| 1. |
- Foldager Jeppesen, Sarah, et al.
(författare)
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Parental satisfaction with paediatric care with and without the support of an eHealth device : a quasi-experimental study in Sweden
- 2024
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Ingår i: BMC Health Services Research. - 1472-6963. ; 24
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Tidskriftsartikel (refereegranskat)abstract
- Background: The period after a child is discharged from hospital is generally described as challenging for the parents. Their satisfaction with the health services received is an important indicator of the quality of care. eHealth devices are increasingly used in health care to support communication with parents. Differences in levels of parental satisfaction by modality of provided care or by parental background are largely unknown. This study aimed to describe satisfaction with health care between sociodemographic groups of parents, who either received or did not receive an eHealth device for communication between parents and hospital staff as a supplement to routine care after a child’s discharge from neonatal or paediatric surgery departments. Methods: Data from a quasi-experimental study was collected in the south of Sweden, between 2019 and 2021. The Pediatric Quality of Life Inventory™ (PedsQL) Healthcare Satisfaction Generic Module was used to assess the parents’ satisfaction with different dimensions of health care. Seventy parents of children hospitalized in a neonatal or a paediatric surgery department were enrolled in intervention (eHealth device, n = 36) and control (no eHealth device, n = 34) groups. Results: The parents reported high overall satisfaction with the health care provided and were also highly satisfied within different dimensions of care. Moreover, they reported high satisfaction with using an eHealth device, although having support from the eHealth device was related to neither higher nor lower levels of satisfaction with care. There was a significant difference between fathers and mothers in the multivariate sub-analysis in certain instances regarding satisfaction with communication and the level of inclusion. Conclusions: Parents were very satisfied with the health care provided, whether or not they received eHealth. Further research looking at groups with and without the support of an eHealth device is required to further develop future paediatric and neonatal care interventions. Communication and support through eHealth can be a tool to alleviate the distress parents experience after their child’s hospital admission, accommodate the family’s transfer to home, and increase satisfaction with care, but it needs to be evaluated before being implemented. Trial registration: Clinical Trials NCT04150120, first registration 4/11/2019.
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| 2. |
- Helland Lindborg, Tonje, et al.
(författare)
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Adolescent boys’ experiences of mental health and school health services - an interview study from Norway
- 2024
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Ingår i: BMC Public Health. - 1471-2458. ; 24:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Mental health problems among adolescents is a global challenge. During the transition to adolescence, physiological, psychological, and social changes occur, leading to increased vulnerability. Thus, adolescent boys are less likely to seek help for mental health problems, which makes them an undetected group. The aim of this study was to gain a deeper understanding of adolescent boys’ experiences of mental health and school health service. Methods: An inductive, qualitative design was chosen using three focus group interviews and three individual interviews. The study included 18 adolescent boys in 7th grade, in a school located in a medium-sized municipality in Norway. The interviews were analysed with qualitative content analysis. The consolidated criteria for reporting qualitative research (COREQ) were followed in this study. Results: The overall theme “barriers towards seeking help”, and three categories— navigating stigma and privacy concerns; perceptions of self-responsibility; and lacking knowledge of mental health problems and help-seeking—described the adolescent boys experiences. The awareness and willingness to seek help were present, but there are barriers preventing the adolescent boys from acting on that willingness. Conclusions: Lack of knowledge and a non-permissive culture for mental health problems among adolescents contributes to decreased help-seeking behaviour among adolescent boys. The school health service is the most related health service for adolescents and should focus on being available and strengthening empowerment and mental health literacy through the development and implementation of interventions to promote mental health.
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| 3. |
- Persson, Helene Åvik, et al.
(författare)
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Professionals’ expectations and preparedness to implement knowledge-based palliative care at nursing homes before an educational intervention : A focus group interview study
- 2021
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 18:17, s. 1-18
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Tidskriftsartikel (refereegranskat)abstract
- The provision of knowledge-based palliative care is rare in nursing homes. There are obstacles to practically performing this because it can be difficult to identify when the final stage of life begins for older persons. Educational interventions in palliative care in nursing homes are a challenge, and joint efforts are needed in an organisation, including preparedness. The aim was to explore professionals’ expectations and preparedness to implement knowledge-based palliative care in nursing homes before an educational intervention. This study has a qualitative focus group design, and a total of 48 professionals working in nursing homes were interviewed with a semi-structured interview guide. Qualitative content analysis with an inductive approach was used for the analysis. One major theme was identified: professionals were hopeful yet doubtful about the organisation’s readiness. The main categories of increased knowledge, consensus in the team, and a vision for the future illustrate the hopefulness, while insufficient resources and prioritisation illustrate the doubts about the organisation’s readiness. This study contributes valuable knowledge about professionals’ expectations and preparedness, which are essential for researchers to consider in the planning phase of an implementation study. The successful implementation of changes needs to involve strategies that circumvent the identified obstacles to organisations’ readiness.
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| 4. |
- Persson, Helene Åvik, et al.
(författare)
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Professionals´ readiness for change to knowledge-based palliative care at nursing homes : a qualitative follow-up study after an educational intervention
- 2022
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Ingår i: BMC Palliative Care. - : Springer Science and Business Media LLC. - 1472-684X. ; 21:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: There has been a global increase in the number of people who are dying of old age. This development implies a need for good palliative care among older persons at the end of life. Here nursing homes have an important role to play. However, the principles of palliative care have not been sufficiently applied in nursing homes, and there is a need to increase the implementation of palliative care in these settings. Therefore the project named Implementation of Knowledge-Based Palliative Care in Nursing Homes (the KUPA project, to use its Swedish acronym) was started as a contribution to filling this knowledge gap. The aim of the present study was to investigate the professionals’ experiences of readiness for change to knowledge-based palliative care at nursing homes after the educational intervention within the KUPA project. Methods: The focus group method was used to interview 39 health-care professionals with the aid of semistructured questions based on the Organizational Readiness for Change theoretical framework. Six focus groups were formed at six nursing homes in two counties in southern Sweden. The groups included different types of professionals: assistant nurses, nurses, occupational therapists, physiotherapists and social workers. The analysis was conducted with an abductive approach and included deductive and inductive content analysis. Results: The analysis revealed one overarching theme: hopeful readiness for change in palliative care despite remaining barriers. The main categories were increased knowledge facilitating development, enhanced team spirit, uncertainty about future plans connected with hopeful readiness and remaining organizational barriers. Conclusions: This study adds knowledge and understanding concerning professionals’ readiness for change palliative care in nursing homes and shows how ready nursing home settings undertake these changes in practice. The Organizational Readiness for Change theory proved suitable for application in nursing homes to assess the professionals’ experiences and to evaluate educational interventions regardless of the organization’s readiness for change. Trial registration: ClinicalTrials NCT02708498, first registration 15/03/2016.
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| 5. |
- Tunje, Abayneh, et al.
(författare)
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Intervention fidelity and factors affecting the process of implementing a mobile phone text messaging intervention among adolescents living with HIV : A convergent mixed-methods study in southern Ethiopia
- 2024
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Ingår i: BMJ Open. - 2044-6055. ; 14:7
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Tidskriftsartikel (refereegranskat)abstract
- Objective To assess the intervention fidelity and explore contextual factors affecting the process of implementing a mobile phone text messaging intervention in improving adherence to and retention in care among adolescents living with HIV, their families and their healthcare providers in southern Ethiopia. Design A convergent mixed-methods design guided by the process evaluation theoretical framework and the Reach, Effectiveness, Adoption, Implementation and Maintenance framework was used alongside a randomised controlled trial to examine the fidelity and explore the experiences of participants in the intervention. Setting Six hospitals and five health centres provide HIV treatment and care to adolescents in five zones in southern Ethiopia. Participants Adolescents (aged 10-19), their families and their healthcare providers. Intervention Mobile phone text messages daily for 6 months or standard care (control). Results 153 participants were enrolled in the process evaluation. Among the 153 enrolled in the intervention arm, 78 (49.02%) were male and 75 (43.8%) were female, respectively. The mean and SD age of the participants is 15 (0.21). The overall experiences of implementing the text messages reminder intervention were described as helpful in terms of treatment support for adherence but had room for improvement. During the study, 30 700 text messages were sent, and fidelity was high, with 99.4% successfully delivered text messages during the intervention. Barriers such as failed text messages delivery, limitations in phone ownership and technical limitations affected fidelity. Technical challenges can hinder maintenance, but a belief in the future of digital communication permeates the experiences of the text message reminders. Conclusions Overall fidelity was high, and participants' overall experiences of mobile phone text messages were expressed as helpful. Contextual factors, such as local telecommunications networks and local electric power, as well as technical and individual factors must be considered when planning future interventions. Trial registration number PACTR202107638293593.
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| 6. |
- Ulvøy, Dagny-Elise, et al.
(författare)
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Parents' experiences of their child's participation in divorce groups in Norway : A phenomenological study
- 2023
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Ingår i: Scandinavian Journal of Caring Sciences. - 1471-6712. ; 37:4, s. 991-1000
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundChildren and youth who experience divorce are found to have increased risk of emotional and behavioural adjustment problems. Different prevention programmes have been developed to help and support children. Previous studies have focused on the child or the group leader's experience with divorce groups, but studies describing parent's experience are missing. The aim of this study was to explore parents' experiences of their child's participation in divorce groups.MethodsAn inductive, qualitative and descriptive design was applied with philosophical orientation in naturalistic inquiry based on the outlines of a phenomenological perspective. Two fathers and three mothers from two different counties in Norway participated whereof four of them were interviewed twice. Systematic text condensation was used for the analysis.ResultsThree themes emerged from the analysis: encouraging the child, missing communication and challenging situations. Parents described how they encouraged the child to attend divorce groups and hoped they would gain a deeper understanding of their parents' divorce and their own feelings. Missing communication relates to lack of information about the groups from the school, the group leader and from the child. Missing information was found to be a challenge for the parents and made them think that the divorce group was beneficial for the child but maybe not always for the family. Parents described challenging situations due to the divorce, and they struggled to understand their child and their own behaviour.ConclusionsThe opportunity for the child to talk to other children in the same situation in divorce groups was positive for the parents. To be beneficial for both children and their parents, structured information and cooperation among the school, the child and both parents are important. The knowledge from this study can support the development and use of intervention programmes in the future.
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| 7. |
- Åvik Persson, Helene, et al.
(författare)
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Early and late signs that precede dying among older persons in nursing homes : the multidisciplinary team's perspective
- 2018
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Ingår i: BMC Geriatrics. - : BioMed Central. - 1471-2318. ; 18
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Tidskriftsartikel (refereegranskat)abstract
- Background: Nursing home residents in Sweden are old, frail and usually have multiple morbidities which often make dying a prolonged suffering. It has been found that older persons at nursing homes receive far less palliative care than younger persons, partly because it is difficult to identify when the final stage of life begins. The identification may help the staff to enable the older person and their families to participate in planning the care in accordance with their own preferences and values. With this in mind the aim was to explore the experiences of early and late signs preceding dying in older persons in nursing homes from the multidisciplinary team's perspective. Methods: The focus group method was used to interview 20 health-care professionals on the basis of semi-structured questions. Four focus groups were conducted at four nursing homes in two counties in southern Sweden. The groups included different professionals such as assistant nurses, registered nurses, occupational therapists, physiotherapists, social workers and unit managers. The analysis was conducted according to the focus group method developed by Kruger and Casey. Results: The analysis revealed one major theme, from unawareness to obviousness, which illustrates that the participants experienced dying as a happening, not a process, and found it difficult to identify early signs. Even though it was a new way of thinking, several suggestions of early signs were presented. The main category "Going into a bubble" illustrates early signs, which meant that the older person showed signs of wanting to withdraw from the outside world. The main category "The body begins to shut down" illustrates late signs, which meant that the older person showed signs that indicate that the body starts to prepare for death. Conclusions: This study conveys new knowledge concerning the multidisciplinary team's collective experience of early and late signs that precede dying. This knowledge can increase the understanding of when a palliative care approach needs to be in place at nursing homes. The use of a palliative care approach in care planning requires consensus in the perception of the dying process of frail older persons.
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| 8. |
- Åvik Persson, Helene
(författare)
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Implementation of knowledge-based palliative care at nursing homes: The professionals' perspective
- 2022
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Dying in older persons precedes often by a prolonged period of frailty and multimorbidity. The global increase in the aged population means more death at an older age and highlights the need to integrate palliative care in elderly care. Knowledge-based palliative care is lacking outside the specialist units, for which reason there is insufficient access to palliative care for older persons. Thus there is a need to implement knowledge and training in palliative care for the professionals in nursing homes. Putting evidence to proper use in practice is experienced as challenging, which calls for an exploration of experiences connected to the implementation of change in order to enhance the readiness for change in the future.The thesis is a part of a larger project, Knowledge-Based Palliative Care for Frail Older Persons in Nursing Homes (Swedish acronym KUPA). The overall aim of the thesis was to explore the professionals’ experiences of signs preceding dying in older persons and of the implementation of knowledge-based palliative care through an educational intervention at nursing homes. The thesis includes three qualitative focus group studies (I-III) and one quantitative study (IV) with pre-post design.In Study I, experiences of early and late signs preceding dying in older persons in nursing homes were explored. The multidisciplinary team found it difficult to identify early signs since it was not part of their ordinary practice, nor indeed something they had an awareness of. Late signs were found obvious and easy to identify, and dying was something that just happened not seen as a process.In Study II, professionals’ expectations and preparedness to implement knowledge-based palliative care in nursing homes were explored. They hoped to gain increased knowledge and improved consensus in the team but questioned the organization’ preparedness to change. Study III investigated experiences of readiness for change after the educational intervention in knowledge-based palliative care at nursing homes. The professionals were hopeful about the implementation of palliative care in the nursing homes and about continuation of the education, despite barriers in the organization. The education increased their knowledge and awareness. In Study IV, the professionals’ experiences of palliative care delivery before and after the educational intervention in nursing homes was evaluated. Some improvements in the experiences of symptom management, of conversation and support and of encounter were found between and within the intervention and control groups.There is a need to introduce palliative care early in the older person’s disease trajectory to increase quality of life. This calls for more knowledge and awareness among the professionals about early-stage palliative care. Furthermore the older person and the next of kin must be informed that palliative care is a part of the care in nursing homes. Increasing the professional’s readiness is a facilitation for all leaders in the health care section when a change is going to be implemented.
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| 9. |
- Åvik Persson, Helene, et al.
(författare)
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Palliative care delivery at nursing homes before and after an educational intervention from professionals' perspective : A pre-post design
- 2023
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Ingår i: Scandinavian Journal of Caring Sciences. - : John Wiley & Sons. - 0283-9318 .- 1471-6712. ; 37:1, s. 229-242
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Tidskriftsartikel (refereegranskat)abstract
- Background The principles of palliative care were developed in hospices and specialised palliative care units and have not been sufficiently adapted to and evaluated in nursing homes. Therefore, an educational intervention from an interprofessional education perspective was performed within the project Implementation of Knowledge-Based Palliative Care in Nursing Homes. The aim of this study was to evaluate professionals' experience of palliative care delivery before and after the educational intervention. Methods The educational intervention for nursing home professionals consisted of five 2-h seminars over 6 months at 20 nursing homes. The intervention and control groups consisted of 129 and 160 professionals from 30 nursing homes respectively. The questionnaire 'Your experience of palliative care' was completed 1 month before (baseline) and after (follow-up) the intervention. Descriptive and inferential statistics were calculated. Results The positive effects at follow-up concerned the use of a valid scale for grading symptoms, attendance to the needs of next of kin (including bereavement support), documentation of older persons' wishes regarding place to die and conversations about their transition to palliative care and about how they were treated. Conclusions This study demonstrates a promising interprofessional educational model. However, the paucity of improvements brought to light at follow-up indicates a need for research directed towards a revision of this model. Supervision of professionals during palliative care delivery is one suggestion for change.
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