Pain assessment strategies in home care and nursing homes in Mid-Norway: a cross-sectional survey

-The prevalence of pain ranges from 27.8% to 86.5% in nursing homes and 42% to 50% in home care. Pain assessment is the first step toward effective pain management. The aim of this study was to explore the use of pain assessment strategies (verbal, numeric, and observation rating scales and standardized questions) in home care and nursing homes. The study was a descriptive cross-sectional survey. Health care providers who were responsible for the patients' medications replied to a questionnaire. In-home care and nursing homes in 11 randomly selected municipalities in Mid-Norway were included. Three hundred ninety-two individuals were included in this study (70% response rate): 271 (69%) from nursing homes and 121 (31%) from home care. The respondents working in home care had a higher educational level than those in working in nursing homes. Pain assessment instruments were not used frequently in nursing homes and home care. Verbal and numeric rating scales were used significantly more frequently in home care than in nursing homes. Registered nurses (RNs) in nursing homes used standardized questions significantly more often than did RNs in home care. RNs and social educators in home care self-reported less competence in treating the patients' total pain experience than did those in nursing homes. Workplace (working in home care) and regular training in the use of pain assessment tools explained more than 20% of the variation in the use of pain assessment tools. Regular training in the use of pain assessment tools is needed for health care workers in home care and nursing homes

Evaluering av Senter for omsorgsforskning Midt-Norge sin forskningsfaglige bistand og veiledning til utviklingssentrene for hjemmetjenester og sykehjem i regionen

Senter for omsorgsforskning (SOF), Midt-Norge er tilknyttet Høgskolen i Nord – Trøndelag (HINT) og har blant annet som oppdrag å yte forskningsfaglig bistand og veiledning til Utviklingssentrene for hjemmetjenester og sykehjem (USHT) i regionen. USHT Midt- Norge består av tre Utviklingssenter for hjemmetjenester (Åfjord, Ålesund og Stjørdal) og tre Utviklingssenter for sykehjem (Trondheim, Kristiansund og Verdal). Målet med studien var å evaluere SOF Midt-Norges bistand og veiledning til USHT i regionen. Kunnskapen vi fikk fra denne evalueringen vil videre danne grunnlag for en mer målrettet arbeidsform og prioriteringer knyttet til dette samarbeidet. Metode: Kvalitativ studie der data ble samlet inn ved hjelp av spørreskjema med åpne spørsmål. Spørreskjemaet ble laget på grunnlag av Helsedirektoratet’s føringer for SOF’s arbeid i forhold til USHT i regionen. Spørreskjemaene ble sendt på e-mail til lederne i USHT. Resultat: Alle USHT i Midt -Norge svarte på spørreskjemaet. Alle USHT hadde skrevet en samarbeidsavtale med SOF.SOF Midt-Norg

Rapportskriving: arbeidsprosess, faser og resultat

Senter for omsorgsforskning Midt-Norge har som mål å bidra til at flere formidler erfaringskunnskap og andre resultater fra prosjekter. Dette notatet beskriver et eksempel på hvordan man kan bygge opp en prosjektrapport om målrettet arbeid med å samle erfaringskunnskap og utvikle praksis i omsorgstjenestene

Kreft og lindring i Værnesregionen: økt kompetanse og økt samhandling om felles utfordringer

Kreft er en av de diagnoser som forventes å øke mest i årene framover. Samtidig lever flere lengre med sin kreftsykdom. Lindrende behandling, pleie og omsorg uavhengig av diagnose krever høy kompetanse. Samhandlingsreformen medfører større ansvar innen kommunehelsetjenesten. Dette krever god kompetanse i kommunene innen fagfeltet kreft og lindring. Formål: Gjennom prosjektet ønsker vi å øke omsorgstjenestens kompetanse, samt å styrke samhandling om felles utfordringer ved kreft og lindrende behandling i Værnesregionen. Vi ønsker å legge forholdene til rette i kommunehelsetjenesten slik at denne brukergruppen skal få et helhetlig og individuelt tilbud i eget hjem eller nærmest mulig hjemmet

KOLS-prosjektet i Værnesregionen: økt kompetanse og bedre samhandling i helsetjenesten i Værnesregionen

KOLS har i løpet av de siste tiårene blitt en folkesykdom. Sannsynligvis har godt og vel 370 000 nordmenn KOLS, og antallet er økende. Nærmere 1400 mennesker dør årlig av sykdommen (Nasjonalt KOLS-råd). KOLS er en alvorlig kronisk sykdom med varig nedsatt lungefunksjon. Det er en lidelse med betydelig grad av sykelighet, uførhet og tidlig død. (Nasjonal strategi for KOLS-området 2006 – 2011) Økt forekomst sammen med det faktum at samhandlingsreformen pålegger kommunene et større ansvar medfører flere KOLS-pasienter, og behov for å heve kompetansen, i kommunehelsetjenesten. Denne rapporten omhandler et prosjekt som har som formål å heve kompetansen på kronisk lungesykdom blant helsepersonell i Værnesregionen. Målsettingen med prosjektet var å opprette en ressursgruppe på kronisk lungesykdom i Værnesregionen, lage et oppslagsverk, og et kortfattet undervisningsopplegg til bruk i internundervisning.Utviklingssenter for hjemmetjenester i Nord- Trøndelag, Stjørdal kommun

Pleiepersonalets selvrapporterte evaluering av opplæring i ergonomisk forflytning, bruk av teknikker og hjelpemidler i en kommune - en longitudinell pilotstudie

Healthcare workers' self-reported evaluation of ergonomic transfer training, use of techniques and aids in a municipality - a longitudinal pilot study Healthcare workers’ self-reported evaluation of ergonomic transfer training, use of techniques and aids in a municipality – a longitudinal pilot. Traditionally, healthcare work in nursing homes is regarded as physically strenuous work with a risk of back injuries stemming from adverse movement techniques. The purpose of the study was to analyse healthcare workers’ self-reported evaluation of ergonomic transfer training in a municipality in Norway. The training aimed to improve healthcare personnel’s ergonomic patient handling. N = 73 health care employees from a nursing home and homes to the disabled. Mean response rate during the three points of measurement was 77 %. Data were collected by questionnaire at baseline, at the end of the training, at 18 months, and 36 months after baseline. Then the data were compared using quantitative analysis at group level. Participants reported adequate training, improved availability of transferrelated resources, and increased use of transfer techniques over the course of the measurement periods. Respondents who asked transfer experts for guidance used transfer techniques more than others did

Validation of Doloplus-2 among nonverbal nursing home patients - an evaluation of Doloplus-2 in a clinical setting

In the present study, more patients were categorized as having pain while using Doloplus-2 compared with nurses' estimation of pain without using any tools. The fact that nurses could not report if the patients were in pain in one third of the patients supports the claim that Doloplus-2 is a useful supplement for estimating pain in this population. However, nurses must use their clinical experience in addition to the use of Doloplus-2, as behaviour can have different meaning for different patients. Further research is still needed about the use of Doloplus-2 in patients not able to self-report their pain.THE WORK (AS DEFINED BELOW) IS PROVIDED UNDER THE TERMS OF THIS BIOMED CENTRAL OPEN ACCESS LICENSE ("LICENSE"). THE WORK IS PROTECTED BY COPYRIGHT AND/OR OTHER APPLICABLE LAW. ANY USE OF THE WORK OTHER THAN AS AUTHORIZED UNDER THIS LICENSE IS PROHIBITED.BY EXERCISING ANY RIGHTS TO THE WORK PROVIDED HERE, YOU ACCEPT AND AGREE TO BE BOUND BY THE TERMS OF THIS LICENSE. THE LICENSOR GRANTS YOU THE RIGHTS CONTAINED HERE IN CONSIDERATION OF YOUR ACCEPTANCE OF SUCH TERMS AND CONDITIONS

Genome-wide meta-analysis of 241,258 adults accounting for smoking behaviour identifies novel loci for obesity traits

Few genome-wide association studies (GWAS) account for environmental exposures, like smoking, potentially impacting the overall trait variance when investigating the genetic contribution to obesity-related traits. Here, we use GWAS data from 51,080 current smokers and 190,178 nonsmokers (87% European descent) to identify loci influencing BMI and central adiposity, measured as waist circumference and waist-to-hip ratio both adjusted for BMI. We identify 23 novel genetic loci, and 9 loci with convincing evidence of gene-smoking interaction (GxSMK) on obesity-related traits. We show consistent direction of effect for all identified loci and significance for 18 novel and for 5 interaction loci in an independent study sample. These loci highlight novel biological functions, including response to oxidative stress, addictive behaviour, and regulatory functions emphasizing the importance of accounting for environment in genetic analyses. Our results suggest that tobacco smoking may alter the genetic susceptibility to overall adiposity and body fat distribution.Peer reviewe

The trans-ancestral genomic architecture of glycemic traits

Glycemic traits are used to diagnose and monitor type 2 diabetes and cardiometabolic health. To date, most genetic studies of glycemic traits have focused on individuals of European ancestry. Here we aggregated genome-wide association studies comprising up to 281,416 individuals without diabetes (30% non-European ancestry) for whom fasting glucose, 2-h glucose after an oral glucose challenge, glycated hemoglobin and fasting insulin data were available. Trans-ancestry and single-ancestry meta-analyses identified 242 loci (99 novel; P < 5 x 10(-8)), 80% of which had no significant evidence of between-ancestry heterogeneity. Analyses restricted to individuals of European ancestry with equivalent sample size would have led to 24 fewer new loci. Compared with single-ancestry analyses, equivalent-sized trans-ancestry fine-mapping reduced the number of estimated variants in 99% credible sets by a median of 37.5%. Genomic-feature, gene-expression and gene-set analyses revealed distinct biological signatures for each trait, highlighting different underlying biological pathways. Our results increase our understanding of diabetes pathophysiology by using trans-ancestry studies for improved power and resolution. A trans-ancestry meta-analysis of GWAS of glycemic traits in up to 281,416 individuals identifies 99 novel loci, of which one quarter was found due to the multi-ancestry approach, which also improves fine-mapping of credible variant sets.Peer reviewe