The importance of interdisciplinarity in accommodating patient needs among Norwegian nurses

What is known on the subject: Previous studies of interdisciplinarity and nursing responsibilities have mainly focused on outcomes such as patient safety, job satisfaction and organizational factors. Mental health nurses often describe role confusion in relation to other health professionals. Opportunities for interdisciplinary communication with other professionals may benefit health care. What the paper adds to existing knowledge: The current large-scale study is the first to investigate whether mental health and SUD nurses' perceptions of their opportunities to accommodate patients' needs are related to interdisciplinarity in the treatment unit and a nursing role with clearly defined responsibilities. Strong interdisciplinarity was associated with greater perceived opportunities to accommodate patients' psychosocial, somatic, and economic and legal needs, while strictly defined nursing roles/responsibilities were related to weaker opportunities to do so. What are the implications of practice: The findings highlight the need to address how mental health and SUD nurses organize practice to meet patients' diverse needs Interdisciplinary teamwork could strengthen nurses' ability to address patient needs Finding the best possible balance of providing service in teams or individually could improve resource utilization at the same time as strengthening patient care, and making sure that the patients' various needs are met. Abstract: INTRODUCTION: Nurses' roles in specialist mental health and substance use disorder (SUD) treatment services are multidimensional and complex. Their responsibility, autonomy and interdisciplinary collaboration may be of importance for their perceived opportunities to accommodate patients' health needs. Previous studies of interdisciplinarity and nursing responsibilities have mainly focused on outcomes such as patient safety, job satisfaction and organizational factors, and included relatively small samples. The studies have also mainly been conducted in other sectors than the mental health and SUD nursing sectors. Aim/question: The aim of this study is to examine the associations between nurses' roles, interdisciplinarity and their perceived opportunities to accommodate patients' psychosocial, somatic and economic/legal needs. Method: A cross-sectional web-based questionnaire survey was conducted in a nationwide sample of Norwegian nurses in the mental health, SUD treatment and combined mental health and SUD treatment sectors. Of 5,501 contactable nurses (74% of the population), 1918 (35%) responded. Results: The results revealed that interdisciplinarity was significantly associated with greater perceived opportunity to accommodate patient needs, whereas strictly defined nursing roles/responsibilities were associated with less opportunity to accommodate these needs. Discussion/implication for practice: Facilitation of interdisciplinary collaboration may improve quality of care for patients in mental health and SUD treatment services.publishedVersio

Lesbian and gay individuals' path into foster parenting in Norway—Barriers and facilitators at the person and system levels

Growing numbers of lesbian, gay, bisexual, transgender, questioning (LGBTQ) people are becoming foster parents in several western countries. The LGBTQ perspective on the child welfare system has received little attention in practice, research and policy. Despite their increased rights, LGBTQ foster parents continue to face challenges related to fostering. Knowledge is needed on LGBTQ individual perceptions of the process of becoming foster parents, including barriers and facilitating factors. This paper reports on the experiences of 13 gay or lesbian foster parents in Norway. The study shows a lack of knowledge about the possibility of becoming foster parents due to lack of information directed at them as a minority group. Participants felt vulnerable and experienced “minority stress” before encountering the child welfare system, while mainly experienced the encounter with the staff as good and respectful. Although several valued being treated “like everyone else” by the system, others questioned why LGBTQ-specific parenting issues were not raised and discussed. Apart from lack of information, the process towards foster parenting seemed mostly hampered by participants' own assumptions that sexual identity would be a barrier and to some extent biological parents' refusal. The study suggests that foster care and child welfare services would benefit from information in recruitment of foster parents, aiming at being more inclusive. Furthermore, we address gender and sexuality diversity related to foster care work and highlight the strengths and challenges it may offer.acceptedVersio

Facilitating factors for seeking help for mental health problems among Norwegian adolescent males: A focus group interview study

Background: Young males are overrepresented in suicide statistics and underrepresented in statistics of help-seeking and receiving help from formal health services compared with young females. Few studies have examined facilitating factors for help-seeking among adolescent males with no previous experience seeking mental health help. This study aimed to explore thoughts, attitudes, and experiences regarding facilitating factors toward formal help-seeking for mental health problems among Norwegian adolescent males. Method: Three focus group interviews were conducted, each including four adolescent males with no experience with help-seeking or receiving help from a help service for mental health problems. The interviews addressed topics such as barriers and facilitating factors for help-seeking and preferences regarding structural factors and modes of delivery of help. Data were analyzed according to the systematic text condensation method. Results: The analysis revealed three main categories of facilitating factors: (1) transparent information and available help services, (2) proactive and outreaching help services, and (3) the possibility for discreet help-seeking. Conclusions: Improving help-seeking is integral to accessing care and improving mental health. Help services can be more accessible and approachable for male adolescents if they offer discretion, the possibility to remain anonymous, the option to receive help in a convenient context, and outreach services.publishedVersio

Måleegenskaper ved den norske versjonen av Symptom Checklist-90-Revidert (SCL-90-R)

Symptom Checklist-90 Revised (SCL-90-R) er et bredspektret screeningverktøy for psykiske plager hos personer over 13 år. SCL-90 ble utviklet av Derogatis og kolleger i 1973 og revidert i 1976 til SCL-90-R. Instrumentet ble oversatt til norsk på 1980-tallet, og i 2010 utga Pearson Inc. en norsk autorisert utgave med instrukser for skåring og administrering. Autoriserte psykologer og leger kan administrere, skåre og tolke testen. Testen er et selvutfyllingsskjema og består av 90 spørsmål som kartlegger symptombelastning innenfor ni forskjellige symptomskalaer. I denne kunnskapsoppsummeringen ønsket vi å undersøke hvilke måleegenskaper som er rapportert for SCL-90-R i skandinaviske studier med ungdom og unge voksne i alderen 13–26 år. Av 1359 referanser inkluderte vi 13 studier i oppsummeringen. Ti studier var basert på kliniske utvalg (f.eks. pasienter med atferdsforstyrrelser, depresjon og spiseforstyrrelser). Ikke-kliniske utvalg inkluderte bl.a. studenter, adopterte barn og barn av skilte foreldre. Ingen av de inkluderte studiene var valideringsstudier. De fleste målte effekt av behandling eller andre tiltak. Det er rapportert gjennomsnitt, standardavvik og indre konsistens. Ingen av de inkluderte studiene inneholdt utfyllende informasjon om for SCL-90-Rs måleegenskaper for ungdom og unge voksne i alderen 13–26 år. Kunnskapsgrunnlaget for SCL-90-R er ikke tilstrekkelig for å kunne si noe om bruken av instrumentet hos denne gruppen.publishedVersio

Family involvement in child welfare services: The association between socio-economic status and self-reported parenting practices

In child welfare policies, as in contemporary society in general, great attention has been given to parenting roles and investing in ‘positive’ parenting practices. Several studies have suggested that socio-economic factors frame parenting practices. There is broad evidence of a significant correlation between socio-economic inequalities and child welfare intervention rates. Nevertheless, few studies have investigated parenting practices in a child welfare population. The aim of the present study was to investigate the association between socio-economic status (SES) and parenting practices in a Norwegian child welfare population. The study was based on a cross-sectional survey conducted in 2018–2019. The sample consisted of 256 parents (71.5% females). Linear regression analysis, adjusting for potential confounding and intermediate factors, was conducted. Lower SES was associated with higher levels of positive parenting/involvement practices (b = 0.146, CI: 0.026–0.266, P = 0.018), indicating an inverse pattern compared with the general population. When adjusting for symptoms of anxiety and depression, the association was slightly attenuated but remained statistically significant. No significant association was found between SES and inconsistent discipline/other disciplinary practices. The present study offers insights that should be useful in practice and further large-scale studies.publishedVersio

Parental chronic illness, internalizing problems in young adulthood and the mediating role of adolescent attachment to parents: A prospective cohort study

Background: Parental chronic illness is associated with an elevated risk for developing social-emotional and behavioral problems in children, in particular internalizing symptoms. This study aimed to investigate the associations between parental chronic illness when participants were adolescents and subsequent internalizing symptoms in young adulthood and whether adolescent attachment to parents or peers mediates these associations. Methods: The study used longitudinal survey data from the Youth and Mental Health Study, a cohort study including a representative sample of youth in central Norway assessed in the period from 1999 to 2000 (mean age 14.9 years) and in 2012 (mean age 27.2 years) (N = 1,266). The data consist of youth self-reports at both time points. Parental chronic illness was reported by the adolescents, quality of attachment was measured using the Inventory of Parent and Peer Attachment (IPPA), and internalizing problems were assessed in young adulthood by using the Adult Self-Report (ASR). Data were analyzed using parallel mediation analyses, controlling for adolescent sex, parental socioeconomic status, and divorce. In addition, separate analyses were conducted for adolescent girls and boys. Results: The total longitudinal effect was significant for both maternal and paternal chronic illness on internalizing problems in young adulthood. The direct effect on internalizing problems was only significant for maternal chronic illness. Attachment to fathers partially mediated the relationship between maternal chronic illness in adolescence and internalizing symptoms in young adulthood, whereas attachment to both mothers and fathers fully mediated the relationship between paternal chronic illness in adolescence and internalizing symptoms in young adulthood. A separate analysis for girls and boys indicated that the results were only significant for girls. Parental chronic illness did not play a significant indirect effect via attachment to peers on internalizing problems. Conclusions: Identifying protective factors in the pathways between parental chronic illness and mental distress in children could guide measures that promote the well-being of the child and family. The study demonstrates the importance of targeting the entire family in chronic illness care.publishedVersio

What is known about the LGBTQ perspective in child welfare services? A scoping review protocol

Introduction In previous studies, it is estimated that sexual minorities (eg, lesbian, gay, bisexual, transgender and questioning (LGBTQ) individuals) are overrepresented in the child welfare system. However, the numbers are unclear, and there are limited studies in this field. No systematic review of LGBTQ issues across a broader context (ie, youth, foster parents and service providers) of child welfare services exists. The overall objective of this scoping review is to systematically scope the existing research on LGBTQ issues in the context of child welfare services, including policy, practice, service providers and users’ perspectives. Methods and analysis The scoping review framework outlined by the Joanna Briggs Institute (JBI) based on previous work by Arksey and O’Malley and Levac and colleagues will guide this review. In addition, the PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation will be used throughout the process. We will search electronic databases (PubMed, EMBASE, PsycINFO, Web of Science and Idunn) and grey literature sources to identify studies that are appropriate for inclusion in this review. Using inclusion and exclusion criteria based on the ‘Population–Concept–Context’ framework, two researchers will independently screen titles, abstracts and full-text articles considered for inclusion. Any qualitative, quantitative and mixed-method study of LGBTQ issues in the child welfare context will be described and synthesised using a thematic synthesis approach. Ethics and dissemination A scoping review is a secondary analysis of published literature and does not require ethics approval. This scoping review is meant to provide an overview of the existing literature, aiming to expand policy-makers’ and practitioners’ knowledge of LGBTQ issues in a child welfare context and identify research gaps that can be used as a basis for further research. The results will be disseminated through a peer-reviewed publication, a conference presentation and a presentation to the key stakeholders.publishedVersio

What is known about the LGBTQ perspective in child welfare services? A scoping review protocol

Introduction In previous studies, it is estimated that sexual minorities (eg, lesbian, gay, bisexual, transgender and questioning (LGBTQ) individuals) are overrepresented in the child welfare system. However, the numbers are unclear, and there are limited studies in this field. No systematic review of LGBTQ issues across a broader context (ie, youth, foster parents and service providers) of child welfare services exists. The overall objective of this scoping review is to systematically scope the existing research on LGBTQ issues in the context of child welfare services, including policy, practice, service providers and users’ perspectives. Methods and analysis The scoping review framework outlined by the Joanna Briggs Institute (JBI) based on previous work by Arksey and O’Malley and Levac and colleagues will guide this review. In addition, the PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation will be used throughout the process. We will search electronic databases (PubMed, EMBASE, PsycINFO, Web of Science and Idunn) and grey literature sources to identify studies that are appropriate for inclusion in this review. Using inclusion and exclusion criteria based on the ‘Population–Concept–Context’ framework, two researchers will independently screen titles, abstracts and full-text articles considered for inclusion. Any qualitative, quantitative and mixed-method study of LGBTQ issues in the child welfare context will be described and synthesised using a thematic synthesis approach. Ethics and dissemination A scoping review is a secondary analysis of published literature and does not require ethics approval. This scoping review is meant to provide an overview of the existing literature, aiming to expand policy-makers’ and practitioners’ knowledge of LGBTQ issues in a child welfare context and identify research gaps that can be used as a basis for further research. The results will be disseminated through a peer-reviewed publication, a conference presentation and a presentation to the key stakeholders