Þátttaka hjúkrunarfræðinga í leshópum : leið til símenntunar, nýrra starfshátta og aukinnar starfsánægju

Neðst á síðunni er að nálgast greinina í heild sinni með því að smella á hlekkinn View/OpenÞessi grein fjallar um leshópa hjúkrunarfræðinga og hvernig þátttaka í þeim getur aukið þekkingu þeirra og starfsánægju. Kröfur um að hjúkrunarfræðingar byggi þjónustu sína á gagnreyndri þekkingu verða æ háværari. Til að meðferð sjúklinga skili árangri er nú þannig talið bráðnauðsynlegt að störf þeirra grundvallist á vísindalegum rannsóknarniðurstöðum en leshópar eru einmitt aðferð til að taka upp nýja starfshætti á deildum. Markmið þessarar greinar er því að vekja athygli á og kynna hvernig hjúkrunarfræðingar geta í dagsins önn viðhaldið þekkingu sinni og tekið upp starfshætti sem samræmast kröfum um gagnreynda þekkingu og gæðaþjónustu

Working proficiently in an ever-changing environment : nurses in surgical wards

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn Skoða/Opna(view/open)Umræða um hjúkrun er oft einsleit og snýst oft um annríki hjúkrunarfræðinga. Mikilvægt er að koma með fleiri sjónarhorn í þá umræðu, greina í hverju annríkið felst og gefa skýra mynd af fjölbreyttum störfum hjúkrunarfræðinga. Störf hjúkrunarfræðinga á skurðlækningadeildum fela í stórum dráttum í sér að annast sjúklinga sem þarfnast skurðaðgerðar. Ekki er þó vitað með vissu hvað starfið felur nákvæmlega í sér enda hefur það lítt verið kannað hérlendis. Markmið rannsóknarinnar var að greina hvað felst í störfum hjúkrunarfræðinga á skurðlækningadeildum. Gagnasöfnun var eigindleg en myndaður var einn rýnihópur með tíu hjúkrunarfræðingum frá átta deildum á skurðlækningasviði. Hópurinn hittist tíu sinnum þar sem þátttakendur greindu nákvæmlega frá einni vakt í starfi sínu og atvikum sem þar höfðu komið upp, staldrað var við ákveðin atriði og kafað dýpra í þau. Umræður hópsins voru teknar upp á segulband, afritaðar, þemagreindar og þemun borin undir þátttakendur. Greind voru fimm meginþemu og eitt yfirþema: „Í hringiðu faglegrar færni“ og stendur það fyrir fjölbreytt störf hjúkrunarfræðinga sem unnin eru af fagmennsku í síbreytilegu umhverfi. Meginþemun eru: 1) að vinna margslungin verk af færni, 2) að finna hið sérstæða meðal hins almenna, 3) að fást við flæði upplýsinga og samskipti, 4) að hrærast í síbreytilegu umhverfi og láta hlutina ganga og 5) að nýta starfsþroskann og njóta hans. Þemun endurspegla að þungamiðjan í starfi hjúkrunarfræðinga á skurðlækningasviði er samskipti við sjúklinga, aðstandendur og samstarfsfólk. Starfið felur einnig í sér að beita tæknilegri færni, hafa eftirlit með hugsanlegum fylgikvillum aðgerða og óeðlilegu ástandi, svo og að bregðast sífellt við breyttu ástandi á deildinni.Discourse about nursing often concentrates on the workload of nurses. It is important to introduce a different perspective on that discourse by presenting a clear picture of the diversity of their work. Being a nurse within a surgical division includes caring for surgical patients. As this aspect has not been studied in great detail in Iceland, it is unclear what precisely the work encompasses. The aim of this study was to identify what the practices of nurses within the surgical wards of Landspítali -University Hospital comprise. Data were collected by qualitative methods. One focus-group was formed with ten nurses who worked at eight wards within the surgical division of Landspítali -University Hospital. The group met ten times and each participant described in detail one shift and the eventful incidences that took place during their working day. The discussions were tape-recorded, analysed, themes detected and verified by the participants. Five main themes emerged with the overarching theme “in the flow of professional competence” entailing a multifaceted and complex work, performed in a ever-changing environment. The main themes are 1) Performing manifold nursing tasks proficiently; 2) To find the particular within the ordinary; 3) To master the flow of information and communication; 4) Existing within an unpredictable environment and getting the work done; 5) To make use of and enjoy one’s professional development. These themes reveal that the essence of the nurses’ practice is communication with patients, relatives and co-workers. However, applying technological competency, surveillance, management and constant adaptation to altered circumstances is also a part of their work

Surgery related information : content, satisfaction and influential factors

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn Skoða/Opna(view/open)Rannsóknir hafa sýnt margháttaðan ávinning sjúklingafræðslu en lítið er vitað um gagnsemi fræðslu eða ánægju skurðsjúklinga á Íslandi með veitta fræðslu. Megintilgangur þessarar rannsóknar var að lýsa fræðslu sem skurðsjúklingar á Landspítala telja sig fá á sjúkrahúsi og heima fjórum vikum síðar og meta hvað hefur áhrif á ánægju þeirra með fræðsluna. Úrtakið var 733 innkallaðir sjúklingar sem fóru í valaðgerð 15. janúar til 15. júlí 2007. Svörun var 74%. Gagna var aflað með tveim spurningalistum, á sjúkrahúsinu og heima fjórum vikum eftir heimkomu. Spurt var um sjúklingafræðslu og ánægju með hana, kvíða og þunglyndi, verki og önnur einkenni, aðdraganda sjúkrahúsvistar og sjúkrahúsdvöl, heilsufar og árangur aðgerða, ánægju með umönnun og stuðning og bakgrunn þátttakenda. Almennt voru sjúklingar ánægðir með fræðsluna. Þeir voru þó ánægðari aðspurðir á spítalanum heldur en heima. Atriði, sem sjúklingar óskuðu frekari fræðslu um á sjúkrahúsinu, voru einkum fylgikvillar aðgerðar, hreyfing, sjúkdómur og verkir en eftir heimkomu ýmislegt sem tengist verkjum og afturbata. Minni ánægja með fræðslu fyrir aðgerð tengdist meiri sársauka á spítalanum, minni gagnsemi upplýsinga fyrir aðgerð, minni stuðningi vina og ættingja á spítala og minni ánægju með umönnun á spítalanum. Þættir, sem höfðu áhrif á minni ánægju með fræðslu á spítala um ferlið eftir að heim var komið, tengdust meðal annars kvíðaeinkennum á spítala og heima, þunglyndiseinkennum á spítala og heima, sársauka á spítala og almennt einkennum fyrir aðgerð og heima. Aðrir þættir, sem þessu tengdust, voru að vilja fá betri upplýsingar, hafa ekki náð sér eftir aðgerð, minni ánægja með stuðning vina og ættingja svo og minni ánægja með umönnun. Þá voru yngri sjúklingar og konur óánægðari. Fræðsluþarfir skurðsjúklinga eru umfangsmiklar og vara fram yfir sjúkrahúsvistina. Bæta þarf einstaka þætti fræðslunnar og skipuleggja sérstaklega mat, fræðslu og eftirfylgd sjúklinga sem fyrirsjáanlega vegnar ver. Ávinningur gæti orðið aukin ánægja sjúklinga og ódýrari heilbrigðisþjónusta vegna fækkunar einkenna, fylgikvilla og endurinnlagna.Research has shown various benefits of patient education. However little is known about its effectiveness and about Icelandic surgical patients’ satisfaction with the education. This study aims to describe the perceived information surgical patients at Landspítali – University hospital receive at the hospital and at home four weeks later and assess what affects their satisfaction with received information. The sample included 733 patients admitted for planned surgery from January 15th to July 15th 2007. The response rate was 74%. Information was collected with two questionnaires, administered at the hospital and at home four weeks later, addressing symptoms, patient information, support, satisfaction, disease, surgery, situation at home, and background. Generally the patients were satisfied with the information received. At the hospital the patients most often wanted more information about complications of surgery, movement, disease, and pain. At home they wanted more information about pain and the period of recovery. Less satisfaction with information was related to more pain at the hospital, less beneficial information before surgery, less support of friends and family at the hospital and less satisfaction with the care they received at the hospital. Less satisfaction with information they received at the hospital about post-discharge recovery was for example related to anxiety at the hospital and at home, depression at the hospital and home and pain at the hospital. Less satisfaction with information they received at the hospital was also related to symptoms in general before surgery and at home, wanting better information, not having recovered after surgery and less satisfaction with the support of friends and family. Women and younger patients were more dissatisfied. Surgical patients have extensive educational needs. Special consideration must be given to the information and follow-up of patients at risk for negative outcome and those who are dissatisfied with care. The benefits could be more satisfied patients and less health care related expenses because of fewer symptoms, complications and readmissions to hospital

Patients' expectations and experiences of provided surgery-related patient education : A descriptive longitudinal study

Funding Information: The authors thank Guðný Bergóra Tryggvadóttir, specialist at the Social Science Research Institute at the University of Iceland for providing statistical support, nurses at the Landspítali University Hospital and at Akureyri Hospital who participated in data collection and the participants who provided valuable information about themselves. Funding Information: The study was funded by the University of Iceland Science Fund, the Landspitali University Hospital Science Fund and the Icelandic Nurses' Association Science Fund Publisher Copyright: © 2022 The Authors. Nursing Open published by John Wiley & Sons Ltd.Aims: The aim of this study was to explore the educational expectations and experiences of surgical patients. Design: Prospective, longitudinal, descriptive and two-centre study. Data were collected with questionnaires at the hospital and 6 weeks and 6 months postsurgery. Methods: Patients undergoing elective surgery and hospitalized overnight from January to July 2016 answered questions about the content of received pre-operative and pre-discharge education, topics they wanted more information on, sources of information, satisfaction with and usefulness of the information and if their recovery was as expected. Results: Patients (N = 697, 49% male, mean age 64.1 [SD 12.6] years) perceived the provided education as useful and satisfactory but less so after discharge. Most common topics which they expected more education about were postoperative complications, pain management, fatigue, lack of stamina and expected recovery time. Most patients received information through face-to-face teaching (79.7%) and in writing (78.4%). Expectations on recovery were related to patients' satisfaction with the education and how useful they evaluated it.Peer reviewe

A man, his spouse and the malignancy. The needs of spouses of men treated with hormonal therapy for prostate cancer

To access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked FilesTilgangur: Hormónahvarfsmeðferð vegna blöðruhálskirtilskrabbameins fylgja víðtækar hliðarverkanir sem hafa áhrif á líðan sjúklings og samband hans og maka hans. Lítið er vitað um sértækar þarfr þessara maka hérlendis. Tilgangur rannsóknarinnar var að skoða vandamál þeirra og þarfr fyrir upplýsingar og stuðning. Aðferð: Blönduð aðferð; lýsandi þversniðsrannsókn og eigindleg viðtöl. Þýðið var makar karla á hormónahvarfsmeðferð vegna blöðruhálskirtilskrabbameins. Rannsóknargögnum var safnað með spurningalista og djúpviðtölum. Gögnin voru greind hvor í sínu lagi og niðurstöður samþættar. Niðurstöður: Spurningalista svöruðu 29 konur og 11 viðtöl voru tekin við 6 þeirra. Helstu vandamál þátttakenda voru: Ótti vegna óvissu um framtíð (n=15), breytingar á persónuleika maka (n=14), ótti um eigin heilsu (n=13) og að sætta sig við veikindi sjúklings (n=13). Helstu vandamál, sem þátttakendur vildu frekari upplýsingar um, voru andlegar breytingar (n=16), persónuleikabreytingar (n=13), líkamleg vandamál sem búast má við (n=13) og líkamlegar breytingar (n=13). Niðurstöður viðtalanna studdu þessar niðurstöður. Þar kom fram að konurnar vildu vera þátttakendur í sjúkdómsferli makans til að geta stutt hann sem best en þær voru of lítt undirbúnar fyrir áhrif meðferðar á makann: persónuleikabreytingar, depurð og niðursveifur, hlédrægni, minnkandi nánd og missi karlmennskunnar. Flestar álitu manninn undir traustri læknishendi og lögðu áherslu á að meðferðin gæf þeim meiri tíma saman, en fundu jafnframt til óvissu um framvindu sjúkdómsins. Aðgangur að stuðningi og upplýsingum skipti miklu. Ályktanir: Makar karla á hormónahvarfsmeðferð fnna margháttaðar breytingar og erfðleika í tengslum við meðferðina. Mikilvægt er að viðeigandi stuðningur og fræðsla af hendi fagfólks sé efd og boðin frá upphaf meðferðar. Lykilorð: blöðruhálskirtilskrabbamein, forvarnir, fræðsla, hormónahvarfsmeðferð, makarAim: Adverse effects of hormonal therapy for advanced prostate cancer affect the relationship and wellbeing of the patient and his spouse. Scarce information exists on the specific problems and needs of spouses for information and support. The study aim was to explore these problems and needs. Method: Mixed method study design; cross-sectional and qualitative interviews. The population were spouses of men receiving hormonal therapy for advanced prostate cancer. A questionnaire and interviews were used for data collection. Data was first analysed separately by descriptive statistics (questionnaire) and thematically (interviews) and then integrated. Results: The questionnaire was answered by 29 women and 11 interviews were conducted with six women. Their main problems were; uncertainty about the future (n=15), changes in personality of the man (n=14), fear for own health (n=13) and accepting the patient’s disease (n=13). Informational needs concerned mental changes (n=16), changes of the patient’s personality (n=13), physical problems (n=13) and what physical changes should be expected (n=13). The interviews supported these results. The women experienced uncertainty and wanted to be more involved in the treatment’s course. Many were unprepared for the treatment’s consequences; depression and downturns, social withdrawal, and loss of intimacy and masculinity. Most believed their husbandsreceived adequate treatment and emphasised that the treatment gave them more time together. More support and information was requested. Conclusion: This group of spouses is confronted with various treatment related changes. Support and information should be improved and holistic service and participation offered from the beginning of the treatment. Keywords:

Symptoms of anxiety and depression in surgical patients at the hospital, 6 weeks and 6 months postsurgery : A questionnaire study

The study was funded by the University of Iceland Science Fund, the Landspitali University Hospital Science Fund and the Icelandic Nurses Association Science Fund. Publisher Copyright: © 2020 The Authors. Nursing Open published by John Wiley & Sons LtdAims: To describe prevalence of symptoms of anxiety and depression in surgical patients at three time points: at hospital postsurgery (T1), 6 weeks (T2) and 6 months (T3) postdischarge from hospital; and detect situations and experiences that predict symptoms of anxiety and depression at T2 and T3. Design: Prospective, explorative two-site follow-up study. Methods: Patients having selected surgeries from January–July 2016 were invited to participate. Final participation was 390 patients. Participation involved answering questionnaires, including the Hospital Anxiety and Depression Scale (HADS). A stepwise multiple linear regression model was employed to calculate predictors of anxiety and depression. Results: The proportion of patients presenting with moderate-to-severe anxiety or depression ranged from 5.4%–20.2% at different times. Major predictors of anxiety at both times were not feeling rested upon awakening and higher scores on HADS-Anxiety at T1 and T2 and at T2 also experiencing more distressing postoperative symptoms. For depression, the major predictors were at both times higher scores on HADS-Depression at T2 and T3 and also at T2 not feeling rested upon awakening and at T3 reporting delayed or very delayed recovery. The four models explained from 43.9%–55.6% of the variance in symptoms of anxiety and depression. Our findings show that patients presenting with psychological distress at the hospital are in a vulnerable position. Also, that benefits of good sleep during the recovery should be emphasized during hospital stay.Peer reviewe

Sense of security during COVID-19 isolation improved with better health literacy - A cross-sectional study

Funding Information: This work was supported by the University of Iceland Research Fund , the Icelandic Nurses’ Association Research Fund and Landspitali University Hospital Science Fund ( A-2022-051 ). Publisher Copyright: © 2023 The AuthorsOBJECTIVE: To assess sense of security, health literacy, and the association between sense of security and health literacy during COVID-19 self-isolation. METHODS: In this cross-sectional survey all adults who caught COVID-19 from the onset of the pandemic until June 2020 in Iceland and received surveillance from a special COVID-19 outpatient clinic, were eligible. Participants retrospectively answered the Sense of Security in Care - Patients' Evaluation and the European Health Literacy Survey Questionnaire. Data were analysed with parametric and non-parametric tests. RESULTS: Participants' (N = 937, 57% female, median age 49 (IQR=23)) sense of security during isolation was Med 5.5 (IQR=1) and 90% had sufficient health literacy. The proposed regression model (R2 =.132) indicated that those with sufficient health literacy had, on average, higher sense of security than those with inadequate health literacy. CONCLUSION: Sense of security was high among individuals who received surveillance from an outpatient clinic during isolation and was associated with health literacy. The high health literacy rate may be an indication of a high COVID-19 specific health literacy rather than general health literacy. PRACTICE IMPLICATIONS: Healthcare professionals can improve the sense of security of patients through measures to improve their health literacy, including their navigation health literacy, by practising good communication, and providing effective patient education.Peer reviewe

Confronting the unknown—Nursing surveillance of COVID-19-infected patients through remote telephone calls and in an on-site urgent clinic

Funding Information: University of Iceland Research Fund. We wish to thank Runólfur Pálsson, MD, Professor and Director of Internal Medicine and Rehabilitation Services, Sigríður Gunnarsdóttir, Chief Nursing Officer for support in conducting this study, Drífa Katrín Guðmundsdóttir Blöndal and Stefanía Bergsdóttir for transcribing the interviews and giving an insightful view on the data analysis and Ásvaldur Kristjánsson for assistance with conducting the focus group interviews. Publisher Copyright: © 2022 The Authors. Journal of Advanced Nursing published by John Wiley & Sons Ltd.Aim: To describe nursing surveillance of coronavirus disease 2019 (COVID-19)-infected patients through remote telephone calls and in an on-site urgent clinic during the first wave of the pandemic as experienced by nurses providing the care. Design: Qualitative descriptive study. Methods: Data were collected through seven semi-structured, audio-recorded, focus group interviews with 24 nurses. Interviews were conducted in May and June 2020, transcribed and analysed using deductive and inductive content analysis into an overarching category, main categories and subcategories. Reporting followed the COREQ guidelines. Results: Nurses relied on intensive listening when assessing and caring for COVID-19-infected patients. They realized that the patients had complex needs for nursing and healthcare which was beyond the scope of a tentatively prescribed assessment scheme. They designed their care to ensure holistic care, reflected in the overarching category, ‘Confronting an unfamiliar health condition in unprecedented circumstances’ and the categories: ‘Digging into the unknown’ and ‘Ensuring holistic nursing care’. The category ‘Contributing to averting catastrophe’ reflects the wealth of knowledge, support and experience that the nurses used to independently deliver care, albeit in interdisciplinary collaboration, working to their greatest potential. They were proud of the significance of their work. Conclusion: Novel nursing surveillance through remote telephone calls and in an on-site urgent care clinic delivered to COVID-19 patients self-managing at home resulted in holistic nursing care during the first wave of the pandemic. This has relevance for professionalism in nursing. Impact: Findings give a unique insight into nursing surveillance of COVID-19-infected patients provided through telephone calls and in on-site urgent care clinics. The potential of intensive listening as conducted in the study suggests that it may be feasible to assess and holistically take care of COVID-19-infected patients, and other patient groups as well, with this form of healthcare. This has relevance for healthcare beyond crisis management during pandemics. Patient or Public Contribution: There was no patient or public contribution as the study only concerned the providers of the service, i.e. the nurses themselves.Peer reviewe

The nurse teacher’s pedagogical cooperation with students, the clinical learning environment and supervision in clinical practicum : a European cross-sectional study of graduating nursing students

Funding Information: This study deepened the knowledge base of European NT cooperation, which has been rarely investigated []. As the results show, NT cooperation varies both between European countries and on the national level. NT cooperation appeared to influence the GNSs’ final clinical practicum experiences positively; those GNSs who had an NT cooperating with them reported more positive experiences than GNSs without this cooperation. This finding is supported by earlier studies [, ] and may indicate the importance of the student-centric [, ] and supportive CLE []. However, NT cooperation has been a priority, especially in Iceland and Spain, where the NT has been assigned with a clear clinical role: In Iceland, a nurse NT (called Clinical Instructors, CIs) consistently meets students on a weekly basis during the clinical practicum, i.e. provides feedback on clinical work, engages in clinical reasoning, encourages independence, and fosters critical thinking based on evidence []. In Spain, NTs (called Academic Mentors) act as a “bridge” between the university and the clinical institution, helping students to integrate concepts and guide their reflection during mentoring sessions. Academic Mentors meet both students and nurses in clinical settings and take part in the students’ learning and assessing process. Conversely, Ireland is in a unique position with both a Clinical Placement Coordinator (CPC) and an NT involved in the supervision of nursing students, albeit the NT is without any clear clinical role. According to the Nursing and Midwifery Board of Ireland, [] the CPC is a registered nurse who promotes the CLE by supporting, facilitating and monitoring the clinical learning of students. The CPC’s role is highly valued as a form of Practice-Based Teachers who support both the mentors and students in clinical practice. Moreover, the clinical role of the NT is diverse in Ireland; some HEIs have a clear NT role while other HEI teachers attend the clinical placements when there is a need to offer support in relation to the assessment of a clinical practicum or when a student fails a clinical practicum. Publisher Copyright: © 2022, The Author(s).Background: A supportive clinical practicum experience may enhance the successful transition and socialization to working life of graduating nursing students. Nurse teachers have the main responsibility of supporting and guiding nursing students with their pedagogical expertise during the students’ clinical practicum. Thus, the clinical role of nurse teachers is seen as an essential part of a high-quality clinical practicum. Nursing students appreciate the nurse teacher’s cooperation with students, but it is often reported to be unattainable. The aim of this study was to explore and compare graduating nursing students’ experiences of the nurse teacher’s pedagogical cooperation with students, the clinical learning environment and supervision in their final clinical practicum, and to analyze factors associated with these experiences in six European countries. Methods: A cross-sectional comparative international survey design was used. The modified Clinical Learning Environment, Supervision and Nurse Teacher (CLES+T) Scale, with a new subscale measuring the nurse teacher’s pedagogical cooperation with students, was used. A convenience sample of graduating nursing students in Finland, Germany, Iceland, Ireland, Lithuania and Spain completed the online survey in 2018–2019. The data were analyzed using a Chi-Square test, Pearson’s correlation coefficients, and linear models. Results: A total of 1796 (response rate 49%) nursing students completed the survey. Overall, students had positive experiences of the nurse teacher’s pedagogical cooperation, the clinical learning environment and supervision in their final clinical practicum. Students in Spain had the most positive experiences. Educational background factors appeared to be associated with the students’ experiences of the nurse teacher’s pedagogical cooperation with students, the clinical learning environment and supervision. The relationships between the subscale Nurse teacher’s pedagogical cooperation with students and the Clinical Learning Environment and Supervision Scale were perceived as weak to strong depending on the country. Conclusions: This study reveals that nurse teachers play an essential role in supporting and guiding nursing students’ final clinical practicum. In this light, researchers, educators, and leaders should collaborate seamlessly between educational institutions and healthcare organizations to establish the nurse teachers’ pedagogical cooperation role within the clinical learning environment.Peer reviewe

A European evaluation of the patients’ role in clinical education: A six-country cross sectional study

Aim: The aim of this study was to analyse the patients' role in clinical education in terms of facilitative student-patient relationship in Finland, Germany, Iceland, Ireland, Lithuania and Spain and factors promoting a more facilitative relationship in clinical education.Background: Nursing students' bedside learning is reliant on patients and the establishment of a person-centred approach develops from the relationships with patients.Design: A multi-country, cross-sectional design was implemented.Methods: Survey data were collected from graduating nursing students and patients between May 2018 and March 2019. The survey consisted of a 13-item facilitative sub-scale of the Student-Patient Relationship Scale as the main outcome measure, which was identical for both populations. In addition, background factors were surveyed with single questions and other scales. Associations between facilitative relationship and background factors were studied with linear models.Results: Altogether, 1796 students and 1327 patients answered the survey. Overall, both students and patients regarded their relationship as facilitative, but students' (median 4.23, 95% confidence interval 4.15-4.23) evaluations were higher than patients' (median 3.75, 95% confidence interval 3.69-3.77). The students' and patients' evaluations differed from each other significantly in all other countries except in Ireland and Lithuania. Corresponding associations for both populations were found in terms of the country and students' cultural confidence.Conclusions: Results signal favourable grounds for students' bedside learning and patient participation in clinical education with the potential to foster a person-centred approach.</p