Likt for alle? : Pasientundervisning til kronisk syke norske og fremmedkulturelle pasienter

Formål: Denne studien har til hensikt å kartlegge hvordan pasientundervisning til kronisk syke gjennomføres, hvordan den tilpasses fremmedkulturelle, sykepleiernes vurdering av dagens tilbud, samt utfordringer og eventuelle hindringer som for å etablere likeverdige tilbud til alle. Litteratur: Det finnes lite litteratur på hvordan pasientundervisning gjennomføres og tilpasses til fremmedkulturelle i Norge i dag. Pasientundervisning som bidrar med informasjon for å håndtere egen sykdom og følge opp behandling er en lovfestet rettighet for alle pasienter i norske sykehus. Pasientundervisning er en viktig del av sykepleien for å hjelpe pasienten til å mestre egen sykdom og på den måten bidra til at han får best mulig livskvalitet. Undervisningen bør være planlagt og tilrettelagt den enkelte pasients behov. Fremmedkulturelle er forskjellige fra den norske befolkningen i forhold til språk, kultur og religion. Dette er faktorer man bør ta hensyn til for å oppnå best mulig resultat av pasientundervisningen. Metode: I denne studien ble det valgt et ikke-eksperimentelt, kvantitativt og utforskende forskningsdesign. Et datainnsamlingsinstrument ble utviklet, pretestet og brukt i en pilotundersøkelse der et lite utvalg sykepleiere ved 11 avdelinger på et større sykehus deltok. Funn: Funn fra pilottesten viser at pasientundervisning sjelden er en planlagt aktivitet, men ofte noe som foretas som del av en annen aktivitet. Undervisningen gis i hovedsak til pasientene individuelt, og skriftlig materiale er det hyppigst brukte hjelpemidlet, også til fremmedkulturelle. Mange poster har skriftlig materiale kun på norsk. Noen sier at de tilpasser undervisningen til pasientens kultur, men svært få ser betydningen av å tilpasse den i forhold til religion. Kommunikasjon rapporteres som den største utfordringen i forhold til pasientundervisning til fremmedkulturelle. Tolk benyttes ved behov, men det hender at pårørende og andre utenforstående personer benyttes i stedet for profesjonelle tolker Et stort flertall tror at økt kunnskap om kultur og religion vil gjøre det enklere å gi pasientundervisning til fremmedkulturelle. Datasamlingsinstrumentet utviklet i studien synes å fange opp viktige faktorer relatert til pasientundervisning generelt og i forhold til fremmedkulturelle. Etter noen justeringer kan instrumentet trolig brukes i en større undersøkelse. Konklusjon: Pasientundervisning er vanlig forekommende til alle kronisk syke pasienter, men funn fra denne studien peker på at det er en aktivitet som bør tilrettelegges og planlegges i større grad enn i dag. Studien viser også rom for forbedringer i undervisningen til fremmedkulturelle, i form av bedre tilpasning til kultur og religion samt økt bruk av profesjonelle tolker. Samtidig viser funnene at pasientundervisning til fremmedkulturelle er et tema som engasjerer mange sykepleiere

Sexual Quality of Life in Patients with Axial Spondyloarthritis in the Biologic Treatment Era

Author's accepted manuscript.This is a pre-copyediting, author-produced PDF of an article accepted for publication in The Journal of Rheumatology following peer review. The definitive publisher-authenticated version Berg, K. H., Rohde, G., Prøven, A., Benestad, E. E. P., Østensen, M. & Haugeberg, G. (2019). Sexual Quality of Life in Patients with Axial Spondyloarthritis in the Biologic Treatment Era. The Journal of Rheumatology, 46(9), 1075-1083 is available online at: https://www.jrheum.org/content/46/9/1075.Objective. To examine the relationship between demographics, disease-related variables, treatment, and sexual quality of life (SQOL) in men and women with axial spondyloarthritis (axSpA). Methods. AxSpA patients were consecutively recruited from 2 rheumatology outpatient clinics in southern Norway. A broad spectrum of demographics, disease, treatment, and QOL data were systematically collected. SQOL was assessed using the SQOL-Female (SQOL-F) questionnaire (score range 18–108). Appropriate statistical tests were applied for group comparison, and the association between independent variables and SQOL-F was examined using multiple linear regression analysis. Results. A total of 360 (240 men, 120 women) axSpA patients with mean age 45.5 years and disease duration 13.9 years were included. Seventy-eight percent were married/cohabiting, 26.7% were current smokers, 71.0% were employed, 86.0% performed > 1-h exercise per week, and 88.0% were HLA-B27–positive. Mean (SD) values for disease measures were C-reactive protein (CRP) 8.5 (12.1) mg/l, Bath Ankylosing Spondylitis Disease Activity Index 3.1 (2.1), Bath Ankylosing Spondylitis Global Score (BAS-G) 3.8 (2.5), Bath Ankylosing Spondylitis Functional Index 2.7 (2.2), and Health Assessment Questionnaire 0.6 (0.5). The proportion of patients using nonsteroidal antiinflammatory drugs was 44.0%, synthetic disease-modifying antirheumatic drugs (DMARD) 5.0%, and biologic DMARD 24.0%. Mean (SD) total sum score for SQOL was 76.6 (11.3). In multivariate analysis, female sex, increased body mass index, measures reflecting disease activity (BAS-G and CRP), and current biologic treatment were independently associated with a lower SQOL. Conclusion. Our data suggest that inflammation in patients with axSpA even in the biologic treatment era reduces SQOL.acceptedVersio

Increased Proportion of Comorbidities but no Deterioration of sexual QOL during a 5-year follow-up in Patients with ax-SpA in the biologic Treatment Era

Author's accepted manuscript.This is a pre-copyedited, author-produced version of an article accepted for publication in Rheumatology following peer review. The version of record Berg, K. H., Rohde, G., Pripp, A., Prøven, A., Benestad, E. E. P., Østensen, M. & Haugeberg, G. (2021). Increased proportion of comorbidities but no deterioration of sexual QOL during a 5-year follow-up in patients with axSpA in the biologic treatment era. Rheumatology, 60(9), 4112-4120 is available online at: https://academic.oup.com/rheumatology/article/60/9/4112/6067306 and https://doi.org/10.1093/rheumatology/keaa887.Objective. To explore patient perception of sexual quality of life (SQOL), an important category of QOL, in male and female patients with axial SpA (axSpA) after a 5 year follow-up. Methods. A broad spectrum of demographic, disease-related, treatment and SQOL data was collected at baseline and at the 5 year follow-up. SQOL was assessed by the SQOL-Female (SQOL-F) questionnaire. For statistical analysis, McNemar’s tests, paired t-tests and multiple regression analyses were applied. Results. A total of 245 axSpA patients (168 men and 77 women) from outpatient clinics were examined (mean age 46 years, mean disease duration 11.9 years at baseline). Compared with baseline, the patients had lower CRP, lower Maastricht Ankylosing Spondylitis Enthesitis Scores, lower BASFI scores, less use of smoking and significantly more patients were treated with biologic DMARDs at the 5 year follow-up. Patient perception of SQOL was basically unchanged at the 5 year follow-up despite a significantly increased proportion of comorbidities, including cardiovascular, endocrine and gastrointestinal disease. A decrease in SQOL after 5 years was observed only in patients exercising 65 years old. Conclusion. In our axSpA patients, no statistically significant changes in SQOL were observed over 5 years, despite a significant increase in comorbidities. Overall disease symptoms decreased, indicating better disease control. Increased use of biologic drugs at the 5 year follow-up may have contributed to this favourable outcome.acceptedVersio

Introduction, adoption, and facilitation of standardized care plans in municipal healthcare services

To ensure patient safety and continuity of care, nurses need access to accurate and timely information. Standardized care plans (SCPs) were implemented in Norwegian municipalities to improve the quality of the patient record content. This study explored the information practice in which SCPs were introduced, how nurses adopted and used the SCPs and identified facilitating factors for routine use of SCPs. Data were collected from participant observations and interviews with nurses, printouts from the care plans, and workshops with nurses and nursing leaders. The study revealed that municipal healthcare is a complex context in which to introduce SCPs with several information sources in use, poor access to the patient record system at the point of care, and large differences in individual knowledge and educational background within the healthcare workforce. There were large variations in how nurses evaluated the usefulness of SCPs and in how they were used. The study also showed that well-functioning technology, engaged leaders and stakeholders, and ongoing access to training and support were important factors for SCPs to become routinely embedded in nurses’ information practice

Riktigere medisinering og mer selvstendighet? Erfaringer med automatisk medisindispenser i Bærum kommune

I rammen av prosjektet ”Trygghetspakken”, støttet av Regionalt Forskningsfond, har Bærum kommune pilotert 10 stk medisindispensere av typen ”Pilly” i tett samarbeid med leverandøren Dignio AS og SINTEF. I alt 16 forskjellige brukere prøvde ut Pilly i løpet av pilot-perioden, i perioder fra kun 1 måned til opptil flere måneder. Denne rapporten dokumenterer erfaringer fra piloten, basert på intervjuer med brukere og intervjuer og spørreundersøkelse blant ansatte. Piloten har etablert forståelse i kommunen for at automatiske medisindispensere som Pilly har stort potensiale for å gi riktigere medisinering i og med at de "tvinger fram" riktig medisineringstidspunkt. I tillegg ser man fra piloten at noen brukere opplever økt selvstendighet, mestring og frihet gjennom at de klarer gjennomføre medisineringen selv og ikke lenger trenger hjemmebesøk fra ansatte i tjenesten for dette formålet. Mest nytte erfares for brukere med fysiske funksjonsutfordringer og begrenset kognisjonssvikt, for eksempel brukere med redusert motorikk/finmotorikk eller svekket syn. Vellykket bruk av medisindispenser er betinget av at brukeren klarer å tilegne seg en grad av forståelse for hvordan denne fungerer. Som med annen velferdsteknologi, vil detaljert kartlegging av brukerbehov samt en innkjøringsfase hvor man tilpasser teknologien og tjenesten til bruker, være en forutsetning for å realisere gevinstpotensialet som er skissert

Facilitating the Implementation of Standardized Care Plans in Municipal Healthcare

Standardized care plans have the potential to enhance the quality of nursing records in terms of content and completeness, thereby better supporting workflow, easing the documentation process, facilitating continuity of care, and permitting systematic data gathering to build evidence from practice. Despite these potential benefits, there may be challenges associated with the successful adoption and use of standardized care plans in municipal healthcare information practices. Using a participatory approach, two workshops were conducted with nurses and nursing leaders (n = 11) in two Norwegian municipalities, with the objective of identifying success criteria for the adoption and integration of standardized care plans into practice. Three themes were found to describe the identified success criteria: (1) “facilitating system level support for nurses' workflow”; (2) “engaged individuals creating a culture for using standardized care plans”; and (3) “developing system level safety nets.” The findings suggest success criteria that could be useful to address to facilitate the integration of standardized care plans in municipal healthcare information practice and provide useful knowledge for those working with implementation and further development of standardized care plans

Exploring the Use of Technology for Active Aging and Thriving

The study explores how older adults with limited digital experience become users of tablet computers (iPad) with Internet access, and how the tablet computers become part of their daily life facilitating active aging and thriving. Volunteer adolescents were mobilised to teach and follow up the participants regularly.acceptedVersio

Exploring the Use of Technology for Active Aging and Thriving

The study explores how older adults with limited digital experience become users of tablet computers (iPad) with Internet access, and how the tablet computers become part of their daily life facilitating active aging and thriving. Volunteer adolescents were mobilised to teach and follow up the participants regularly

Sexual Quality of Life in Patients with Axial Spondyloarthritis in the Biologic Treatment Era

Objective. To examine the relationship between demographics, disease-related variables, treatment, and sexual quality of life (SQOL) in men and women with axial spondyloarthritis (axSpA). Methods. AxSpA patients were consecutively recruited from 2 rheumatology outpatient clinics in southern Norway. A broad spectrum of demographics, disease, treatment, and QOL data were systematically collected. SQOL was assessed using the SQOL-Female (SQOL-F) questionnaire (score range 18–108). Appropriate statistical tests were applied for group comparison, and the association between independent variables and SQOL-F was examined using multiple linear regression analysis. Results. A total of 360 (240 men, 120 women) axSpA patients with mean age 45.5 years and disease duration 13.9 years were included. Seventy-eight percent were married/cohabiting, 26.7% were current smokers, 71.0% were employed, 86.0% performed > 1-h exercise per week, and 88.0% were HLA-B27–positive. Mean (SD) values for disease measures were C-reactive protein (CRP) 8.5 (12.1) mg/l, Bath Ankylosing Spondylitis Disease Activity Index 3.1 (2.1), Bath Ankylosing Spondylitis Global Score (BAS-G) 3.8 (2.5), Bath Ankylosing Spondylitis Functional Index 2.7 (2.2), and Health Assessment Questionnaire 0.6 (0.5). The proportion of patients using nonsteroidal antiinflammatory drugs was 44.0%, synthetic disease-modifying antirheumatic drugs (DMARD) 5.0%, and biologic DMARD 24.0%. Mean (SD) total sum score for SQOL was 76.6 (11.3). In multivariate analysis, female sex, increased body mass index, measures reflecting disease activity (BAS-G and CRP), and current biologic treatment were independently associated with a lower SQOL. Conclusion. Our data suggest that inflammation in patients with axSpA even in the biologic treatment era reduces SQOL