Hva opplever sykepleierstudenter som hensiktsmessig bruk av studentresponssystem i undervisning i palliativ omsorg?

Studentresponssystem (SRS) har vært brukt over lengre tid i flere utdanninger, men har forholdsvis nylig blitt tatt i bruk innen sykepleierutdanningen. Å ta i bruk SRS i større klasser er en tilnærming for å aktivisere og engasjere studenter under forelesning. Hensikten med studien var å beskrive hva sykepleierstudenter opplever som hensiktsmessig bruk av SRS med tanke på deres læring. Data ble samlet fra ett fokusgruppeintervju med fire andreårs sykepleierstudenter som gjennomførte kurs i palliativ omsorg i 2013. Tre temaer ble identifisert; valg av pedagogisk metode som fremmer læring, tilbakemelding til og fra lærer, og gjennomføring av avstemning. Funnene tyder på at hensiktsmessig bruk av SRS forutsetter engasjerte lærere som kombinerer SRS med pedagogiske metoder som tilrettelegger for refleksjon og interaksjon mellom studentene, og mellom studenter og lærer

Intensive care nurses’ experiences using volatile anaesthetics in the intensive care unit: An exploratory study

Objective: To explore the experiences intensive care nurses have with volatile anaesthetics in the intensive care unit. Research methodology and design: A qualitative exploratory and descriptive design was used. Data were collected in 2019 from individual interviews with nine intensive care nurses, who were recruited using purposive sampling. Data were analysed using systematic text condensation. Setting: The study was undertaken in two general intensive care units from different university hospitals in Norway where volatile anaesthetics were utilised. Findings: Three categories emerged from the data analysis: experiencing the benefits of volatile anaesthetics; coping with unfamiliarity in handling volatile anaesthetics; and meeting challenges related to volatile anaesthetics in practice. Conclusion: The intensive care nurses had positive experiences related to administering volatile anaesthetics in the intensive care unit and responded positively to the prospect of using it more often. Because volatile anaesthetics were rarely used in their units, the participants felt uncertain regarding its use due to unfamiliarity. Collegial support and guidelines were perceived as pivotal in helping them cope with this uncertainty. The participants also experienced several challenges in using volatile anaesthetics in the intensive care unit, with ambient pollution being regarded as the main challenge.acceptedVersio

The significance of different nutritional interventions in the development of intensive care unit acquired weakness – a systematic review

Bakgrunn: Stadig flere intensivpasienter overlever kompliserte intensivforløp. I ettertid sliter mange intensivoverlevere med muskelsvakhet, polynevropati og redusert fysisk funksjon som følge av intensive care unit acquired weakness (ICUAW). Ernæring er avgjørende for opprettholdelse av muskler, og flere studier har undersøkt ernæringsintervensjoners effekt på utvikling av ICUAW. Hensikt: Hensikten med denne systematiske litteraturstudien var å undersøke betydningen av ernæring på utvikling av ICUAW. Metode: Denne systematiske litteraturstudien ble gjennomført etter det metodiske rammeverket beskrevet av Booth, Sutton og Papaioannou. Et systematisk litteratursøk ble gjennomført i databasene Cinahl, Medline og Embase. Studier ble inkludert dersom de var randomiserte kontrollerte studier som undersøkte effekten av en ernæringsintervensjon som ble gitt mens pasienten var innlagt på intensivavdeling. Utfallsmålet i de inkluderte studiene måtte være ICUAW eller utfallsmål som favnes av ICUAW-begrepet, som muskelsvakhet, muskelatrofi eller redusert fysisk funksjon. Resultater: Tyve artikler oppfylte inklusjonskriteriene. Ulike ernæringsintervensjoner og ulike målemetoder på muskelsvakhet, muskelmasse og fysisk funksjon ble benyttet i primærstudiene. Studier som målte korttidseffekter av ernæringsintervensjoner, viste sprikende resultater. Ingen av studiene som målte ICUAW etter utskrivelse fra sykehus fant effekt av ernæringsintervensjonen mot ernæringen som kontrollgruppen fikk. Flere av de inkluderte studiene hadde for små utvalg til å finne forskjeller i endepunkt som betegnes som ICUAW ettersom flere av studiene var pilotstudier og andre hadde ICUAW som sekundærutfall. Konklusjon: Denne litteraturstudien kan ikke fastslå hvilken betydning ernæring har for utvikling av ICUAW. På grunn av at intensivpopulasjonen er en heterogen pasientgruppe, har pasientene derfor ofte ulike behov for ernæring. Fremtidige studier bør designes ut fra intensivpasientenes individuelle ernæringsbehov. Videre er det et behov for standardisering av hvordan ICUAW måles, slik at resultater fra fremtidige studier kan sammenlignes.publishedVersio

Hva opplever sykepleierstudenter som hensiktsmessig bruk av studentresponssystem i undervisning i palliativ omsorg?

Studentresponssystem (SRS) har vært brukt over lengre tid i flere utdanninger, men har forholdsvis nylig blitt tatt i bruk innen sykepleierutdanningen. Å ta i bruk SRS i større klasser er en tilnærming for å aktivisere og engasjere studenter under forelesning. Hensikten med studien var å beskrive hva sykepleierstudenter opplever som hensiktsmessig bruk av SRS med tanke på deres læring. Data ble samlet fra ett fokusgruppeintervju med fire andreårs sykepleierstudenter som gjennomførte kurs i palliativ omsorg i 2013. Tre temaer ble identifisert; valg av pedagogisk metode som fremmer læring, tilbakemelding til og fra lærer, og gjennomføring av avstemning. Funnene tyder på at hensiktsmessig bruk av SRS forutsetter engasjerte lærere som kombinerer SRS med pedagogiske metoder som tilrettelegger for refleksjon og interaksjon mellom studentene, og mellom studenter og lærer

Haematological nurses' experiences about palliative care trajectories of patients with life-threatening haematological malignancies: A qualitative study

This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.Aims: To explore haematological nurses' experiences about the palliative care trajectories of patients with life-threatening haematological malignancies. Design: A qualitative study with a descriptive and explorative design. Methods: Data were collected through 12 individual semi-structured interviews of nurses who work with patients with haematological malignancies from four hospitals in Norway. The data were analysed using systematic text condensation. The study was reported according to the Consolidated Criteria for Reporting Qualitative Research checklist. Results: Three categories emerged from the data analysis: focus on a cure delays integration of palliative care, dialogue with patients facilitates palliative care and the need for enhanced interdisciplinary understanding. Patient or public contribution: No patient or public contribution since nurses' experiences were explored.publishedVersio

Technology–supported guidance model to support the development of critical thinking among undergraduate nursing students in clinical practice: protocol of an exploratory, flexible mixed methods feasibility study.

International Registered Report Identifier (IRRID): DERR1-10.2196/31646Background: Critical thinking is an essential set of skills in nursing education, and nursing education therefore needs a sharper focus on effective ways to support the development of these skills, especially through the implementation of technological tools in nursing education. Objective: The aim of this study protocol is to assess the feasibility of a technology-supported guidance model grounded in the metacognition theory for nursing students in clinical practice. Methods: Both quantitative (research questionnaires) and qualitative (focus group interviews) approaches will be used to collect data for a feasibility study with an exploratory, flexible mixed methods design to test a newly developed intervention in clinical practice. Results: The intervention development was completed in December 2020. The intervention will be tested in 3 independent nursing homes in Norway. Conclusions: By determining the feasibility of a technology-supported guidance model for nursing students in clinical practice, the results will provide information on the acceptability of the intervention and the suitability of the outcome measures and data collection strategy. They will also identify the causes of dropout and obstacles to retention and adherence.publishedVersio

Psychometric properties of the Norwegian version of the clinical learning environment comparison survey

Aim: To translate The Clinical Learning Environment Comparison Survey (CLECS) into Norwegian and to evaluate the psychometric properties of the Norwegian version. Design: A cross-sectional survey including a longitudinal component. Methods: The CLECS was translated into Norwegian following the World Health Organization guidelines, including forward translation, expert panel, back-translation, pre-testing and cognitive interviewing. Nursing students at a Norwegian university college were invited to participate in the study (psychometrical testing) based on informed consent. Reliability and validity of the translated version of CLECS were investigated using a confirmatory factor analysis (CFA), Cronbach's alpha and test–retest analysis. Results: A total of 122 nursing students completed the questionnaire and Cronbach alphas for the CLECS subscales ranged from 0.69 to 0.89. CFA goodness-of-fit indices (χ2/df = 1.409, CFI = 0.915, RMSEA = 0.058) showed acceptable model fit. Test–retest ICC ranged from 0.55 to 0.75, except for two subscales with values below 0.5.publishedVersio

Patients' experiences with a welfare technology application for remote home care: A longitudinal study

This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.Aims and Objectives: To explore the longitudinal experiences using an application named remote home care for remote palliative care among patients with cancer living at home. Background: Introducing welfare technology in home-based care for patients with cancer in the palliative phase is internationally suggested as a measure to remotely support palliative care needs. However, little is known about the experiences of patients utilising welfare technology applications to receive home-based care from healthcare professionals in a community care context. Although living with cancer in the palliative phase often presents rapidly changing ailments, emotions and challenges with patients' needs changing accordingly, no studies exploring the longitudinal experiences of patients were found. Design: A qualitative study with a longitudinal, exploratory design. Methods: Data were collected through individual interviews with 11 patients over 16 weeks. The data were analysed using qualitative content analysis. The COREQ checklist guided the reporting of the study. Results: Three themes were identified: (1) potential to facilitate self-governance of life-limiting illness in daily life, (2) need for interpersonal relationships and connections, and (3) experiences of increased responsibility and unclear utility of the Remote Home Care. Conclusion: The results showed that remote home care facilitated patients' daily routines, symptom control and improved illness-management at home. Interpersonal relationships with healthcare professionals were considered pivotal for satisfactory follow-up. Infrastructural glitches regarding data access, information sharing and lack of continuous adjustments of the application represented major challenges, with the potential to impose a burden on patients with cancer in the palliative phase Relevance to Clinical Practice: By exploring the experiences of patients in palliative care over time as the disease progresses, this study provides constructive insights for the design and development of welfare technology applications and optimal care strategies. Patient or Public Contribution: The remote home care was developed by interdisciplinary healthcare professionals.publishedVersio

Integrating simulation training during clinical practice in nursing homes: An experimental study of nursing students´ knowledge acquisition, self-efficacy and learning needs

Background Limited access to supervision, feedback and quality learning experiences pose challenges to learning in the clinical setting for first-year nursing students who are beginning their clinical experiences. Prior studies have indicated that simulation training, as a partial replacement of clinical practice hours, may improve learning. However, there has been little research on simulation training integrated as a partial replacement during first-year students’ clinical practice in nursing homes. The primary aim of this study was to examine first-year nursing students’ knowledge acquisition and self-efficacy in integrating a partial replacement of clinical hours in nursing homes with simulation training. Its secondary aim was to examine perceptions of how learning needs were met in the simulated environment compared with the clinical environment. Design The primary aim was addressed using an experimental design that included pre- and post-tests. The secondary aim was investigated using a descriptive survey-based comparison. Methods First-year students at a Norwegian university college (n = 116) were asked to participate. Those who agreed (n = 103) were randomly assigned to the intervention group (n = 52) or the control group (n = 51). A knowledge test, the General Self-efficacy Scale and the Clinical Learning Environment Comparison Survey were used to measure students’ outcomes and perceptions. The data were analysed using independent samples t-tests, chi-square tests and paired samples t-tests. Results Knowledge scores from pre- to post-tests were significantly higher in the intervention group than in the control group with a medium to large effect size (p < 0.01, Hedges’ g = 0.6). No significant differences in self-efficacy were identified. Significant differences (p <  0.05) were observed between the simulated and the clinical environment with regard to meeting learning needs; effect sizes ranged from small and medium to large (Cohen’s d from 0.3 to 1.0). Conclusion Integrating the partial replacement of clinical hours in nursing homes with simulation training for first-year nursing students was positively associated with knowledge acquisition and meeting learning needs. These findings are promising with regard to simulation as a viable partial replacement for traditional clinical practice in nursing homes to improve learning.publishedVersio

Many patients with persistent pain one year after TKA report improvement by 5-7 years: A mixed methods study

This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.Background: Approximately 20% of patients report pain 12 months after TKA. No studies have investigated patients’ experiences of living with persistent postsurgical pain 5 to 7 years after TKA by combining a qualitative and quantitative methodology. Question/purpose: In a mixed-methods study, we explored patients’ experiences of living with persistent pain up to 7 years after primary TKA. We asked: In a subgroup analysis of patients who reported persistent pain 1 year after TKA surgery, how do patients live with persistent pain at the 5- to 7-year postoperative timepoint? Methods: This follow-up study was part of a longitudinal study of pain, symptoms, and health-related quality of life in patients who underwent TKA for osteoarthritis. The present study targeted a subgroup of patients (22% [45 of 202]) identified in the longitudinal study who reported no improvement in pain interference with walking at 12 months after surgery. Inclusion criteria were: all 31 patients in this subgroup who attended their 5-year follow-up at the hospital and lived within a 2-hour drive from the hospital. Eight patients declined or were unable to participate due to illness or death. Hence, the final sample consisted of 23 patients (13 women and 10 men). The participants’ mean age at surgery was 66 6 10 years. There were no differences in sociodemographic baseline data between the 23 included and the 22 excluded participants. A mixed-methods approach was employed, in which the quantitative data were followed up and investigated with qualitative interviews. Instruments used were the Brief Pain Inventory preoperatively, 12 months, and 5 years after surgery, as well as a semistructured interview guide. The individual interviews were conducted at one timepoint 5 to 7 years postsurgery to capture how pain was experienced at that timepoint. The interviews were audiorecorded, transcribed, and analyzed using qualitative content analysis. Meaning units were identified, condensed, and sorted into subthemes that were interpreted and abstracted into themes, guided by the research question. With a small sample, the quantitative analysis focused on descriptive statistics and nonparametric statistics when comparing demographics of included and nonincluded patients. In addition, two multivariate mixed models for repeated measures were employed to estimate within‐patient and between‐patient variations as well as to assess the effect of time on the pain outcomes. Results: Pain with walking decreased from 12 months to 5 years postoperatively (estimated mean score 7 versus 4, difference of means -3 [95% CI -5 to -2]; p < 0.001). Pain with daily activity decreased from 12 months to 5 years postoperatively (estimated mean score 6 versus 3, difference of means -3 [95% CI -4 to -1]; p < 0.001). Pain intensity (average pain) decreased from 12 months to 5 years postoperatively (estimated mean score 5 versus 4, difference of means -1 [95% CI -3 to 0]; p = 0.03). The results are presented as point estimates rounded up to whole numbers. The qualitative data analysis yielded three themes: persistent limitations after TKA, regained wellness over time, and complexity in physical challenges. Intermittent pain with certain movements resulted in limitations with some activities in everyday life and seemed to persist beyond 5 years. Multiple painful body sites and presence of comorbidities seemed to interfere with regained wellness over time. Conclusion: In this subgroup of patients experiencing postsurgical persistent pain 12 months after primary TKA, persistent postsurgical pain still limited certain activities for the participants, although pain seemed to be less influential in their everyday lives after 5 years to 7 years. Clinicians may use these findings to inform and guide patients with delayed improvements in pain into more realistic expectations for recovery, rehabilitation, and strategies for coping with pain and impaired function. However, it is imperative to rule out other reasons for pain in patients reporting pain 12 months and longer after surgery and to be attentive of possible changes in pain over time.publishedVersio