The importance of addressing ageism in Swedish healthcare

Ageism is discrimination against individuals or groups based on their age. In the Swedish healthcare context, the term isuncommon, despite the fact that older people are a significant class of users. One of every five individuals in Sweden is 65 yearsof age or older, and the proportion of older people in the population is rising. Therefore, ageism in healthcare warrants moreawareness and focus. In three recent articles that we have published relating to nutritional, depression and continence care forolder people, we found indications of ageism even though we did not aim to study it. There is a need to identifythe manifestations of ageism and label them, and to become alert to both the visible and invisible expressions of ageism.This will help in the development of interventions and policies to eliminate ageism in healthcare. With health inequalitiesgrowing and seemingly becoming the norm rather than the exception in Sweden and other European countries, it has becomeimperative to address and eliminate health inequalities through a range of initiatives and mechanisms. Fighting ageism in differentsettings must be a part of this larger goal

Physical Activity Patterns Among Women and Men During Pregnancy and 8 Months Postpartum Compared to Pre-pregnancy : A Longitudinal Study.

Background: Realizing the essential prerequisite of regular physical activity (PA) it is essential to have knowledge about how different life change events may influence individual's participation. Many studies have documented that pregnancy and the transition to parenthood are life change events associated with decreased PA among women however, the examination of changes of PA in the male parent during this major life change event has been largely neglected in scientific literature and a significant research gap can be found. In the light of this, this longitudinal study aimed to follow changing PA patterns among women and men during pregnancy and 8 months postpartum compared to pre-pregnancy. Methods: In this study, 123 women and 112 men (partners of the women) that lived in the municipality of Karlskrona, Sweden, were included. Data were collected between 2008 and 2010. The self-reported amount of PA performed outdoors and indoors before pregnancy throughout the entire pregnancy, and 8 months postpartum, were measured. Results: We found similar changes in PA patterns among both women and men during pregnancy and 8 months postpartum when compared to pre-pregnancy. In almost all the activities studied except for walking/strolling, a significant decline was found. Conclusions: Our findings contribute new knowledge about changes in men's PA patterns from pre-pregnancy to pregnancy and postpartum. As couples seem to change activity patterns similarly, it is important to promote family-based PA initiatives and encourage couples to be active together during pregnancy and postpartum

A scoping review of refugees' experiences of healthcare

Background: During recent years, Europe has faced increased immigration. The growing number of refugees presents huge challenges to the healthcare systems of host countries. However, healthcare professionals are generally unprepared to understand and address the health and care needs of refugees. More information about refugees’ experiences of the healthcare system is urgently needed to improve the quality of healthcare delivered and provide opportunities for better access. The aim of this study was to learn more about refugees’ experience of the healthcare system in their host country. Methods: The study was conducted as a scoping review. A systematic search of articles was done in Medline, Cinahl and Psychinfo. 619 articles were found in the searches. Twenty-six articles were included in the study. Results: The results showed that the communication between the health professionals and the refugees was important but poor language skills were perceived as a barrier for good communication. There was a need for both increased oral and written information about the health care system and the right to health care in the host countries. Supportive health professionals were of great importance for a good interaction between the refugee and the health care system. In some of the studies included, some refugees had felt discrimination due to their low proficiency in the national language, or because of race or accent. There was a perceived need for more culturally appropriate health care for the refugees. Conclusions: Since refugees may be at greater risk of poor mental and physical health compared to the rest of the population, there is an urgent need for improvement in communication, interpretation, support and delivery of a culturally appropriate care

Physical Activity Patterns Among Women and Men During Pregnancy and 8 Months Postpartum Compared to Pre-pregnancy : A Longitudinal Study.

Background: Realizing the essential prerequisite of regular physical activity (PA) it is essential to have knowledge about how different life change events may influence individual's participation. Many studies have documented that pregnancy and the transition to parenthood are life change events associated with decreased PA among women however, the examination of changes of PA in the male parent during this major life change event has been largely neglected in scientific literature and a significant research gap can be found. In the light of this, this longitudinal study aimed to follow changing PA patterns among women and men during pregnancy and 8 months postpartum compared to pre-pregnancy. Methods: In this study, 123 women and 112 men (partners of the women) that lived in the municipality of Karlskrona, Sweden, were included. Data were collected between 2008 and 2010. The self-reported amount of PA performed outdoors and indoors before pregnancy throughout the entire pregnancy, and 8 months postpartum, were measured. Results: We found similar changes in PA patterns among both women and men during pregnancy and 8 months postpartum when compared to pre-pregnancy. In almost all the activities studied except for walking/strolling, a significant decline was found. Conclusions: Our findings contribute new knowledge about changes in men's PA patterns from pre-pregnancy to pregnancy and postpartum. As couples seem to change activity patterns similarly, it is important to promote family-based PA initiatives and encourage couples to be active together during pregnancy and postpartum

Refugees’ experiences of healthcare in the host country : a scoping review

Background: During the last years, Europe experienced an increase in immigration due to a variety of worldwide wars and conflicts, which in turn resulted in a greater number of physical and mental health issues present among the refugees. These factors place high demands not only on the refugees, but also on healthcare professionals who meet the refugees in different situations. Information about the refugees’ experiences of the healthcare systems in their host countries is urgently needed to improve the quality of healthcare delivered, as well as to provide opportunities for better access. The aim of this scoping review is to compile research about the experiences that the refugees have with the healthcare systems in their host countries. Methods: This study was conducted as a scoping review and the methodology is derived from Levac et al. and with inspiration from the framework of Arksey & O’Malley. A systematic article search was done in Medline, Cinahl and Psychinfo. A total of 619 articles were found in the search and finally 26 articles met the inclusion criteria and were included. Results: The results show that communication between healthcare professionals and refugees is important, however, insufficient language knowledge acts as an effective communication barrier. There is a need for more information to be given to the refugees about the reception country’s healthcare system in both oral and written formats, as well as the right to healthcare. Support from healthcare professionals is also important for refugees to have a positive experience with healthcare. In some of the studies included, refugees experienced discrimination due to low proficiency in the language of the host country, and/or because of their race or accent, which shows that culturally appropriate healthcare is needed for them. Conclusions: Since refugees are suffering from poor mental and physical health and could therefore be at a greater risk of morbidity and mortality in comparison to the rest of the population of the host country, there is an urgent need for improvements in communication, interpretation, support, and deliverance of culturally appropriate healthcare

Nursing students' experiences of caring for ethnically and culturally diverse patients : A scoping review

Little is known about nursing students' experiences of caring for patients from diverse cultures, which is an important factor in educational settings when it comes to understanding whether the teaching strategies applied are successful. Thus, the aim of this study was to conduct a scoping review of the literature, thereby synthesising existing studies to explore nursing students' experiences of caring for patients with different cultural backgrounds from theirs. A systematic article search was done in PubMed, CINAHL and ERIC. A total of 996 studies were found in the searches and finally seven studies met the inclusion criteria and were included. The analysis of the seven included studies was interpreted to represent two overarching themes, namely the challenge of communication and non-mutual language and the challenge of culture and culturally influenced behaviour, representing nursing students' experiences of caring for patients with a different cultural background from theirs. A major challenge for nursing educators appears to be creating pedagogical interventions that cultivate a humble, solicitous and caring curiosity among students, such that they do not perceive only challenges in caring for culturally diverse patients

Nurse practitioner in Swedish municipal elderly care : A Delphi study of challenges and opportunities

Introduction Worldwide, countries are struggling with strained healthcare systems, especially due to the growing number of frail elderly. Developing the role of nurse practitioner in the care of the frail elderly is therefore of interest to make the care chain more efficient. In Sweden, the role is in an early development phase, but more research is needed. Aim The aim was to investigate how stakeholders at the national level express the challenges and opportunities of the evolving nurse practitioner role in Swedish municipal elderly care. Method A Delphi survey technique with three rounds of electronic questionnaires was used. Twenty-seven experts responded to the first questionnaire, containing two open questions; what opportunities respectively challenges do you see in developing and implementing the nurse practitioner role in municipal elderly care? The following questionnaires consisted of statements to rate using a four-grade Likert scale, and 20 and 17 responded to the second and third, respectively. The first round was analysed using content analysis, and the other two with descriptive statistics. Results Thirty-four statements about challenges and opportunities related to the nurse practitioner role in municipal elderly care were identified and rated as important. Conclusion The findings provide knowledge that can contribute to discussions and decisions to refine the nurse practitioner role in Swedish municipal elderly care. The nurse practitioner role may contribute with much-needed competence to the elderly care. However, it is important to consider the challenges that need to be overcome before the development of the role. To solve this, it is necessary to have clear national guidelines concerning issues of education, title protection and the mandate and authority of the NP role

The Association Between Self-perceived Health and Sleep-Quality and Anxiety Among Newly Arrived Refugees in Sweden : A Quantitative Study.

Previous research findings suggest that insomnia could be related to decreased health status and that it could also be affected by traumatic life experiences, such as war. Good health is important for newly arrived refugees for an effective integration process. The aim of the present study is, therefore, to investigate the association between self-perceived health and sleep quality among newly arrived refugees in Sweden. The results are based on 681 migrants who participated in a survey between 2015 and 2016. There was a significant odds ratio (OR) after adjustment for confounders for newly arrived refugees that were experiencing bad self-perceived health to also experience bad sleep: OR 8.07 (4.34-15.00). Furthermore, the OR remained significant but lower after adjustments for confounders for newly arrived refugees that had bad self-perceived health to be suffering from anxiety during sleep, with OR 3.83 (2.11-6.94)

Registered nurses’ and older people’s experiences of participation in nutritional care in nursing homes: a descriptive qualitative study

Abstract Background The evaluation and treatment of older people’s nutritional care is generally viewed as a low priority by nurses. However, given that eating and drinking are fundamental human activities, the support and enhancement of an optimal nutritional status should be regarded as a vital part of nursing. Registered nurses must therefore be viewed as having an important role in assessing and evaluating the nutritional needs of older people as well as the ability to intervene in cases of malnutrition. This study aimed to illuminate the experience of participating in nutritional care from the perspectives of older people and registered nurses. A further aim is to illuminate the latter’s experience of nutritional care per se. Methods A qualitative, descriptive design was adopted. Data were collected through semi-structured interviews (n = 12) with eight registered nurses and four older persons (mean age 85.7 years) in a city in the southern part of Sweden. The subsequent analysis was conducted by content analysis. Result The analysis reflected three themes: ‘participation in nutritional care equals information’, ‘nutritional care out of remit and competence’ and ‘nutritional care more than just choosing a flavour’. They were interpreted to illuminate the experience of participation in nutritional care from the perspective of older people and RNs, and the latter’s experience of nutritional care in particular per se. Conclusions Our findings indicate that a paternalistic attitude in care as well as asymmetry in the nurse-patient relationship are still common characteristics of modern clinical nursing practice for older people. Considering that participation should be central to nursing care, and despite the RN’s awareness of the importance of involving the older persons in their nutritional care this was not reflected in reality. Strategies to involve older persons in their nutritional care in a nursing home context need to take into account that for this population participation might not always be experienced as an important part of nursing care

Interprofessional Teamwork to Promote Health : First-Time Parents' Experiences of a Combined Home Visit by Midwife and Child Health Care Nurse

Background: To achieve the requisites for a child’s healthy development and to reducehealth inequalities, it is important to promote health initiatives at an early stage in a child’slife and to include the parents. Home visits by healthcare professionals have been foundto have positive health effects for both the baby and the parents. From an extended homevisit programme in Sweden, our aim was to illuminate first-time parents’ experience of ahome visit conducted by a midwife and a child health care nurse 1–2 weeks postnatal.Methods: Data was collected by interviews (n = 13) with first-time parents. Thetranscribed texts were analyzed using inductive content analysis.Results: The participants’ experiences could be understood from the two themes, Atrust in the professionals and Feeling safe as a new parent. The participants experiencedthat the midwives and the child health care nurses complemented each other andappreciated to get knowledge and information from both professions. In their own home,they felt secured and relaxed, and the professionals could help them provide a safe homeenvironment for the child.Conclusion: By meeting both professionals at the same time and in their own home,the participants experienced that the needs of the baby and their needs and concernsas new parents were included and supported