Fysisk aktivitet i naturen for pasienter med depresjon

Sammendrag Bakgrunn: I psykiatrisk behandling viser pasientundersøkelser at kroppens fysiske helse fortsatt blir lite vektlagt, selv om fysisk aktivitet er ansett som en egnet metode for hjelp til selvhjelp ved psykiske lidelser, og har positiv effekt på symptomer ved depresjon (Danielsen, 2021, s.6; Martinsen, 2018, s.26). Hensikt: Tilegne oss mer kunnskap og få en dypere forståelse for hvordan man som sykepleier kan fremme psykisk helse hos pasienter med depresjon, ved å tilrettelegge for fysisk aktivitet i naturen. Metode: Vi har gjennomført en litteraturstudie basert på fire kvalitative studier. Vi har benyttet modell for analyse av Friberg, og sortert data i nye hoved- og underkategorier ut ifra vår problemstilling. Resultat:Vi kom frem til tre hovedkategorier og fem underkategorier. Hovedkategoriene individuelle faktorer, sosiale faktorer og fysisk aktivitet i naturen kom frem som viktige faktorer for at sykepleier skal kunne fremme den psykiske helsen hos pasienter med depresjon, ved å tilrettelegge for fysisk aktivitet i naturen. Konklusjon: Fysisk aktivitet i naturen ser ut til å ha en helsefremmende effekt for pasienter med depresjon. Å ta hensyn til depresjonens forløp, utfordringer knyttet til depresjonen og pasientenes preferanser, samt hjelpe pasienten å finne meningsfulle aktiviteter, kom frem som viktige faktorer for å tilrettelegge for fysisk aktivitet i naturen. Aktiviteter i naturen ser ut til å bidra til glede og tilstedeværelse for pasient og sykepleier. Rollene mellom pasient og sykepleier kan bli mer likeverdige i naturen, som trekkes frem som en viktig faktor i relasjonsbygging. Nøkkelord: Psykisk helse, depresjon, friluftsliv, natur og fysisk aktivitet, sykeplei

Quantifying microsatellite mutation rates from intestinal stem cell dynamics in Msh2-deficient murine epithelium

Microsatellite sequences have an enhanced susceptibility to mutation and can act as sentinels indicating elevated mutation rates and increased risk of cancer. The probability of mutant fixation within the intestinal epithelium is dictated by a combination of stem cell dynamics and mutation rate. Here we exploit this relationship to infer microsatellite mutation rates. First a sensitive, multiplexed and quantitative method for detecting somatic changes in microsatellite length was developed that allowed the parallel detection of mutant [CA]n sequences from hundreds of low-input tissue samples at up to 14 loci. The method was applied to colonic crypts in Mus musculus and enabled detection of mutant subclones down to 20% of the cellularity of the crypt (around 50 of 250 cells). By quantifying age-related increases in clone frequencies for multiple loci, microsatellite mutation rates in wild-type and Msh2- deficient epithelium were established. An average 388-fold increase in mutation per mitosis rate was observed in Msh2-deficient epithelium (2.4 x10-2) compared to wild- type epithelium (6.2 x10-5)

Reasons for not reporting patient safety incidents in general practice - a qualitative study

OBJECTIVE: To explore the reasons for not reporting patient safety incidents in general practice. DESIGN: Qualitative interviews with general practitioners and members of the project group. SETTING: General practice clinics in the Region of Northern Jutland in Denmark. SUBJECTS: Twelve general practitioners. MAIN OUTCOME MEASURES: The experiences and reflections of the involved professionals with regard to system use and non-use. RESULTS: While most respondents were initially positive towards the idea of reporting and learning from patient safety incidents, they actually reported very few incidents. The major reasons for the low reporting rates are found to be a perceived lack of practical usefulness, issues of time and effort in a busy clinic with competing priorities, and considerations of appropriateness in relation to other professionals. CONCLUSION: The results suggest that the visions of formal, comprehensive, and systematic reporting of (and learning from) patient safety incidents will be quite difficult to realize in general practice. Future studies should investigate how various ways of organizing incident reporting at the regional level influence local activities of reporting and learning in general practice

The challenges of boundary spanners in supporting inter-organizational collaboration in primary care:a qualitative study of general practitioners in a new role

BACKGROUND: The visions of more integrated care have created new roles and accountabilities for organizations and professionals. Thus, professionals are increasingly expected to engage in boundary spanning activities in order to facilitate inter-organizational and inter-sectoral collaboration. However, this task can be difficult for individual actors and it is important to investigate the work and challenges of boundary spanners in various settings. This study explores the challenges related to a new boundary spanning role for general practitioners employed to facilitate collaboration between the municipalities and general practice. METHODS: The study is based on semi-structured interviews with ten general practitioners acting as municipal practice consultants in the Capital Region of Denmark. The transcribed interviews were analyzed in several steps organizing the material into a set of coherent and distinct categories covering the different types of challenges experienced by the informants. RESULTS: The main challenges of the general practitioners acting as boundary spanners were: 1) defining and negotiating the role in terms of tasks and competencies; 2) representing and mobilizing colleagues in general practice; 3) navigating in an unfamiliar organizational context. CONCLUSIONS: The results support previous studies in emphasizing the difficult and multifaceted character of the boundary spanning role. While some of these challenges are not easily dealt with due to their structural causes, organizations employing boundary spanners should take note of these challenges and support their boundary spanners with matching resources and competencies

Coping and Social Resilience during the COVID-19 Pandemic: A Qualitative Follow-Up Study among Healthcare Workers in Norwegian Public In-Home Services

Background: Healthcare workers (HCWs) are central and serve in the frontlines when epidemics threaten public health. Thus, certain communities may be hardest hit by these challenges. Interventions supporting HCWs are important, and to develop these, understanding their experiences is essential. Aim: To explore how HCWs in Norwegian public in-home services experienced work during the COVID-19 pandemic over time. Method: A longitudinal qualitative study with two data collections approximately one year apart (2021 and 2022) was performed. Individual interviews were conducted with HCWs. Results: The analysis resulted in six main themes: Changing everything, Redefining ‘necessary tasks’, Distancing and loneliness, Cooperation and coordination, More infections and fewer worries and Lessons for the future. These indicate capabilities and processes, how they are evolving over time, and outcomes. The first two themes focus on the first period of the pandemic, the next two on the ongoing intermediate period, and the final two cover the last period. Conclusion: The HCWs’ narratives have demonstrated their collective coping based on adaptive and transformative capacities. Further, they have enlisted experienced social resilience in their strategies for coping with the COVID-19 challenges