Study circles improve the precision in nutritional care in special accommodations

Background: Disease-related malnutrition is a major health problem in the elderly population, but it has until recently received very little attention, especially are management issues under-explored. By identifying residents at the risk of undernutrition, appropriate nutritional care can be provided. Objectives: Do study circles and policy documents improve the precision in nutritional care and decrease the prevalence of low or high BMI? Design: Pre and post intervention study. Setting: Special accommodations (nursing homes) within six municipalities were involved. Participants: In 2005, 1726 (90.4%) out of 1910 residents agreed to participate and in 2007, 1526 (81.8%) out of 1866 residents participated. Intervention: Study circles in one municipality, having a policy document in one municipality and no intervention in four municipalities. Measurements: Risk of undernutrition was defined as involving any of: involuntary weight loss, low BMI, and/or eating difficulties. Overweight was defined as high BMI. Results: In 2005 and 2007, 64% of 1726 and 66% of 1526 residents respectively were at the risk of undernutrition. In 2007 significantly more patients in the study circle municipality were accurately provided protein and energy enriched food compared to in the no intervention municipalities. There was a decrease in the prevalence of low BMI in the study circle municipality and the prevalence of overweight increased in the policy document municipality between 2005 and 2007

Vägar genom sjuksköterskeutbildningen : studenters berättelser

Syftet är att utifrån studenters livsberättelser, få kunskap om och förståelse för hur de upplever och hanterar sjuksköterskeutbildningens olika delar med särskilt fokus på spänningsfälten mellan: yrkesexamen – akademisk examen, högskoleförlagd utbildning – verksamhetsförlagd utbildning samt huvudämnet omvårdnad – stödämnet medicinsk vetenskap. Syftet är vidare att få kunskap om och förståelse för aspekter av betydelse för studenters lärande på vägen genom utbildningen. Den teoretiska och metodologiska ansatsen är Life History. Designen är longitudinell och studien inleddes med en enkätundersökning med en enkät till alla antagna studenter vid det aktuella lärosätet. Åtta studenter följdes därefter med återkommande intervjuer under hela utbildningstiden. Studenternas berättelser visade att de upplevde och hanterade vägen genom utbildningen olika, utifrån deras individuella föreställningar och erfarenheter. De aspekter som var av betydelse för studenternas lärande var; att ha ett tydligt mål, att föreställningar omvärderas, att få bekräftelse, att det abstrakta blir konkret, utbildningen som en del av livet, att pendla mellan närhet och distans till det kommande yrket och att hantera teori och praktik i relation till varandra. Det visade sig att yrkesexamen var viktigast för studenterna och att de hade svårt att finna betydelse i den akademiska delen av utbildningen. Studenterna upplevde att det var i den verksamhetsförlagda utbildningen de lärde sig och utvecklades professionellt. Förväntningarna med betoning på medicinsk vetenskap lever fortfarande kvar i studenternas föreställningar om utbildningen och yrket. Spänningen mellan studenternas föreställningar och mötet med utbildningens innehåll var tydlig. Den kunskap studien har gett kan användas för att stödja studenternas lärandeprocess. En viktig pedagogisk implikation är att använda berättande som metod i utbildningen. Berättande är ett sätt att möta studenten men också en väg till lärande då berättande i sig hjälper studenten att skapa mening. Lärare måste även finna pedagogiska former som hjälper studenten att dels konkretisera, dels se utbildningens innehåll som en förståelig och meningsfull helhet istället för som spänningsfält mellan olika delar.The aim of this study is to gain knowledge and understanding of how nursing students experience and manage the different parts of the education. A particular focus is set on the tension between a professional degree and an academic degree, between theoretical and clinical studies, and between the subjects nursing and medical science. Furthermore, the aim is to gain knowledge and understanding of aspects that are important to students’ learning on their path through the education. Life History was used as a theoretical and methodological approach of the study. The design was longitudinal and the study opened with a questionnaire to all students at the start of the education. Eight students were then interviewed recurrently throughout their education. The narratives of the students showed that they experienced and managed the education based on their individual notions and experiences. The education is a process in which students find their own way through the many diverse fields of the education. Aspects of importance for the students learning were: To have a clear goal, to revalue ones notions, to be acknowledged, when the abstract becomes tangible, to see education as a part of life, to hover between closeness and distance regarding the future profession and finally: to manage theory and practice in relation to one another. The professional degree seemed to be of highest importance to the students, and they had difficulties to see the meaning of the academic part of the education. The results showed that the students experienced that they learned and developed professionally in the clinical parts of the education and that emphasis on medical science still is present in the students’ notions about the education and the profession. The knowledge gained through this study can be used to support the students’ process of learning. An important implication is to use narration as a method within the education. Narration is one way of meeting the student but it is also a way to learn as narration in itself helps the student to create meaning. Teachers must also find ways that will help the student to understand that he or she needs to concretize and view the contents of the education as an comprehensive and meaningful entity instead of seeing them as diverse fields of study

The shift from a medical to a nursing orientation: A comparison of Swedish nursing students' expectations when entering the nursing degree programme in 2003 and 2013.

The focus of education in nursing has changed over time with a decreased focus on biomedicine and an increased focus on nursing science. It is therefore important to investigate whether these changes are also reflected in the students' conceptions and expectations of the programme over time

The nursing programme in the rear-view mirror. Interviews with Swedish nurses one year after their graduation

In order to increase the understanding of how students assimilate the knowledge they need to carry out their professional duties, knowledge about the experience of the nursing education in the light of the first year of employment is important. The aim of this study was to describe nurses' views of their education, one year after their graduation. Interviews with eight nurses, aged 24 to 40 years, were analysed using manifest qualitative content analysis. The results show that, when viewing their education in the rear-view mirror, they emphasised the importance of the applied courses but had started to acknowledge the importance of training in scientific methods, which during their education was seen as less important. They also stated that their training in medical science had been sufficient, although during their education they expressed doubts about whether this level of knowledge would be enough. The nurses also realised that knowledge concerning the subject of nursing science afforded them both opportunities and the potential possibilities to influence nursing care provision. The study indicates that nursing education gives the students the tools they need to perform their assignments as registered nurses, even if clinical experience is required to internalise and consolidate the knowledge. (C) 2010 Elsevier Ltd. All rights reserved

The Transition From Rookie to Genuine Nurse: Narratives From Swedish Nurses 1 Year After Graduation

This article describes nurses' experiences during their first year after graduation, based on the qualitative content analysis of eight interviews. The results show that the nurses experienced a transition from "being a rookie," including being accepted as a member of the team and respected as a colleague, to "becoming a genuine nurse," including the feeling of being able to shoulder responsibility, prioritize tasks, and convey confidence to patients. This transition seems to occur regardless of support, and it is important to be aware of nurses' level of maturity and to adjust the degree of responsibility given to them because they may not be comfortable revealing their limitations to others. J Contin Educ Nurs 2010;41(4):186-192

Swedish nursing students' experience of aspects important for their learning process and their ability to handle the complexity of the nursing degree program.

The aim of the study was to explore nursing students' experiences of aspects important for their learning process and their ability to handle the complexity of the nursing degree program. The study was longitudinal and qualitative based on interviews with nursing students, six women and two men aged 20-36, during their three years of education. In all, seven patterns were found embracing aspects of importance for the students' learning: Having a clear goal, being able to re-evaluate one's ideas, being acknowledged, when the abstract becomes tangible, using one's own experiences as a tool for learning, hovering between closeness and distance regarding one's future profession and handling theory and practice in relation to one another. The results show the importance of providing clinical courses, strongly connected to the theoretical parts of the program and to use reflection and experience-based learning in the nursing program

The use of drama to support reflection and understanding of the residents' situation in dementia care: a pilot study.

Background: One key aspect of person-centredness is striving to understand both the patients' experiences and behaviours from their perspective. These aspects are precisely those that staff in dementia care highlight as causing them most difficulty because the people in their care have major problems expressing themselves. There is thus a need to develop a method to help the staff to achieve interpretation through reflection. Aim: The aim of this study was to explore the use of drama as a tool to support reflection among staff working in the residential care of people with dementia. Design: A qualitative evaluation of a programme consisting of three drama sessions with staff working in residential care (n = 10 nurse assistants). Methods: Data comprised observations and tape recordings of the sessions, the researchers' reflections after each session and a focus-group interview with the participants. The texts were analysed using qualitative content analysis. Results: The analysis showed that: (i) the exercises stimulate reflection about daily caring practice; (ii) the participants must receive extensive information about the purpose of the sessions; (iii) the research team must secure the defined frames and conditions and have practical knowledge about caring for people with dementia and (iv) the management needs to be stable, committed and supportive. Conclusion: Drama seems to be a valid tool to aid reflection, but several adjustments are needed concerning both the content of the sessions and the methodology. When designing a larger intervention study, it would be preferable to the sessions to be combined with staff support to effect changes in care provision resulting from their increased awareness of the residents' situation and experience. Implications for practice. Our results showed that drama can be a means to enhance reflection among staff in residential care for people with dementia. Further research is however needed concerning the effects for the staff's situation and nursing care quality

The Transition from Rookie to Genuine Nurse: Narratives from Swedish Nurses 1 Year After Graduation

This article describes nurses' experiences during their first year after graduation, based on the qualitative content analysis of eight interviews. The results show that the nurses experienced a transition from "being a rookie," including being accepted as a member of the team and respected as a colleague, to "becoming a genuine nurse," including the feeling of being able to shoulder responsibility, prioritize tasks, and convey confidence to patients. This transition seems to occur regardless of support, and it is important to be aware of nurses' level of maturity and to adjust the degree of responsibility given to them because they may not be comfortable revealing their limitations to others. J Contin Educ Nurs 2010;41(4):186-192

Ethical aspects of a predictive test for Huntington's Disease: A long term perspective.

A predictive genetic test for Huntington's disease can be used before any symptoms are apparent, but there is only sparse knowledge about the long-term consequences of a positive test result. Such knowledge is important in order to gain a deeper understanding of families' experiences