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Leder
(side 3)
av Bengt Karlsson og Ingrid Poulsen
Essay
Vitenskapelig publikasjon
(side 7-17)
av Helle Terkildsen Maindal, Peter Vedsted og Ellen M. Mikkelsen
Translation and cultural adaptation of the Danish version of „The Patient Activation Measure“
Engelsk sammendrag

Patients’ activation is a cornerstone in chronic care and disease management programs, but adequate measures of activation are lacking in Danish healthcare. Hibbard developed the American Patient Activation Measure (PAM) defining „activation“ as knowledge, skills, confidence and behavior critical for chronic illness management.

The aim of the study is to present the translation and adaptation of PAM to Danish regarding concept and item equivalence. The procedure followed WHO recommendations: (1) Forward translation, (2) Expert panel back-translation, (3) Pre-testing and cognitive interviewing, and (4) Final version and documentation.

Forward and back-translations were done separately and independently by four translators, followed by an adjustment by the expert panel. Minor changes to the first Danish PAM drafts were made after a pretest and a cognitive debriefing in a focus group among 12 participants recruited from a Type 2 Diabetes outpatient clinic. PAM is now available in Danish and is expected to be useful for clinical assessment and research purposes.

(side 18-27)
av Annette Fløe Møller og Gitte Sylvester Jensen
How can clinical instructors contribute to teaching in the skills laboratories?
Engelsk sammendrag

The purpose of this study is to investigate whether it would be of any advantage to nursing students’ learning abilities that the external clinical instructors are participating in the ordinary classes at the nursing school’s skills lab, and furthermore to evaluate the associated organizational challenges of their cooperation with the school teachers. The study follows the action research method, where the first part consists of observational studies by the clinical instructors, and the second part consists of interviews with both teachers and clinical instructors after they have been involved in the skills lab. All interviews were analyzed using Hiim and Hippes didactical relation model.

The clinical instructors’ presence means that teaching is more authentic, more practical, and that there is a better link between theory and practice, which is of benefit to students’ learning. However, it was found that cooperation between school teachers and clinical instructors poses major logistical challenges such as the need for clear agreements on employment status, salary and preparation time. Moreover, there will also be a need for establishing common goals for education, including clarification of the roles of clinical instructors and school teachers, should active cooperation between school teacher and clinical instructors be considered implemented in future education plans for the benefit of students, clinical instructors and teachers.

(side 28-37)
av Vibeke Lorentzen og Kirsten Beedholm Poulsen
Stimulating nurse students’ development preparedness – reflections and experience
Engelsk sammendrag

This article reflects on how nurses’ and students’ competencies can be strengthened for their involvement in the development of clinical nursing practice. The article is divided into three parts: 1) The development of a clinical tool and the students’ participation in the professional development of nursing practice. 2) A completed study involving students’ and registered nurses’ joint efforts in clinical practice to make a clinical tool to strengthen and develop the professional nursing practice. An example demonstrates how such a project can be organized and suggests how the nursing education, new graduate nurses and experienced registered nurses can participate in the development of the professional nursing practice. 3) A discussion of the opportunities and barriers related to research and projects, which points out that research contributes not only with new knowledge and development of the professional nursing practice, but equally important it contributes to developing the competencies of registered nurses and student nurses in their clinical practice.

Vitenskapelig publikasjon
(side 38-47)
av Inger Beate Larsen og Anders Johan W. Andersen
A Holy Duty – How do users of the mental health care system describe themselves, and what are their reasons for turning their experiences into written texts?
Engelsk sammendrag

This article is the first of three articles based on an extensive research on twelve Scandinavian autobiographies published in the period 1918 to 2008. The books are all written by people who by themselves or others have been described as having mental health problems. Historically, there have been differences in the understanding and perception of what kinds of people have mental health problems, or are described as having mental disorders. This article discusses the background of the authors and their motives for publishing books about their experiences of mental health problems. In relation to the authors’ backgrounds, the results show variation. However regarding their motivation for writing, we find similarities both between periods of time and geography. The authors wish to help others, to help themselves and to inform the community about conditions in the treatment system that ought to be changed. The consistent critique by these authors through different time periods shows that basic assumptions and models of thought within the mental health care system need further consideration.

(side 48-56)
av Irene Harkinn Andersen, Siri Ytrehus og Ellen Karine Grov
Palliative Nursing for Patients with Chronic Obstructive Pulmonary Disease (COPD)
Engelsk sammendrag

Patients with Chronic Obstructive Pulmonary Disease (COPD) are eligible for palliative care due to the major physical and mental challenges in the final phase of their lives. Anxiety and dyspnoea are two main symptoms with which patients with COPD struggle. The aim of this study is therefore to investigate what nurses perceive as their focus when caring for COPD patients who suffer from anxiety and dyspnoea when hospitalized. The study has a qualitative, phenomenological hermeneutic approach, and data is analyzed by means of Malterud’s four steps method. Four aspects are identified as significant to the nurses’ approach when caring for a patient with COPD:

  • The nurses describe great responsibility and effort to help the patient – especially in relation to personal, creative nursing to help the patient.
  • Availability and time to relieve suffering.
  • Solidarity with the COPD-patient.
  • Health care personnel providing information about the illness and coping strategies relieve the nurses’ work load. Nursing approaches are characterized as individual, relational, and professional.
Vitenskapelig publikasjon
(side 57-66)
av Ellen M. Mikkelsen og Helle Terkildsen Maindal
Pilot testing of an internet-based pregnancy planning study „Snart-gravid.dk“
Engelsk sammendrag

Before launching a new study, pilot testing is often recommended, however, it is seldom described in depth. Here, we report extensively on a pilot study using the internet as a new method for recruitment and data collection in a prospective cohort study of women planning a pregnancy. We aimed to enroll 2500 participants in six months and attain more than 75 % after 12 months follow up. To test data completeness and validity we randomized participants to fill out either a long or a short version of the baseline questionnaire and compared self-reported data with registry-based data. We succeeded in enrolling 2288 participants, and the participation rate was 82 % after 12 months. We found high correlations (0.96) for self-reported vs. registry-based data and no difference in participation rate or data completeness according to questionnaire length. Overall, the internet-based methods seem promising and we plan to launch the full study.

Vitenskapelig publikasjon
(side 67-76)
av Anette Häggblom og Ingrid Poulsen
„Often it becomes quiet“ – nurses’ meeting with abused women
Engelsk sammendrag

In a constantly changeable world, men’s violence against women continues to be an unchanging, ever present factor in intimate relationships. Most of the women seek help, sometimes from the public healthcare service.

This study is a result of interviews with nurses who treated abused women in their medical practices. The theoretical description and analysis of the concept of acting on a sudden impulse comes from Martinsen’s caring perspectives and Løgstrup’s philosophical theories. Based on a phenomenology-hermeneutics method, the study analyzes the importance of nurses’ ability to grasp and comprehend a situation and therefore act. The nurses described how they perceived specific situations, were open towards impressions and then acted. They described how they were guided by a sudden impulse, which contributed to a concrete solution in a difficult situation. The nurses could not prepare themselves to receive this sudden impulse beforehand, since this sudden idea sprung out of the situation, a onetime happening only. Sudden impulses are indispensable resources in the meeting with patients and can be of decisive importance in the care of abused women.

(side 77-81)
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