3-75.1), respectively. Factors associated with having a registry diagnosis included dementia in the family, not being in the youngest or oldest age group, higher education, more severe cognitive decline, and greater need for help with activities of daily living. CONCLUSIONS: Undiagnosed dementia is common, as only one-third of those with dementia are diagnosed. Diagnoses appear to be made at a late stage of dementia

Needs-appropriate services for people with young onset dementia: The perspectives of healthcare professionals

Young onset dementia has become a growing challenge in national healthcare systems. Concerns about the situation have already been expressed; however, they mostly report the views of services end-users. Aimed at finding out useful further improvement, interviews documenting the working experiences of professionals addressing healthcare services to people with young onset dementia (YOD) were analysed qualitatively. The interviews resulted in four themes and twelve categories. The themes regarded services’ complexity and responsiveness, the levels of education and knowledge on YOD, the impact that serving people with YOD reflects on staff working experience and quality of life, and a series of proposals aimed at improving services by giving people with YOD and families the provision of care they deserve. Although some of the themes recapped the ones reported in the previous literature, the mixture of internally and externally driven instances represented in the themes depict the complexity of care delivery in the services. Findings are discussed in the light of a pragmatical framework capable of suggesting what changes services should implement to be timely responsive