How can we support children, adolescents and young adults in managing chronic health challenges? A scoping review on the effects of patient education interventions

Objectives This scoping review aims to give a comprehensive and systematic overview of published evaluations and the potential impact of patient education interventions for children, adolescents and young adults who are living with chronic illness and/or impairment loss. Methods Relevant literature published between 2008 and 2018 has been comprehensively reviewed, with attention paid to variations in study, intervention and patient characteristics. Arksey and O'Malley's framework for scoping studies guided the review process, and thematic analysis was undertaken to synthesize extracted data. Results Of the 7214 titles identified, 69 studies were included in this scoping review. Participant‐reported benefits of the interventions included less distress from symptoms, improved medical adherence and/or less use of medication, and improved knowledge. The majority of studies measuring physical activity and/or physiologic outcomes found beneficial effects. Interventions were also beneficial in terms of decreased use of urgent health care, hospitalization, visits to general practitioner and absence from school. By sharing experiences, participants had learned from each other and attained new insight on how they could manage illness‐related challenges. Discussion Study results corroborate previous research suggesting that different types of patient education interventions have a positive impact on children, adolescents and young adults, but research on this field is still in a starting phase. The results summed up in the current review supports the utility of patient education interventions that employ behavioural strategies tailored to the developmental needs of children, adolescents and young adults with different cultural backgrounds.publishedVersionsubmittedVersio

A people of promise: : Refiguring selves among Pentecostal-Charismatic in Wentworth, South Africa

The thesis investigates how a sense of self as a born-again Christian is produced and reproduced through ritual practices. The investigation is based on a fieldwork in a Pentecostal-Charismatic community in the former Coloured Group Area of Wentworth, Durban, South Africa. Here I am concerned with how the ritual practices of giving testimonies, prayer, recruiting new members and "memory healing" are used as mediating devices for the production and reproduction of a born-again self. The analysis is divided in two major parts. In part 1, I treat the ritual practices as identity practices that constantly engage in dialogical encounters with God and the Devil. These encounters occur on the level of individual people in conversion and prayer, and on the level of the church witnessing to the "non-born-again" in Wentworth, constituting a local struggle of identification. In part 2, I analyse a healing narrative told by a middle-aged woman in the church after she have gone through a process of memory healing that changed her sense of self. In order to understand the significance of this healing as a process transforming identity, I focus on the connections evoked in the narrative between the stated experiences of being Coloured and the pain of remembering the past. This investigation show how the healing of these painful memories, refigured as evil spirits, constitutes an embodied experience of "release". I argue that this experience refigure the meaning attached to and the experiences of being a Coloured into a spiritual device for forming and reforming a sense of self as a born-again Christian. At last I discuss the key symbolic theme of breaking with the past, prevalent in all ritual practices mentioned above. The discussion is both empirical and analytical. As for the first I argue that an important device for the cultural production of a born-again subjectivity, is the repeated rupture with ones personal past. Analytically I draw on other studies to discuss the potential of time as a comparative category for comparing religious movements in contemporary Southern Africa

Health education competence, self-management

Background: The health education competence of health professionals who deliver self-management programmes to those with long-term health challenges have been little reported and discussed in either Nordic or international research literature. Purpose: The purpose of the study is to provide a systematic literature review of studies describing key health education competencies. We included both quantitative and qualitative studies as well as a systematic literature review. Method: We conducted a systematic literature search in Medline, Embase, PsychInfo and Cinahl to identify various types of studies describing health education skills in self-management programmes. Results: The studies describe six competence areas considered essential for ensuring patients and service users good outcomes from self-management programmes. These areas are: knowledge and skills in group management, disease and diagnosis, communication, coping and coping strategies, education and personal qualities and attitudes. The quality of the studies varies. Conclusion: The studies emphasise that competence in health education is crucial for ensuring that patients and service users derive benefit from self-management programmes. We need more high-quality research together with efforts to improve the quality of health education training measures and the education of students, health professionals and service user representatives.publishedVersio

Health education competence, self-management

Background: The health education competence of health professionals who deliver self-management programmes to those with long-term health challenges have been little reported and discussed in either Nordic or international research literature. Purpose: The purpose of the study is to provide a systematic literature review of studies describing key health education competencies. We included both quantitative and qualitative studies as well as a systematic literature review. Method: We conducted a systematic literature search in Medline, Embase, PsychInfo and Cinahl to identify various types of studies describing health education skills in self-management programmes. Results: The studies describe six competence areas considered essential for ensuring patients and service users good outcomes from self-management programmes. These areas are: knowledge and skills in group management, disease and diagnosis, communication, coping and coping strategies, education and personal qualities and attitudes. The quality of the studies varies. Conclusion: The studies emphasise that competence in health education is crucial for ensuring that patients and service users derive benefit from self-management programmes. We need more high-quality research together with efforts to improve the quality of health education training measures and the education of students, health professionals and service user representatives

En mixed methods studie: Sykepleierstudenters syn på kunnskap og læringtudie: Sykepleierstudenters syn på kunnskap og læring

Bakgrunn: De siste årene har kunnskapssyn og kritisk tenkning i sykepleie blitt satt på agendaen. Hensikt: Hensikten med artikkelen er å undersøke dagens sykepleierstudenters syn på kunnskap og læring. Metode: Artikkelen har et «explanatory mixed methods design» og bruker kvantitative data fra en kandidatundersøkelse om syn på viktigheten av ulike typer læringsaktiviteter og kompetanseelementer, samt fokusgruppeintervju med tolv av disse studentene. Hensikten med fokusgruppene var å utdype og utvide vår informasjon om studentenes syn på kunnskap. Resultater: Den kvantitative analysen tyder på at praksisstudier, praktiske og teoretiske kunnskaper og forskning anses som noe av det viktigste for å bli en sykepleier. Analysen av de kvalitative dataene peker imidlertid også på at studenter innehar et teknisk-instrumentelt syn på kunnskap og læring som innebærer at visse typer kunnskaper anses som lite relevant for deres egen utvikling. Konklusjon: Studenters instrumentelle kunnskapssyn representerer en utfordring for framtidig sykepleierutdanning

En mixed methods studie: Sykepleierstudenters syn på kunnskap og læringtudie: Sykepleierstudenters syn på kunnskap og læring

Bakgrunn: De siste årene har kunnskapssyn og kritisk tenkning i sykepleie blitt satt på agendaen. Hensikt: Hensikten med artikkelen er å undersøke dagens sykepleierstudenters syn på kunnskap og læring. Metode: Artikkelen har et «explanatory mixed methods design» og bruker kvantitative data fra en kandidatundersøkelse om syn på viktigheten av ulike typer læringsaktiviteter og kompetanseelementer, samt fokusgruppeintervju med tolv av disse studentene. Hensikten med fokusgruppene var å utdype og utvide vår informasjon om studentenes syn på kunnskap. Resultater: Den kvantitative analysen tyder på at praksisstudier, praktiske og teoretiske kunnskaper og forskning anses som noe av det viktigste for å bli en sykepleier. Analysen av de kvalitative dataene peker imidlertid også på at studenter innehar et teknisk-instrumentelt syn på kunnskap og læring som innebærer at visse typer kunnskaper anses som lite relevant for deres egen utvikling. Konklusjon: Studenters instrumentelle kunnskapssyn representerer en utfordring for framtidig sykepleierutdanning

Helsepedagogikk – fra begrep til praksis i helsefagutdanninger: Hva kjennetegner studentenes erfaringer?

Helsepedagogikk er et sammenfattende begrep for læring, veiledning og undervisning av pasienter som hjelp til å mestre sykdom og fremme helse. Helsepedagogiske ferdigheter fremtrer i læreplaner til bachelorutdanningene i ergoterapi, sykepleie og fysioterapi. Basert på funn i en kvalitativ studie diskuterer artikkelen hvordan helsefagstudenter fra disse utdanningene erfarer sammenhengen mellom teoretisk undervisning og helsepedagogiske ferdigheter i praksisstudier. Selv om helsepedagogiske tema ble belyst i den teoretiske delen av utdanningen, savnet studentene mer sammenheng og forankring av helsepedagogiske ferdigheter i kliniske studier. Studien viser at bachelorutdanningene i ergoterapi, sykepleie og fysioterapi bør styrke sammenhenger (koherens) mellom teoretiske og praktiske læringsaktiviteter i denne tematikken. Artikkelen avslutter med å vise til behov for videre forskning

Hospital Social Workers’ Boundary Work in Paediatric Acute Wards—Competitive or Collaborative?

Recent research suggests that the notion of boundary work can improve our understanding of interprofessional tension and collaboration in health care, yet hospital social workers (HSWs) have not received sufficient attention in this area. Using boundary work as a theoretical framework, this article investigates HSWs’ boundary work in interactions with other health care professionals in paediatric acute wards. The data were based on in-depth interviews with nineteen HSWs at hospitals in Norway about their experiences with interprofessional collaboration. Based on their situated narratives, abductive analysis was performed, using the conceptually distinct but inter-related forms of competitive and collaborative boundary work that are grounded in Abbott’s framework of jurisdiction. The findings demonstrate how HSWs construct, defend and extend boundaries to create distinctions between themselves and others, and how they sometimes adapt and downplay boundaries in order to achieve common goals and perform their work. As a facilitator of this process, the HSW might be viewed as a boundary subject. This, in turn, can result in optional and intentional ways for HSWs to carry out boundary work. There is reason to believe that, the less specific educational requirements and role guidelines, the more important these mechanisms become

Hospital social workers’ contributions to increasing health literacy among parents of acutely and critically ill children

Hospital social workers often engage in health literacy activities to support patients’ and families’ functioning and adjustment to illness, but social work literature has seldom used health literacy terminology. This paper reports on a qualitative study of paediatric hospital social workers’ understanding of the needs of parents with acutely ill children and how their contributions may accommodate these needs to strengthen parental health literacy. Utilising systematic text condensation, the study reveals four themes: (1) understanding of medical information, (2) counselling and service coordination, (3) emotional needs, and (4) timing of information. The findings suggest that hospital social workers make valuable additions to health literacy

Helsepedagogikk i læreplaner - en didaktisk analyse

Helseprofesjonene møter i økende grad pasienter, brukere og pårørende som trenger kunnskap om hvordan de kan leve best mulig med langvarige helseutfordringer. Det mangler imidlertid studier av hvordan læreplanene for helseprofesjonsutdanningene imøtekommer behovene i helsetjenesten for helsepedagogisk kompetanse. I denne artikkelen undersøker vi hvordan helsepedagogikk fremtrer i læreplaner til bachelorutdanningene i ergoterapi, sykepleie og fysioterapi. En summativ innholdsanalyse viser at det er en manglende sammenheng mellom læreplandokumenter på ulike nivå (ramme-, program-, og emneplaner) og mellom didaktiske kategorier som mål, innhold, arbeids- og undervisningsformer. Artikkelen avslutter med å vise til behov for videre forskning