32 research outputs found

    Does professional identity play a critical role in the choice to remain in the nursing profession?

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    Aim To explore aspects of professional identity in nurses’ written narratives of what is significant to their choice to remain in the profession. Design This study used a qualitative design and was underpinned by a hermeneutical approach. Methods The participants were recruited via purposive sampling procedures and included 13 nurses aged 26 to 62 years. The data were collected in the form of written narratives to initiate the nurses’ reflections on the decision to remain in the profession. A thematic analysis was conducted. Results The analysis revealed two themes: acting as a professional contributor and realigning to maintain professional belongingness. In the nurses’ written narratives, these aspects of professional identity were clearly significant to their choice to remain in the profession. In a complexly interwoven way, the aspects constructed who the nurses were as professionals, and thus, professional identity seems to play a critical role in the choice to remain.publishedVersio

    Solidarity in a community of nursing colleagues

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    Introduction Several concepts have been used to describe the qualities of communities of nursing colleagues. Nonetheless, few studies have shed light on nursing communities by drawing on the concept of solidarity. Objective To explore solidarity among a community of nursing colleagues. Methods A qualitative research design with a reflective life world approach was selected. This study reused data from a larger Norwegian empirical study. The data from the original study consisted of qualitative interviews and follow-up interviews with 13 nurses (RNs). The research context was municipality and specialist health services. A secondary data analysis was conducted. The study was based on the SRQR reporting guidelines. Results The results were formulated under two themes: 1) having indispensable relationships and 2) encountering a relative absence of sympathy. Conclusion A sense of community among nursing colleagues seems to rely on solidarity: whatever affects one nurse affects another. The solidarity that arose from the content of commonalities involved maintaining indispensable relationships with nursing colleagues by supporting and aiding them and simultaneously enduring a relative absence of sympathy. Solidarity among the community in this study was not a peripheral concept of the general notion of solidarity, implying that the commonalities within the collegial relationships were ambiguous and could shift from something good to something relatively good and vice versa. Such a shift was evidenced by nurses’ experiences of their community.publishedVersio

    Epistemic discourses concerning the competence developed in a Norwegian master's degree program in health science

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    It has been claimed that various discourses related to competence influence higher education, but there is limited understanding of the discourses underlying competence development. The specific aim of this study was to explore epistemic discourses concerning the development of competence of health professionals with a master’s degree in health science. Accordingly, the study was qualitative and adopted discourse analysis. Twelve participants, all of whom were Norwegian health professionals aged between 29 and 49 years, participated in this study. Four participants were in the final stage of study for their master’s degree with three months left before completion, four had completed their degree two weeks before their participation, and four had been working for one year after the completion of their degree. Data were collected in three group interviews. Three epistemic discourses were revealed: (1) a critical thinking competencies discourse, (2) a scientific thinking competencies discourse, and (3) a competence-in-use discourse. The former two discourses were considered the dominant discourses and indicated that a knowing “that” discourse connected the specialized competence of different health professionals with a wider field of competence. This wider field transcended the boundaries of various health disciplines and represented a novel competence developed through a synergizing process between critical and scientific thinking competencies, which seems to drive continued competence development. A competence-in-use discourse was formed in the process. This discourse can be viewed as a unique outcome that contributes to health professionals’ specialized competence and suggests that a knowing “how” discourse was also an underlying background discourse.publishedVersio

    From a professional practitioner to a practicebased researcher: a qualitative study of Norwegian PhD candidates in the fields of health, welfare and education

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    This study aims to describe and interpret the critical aspects of the development of PhD candidates’ professionally relevant, practice-near research competence in the fields of health, welfare and education. To provide knowledge regarding their development, a qualitative research design and phenomenological hermeneutic approach were used. Ten PhD candidates at a Norwegian multi-disciplinary research school were recruited through non-probability sampling. The following four themes emerged from the analysis: (1) relinquishing the professional status as a practitioner, (2) struggling at a low level of competence, (3) achieving autonomy as a PhD candidate, and (4) wanting to advance professional practice. The PhD candidates experienced loss when they relinquished their former professional status to become researchers while simultaneously struggling at a low level of competence compared to that of other qualified researchers. Thus, the importance of achieving autonomy to advance professional practice cannot be too strongly emphasised when PhD candidates are newcomers in a peripheral position within research communities.publishedVersio

    What school nurses receive for themselves that influences their remaining in practice: A qualitative study

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    Background Previous research indicates a link between what nurses receive for themselves and their remaining in practice. In Norway, school nurses tend to remain in practice, but what it is they receive for themselves has been scarcely studied. The aim of this study, therefore, was to describe and interpret what it is school nurses receive for themselves that influences their remaining in practice. Method The study has a qualitative design with a hermeneutic approach. Data were collected through individual interviews on two separate occasions with 15 Norwegian school nurses. The data were analysed using a phenomenological hermeneutic method. Results Two themes demonstrate what it is the school nurses receive for themselves: (1) ‘Gaining interesting workdays for yourself’ and (2) ‘Attaining pleasure for yourself’. Each theme has two sub-themes. The first theme involved the school nurses ‘having an attractive scope of practice’ and ‘having varied tasks’. The second theme involved ‘being trusted’ and ‘being given a response’. The study themes can be comprehensively understood as an expression of what the school nurses identify as the main locus of the good work-life. The school nurses’ remaining seems to revolve around what it is they receive on their own behalf: an affirmation for their ordinary life and what they do as a nurse. Conclusion This study highlights that what school nurses receive on their own behalf may influence their remaining in practice. It adds to previous research with a more specific understanding of nurses remaining in practice by stating that in identifying the main locus of the good work-life, the school nurses received affirmation for their ordinary life and what they do as a nurse. Thus, it is important that nurses identify the main locus of a good work-life for themselves, as receiving affirmation for what they do in their ordinary workdays may influence their remaining in practice.publishedVersio

    What school nurses strive to achieve for themselves in order to remain in practice: A qualitative study

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    Aim This study aims to describe and interpret what it is school nurses strive to achieve for themselves in order to remain in practice. Design A qualitative study with a hermeneutic approach. Method The data were collected by means of in-depth interviews with 15 Norwegian school nurses on two separate occasions and analysed using a phenomenological hermeneutic method. Results The analysis resulted in the following themes: (1) trusting your own professional ability, (2) aspiring to appreciation and (3) accomplishing self-care. These themes were reflected in the school nurses' choices and actions and were regarded as an expression of what was of value to them as a nurse. Thus, the nurses' realizing what they strived to achieve for themselves can comprehensively be understood as a good of higher value for their remaining in nursing practice.publishedVersio

    Trivsel eller mistrivsel som sykepleier? Hva er sykepleiere mest og minst fornĂžyd med i jobbene sine?

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    Dette arbeidsnotatet oppsummerer empirien i prosjektet ”Betingelser for trivsel blant sykepleiere pĂ„ sykehus, sykehjem og i hjemmesykepleien.” Hvordan trives sykepleiere i jobbene sine de fĂžrste Ă„rene etter endt sykepleierutdanning? Hva er de mest og hva er de minst fornĂžyd med? Hovedvekten i notatet legges pĂ„ Ă„ presentere hva sykepleierne har svart pĂ„ disse spĂžrsmĂ„lene. I en seinere publikasjon vil vi diskutere denne empirien opp i mot annen teori og forskning. Vi har valgt Ă„ presentere svarene separat for de tre hovedfeltene sykepleierne jobber i; sykehus, sykehjem og i hjemmesykepleien. Dette fordi det dreier seg om ulike arbeidsfelt med til dels ulike arbeidsoppgaver. Margareth Haukom har analysert de Ă„pne svarene fra sykepleierne pĂ„ sykehus og skrevet del 2 under resultater. Ingfrid Kristoffersen har analysert de Ă„pne svarene fra sykepleierne pĂ„ sykehjem og skrevet del 3 under resultater. Oddvar FĂžrland har analysert de Ă„pne svarene fra hjemmesykepleierne og de kvantitative dataene og skrevet del 1 og 4 under resultater. VĂ„rt hĂ„p er at notatet kan vĂŠre nyttig lesning bĂ„de for sykepleierne selv og for arbeidsgiverne som legger rammebetingelsene for sykepleiernes jobbinnhold. Ved Ă„ legge til rette for faktorene de trekker fram som trivselskapende, og vĂŠre bevisst forholdene de trekker fram som negative ved jobbene sine, kan de bidra til positiv utvikling pĂ„ arbeidsplassene for sykepleiere. Prosjektet er en del av den prospektive kohortstudien ”YrkeslĂžp og yrkesverdier blant sykepleiere.” Denne ble initiert av Diakonissehjemmets hĂžgskole og er finansiert av Helse Vest og Diakonissehjemmets hĂžgskole. Takk for denne ressurstildelingen. Videre takker vi Turid Hiorth Aarra og Inger BjĂžrkhaug som har skrevet av sykepleiernes svar pĂ„ de Ă„pne spĂžrsmĂ„lene og pĂ„ denne mĂ„ten gjort dem klar for videre analyser. En sĂŠrlig takk til Herdis AlvsvĂ„g for veiledning og konstruktive kommentarer til analysene og manuskriptet. Sist, men ikke minst: Takk til alle sykepleierne som har svart pĂ„ spĂžrsmĂ„lene som dette arbeidsnotatet bygger pĂ„! Deres svar vil forhĂ„pentligvis fungere som viktige tilbakemeldinger til dem som har ansvaret for rammebetingelser og jobbinnhold for sykepleiere

    «Perseverance is the key»: A qualitative and quantitative evaluation of a pilot project, the LP model in upper secondary schools 2008–2010 (LPVGO)

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    Norsk: LP-modellen har vĂŠrt anvendt i norske grunnskoler fra hĂžsten 2006. SkoleĂ„ret 2008/2009 ble det iverksatt et pilotprosjekt der 7 videre­gĂ„ende skoler skulle prĂžve ut om LP-modellen ogsĂ„ egnet seg for videre­gĂ„ende opplĂŠring. I pilotprosjektet har man brukt de innovasjonsstrategiene som ligger i LP-modellen, med noen tilpasninger til videregĂ„ende opplĂŠring. Det er LillegĂ„rden kompetansesenter som har hatt det faglige og administrative ansvaret i prosjektet, mens Senter for praksisrettet utdanningsforskning ved HĂžgskolen i Hedmark har hatt evalueringsansvaret. Denne evalueringen bestĂ„r av en kvantitativ og en kvalitativ undersĂžkelse. Den kvantitative evalueringen er i form av analyse av resultater fra to elektroniske kartleggingsundersĂžkelser. Den fĂžrste ble gjennomfĂžrt hĂžsten 2008, der skolene fikk et bilde av skolens utgangspunkt fĂžr arbeidet med LP-modellen ble iverksatt, innenfor ulike faktorer i lĂŠringsmiljĂžet. Den andre undersĂžkelsen, som er identisk med den fĂžrste, ble gjennomfĂžrt 2 Ă„r etter, hĂžsten 2010. Her fikk den enkelte skole et bilde av sin endring eller utvikling fra den fĂžrste til den andre kartleggingsundersĂžkelsen. Den kvalitative evalueringen ble gjennomfĂžrt hĂžsten 2009, og er i form av intervjuer bĂ„de pĂ„ skolenivĂ„ og fylkesnivĂ„, samt intervju med representanter fra LillegĂ„rden kompetansesenter. PĂ„ skolenivĂ„ er alle skoleledere og skolekoordinatorer ved de 7 videregĂ„ende skolene intervjuet. I tillegg er det gjennomfĂžrt et gruppeintervju med to lĂŠrergrupper pĂ„ hver skole. PĂ„ fylkesnivĂ„ har det vĂŠrt intervjuer med fylkeskoordinatorer og en representant fra hver PP-tjeneste som er tilknyttet prosjektet. Problemstillingene i denne rapporten er som fĂžlger: ∙ Hvilke erfaringer er gjort i forhold til skolenes initiering og implementering av pilotprosjektet LP-modellen i videregĂ„ende opplĂŠring? ∙ Hvilke resultater viser kartleggingsundersĂžkelsen at skolene har oppnĂ„dd i lĂžpet av prosjektperioden? ∙ Finnes det sammenhenger mellom de kvalitative og kvantitative funnene som kan relateres til arbeidet med LP-modellen? For Ă„ gi et kort svar pĂ„ den fĂžrste problemstillingen, sĂ„ viser resultatene fra den kvalitative studien at det var noe frustrasjon og misnĂžye blant lĂŠrerne pĂ„ det tidspunktet intervjuene ble foretatt. Det kan vĂŠre ulike Ă„rsaker til det. En forklaring kan vĂŠre at noen av lĂŠrerne fĂžlte at prosjektet var tredd ned over hodene de- res, en annen kan vĂŠre selve tidspunktet intervjuene ble foretatt pĂ„. Noen skoler hadde jobbet med LP ett Ă„r, mens andre hadde bare et halvt Ă„rs erfaring. De mo- mentene som allikevel ble trukket frem som positive var lĂŠrersamarbeidet, avsatt tid til pedagogisk diskusjon og opplevelsen av Ă„ fĂ„ et felles sprĂ„k. KartleggingsundersĂžkelsen i 2010 viser til bedre resultater enn det grunnskolene i LP-modellen har hatt. Det er mange faktorer med effektstĂžrrelser pĂ„ over 0,20 i det kvantitative datamaterialet, noe som indikerer at det har skjedd en endring mellom fĂžrste og andre kartleggingsundersĂžkelse. HĂžsten 2010 gir elevene ut- trykk for at de opplever mindre brĂ„k og uro i timene, noe mindre utagerende atferd, en bedre relasjon med lĂŠrerne sine og medelever, samt at det ser ut til Ă„ vĂŠre et noe bedre innhold pĂ„ timene og en bedre struktur, enn det elevene hĂžsten 2008 opplevde. Elevenes kontaktlĂŠrere vurderer at elevene i 2010 har bedre kontroll pĂ„ sinnet sitt og at de er mer tolerante overfor andre. Videre viser resultatene en effektstĂžrrelse pĂ„ over 0,20 pĂ„ alle faktorer pĂ„ lĂŠrerskjemaet, bortsett fra ett. Resultatene dokumenter at lĂŠrerne i 2010 trives bedre, utĂžver et bedre samarbeid, har fĂ„tt en bedre relasjon til elevene sine og fĂžler at de har bedre kompetanse pĂ„ Ă„ hĂ„ndtere atferdsproblemer, enn i 2008. I det kvantitative datamaterialet er det ogsĂ„ kjĂžrt variansanalyser etter utdannings- program. Resultatene tilsier at bĂ„de elever og lĂŠrere pĂ„ yrkesfaglig studiepro- gram kan vise til fere effektstĂžrrelser enn elever og lĂŠrere pĂ„ studieforberedende utdanningsprogram. Det er ogsĂ„ kjĂžrt noen analyser pĂ„ skolenivĂ„ og man fnner til dels store forskjeller mellom skolenes resultater. Det ser ogsĂ„ ut til at det er sammenfall mellom lĂŠrere og elevers vurderinger av ulike faktorer pĂ„ skolenivĂ„. Studien fnner sammenhenger mellom omrĂ„der lĂŠrerne har drĂžftet i lĂŠrergrup- pene og iverksatt tiltak pĂ„ og resultater i det kvantitative materialet. Resultatene fra det kvantitative datamaterialet kan indikere at lĂŠrernes systematiske arbeid i lĂŠrergruppene har gitt en positiv utvikling av egen praksis, bĂ„de nĂ„r det gjelder kompetanse i klasseledelse og til Ă„ skape gode relasjoner til elevene.English: The LP-model has been used in Norwegian primary og lower secondary schools from 2006. In the school year 2008/2009 a pilot project was implemented in 7 upper secondary schools where the aim was to assess to what extent the LP model was also suitable for upper secondary education. In the pilot project innovation strategies in the LP model were adapted to upper secondary education. LillegĂ„rden Resource Centre were the project managers and assured quality, while the Centre for Studies of Educational Practice, Hedmark University College assumed respon- sibility for undertaking the evaluation. The evaluation consists of a quantitative and a qualitative survey. The quantitative evaluation is based upon an analysis of results from two electronic surveys. The frst was conducted in autumn 2008. The aim was to obtain knowledge of the schools before they commenced the implementation of the LP model. A selection of factors in the learning environment were examined. The second survey, which is identical to the frst, was conducted after 2 years in the fall of 2010. This gave the school a picture of the changes or development between the two surveys. The qua- litative evaluation was conducted autumn 2009, in the form of interviews at both school and county level, as well as interviews with representatives from LillegĂ„rden Resource Centre. At the school level all school principals and school coordinators responsible for the LP model at the 7 upper secondary schools were interviewed. In addition, a group interview was conducted with two teams of teachers in each school. At the county level, there have been interviews with the coordinators in the county and one representative from each educational psychological service associated with the project. The topics addressed in this report are as follows: ∙ What experiences have been made in relation to the school’s initiation and implementation of the pilot project LP model in upper secondary education? ∙ What do the results form the survey show with respect to what schools have achieved during the project period? ∙ Are there connections between the qualitative and quantitative results, and how can these be related to the work of the LP model? To give a brief answer to the frst topic; The results from the qualitative study indi- cate that there was some frustration and dissatisfaction among the teachers at the time of the interviews. There may be a number of reasons for this. One explanation maybe that some of the teachers felt that the project was «imposed from above.» Another, the time of interviews. Some schools had worked with LP one year, while others had only a half year of experience. Positively highlighted factors where the cooperation between teachers, allocated time for discussion and experience of establishing a shared language of educational practices in school. The survey in 2010 indicates better results than evaluations of primary schools who have used the LP model. There are several factors with effect sizes of 0.20 in the student survey. In Fall 2010 students stated that they experienced less noise and disturbance in the classroom, less disruptive behavior, a better relationship with their teachers and peers, and that there appears to be a better content in the teaching and a better structure in the classroom. Students’ form teachers judged their students in 2010; The student had better cognitive control and that they were more tolerant of others. Furthermore, the results show a positive effect across all factors in the teacher assessment, with the exception of one. The results document that teachers in 2010 are more positive and enthusiastic, they complete their school work better in cooperation with others, had a better relationship with their students and feel that they have improved skills with respect to dealing with behavioral problems. In the quantitative data variance analyses of the educational program were under- taken. The results indicate that both the students and their teachers in vocationally programs can display multiple effect sizes, more than students and teachers in vocational education programs. In this evaluation there were also some analyses of the school level, and we fnd relatively large differences between schools’ with regard to performance. It also seems that there is a correlation between teachers and students’ evaluations of different factors at the school level. In total, this evaluation found correlations between areas teachers had discussed in their groups and implemented measures and results of that, in the quantitative material. The results of the quantitative data may indicate that teachers’ systema- tically working in teacher groups may experience a positive development of their own educational practice, both in terms of expertise in class management and in establishing and maintaining good relationships with students.LillegĂ„rden kompetansesente

    Correlation between gene expression and MRI STIR signals in patients with chronic low back pain and Modic changes indicates immune involvement

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    Disability and distress caused by chronic low back pain (LBP) lacking clear pathoanatomical explanations cause huge problems both for patients and society. A subgroup of patients has Modic changes (MC), identifiable by MRI as vertebral bone marrow lesions. The cause of such changes and their relationship to pain are not yet understood. We explored the pathobiology of these lesions using profiling of gene expression in blood, coupled with an edema-sensitive MRI technique known as short tau inversion recovery (STIR) imaging. STIR images and total RNA from blood were collected from 96 patients with chronic LBP and MC type I, the most inflammatory MC state. We found the expression of 37 genes significantly associated with STIR signal volume, ten genes with edema abundancy (a constructed combination of STIR signal volume, height, and intensity), and one gene with expression levels significantly associated with maximum STIR signal intensity. Gene sets related to interferon signaling, mitochondrial metabolism and defense response to virus were identified as significantly enriched among the upregulated genes in all three analyses. Our results point to inflammation and immunological defense as important players in MC biology in patients with chronic LBP.publishedVersio

    Dissecting the shared genetic basis of migraine and mental disorders using novel statistical tools

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    Migraine is three times more prevalent in people with bipolar disorder or depression. The relationship between schizophrenia and migraine is less certain although glutamatergic and serotonergic neurotransmission are implicated in both. A shared genetic basis to migraine and mental disorders has been suggested but previous studies have reported weak or non-significant genetic correlations and five shared risk loci. Using the largest samples to date and novel statistical tools, we aimed to determine the extent to which migraine’s polygenic architecture overlaps with bipolar disorder, depression and schizophrenia beyond genetic correlation, and to identify shared genetic loci. Summary statistics from genome-wide association studies were acquired from large-scale consortia for migraine (n cases = 59 674; n controls = 316 078), bipolar disorder (n cases = 20 352; n controls = 31 358), depression (n cases = 170 756; n controls = 328 443) and schizophrenia (n cases = 40 675, n controls = 64 643). We applied the bivariate causal mixture model to estimate the number of disorder-influencing variants shared between migraine and each mental disorder, and the conditional/conjunctional false discovery rate method to identify shared loci. Loci were functionally characterized to provide biological insights. Univariate MiXeR analysis revealed that migraine was substantially less polygenic (2.8 K disorder-influencing variants) compared to mental disorders (8100–12 300 disorder-influencing variants). Bivariate analysis estimated that 800 (SD = 300), 2100 (SD = 100) and 2300 (SD = 300) variants were shared between bipolar disorder, depression and schizophrenia, respectively. There was also extensive overlap with intelligence (1800, SD = 300) and educational attainment (2100, SD = 300) but not height (1000, SD = 100). We next identified 14 loci jointly associated with migraine and depression and 36 loci jointly associated with migraine and schizophrenia, with evidence of consistent genetic effects in independent samples. No loci were associated with migraine and bipolar disorder. Functional annotation mapped 37 and 298 genes to migraine and each of depression and schizophrenia, respectively, including several novel putative migraine genes such as L3MBTL2, CACNB2 and SLC9B1. Gene-set analysis identified several putative gene sets enriched with mapped genes including transmembrane transport in migraine and schizophrenia. Most migraine-influencing variants were predicted to influence depression and schizophrenia, although a minority of mental disorder-influencing variants were shared with migraine due to the difference in polygenicity. Similar overlap with other brain-related phenotypes suggests this represents a pool of ‘pleiotropic’ variants that influence vulnerability to diverse brain-related disorders and traits. We also identified specific loci shared between migraine and each of depression and schizophrenia, implicating shared molecular mechanisms and highlighting candidate migraine genes for experimental validation
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