How to become an expert educator: A qualitative study on the view of health professionals with experience in patient education

Background: Health professionals with the level of competency necessary to provide high-quality patient education are central to meeting patients' needs. However, research on how competencies in patient education should be developed and health professionals trained in them, is lacking. The aim of this study was to investigate the characteristics of an expert educator according to health professionals experienced in patient education for patients with coronary heart disease, and their views on how to become an expert educator. Methods: This descriptive qualitative study was conducted through individual interviews with health professionals experienced in patient education in cardiac care. Participants were recruited from cardiac care units and by using a snowball sampling technique. The interviews were audiotaped and transcribed verbatim. The data were analyzed with thematic approaches, using systematic text condensation. Results: Nineteen Icelandic and Norwegian registered nurses, physiotherapists, and cardiologists, who had worked in cardiac care for 12 years on average, participated in the study. Being sensitive to the patient's interests and learning needs, and possessing the ability to tailor the education to each patient's needs and context of the situation was described as the hallmarks of an expert educator. To become an expert educator, motivation and active participation of the novice educator and a supportive learning environment were considered prerequisites. Supportive educational resources, observation and experiential training, and guidance from experienced educators were given as examples of resources that enhance competence development. Experienced educators expressed the need for peer support, inter-professional cooperation, and mentoring to further develop their competency. Conclusions: Expert patient educators were described as those demonstrating sensitivity toward the patient's learning needs and an ability to individualize the patient's education. A supportive learning environment, inner motivation, and an awareness of the value of patient education were considered the main factors required to become an expert educator. The experienced educators expressed a need for continuing education and peer support.Central Norway Regional Health AuthorityPeer Reviewe

Use of psychiatric medication in three Arctic nursing homes: association with dementia and psychiatric symptoms.

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 DownloadAs more people reaches advanced age, more people experience cognitive impairment and dementia. Dementia is a degenerative disease in which behavioural and psychological symptoms frequently occur, resulting in admissions to nursing homes (NHs), where the most common treatment has been medical treatment. The aim was to compare three rural Arctic NHs in Iceland in their use of psychiatric medication, type of dementia among residents, level of cognitive impairment and selected quality indicators, as well as considering national data, for the period 2016-2018. Data from the interRAI-MDS 2.0 evaluation were used. Residents with severe cognitive impairment used more antipsychotic medications, and residents with mild and severe cognitive impairment used more antidepressants than residents with no cognitive impairment did. Diagnoses of Alzheimer's Disease and Related Dementias (ADRD) are more common in the capital area and the national average than they are in the rural NHs. This indicates need for diagnostic assessments of ADRD to be conducted in rural areas. Benchmarking is beneficial for local and national regulatory bodies to find areas for improvement. The NHs did not have a lower quality of care compared with the whole country, but areas for improvement were identified. One of the NHs has already started this process. Keywords: Nursing homes; arctic areas; dementia; psychiatric medication.Icelandic Nurses Associatio

Heilsa og lifun íbúa fyrir og eftir setningu strangari skilyrða fyrir flutningi á hjúkrunarheimili 2007

INNGANGUR Fjölmargir þættir hafa áhrif á þjónustuþörf og lifun íbúa hjúkrunarheimila, meðal annars inntökuskilyrði fyrir flutningi á hjúkrunarheimili. Markmið rannsóknarinnar var að athuga hvort munur væri á heilsufari, lifun og forspárgildi mismunandi heilsufars- og færnivísa fyrir eins og tveggja ára lifun þeirra sem fluttu inn á íslensk hjúkrunarheimili á árunum 2003-2007 annars vegar og 2008-2014 hins vegar. EFNIVIÐUR OG AÐFERÐIR Lýsandi, afturskyggn samanburðarrannsókn. Gögnin fengust úr gagnagrunni á vegum Embættis landlæknis yfir allar interRAI-matsgerðir á íslenskum hjúkrunarheimilum frá 1. janúar 2003 til og með 31. desember 2014 (N=8.487). NIÐURSTÖÐUR Marktækur munur var á heilsu og lifun nýrra íbúa hjúkrunarheimila fyrir og eftir 31. desember 2007. Á seinna tímabilinu var meðalaldur 82,7 ár, en 82,1 ár á hinu fyrra og tíðni Alzheimer-sjúkdóms, blóðþurrðarsjúkdóms í hjarta, hjartabilunar, sykursýki og langvinnrar lungnateppu jókst. Eins árs lifun lækkaði úr 73,4% í 66,5% eftir 1. janúar 2008 og tveggja ára lifun úr 56,9% í 49,1%. Sterkustu áhættuþættirnir fyrir dauðsfalli innan eins og tveggja ára frá komu á báðum tímabilum voru sjúkdómsgreiningarnar hjartabilun og langvinn lungnateppa, auk fleiri stiga á lífskvarðanum og langa ADL-kvarðanum. ÁLYKTUN Í kjölfar reglugerðarbreytingar 2007 voru þeir sem fluttu á hjúkrunarheimili eldri og veikari við komu og lifðu skemur eftir vistaskiptin en þeir sem fluttu inn fyrir breytingu. Niðurstöðurnar benda til að markmið reglugerðarbreytingarinnar, að forgangsraða þeim sem voru veikastir, hafi því náðst. Því má telja líklegt að umönnunarþörf íbúa sé önnur og meiri en áður.Introduction: Many factors influence the nursing needs and survival of nursing home residents, including the admission criteria. The aim of the study was to compare health, survival and predictors for one- and two-year survival of people entering Icelandic nursing homes between 2003–2007 and 2008–2014. Material and methods: Retrospective, descriptive, comparative study. The data was obtained from a Directorate of Health database for all interRAI assessments of Icelandic nursing homes from January 1, 2003, to December 31, 2014 (N = 8487). Results: There was a significant difference in the health and survival of new nursing home residents before and after December 31, 2007. In the latter period, the mean age was 82.7 years. In the previous period, it was 82.1 years, and the prevalence of Alzheimer‘s disease, ischemic heart disease, heart failure, diabetes and COPD increased between the periods. One-year survival decreased from 73.4% to 66.5%, and two-year survival decreased from 56.9% to 49.1%. The strongest mortality risk factors were heart failure and chronic obstructive pulmonary disease, as well as high scores on the CHESS scale and ADL long scale. Conclusion: After 2007, new residents were older, in poorer health, and their life expectancy was shorter than for those moving to nursing homes before that. The results suggest that the aim of the regulatory change was achieved, i.e., to prioritise those in worst health. Their care needs may therefore be different and greater than before.Rannsakendur vilja þakka styrk til rannsóknarinnar frá vísindasjóði Landspítala og vísindasjóði Félags íslenskra hjúkrunarfræðinga.Peer reviewe

Bologna Process, More or Less: Nursing Education in the European Economic Area: A Discussion Paper

The Bologna Declaration and the subsequent processes is the single most important reform of higher education taking place in Europe in the last 30 years. Signed in 1999, it includes 46 European Union countries and aimed to create, a more coherent, compatible, comparable and competitive European Higher Education Area. The purpose of this paper is to discuss the Bologna Declaration achievements in nursing education at 2010 within eight countries that first signed the Declaration on 1999. Researchers primarily identified national laws, policy statements, guidelines and grey literature; then, a literature review on Bologna Declaration implementation in nursing was conducted on the Medline and CINAHL databases. Critical analyses of these documents were performed by expert nurse educators. Structural, organizational, functional and cultural obstacles are hindering full Bologna Process implementation in nursing education within European Economic Area. A call for action is offered in order to achieve a functionally unified system within nursin

The psychosocial self-efficacy in adolescents with type 1 diabetes

Aim: To analyse psychosocial self‐efficacy in adolescents with type 1 diabetes, evaluate associations between self‐efficacy and metabolic control and background variables and determine psychometric properties of the Finnish Diabetes Empowerment Scale (Fin‐DES‐28).Design: A descriptive correlational survey.Methods: The data were collected with the Finnish Diabetes Empowerment Scale from 13–16‐year‐old adolescents with type 1 diabetes (N = 189, 34%) in one university hospital district area in 2014.Results: The level of psychosocial self‐efficacy was quite good. The highest scores were in managing the psychosocial aspects of diabetes, followed by assessing dissatisfaction and readiness to change and setting and achieving diabetes goals. The self‐efficacy did not correlate with metabolic control or background variables. A positive association was found between self‐efficacy and understanding of diabetes and its treatment, adjustment of diabetes to life and the relationship with the doctor and the nurse. The internal consistency of the Finnish Diabetes Empowerment Scale was adequate. The low response rate limits generalization

The psychosocial self‐efficacy in adolescents with type 1 diabetes

Publisher's version (útgefin grein)Aim: To analyse psychosocial self‐efficacy in adolescents with type 1 diabetes, evalu‐ ate associations between self‐efficacy and metabolic control and background varia‐ bles and determine psychometric properties of the Finnish Diabetes Empowerment Scale (Fin‐DES‐28). Design: A descriptive correlational survey. Methods: The data were collected with the Finnish Diabetes Empowerment Scale from 13–16‐year‐old adolescents with type 1 diabetes (N = 189, 34%) in one univer‐ sity hospital district area in 2014. Results: The level of psychosocial self‐efficacy was quite good. The highest scores were in managing the psychosocial aspects of diabetes, followed by assessing dis‐ satisfaction and readiness to change and setting and achieving diabetes goals. The self‐efficacy did not correlate with metabolic control or background variables. A positive association was found between self‐efficacy and understanding of diabetes and its treatment, adjustment of diabetes to life and the relationship with the doctor and the nurse. The internal consistency of the Finnish Diabetes Empowerment Scale was adequate. The low response rate limits generalization.Peer reviewe

Translation and cross-cultural adaptation of the European Health Literacy Survey Questionnaire, HLS-EU-Q16: The Icelandic version

BACKGROUND: Health literacy (HL) is defined as the knowledge and competences of people to meet the complex demands of health in modern society. It is an important factor in ensuring positive health outcomes, yet Iceland is one of many countries with limited knowledge of HL and no valid HL measurement. The aim of this study was to translate the European Health Literacy Survey Questionnaire- short version (HLS-EU-Q16) into Icelandic, adapt the version, explore its psychometric properties and establish preliminary norms. METHODS: The HLS-EU-Q16 translation model included three steps: 1) translation-back-translation of HLS-EU-Q16 including specialists' review (n = 6); 2) cognitive interviewing of lay people (n = 17); and 3) psychometric analysis with survey participants. The HLS-EU-Q16 includes 16 items, with scores ranges from zero (low/no HL) to 16 (high HL). Statistics included were descriptive, internal consistency measured by Cronbach's α, exploratory factor analysis, and multivariate linear regression. RESULTS: After the translation and cognitive interviewing, 11 of the HLS-EU-Q16 items were reworded to adapt the instrument to Icelandic culture while maintaining their conceptual objectives. Survey participants were 251. Internal consistency of the translated and adapted instrument was α = .88. Four factors with eigenvalues > 1.0 explained 62.6% of variance. Principal component analysis with Oblimin rotation presented four latent constructs, "Processing and Using Information from the Doctor" (4 items, α = .77), "Processing and Using Information from the Family and Media" (4 items, α = .85), "Processing Information in Connection to Healthy Lifestyle" (5 items, α = .76), and "Finding Information about Health Problems/Illnesses" (3 items, α = .73). Lower self-rated health was an independent predictor of lower HL (β = -.484, p = .008). Preliminary norms for HL ranged from five to 16 (M 13.7, SD ± 2.6) with 72.5% with sufficient HL (score 13-16), 22% with problematic HL (score 9-12) and 5.5% with inadequate HL (score 0-8). CONCLUSIONS: The Icelandic version of HLS-EU-Q16 is psychometrically sound, with reasonably clear factor structure, and comparable to the original model. This opens possibilities to study HL in Iceland and compare the results internationally. The translation model introduced might be helpful for other countries where information on HL is missing based on lack of validated tools.Háskólinn á Akureyri (IS) research fundPeer Reviewe

Self-rated health and socio-economic status among older adults in Northern Iceland

Publisher's version (útgefin grein)Little is known about self-rated health (SRH) of older people living in more remote and Arctic areas. Iceland is a high-income country with one of the lowest rates of income inequality in the world, which may influence SRH. The research aim was to study factors affecting SRH, in such a population living in Northern Iceland. Stratified random sample according to the place of residency, age and gender was used and data collected via face-to-face interviews. Inclusion criteria included community-dwelling adults ≥65 years of age. Response rate was 57.9% (N = 175), average age 74.2 (sd 6.3) years, range 65–92 years and 57% were men. The average number of diagnosed diseases was 1.5 (sd 1.3) and prescribed medications 3.0 (sd 1.7). SRH ranged from 5 (excellent) to 1 (bad), with an average of 3.26 (sd 1.0) and no difference between the place of residency. Lower SRH was independently explained by depressed mood (OR = 0.88, 95% CI = 0.80–0.96), higher body mass index (OR = 0.93, 95% CI = 0.87–0.99), number of prescribed medications (OR = 0.88, 95% CI = 0.78–1.00) and perception of inadequate income (OR = 0.45, 95% CI = 0.21–0.98). The results highlight the importance of physical and mental health promotion for general health and for ageing in place and significance of economic factors as predictors of SRH.This work was supported by the Háskólinn á Akureyri [R-1803]; Icelandic Regional Development Institute (Byggðastofnun) [102022].Peer Reviewe

Knowledge expectations of surgical orthopaedic patients: a European survey

Ageing population entails a growing international problem of osteoarthritis. Best practices for education of these patients are lacking. This study focused on empowering education in Northern (Finland, Iceland, Lithuania and Sweden) and Southern Europe (Cyprus, Greece and Spain). The aim was to analyse associations between expected knowledge and background factors. The data were collected from European arthroplasty patients with the Knowledge Expectations of hospital patients- scale, (KE(hp) - scale), including bio-physiological, functional, experiential, ethical, social and financial dimensions. Patients had essential bio-physiological and functional knowledge expectations. Women expected more than men, employed less than retired, unemployed or who worked at home. Generally, patients in Northern countries expected more than in Southern countries. However, highest expectations were found in Sweden and Greece, lowest in Spain and Cyprus. There are differences in knowledge expectations based on patients' backgrounds. Development of common standards in European patient education needs further research

Bologna process, more or less: nursing education in the European economic area: a discussion paper

Palese A, Zabalegui A, Sigurdardottir AK, Bergin M, Dobrowolska B, Gasser C, Pajnkihar M, Jackson C. Abstract Abstract The Bologna Declaration and the subsequent processes is the single most important reform of higher education taking place in Europe in the last 30 years. Signed in 1999, it includes 46 European Union countries and aimed to create, a more coherent, compatible, comparable and competitive European Higher Education Area. The purpose of this paper is to discuss the Bologna Declaration achievements in nursing education at 2010 within eight countries that first signed the Declaration on 1999. Researchers primarily identified national laws, policy statements, guidelines and grey literature; then, a literature review on Bologna Declaration implementation in nursing was conducted on the Medline and CINAHL databases. Critical analyses of these documents were performed by expert nurse educators. Structural, organizational, functional and cultural obstacles are hindering full Bologna Process implementation in nursing education within European Economic Area. A call for action is offered in order to achieve a functionally unified system within nursing