Experiences and challenges of the use Subacute and Acute Dysfunction in the Elderly-SAFE Work team coordinators experiences and challenges in the introduction and use of SAFE of in home-based nursing: A qualitative study from the Norwegian context

Old age is the leading cause of impaired bodily function, which gradually increases healthcare service needs. To offer the best possible care in the home and to be able to detect health-related functional impairment at an early stage, it is necessary to carry out systematic and structured observations. The assessment tool Subacute and Acute Dysfunction in the Elderly (SAFE) has been developed explicitly for these structured observations. This study aims to explore the experiences and challenges of home-based care work team coordinators (WTCs) regarding the introduction and use of SAFE.

METHOD

The present qualitative study was performed following Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines. The data were collected through individual interviews (n = 3) and focus group (FG) interviews (n = 7). The interview transcripts were analysed using the Gioia method.

RESULTS

Five aggregated dimensions were identified: Varying acceptance of SAFE, Structuring and quality-assurance of home-based nursing practice, Obstacles for the integration of SAFE in daily practice, Acceptance and use of SAFE require continuous supervision and SAFE contributes to increased quality of nursing care.

CONCLUSION

The introduction of SAFE contributes to a structured follow-up of functional status in patients receiving home care. In order to incorporate the tool into home care practice, it is essential to set aside time to introduce the tool and to support nurses' use of it by offering continuous supervision.

Prevalence and predictive factors of depressive symptoms among primiparae in antenatal care: A cross-sectional study in the new families programme

AIM/OBJECTIVE

To estimate the prevalence and assess the strength of associations between antenatal depressive symptoms and selected possible predictive factors among women attending antenatal care for the first time at the Child Health Centre.

BACKGROUND

Evidence suggests that antenatal depression is a health problem as prevalent as postpartum depression. Antenatal depressive symptoms may persist into the postpartum period and potentially disturb the attachment between mother and family.

DESIGN

Cross-sectional.

METHODS

A sample of 228 women who participated in the New Families research programme answering a questionnaire at Week 28 of pregnancy were included. The Edinburgh Postnatal Depression Scale was used as outcome measure. Prevalence was estimated, and backward stepwise logistic regression analysis was performed to examine associations with somatic, psychiatric and social factors. STROBE checklist was followed.

RESULTS

Prevalence of depressive symptoms in this sample was 17.9%. Women reporting not sleeping enough had significantly higher odds of having depressive symptoms. Pregnant women with high relationship satisfaction were less likely to have depressive symptoms. Neither maternal age, education, previous depression, coming from a non-Nordic country nor having complications during pregnancy were statistically significantly associated with depressive symptoms.

CONCLUSIONS

High prevalence of depressive symptoms may also be present in low-risk populations. Sleep and relationship satisfaction are topics that need to be addressed during pregnancy.

RELEVANCE TO CLINICAL PRACTICE

The prevalence of depressive symptoms in this sample of low-risk pregnant women indicates that health personnel needs to be aware of depressive symptoms among women with no risk indicators. Identifying predictive factors associated with depressive symptoms may help midwives, public health nurses and general practitioners support parents. Our results indicate a potential need for screening for depressive symptoms in pregnancy and underscore the importance of involving partners in antenatal care.

PATIENT/PUBLIC CONTRIBUTION

Parents and health personnel participated in designing the New Family research programme.

Home Care Nurses' Experiences of the Use and Introduction of the Subacute Functional Decline in the Elderly Instrument

Introduction

Registered nurses are crucial in home care nursing for elderly patients, as detecting geriatric conditions can be difficult due to age-related changes or communication barriers. Disability is often overlooked in elderly care, requiring different assessment tools to determine patient status and necessary nursing interventions. During the COVID-19 pandemic, the subacute functional decline in the elderly (SAFE) instrument was implemented in some Oslo districts to detect early signs of sub acute functional decline in hospital and home care settings. However, the nurses' perception of this new assessment tool and its effectiveness has not been evaluated.

Objectives

This study aims to explore home care nurses' experiences and perceptions regarding the introduction and use of the new assessment tool, SAFE. Objectives were to conduct focus group interviews and perform qualitative analysis.

Method

The study followed Consolidated Criteria for Reporting Qualitative Research guidelines, had a qualitative design, and included 15 out of 60 permanently employed RNs at Oslo municipality's home care service in Frogner district. Data was collected via three focus group interviews and analyzed thematically.

Results

The study identified three themes: (1) Nurses learned to use SAFE through direct experience due to a lack of standard introduction or training. (2) SAFE supported patient-centred care by enabling communication, preventive work, and identifying patients' needs. (3) Integrating SAFE into electronic databases and daily clinical work could improve nursing efficiency.

Conclusion

Overall, using SAFE can improve patient outcomes and care quality in home care, but clear guidelines, ongoing support, and standardized procedures are crucial for its effectiveness. Regular updates and complete management support are also necessary. The study's findings align with previous research and can guide the development and implementation of tools in home care to enhance patient outcomes and the quality of care delivered.

Measurement instruments for parental stress in the postpartum period: A scoping review

Background

Parenting stress is a particular type of stress that is conceptualized as a negative psychological response to the numerous obligations associated with raising children. Despite a considerable increase in research on parenting stress, little attention has been given to the ways parenting stress are measured.

Objectives

This scoping review aimed to provide an overview of available instruments measuring parental stress and to describe their psychometric properties.

Methods

We conducted a scoping review in accordance with international guidelines for scoping reviews. The main search strategy was searches in seven electronic databases. Pairs of reviewers selected relevant studies based on predetermined inclusion and exclusion criteria. Studies had to report one or more psychometric properties of an instrument measuring stress in parents with children 0–12 months. For each included study, we collected information relevant to the review question, guided by the COnsensus based Standards for the selection of health status Measurement INstruments (COSMIN). Finally, we collated, summarized, and reported the findings descriptively.

Results

From 2164 unique record, 64 studies from 24 countries were included. They described 15 instruments, of which four were generic and eleven parental-specific self-administered instruments. Only two studies examined parental stress among fathers. Eleven of the studies were validation studies, but they only described seven of the 15 instruments. Internal consistency was the only information provided by 73.4% of the included studies. None of the instruments had information on all measurement properties as per the COSMIN criteria, and there was no information about measurement error, responsiveness, or interpretability for any of the 15 instruments.

Discussion

There are presently 15 instruments with some associated psychometric information being used to measure parental stress among parents with young children, but the amount of information on the instruments’ psychometric properties is slight. There is a need for further research.

The relationship of existential well - being to identity, religious coping, mental and general health among Norwegian aging women

The aim of this study was to explore the relationship of existential spirituality to identity processing, religious coping and mental and general health among younger and older aged women in Norway. Participant's included 120 women aged 31-91 who took part in a postal survey. Results showed that both accommodative and balancing identity processes were associated with existential well -being among both the younger and older aged. Among the younger - aged, mental health was also significantly associated with existential well-being, Moreover, among the older aged, religious coping in the form of discontent, was found to be associated with existential well-being.

Diet, nutritional status and school performance among adolescents in Gaza Strip

The associations between dietary intake, nutritional status and school performance among 932 adolescents aged 12-15 years were examined in a cross-sectional survey in 2002 in north Gaza Strip. School performance was obtained from school records and height and weight were measured for body mass index (BMI). Self-administered questionnaires included sociodemographic characteristics and food frequency intakes. Adolescents consuming fruit and vegetables more than 3 times per week were more likely to have good school performance (72.6% versus 59.9%). When adjusting for sociodemographic variables and BMI, fruit and vegetables intake was positively associated with school performance (OR = 1.61, 95% CI: 1.11-2.32) and stunting was negatively associated (OR = 0.53, 95% CI: 0.31-0.90). The findings support a broader implementation of school nutrition programmes.