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Artikler
Palliative care in rural and remote areas
Challenges facing rural nurses in palliative cancer care in the far North of Norway
Vitenskapelig publikasjon
(side 150-163)
av Trine Lise Edvardsen, Geir F. Lorem & Grete Mehus
Sammendrag

Introduction: In Finnmark, the northernmost county of Norway, many villages are remote and scattered between vast stretches of uninhabited land, with mountain crossings that are often closed in winter or where one can only drive in single file behind a snowplough. This may mean periodic total isolation and daily challenges with long distances to other professionals and hospitals. These special circumstances mean that nurses must act more independently than elsewhere. Objectives: The aim was to explore the challenges of rural nurses in palliative cancer care, and the prerequisites to maintain a suitable professional standard in their nursing. Methods: This study is qualitative with an explorative design and reports the results of the content analysis of interviews with five nurses, living in small, multi-ethnic villages. Findings: The main finding of the study is that the nurses experienced themselves as being alone geographically and professionally in their practice of palliative care. The established infrastructure for performing advanced nursing in patients’ homes is poorly adapted to the geographical and professional situation in rural areas such as Finnmark, and suboptimal information about patients arriving from hospitals can compromise the quality of care. Advanced nursing is performed when specialists are far away and there is no palliative team, and they care for patients who are often their family members, friends and acquaintances, which involves role ambiguity and a risk of over-involvement. Conclusion: The study shows that requirements to enhance palliative cancer care are to establish palliative teams, discharge summaries present in transition, the necessary drugs and medical equipment for several days, and relevant training of personnel.

Vitenskapelig publikasjon
(side 164-175)
av Eli-Anne Skaug, Stina Ekman & Jörg W. Kirchhoff
SammendragEngelsk sammendrag

Utdanningsinstitusjoner har et ansvar for å sikre at sykepleiere har en kompetanse som er i samsvar med samfunnets behov og sikrer kvalitet på sykepleien. Av den grunn er det behov for å kartlegge sykepleierstudenters kompetanse. Nurse Professional Competence skalaen er et instrument som har vist seg å være egnet i denne sammenhengen. I denne artikkelen presenteres oversettelsen, tilpasningen og testingen av instrumentet i en norsk kontekst. Innledningsvis ble instrumentet oversatt og tilpasset norsk kontekst i samsvar med anbefalte retningslinjer. Instrumentet ble testet på 127 studenter. Instrumentets reliabilitet varierte med en Cronbach’s alpha fra 0,69 – 0,92. I tillegg ble et panel på 11 studenter, fordelt i to fokusgrupper, intervjuet for å styrke instrumentets validitet. Intervjuene viste at studentene opplevde at instrumentet var dekkende for sykepleiefaglig kompetanse og i samsvar med innholdet i utdanningen. Vi anbefaler å bruke Nurse Professional Competence skalaen ved kartlegging av sykepleierstudenters samlede kompetanse ved endt utdanning. Videre studier er nødvendig i arbeidet med å validere instrumentet.

Educational institutions have a responsibility to ensure that nurses have a competence that is in accordance with the needs of society to ensure quality in nursing. For that reason, it is necessary to map the nursing students’ competence. The Nurse Professional Competence scale is an instrument that has proven to be appropriate in this context. This article aims to present the translation, adjustment and testing of the instrument in a Norwegian context. Initially, the scale has been translated in accordance with approved recommendations. During translation, concepts in the instrument have been adjusted to the Norwegian context. The instrument was tested on 127 students. The reliability of the instrument ranged with a Cronbach’s alpha from 0.69 to 0.92. In addition, a panel of 11 students, divided into two focus groups, were interviewed to strengthen the validity of the instrument. The students find that the instrument covers the competencies in nursing and is consistent with the content of their education. We recommend the scale in mapping nursing students’ total competence after completion of education. Further studies are required to validate the instrument.

Vitenskapelig publikasjon
(side 176-184)
av Ida Mykkeltveit & Signe Berit Bentsen
SammendragEngelsk sammendrag

Scrub Practitioners’ List of Intraoperative Non-Technical Skills (SPLINTS) er et observasjons- og vurderingsinstrument som gir et formelt rammeverk og felles begrepsapparat for å vurdere ikke-tekniske ferdigheter hos operasjonssykepleiere. Hensikten med denne studien er å beskrive oversettelsen og tilpasningen av SPLINTS fra engelsk til norsk (SPLINTS-no). SPLINTS-no er oversatt etter anerkjente prosedyrer med oversettelse og tilbake-oversettelse. I oversettelsen ble flere trinn benyttet for å sikre tverrkulturell tilpassing. I tillegg til to uavhengige oversettere deltok et ekspertpanel med fem erfarne studentveiledere med spesialutdanning i operasjonssykepleie. De leste gjennom SPLINTS-no, korrigerte språk og vurderte anvendbarheten av SPLINTS-no. Til slutt ble SPLINTS-no oversatt tilbake til engelsk og godkjent av utviklerne av SPLINTS. Originalversjonen er ivaretatt i oversettelsesprosedyren og eksempler på hensiktsmessig og uhensiktsmessig adferd er tilpasset den sterile og koordinerende operasjonssykepleier i Norge. Vurderingsskalaen er endret fra fire til fem nivå i samsvar med den danske versjonen av SPLINTS. SPLINTS-no kan anvendes både under utdanningen og til å videreutvikle kompetanse hos operasjonssykepleiere gjennom observasjon og tilbakemelding, og gir norske operasjonssykepleiere mulighet til å utvikle ikke-tekniske ferdigheter på lik linje med tekniske ferdigheter.

The Scrub Practioners’ List of Intraoperative Non-Technical Skills (SPLINTS) is an observation and assessment tool that provides a formal framework and a uniform language for assessing non-technical skills for operating room nurses. The aim of this study is to describe the translation and cross-cultural adaption process of the Norwegian version of SPLINTS (SPLINTS-no). SPLINTS was translated into Norwegian using recognized procedures for forward and backward translation. Different steps were integrated in the translation process to ensure cross-cultural adaption, using an expert committee consisting of five operating room nurses. The committee reviewed SPLINTS and examined whether the tool is understandable and usable for assessing the non-technical skills of Norwegian operating room nurses and students. The tool was translated back into English and accepted by the original author. SPLINTS-no is considered a useful tool for raising the awareness of non-technical skills with both operating room nurses and students. The original version is still intact after translation, but examples of appropriate and inappropriate practices are adapted to operating room nurses in Norway. In addition, the assessment scale was changed from four to five levels in accordance with the Danish version of SPLINTS. SPLINTS-no gives Norwegian operating room nurses an opportunity for practicing both non-technical and technical skills. Feedback at non-technical skills is needed in the education of operating room nurses and operating room nurses in order to develop excellent practices.

Vitenskapelig publikasjon
(side 185-200)
av Mette Stie, Anne-Lisbeth Pedersen, Pia Koustrup, Bodil Winther, Bente Hoeck & Charlotte Delmar
SammendragEngelsk sammendrag

Artiklen præsenterer resultaterne af en Fairclough-inspireret kritisk diskursanalyse af, hvordan pårørende bliver beskrevet i danske sundhedspolitikker. På baggrund af Faircloughs tredimensionelle model for diskursanalyse samt perspektivering til ideologien om Danmark som en konkurrencestat, som beskrevet af K.O. Pedersen, er der analyseret otte politikker udgivet af danske sundhedsmyndigheder, institutioner og patientinteresseorganisationer i perioden 2014-2018. Analysen viser tre diskurser om pårørende i den politiske vision om inddragelse af patienter og pårørende: 1) Den rationelle pårørende 2) Prinsgemal syndromet – ansvarlig, men i anden række, og 3) At spille rollen som en ressourcestærk pårørende. Vi viser, at diskurserne kan have betydning for, hvordan sygeplejersker opfatter og møder pårørende, samt hvordan pårørende forventes at agere. Ved disse diskurser er der risiko for, at pårørende bliver overset som personer med egne behov, ønsker og præferencer. Derudover betyder diskurserne, at ressourcestærke pårørende er en forudsætning for, at patienten kan modtage den bedste pleje. Vi konkluderer, at pårørende opfattes som middel til at nå målet om et konkurrencedygtigt sundhedsvæsen.

This article presents the findings of a Fairclough-inspired critical discourse analysis aiming to clarify how relatives are articulated in Danish Health Care Policies. Drawing on Fairclough’s three-dimensional framework for analyzing discourse, and using the ideology of a competitive state as described by K.O. Pedersen as an interpretive lens, we have analyzed eight policy papers published by Danish Health Care authorities, institutions and patient interest groups from 2014-2018. The analysis revealed three discourses about relatives within the political vision of involvement of patients and relatives: 1) The rational relative 2) The responsible yet subordinated relative, and 3) Playing the role as a resourceful relative. We argue that the discourses affect how nurses perceive relatives, and how relatives are allowed and expected to be. There is a risk that viewing relatives as persons with needs, wishes and preferences is missed as well as having resourceful relatives is a prerequisite for receiving the best care. Further, we argue that within the discourses, relatives are perceived as the mean of achieving the goal of Denmark becoming a state of competitiveness. Hence the discourses support the maintenance of the ideology of a competitive health service.

Å lide når en lever med overvekt og fedme
– en utfordring i omsorg og behandling
Vitenskapelig publikasjon
(side 201-212)
av Bodil Furnes, Elin Dysvik & Venke Ueland
SammendragEngelsk sammendrag

Bakgrunn: Studien belyser eksistensielle erfaringer ved å leve med fedme. Vår tids krav til kroppens utseende kan være med på å øke menneskers sårbarhet. Når kroppen kommer i forgrunnen, utfordres forholdet til seg selv. Mennesket kan erfare lidelse og krenkelse når det opplever å ikke få være et fullverdig menneske. Hensikt: Studiens hensikt er å få en dypere forståelse for individuelle eksistensielle erfaringer og utfordringer hos personer med fedme. Metode: Studien har en kvalitativ forskningsdesign med en fenomenologisk hermeneutisk tilnærming. Datainnsamlingen består av kvalitative intervjuer med 18 personer med fedme. Dataene analyseres og fortolkes ved hjelp av Kvales tre fortolkningsnivå: selvforståelse, common sense og teoretisk forståelse. Erikssons teori om lidelse og krenkelse, benyttes for å utdype studiens funn. Funn: Studiens funn gir innblikk i eksistensielle erfaringer ved å leve med fedme trer frem i form av å ‘kjenne seg mislykket’ og ‘miste seg selv’. Konklusjon: Å leve med fedme kan erfares som en lidelse ved at hele personens livssituasjon berøres og blir en trussel mot egen eksistens. Helsevesenet utfordres til å ‘se mennesket’ og møte hele mennesket med verdighet.

Background: This study is based on existential experiences of living with obesity. Our current focus on demands on the body’s appearance might increase human vulnerability. When the body comes to the fore, the relationship with oneself might be challenged. Human beings can experience suffering and violation when not feeling oneself as a full human being. Aim: The aim of the study is to gain a deeper understanding of the individual existential experiences of people with obesity. Method: The study is qualitative with a phenomenological hermeneutic approach. Data are collected through qualitative interviews with 18 obese people. The data is analyzed and interpreted by Kvale’s three levels of interpretation: self-understanding, common sense and theoretical understanding. Eriksson’s theory of suffering and violation helps to deepen the study’s findings. Findings: Findings give insight into existential experiences of living with obesity and appear as ’feeling unsuccessful’ and ’losing oneself’. Conclusion: Living with obesity can be experienced as suffering by touching the whole person’s life situation. The health system is challenged to ’see and meet the whole person’ with dignity.

«Sometimes falling out of normal life»
A qualitative study of children and their experiences with a life with allergy and asthma
Vitenskapelig publikasjon
(side 213-222)
av Hildegunn Sundal & Else Lykkeslet
Sammendrag

The combination of asthma and allergy is one of the most common chronic diseases in childhood. The aim of this article is to illuminate children’s experiences with allergies and asthma through their stories of everyday life. The study is grounded in a phenomenological philosophy of lifeworld and thus employs a qualitative design. The data were collected through qualitative in-depth interviews with four children, aged 9-12 years, with each child interviewed three times. A narrative analysis was conducted from the responses. Four stories, one from each child, were written and later analyzed as one narrative, representing the findings of the study. The main finding is that living with a disease may cause a child to fall out of normal life. This narrative contains three sub-narratives: everyday life with an intrusive disease, supporters in everyday life, and the hope to be included in normal life. Using a narrative analytical approach provided a cohesive story of the children’s experiences. In these narratives, the contexts of the children’s lives are prominent, yielding stories in which everyday life, the children’s lifeworld, emerges. These stories, in turn, offer healthcare professionals insight into the experiences of children living with chronic disease.

Nordisk sygeplejeforskning

3-2020, årgang 10

https://www.idunn.no/nsf

Nordisk Sygeplejeforskning – Nordic Nursing Research is a scientifically and peer-reviewed level-one journal. The journal publishes scientific articles and essays. Nordic Nursing Research addresses researchers within the fields of nursing science and health, teachers in the health education, nurses in clinical practice and other professionals.

The journal publishes articles in Norwegian, Danish, Swedish and English.

Nordisk Sygeplejeforskning – Nordic Nursing Research er et vitenskapelig og fagfellevurdert tidsskrift på nivå 1. Tidsskriftet publiserer vitenskapelige artikler og essays, og henvender seg til forskere innen sykepleievitenskap og helsefag, undervisere, sykepleiere i klinisk praksis og andre fagprofesjonelle.

Tidsskriftet publiserer artikler på norsk, dansk, svensk og engelsk.

 

Editor

Pia Dreyer (PhD), Aarhus Universitetshospital

 

National editor Denmark

Elizabeth Rosted (PhD) Sjællands Universitetshospital, Roskilde

 

National editor Norway

Heidi Jerpseth (Postdoktorstipendiat), Høgskolen i Oslo og Akershus

 

Editorial assistant

Nina Falsen Krohn

Typeset: Type-it AS

ISSN online: 1892-2686

DOI: 10.18261/issn.1892-2686

The journal is owned jointly by Dansk Selskab for Sygeplejeforskning and Norsk Selskab for Sykepleieforskning NSF and published by Universitetsforlaget.

© Universitetsforlaget 2020 / Scandinavian University Press

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