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Storm M, Morken IM, Austin RC, Nordfonn O, Wathne HB, Urstad KH, Karlsen B, Dalen I, Gjeilo KH, Richardson A, Elwyn G, Bru E, Søreide JA, Kørner H, Mo R, Strömberg A, Lurås H, Husebø AML. Evaluation of the nurse-assisted eHealth intervention 'eHealth@Hospital-2-Home' on self-care by patients with heart failure and colorectal cancer post-hospital discharge: protocol for a randomised controlled trial. BMC Health Serv Res 2024; 24:18. [PMID: 38178097 PMCID: PMC10768157 DOI: 10.1186/s12913-023-10508-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 12/20/2023] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND Patients with heart failure (HF) and colorectal cancer (CRC) are prone to comorbidity, a high rate of readmission, and complex healthcare needs. Self-care for people with HF and CRC after hospitalisation can be challenging, and patients may leave the hospital unprepared to self-manage their disease at home. eHealth solutions may be a beneficial tool to engage patients in self-care. METHODS A randomised controlled trial with an embedded evaluation of intervention engagement and cost-effectiveness will be conducted to investigate the effect of eHealth intervention after hospital discharge on the self-efficacy of self-care. Eligible patients with HF or CRC will be recruited before discharge from two Norwegian university hospitals. The intervention group will use a nurse-assisted intervention-eHealth@Hospital-2-Home-for six weeks. The intervention includes remote monitoring of vital signs; patients' self-reports of symptoms, health and well-being; secure messaging between patients and hospital-based nurse navigators; and access to specific HF and CRC health-related information. The control group will receive routine care. Data collection will take place before the intervention (baseline), at the end of the intervention (Post-1), and at six months (Post-2). The primary outcome will be self-efficacy in self-care. The secondary outcomes will include measures of burden of treatment, health-related quality of life and 30- and 90-day readmissions. Sub-study analyses are planned in the HF patient population with primary outcomes of self-care behaviour and secondary outcomes of medication adherence, and readmission at 30 days, 90 days and 6 months. Patients' and nurse navigators' engagement and experiences with the eHealth intervention and cost-effectiveness will be investigated. Data will be analysed according to intention-to-treat principles. Qualitative data will be analysed using thematic analysis. DISCUSSION This protocol will examine the effects of the eHealth@ Hospital-2-Home intervention on self-care in two prevalent patient groups, HF and CRC. It will allow the exploration of a generic framework for an eHealth intervention after hospital discharge, which could be adapted to other patient groups, upscaled, and implemented into clinical practice. TRIAL REGISTRATION Clinical trials.gov (ID 301472).
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Affiliation(s)
- Marianne Storm
- Department of Public Health, Faculty of Health Sciences, University of Stavanger, 4036, Stavanger, Norway.
- Faculty of Health Sciences and Social Care, Molde University College, Molde, Norway.
- Research Group of Nursing and Health Sciences, Research Department, Stavanger University Hospital, Stavanger, Norway.
| | - Ingvild Margreta Morken
- Research Group of Nursing and Health Sciences, Research Department, Stavanger University Hospital, Stavanger, Norway
- Department of Quality and Health Technologies, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Rosalynn C Austin
- Department of Public Health, Faculty of Health Sciences, University of Stavanger, 4036, Stavanger, Norway
- Department of Cardiology, Portsmouth Hospitals University NHS Trust, Portsmouth, UK
- National Institute of Health and Care Research (NIHR) Applied Research Collaborative (ARC) Wessex, Southampton, SO17 1BJ, UK
| | - Oda Nordfonn
- Department of Health and Caring Science, Western Norway University of Applied Science, Stord, Norway
| | - Hege Bjøkne Wathne
- Department of Public Health, Faculty of Health Sciences, University of Stavanger, 4036, Stavanger, Norway
| | - Kristin Hjorthaug Urstad
- Department of Public Health, Faculty of Health Sciences, University of Stavanger, 4036, Stavanger, Norway
- Faculty of Health Studies, VID Specialized University, Oslo, Norway
| | - Bjørg Karlsen
- Department of Public Health, Faculty of Health Sciences, University of Stavanger, 4036, Stavanger, Norway
| | - Ingvild Dalen
- Department of Quality and Health Technologies, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
- Section of Biostatistics, Department of Research, Stavanger University Hospital, Stavanger, Norway
| | - Kari Hanne Gjeilo
- Department of Public Health and Nursing, Faculty of Medicine, and Health Sciences, NTNU - Norwegian University of Science and Technology, Trondheim, Norway
- Department of Cardiology, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Alison Richardson
- National Institute of Health and Care Research (NIHR) Applied Research Collaborative (ARC) Wessex, Southampton, SO17 1BJ, UK
- University Hospital Southampton NHS Foundation Trust, Southampton General Hospital, Mailpoint 11, Clinical Academic Facility (Room AA102), South Academic Block, Tremona Road, Southampton, SO16 6YD, UK
| | - Glyn Elwyn
- The Dartmouth Institute for Health Policy and Clinical Practice at the Geisel School of Medicine at Dartmouth College, Hanover, NH, USA
| | - Edvin Bru
- Centre for Learning Environment, University of Stavanger, Stavanger, Norway
| | - Jon Arne Søreide
- Department of Gastrointestinal Surgery, Stavanger University Hospital, Stavanger, Norway
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Hartwig Kørner
- Department of Gastrointestinal Surgery, Stavanger University Hospital, Stavanger, Norway
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Rune Mo
- Department of Cardiology, St. Olav's Hospital, and Trondheim University Hospital, Trondheim, Norway
- Department of Circulation and Medical Imaging, Faculty of Medicine, and Health Sciences, NTNU - Norwegian University of Science and Technology, Trondheim, Norway
| | - Anna Strömberg
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- Department of Cardiology, Linköping University, Linköping, Sweden
| | - Hilde Lurås
- Avdeling for Helsetjenesteforskning (HØKH), Akershus University Hospital, Lørenskog, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Anne Marie Lunde Husebø
- Department of Public Health, Faculty of Health Sciences, University of Stavanger, 4036, Stavanger, Norway
- Research Group of Nursing and Health Sciences, Research Department, Stavanger University Hospital, Stavanger, Norway
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Laugaland KA, Handeland M, Aase I, Husebø AML, Frøiland C, Akerjordet K. Supporting the nurse educator in clinical education - a qualitative evaluation of a digital educational resource DigiVIS. BMC Nurs 2023; 22:432. [PMID: 37974177 PMCID: PMC10652471 DOI: 10.1186/s12912-023-01599-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 11/07/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Despite the increased use of technology for teaching and learning in clinical nursing education, relatively little attention seems to be directed toward the usefulness of digital educational resources (DERs) to support nurse educators' educational role in clinical nursing education. METHODS An interpretive descriptive qualitative study design was conducted to evaluate the usefulness of a DER to support nurse educators in clinical nursing education. Data were collected through two focus group interviews with part-time and novice educators (n = 5) and full-time, more experienced educators (n = 5), after they had overseen student nurses in nursing home placements. Data were analyzed using thematic analysis and Standards for Reporting Qualitative Research guidelines were used for this study. FINDINGS The analysis identified three themes related to nurse educators' experiences of the usefulness of a DER to support their educational role while overseeing first-year students on clinical placements in nursing homes: (1) Provides academic support and a sense of security (2) promotes pedagogical efficacy, and (3) represents a flexible resource for educational planning. CONCLUSION This study shows that a digital educational resource can be an efficient and useful supplementary strategy to support the nurse educator's role in clinical nursing education. Future research is required to systematize knowledge about the impact of DERs on orientation and training, as well as motivation and facilitators for, and barriers to, their use to enhance quality and strengthen the nurse educator's role in clinical nursing education.
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Affiliation(s)
- Kristin A Laugaland
- SHARE-Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Kjell Arholms Gate 41, Stavanger, 4036, Norway.
| | - Maria Handeland
- Department of Care and Ethics, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Ingunn Aase
- SHARE-Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Kjell Arholms Gate 41, Stavanger, 4036, Norway
| | | | - Christina Frøiland
- SHARE-Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Kjell Arholms Gate 41, Stavanger, 4036, Norway
| | - Kristin Akerjordet
- SHARE-Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Kjell Arholms Gate 41, Stavanger, 4036, Norway
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Frøiland CT, Husebø AML, Aase I, Akerjordet K, Laugaland K. A digital educational resource to support and enhance effective mentorship practices of nursing students in nursing homes: a qualitative study. BMC Nurs 2023; 22:423. [PMID: 37953235 PMCID: PMC10641992 DOI: 10.1186/s12912-023-01570-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 10/20/2023] [Indexed: 11/14/2023] Open
Abstract
BACKGROUND There is a grooving body of evidence emphasising the need to support and enhance effective mentorship practices for nursing students in nursing home placements, including strengthening of the pedagogical competence of registered nurse mentors. Owing to the necessity for multifaceted mentoring competence and the challenges of workload registered nurses are facing, the use of flexible digital educational resources has been suggested. However, current knowledge on the effectiveness of digital educational resources in enhancing mentorship practices in nursing homes is scarce. This study aimed to explore the perception of registered nurse mentors regarding the effectiveness of a digital educational resource, particular its usability and value-in-use in supporting and enhancing mentorship practices in nursing homes. METHODS The study applied an exploratory descriptive qualitative design. Pre- and post-mentoring semi-structured focus group interviews were conducted among a total of 23 registered nurse mentors across three Norwegian nursing homes. The transcribed interviews were thematically analysed. Standards for reporting qualitative research were followed. RESULTS The analysis yielded one pre-mentoring theme: (1) predominant enthusiasm and satisfaction and three post-mentoring themes: (2) enhanced confidence and motivation, (3) enhanced mentoring competence in supporting the nursing students' learning process, and (4) factors influencing the value-in-use of the digital educational resource. CONCLUSIONS Digital educational resources support effective mentorship practices by enhancing the confidence and motivation in the mentor role and by enabling more goal-oriented supervision and assessment tailored to the learning goals of students. The implementation of digital educational resources to support and enhance effective mentorship practices is an important avenue for further research towards achieving high-quality learning environments in clinical nursing education in general and nursing homes. Based on the study findings, nursing educational institutions should consider offering digital educational resources to develop, support, and advance mentorship training, which may more effectively impact and improve the quality of clinical nursing education.
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Affiliation(s)
- Christina T Frøiland
- SHARE - Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Kjell Arholms Gate 41, N-4036, Stavanger, Norway.
| | - Anne Marie Lunde Husebø
- Department of Public Health, Faculty of Health Sciences, University of Stavanger, Kjell Arholms Gate 41, N-4036, Stavanger, Norway
| | - Ingunn Aase
- SHARE - Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Kjell Arholms Gate 41, N-4036, Stavanger, Norway
| | - Kristin Akerjordet
- SHARE - Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Kjell Arholms Gate 41, N-4036, Stavanger, Norway
| | - Kristin Laugaland
- SHARE - Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Kjell Arholms Gate 41, N-4036, Stavanger, Norway
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Hunsbedt Fjellså HM, Husebø AML, Braut H, Mikkelsen A, Storm M. Older Adults' Experiences With Participation and eHealth in Care Coordination: Qualitative Interview Study in a Primary Care Setting. J Particip Med 2023; 15:e47550. [PMID: 37782538 PMCID: PMC10580142 DOI: 10.2196/47550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 07/06/2023] [Accepted: 07/27/2023] [Indexed: 10/03/2023] Open
Abstract
BACKGROUND Owing to the demographic changes in the elderly population worldwide, delivering coordinated care at home to multimorbid older adults is of great importance. Older adults living with multiple chronic conditions need information to manage and coordinate their care. eHealth can be effective for gaining sufficient information, communicating, and self-managing chronic conditions. However, incorporating older adults' health preferences and ensuring active involvement remain challenging. More knowledge is needed to ensure successful participation and eHealth use in care coordination. OBJECTIVE This study aimed to explore multimorbid older adults' experiences with participation and eHealth in care coordination with general practitioners (GPs) and district nurses (DNs). METHODS The study had a qualitative explorative approach. Data collection included semistructured interviews with 20 older adults with multimorbidity receiving primary care services from their GPs and DNs. The participants were included by their GPs or nurses at a local intermunicipal acute inpatient care unit. The data analysis was guided by systematic text condensation. RESULTS We identified 2 categories: (1) older adults in charge of and using eHealth in care coordination, and (2) older adults with a loss of control in care coordination. The first category describes how communication with GPs and DNs can facilitate participation, the importance of managing own medication, and how eHealth can support older adults' information needs. The second category focuses on older adults who depend on guidance and help from their GPs and DNs to manage their health, describing how a lack of capacity and system support to be involved makes these adults lose control of their care coordination. CONCLUSIONS Being in charge of care coordination is important for older multimorbid adults. The results show that older adults are willing to use eHealth to be informed and to seek information, which ensures high levels of participation in care coordination. Future research should investigate how older adults can be involved in electronic information sharing with health care providers.
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Affiliation(s)
| | - Anne Marie Lunde Husebø
- Department of Public Health, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
- Research Group of Nursing and Health Sciences, Stavanger University Hospital, Stavanger, Norway
| | - Harald Braut
- Department of Innovation, Leadership, and Marketing, Business School, University of Stavanger, Stavanger, Norway
| | - Aslaug Mikkelsen
- Department of Innovation, Leadership, and Marketing, Business School, University of Stavanger, Stavanger, Norway
- Stavanger University Hospital, Stavanger, Norway
| | - Marianne Storm
- Department of Public Health, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
- Faculty of Health Sciences and Social Care, Molde University College, Molde, Norway
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Tangeraas Hansen MJ, Storm M, Syre H, Dalen I, Husebø AML. Attitudes and self-efficacy towards infection prevention and control and antibiotic stewardship among nurses: A mixed-methods study. J Clin Nurs 2023; 32:6268-6286. [PMID: 36841961 DOI: 10.1111/jocn.16657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 02/06/2023] [Indexed: 02/27/2023]
Abstract
AIMS To gain a comprehensive understanding of nurses' infection control practices, antibiotics stewardship attitudes and self-efficacy when caring for patients with multidrug-resistant bacterial infections in a hospital setting. BACKGROUND Multidrug-resistant bacteria cause a substantial health burden by complicating infections and prolonging hospital stays. Attitudes and self-efficacy can inform professional behaviour. Nurses' attitudes and self-efficacy concerning multidrug-resistant bacteria, infection prevention and control and antibiotic stewardship are vital in keeping patients safe. DESIGN A descriptive and convergent mixed-methods design involving quantitative and qualitative approaches was used. METHODS Two hundred and seventeen nurses working in clinical practice at seven different hospital wards (i.e., general medicine, surgical, haematological and oncology) at a Norwegian university hospital were invited to participate. Data were collected in February and March 2020 via two questionnaires: the Multidrug-Resistant Bacteria Attitude Questionnaire and the General Perceived Self-Efficacy Scale (n = 131) and four focus group interviews (n = 22). The data were analysed using descriptive statistics and systematic text condensation. RESULTS Most nurses showed moderate knowledge, adequate behavioural intentions towards infection prevention and antibiotic stewardship, and high self-efficacy. However, they reported negative emotions towards their knowledge level and negative emotions towards nursing care. The nurses appeared uncertain about their professional influence and role in antibiotic stewardship practices. Organisational and relational challenges and ambivalent perceptions of nurses' role were potential explanations. CONCLUSION Nurses report moderate attitudes and high self-efficacy when caring for patients with multidrug-resistant bacterial infections. This study suggests that nurses experience organisational and relational factors in their work environment that challenge their attitudes towards infection prevention and control and antibiotic stewardship practices. Measures that strengthen their knowledge and emotional response underpin correct infection prevention and control behaviour. A role clarification is needed for antibiotic stewardship. No Patient or Public Contribution. RELEVANCE TO CLINICAL PRACTICE Measures to increase attitudes towards infection prevention and control, antibiotic stewardship and multidrug resistance is recommended. Measures should be taken to overcome organisational challenges. A clarification of the nurses' role in antibiotic stewardship is needed.
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Affiliation(s)
| | - Marianne Storm
- Department of Public Health, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
- Faculty of Health Sciences and Social Care, Molde University College, Molde, Norway
| | - Heidi Syre
- Department of Medical Microbiology, Stavanger University Hospital, Stavanger, Norway
| | - Ingvild Dalen
- Section of Biostatistics, Research Department, Stavanger University Hospital, Stavanger, Norway
| | - Anne Marie Lunde Husebø
- Research Group of Nursing and Health Sciences, Research Department, Stavanger University Hospital, Stavanger, Norway
- Department of Public Health, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
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Frøiland CT, Akerjordet K, Aase I, Husebø AML, Andersen LL, Laugaland K. Registered nurse mentors' experiences from co-creation in higher education targeting enhancement of mentorship practices in nursing homes: A qualitative study. J Adv Nurs 2023. [PMID: 36788643 DOI: 10.1111/jan.15602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 01/02/2023] [Accepted: 02/05/2023] [Indexed: 02/16/2023]
Abstract
AIM To explore registered nurse (RN) mentors' experiences of participating in the co-creation of a digital educational resource intended to enhance mentorship practices of first-year nursing students in clinical placement in nursing homes. DESIGN An interpretive, descriptive qualitative study design. METHODS Data were collected through two focus group interviews with 15 RN mentors (n = 15) participating in co-creative workshops. The co-creative process entailed four co-creative workshops conducted over a 17-month period (June 2019 to end of Oct 2020). Focus group interviews were conducted following the second and third workshops (i.e., in Dec 2019 and in Oct 2020) and data were analysed using thematic analysis. The consolidated criteria for reporting qualitative research (COREQ) checklist was used to report the findings. RESULTS The analysis identified three themes: (1) co-creative reflective dialogues contributed to knowledge development and increased motivation among mentors; (2) the co-creative approach facilitated and validated the nursing academic-practice tripartite partnership; and (3) effectiveness of workshop structure in facilitating collaboration and mitigating power inequities. CONCLUSION A co-creative process provides notable opportunities to advocate for mentorship needs and to enhance mentorship practices in nursing homes. IMPACT Our study adds to the evidence on co-creation in nursing education, providing insights on the co-creative process and methodology. Higher Education Institutions are uniquely positioned to act as a co-creative arena for the academic-practice collaboration and for the development of educational resources within nursing education. Co-creation may facilitate stronger academic-practice partnership that may more effectively impact mentorship practices in nursing homes and health care system effectiveness. PUBLIC CONTRIBUTIONS The RNs included in the study were involved in the co-creative process as active contributors informing the digital educational resource content and design.
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Affiliation(s)
- Christina T Frøiland
- Faculty of Health Sciences, SHARE - Centre for Resilience in Healthcare, University of Stavanger, Stavanger, Norway.,Department of Quality and Health Technology, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Kristin Akerjordet
- Faculty of Health Sciences, SHARE - Centre for Resilience in Healthcare, University of Stavanger, Stavanger, Norway.,Department of Quality and Health Technology, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway.,Faculty of the Arts, Social Sciences and Humanities, School of Psychology, University of Wollongong, Wollongong, Australia
| | - Ingunn Aase
- Faculty of Health Sciences, SHARE - Centre for Resilience in Healthcare, University of Stavanger, Stavanger, Norway.,Department of Quality and Health Technology, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Anne Marie Lunde Husebø
- Department of Public Health, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | | | - Kristin Laugaland
- Faculty of Health Sciences, SHARE - Centre for Resilience in Healthcare, University of Stavanger, Stavanger, Norway.,Department of Quality and Health Technology, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
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Kushniruk A, Morken IM, Storm M, Husebø AML. Designing a Future eHealth Service for Posthospitalization Self-management Support in Long-term Illness: Qualitative Interview Study. JMIR Hum Factors 2023; 10:e39391. [PMID: 36745492 PMCID: PMC9941902 DOI: 10.2196/39391] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 09/09/2022] [Accepted: 11/14/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND For patients with noncommunicable diseases (NCDs; eg, heart failure [HF] and colorectal cancer [CRC]), eHealth interventions could meet their posthospital discharge needs and strengthen their ability to self-manage. However, inconclusive evidence exists regarding how to design eHealth services to meet the complex needs of patients. To foster patient acceptability and ensure the successful development and implementation of eHealth solutions, it is beneficial to include different stakeholders (ie, patients and health care professionals) in the design and development phase of such services. The involvement of different stakeholders could contribute to ensuring feasible, acceptable, and usable solutions and that eHealth services are developed in response to users' supportive care needs when transitioning to home after hospitalization. This study is the first step of a larger complex intervention study aimed at meeting the postdischarge needs of 2 NCD populations. OBJECTIVE This study aimed to explore the perspectives of patients with HF and CRC and health care professionals on patient self-management needs following hospital discharge and investigate how a future nurse-assisted eHealth service could be best designed to foster patient acceptability, support self-management, and smooth the transition from hospital to home. METHODS A qualitative, explorative, and descriptive approach was used. We conducted 38 semistructured interviews with 10 patients with HF, 9 patients surgically treated for CRC with curative intent, 6 registered nurses recruited as nurse navigators of a planned eHealth service, and 13 general practitioners experienced in HF and CRC treatment and follow-up care. Patients were recruited conveniently from HF and CRC outpatient clinics, and the nurses were recruited from the cardiology and gastro-surgical departments at a university hospital in the southwest of Norway. The general practitioners were recruited from primary care in surrounding municipalities. Semistructured interview guides were used for data collection, and the data were analyzed using thematic analysis. RESULTS In total, 3 main themes were derived from the data analysis: expecting information, reassurance, and guidance when using eHealth for HF and CRC self-management; expecting eHealth to be comprehensible, supportive, and knowledge promoting; and recognizing both the advantages and disadvantages of eHealth for HF and CRC self-management. The data generated from this interview study depicted the diverse needs for self-management support of patients with CRC and HF after hospital discharge. In addition, valuable suggestions were identified regarding the design and content of the eHealth service. However, participants described both possible advantages and disadvantages of a remote eHealth service. CONCLUSIONS This study is the first step in the development of an eHealth service for posthospitalization self-management support for long-term illnesses. It concerns patients' supportive care needs and user requirements of an eHealth service. The findings of this study may add value to the planning and development of eHealth interventions for patients with NCDs.
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Affiliation(s)
| | - Ingvild Margreta Morken
- Department of Quality and Health Technologies, University of Stavanger, Stavanger, Norway.,Research Group for Health and Nursing Sciences, Stavanger University Hospital, Stavanger, Norway
| | - Marianne Storm
- Faculty of Health Sciences and Social Care, Molde University College, Molde, Norway
| | - Anne Marie Lunde Husebø
- Department of Public Health, University of Stavanger, Faculty of Health Sciences, Stavanger, Norway.,Research Group for Health and Nursing Sciences, Stavanger University Hospital, Stavanger, Norway
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Fjellså HMH, Husebø AML, Storm M. eHealth in Care Coordination for Older Adults Living at Home: A Scoping Review (Preprint). J Med Internet Res 2022; 24:e39584. [DOI: 10.2196/39584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 08/09/2022] [Accepted: 08/10/2022] [Indexed: 11/13/2022] Open
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Morken IM, Storm M, Søreide JA, Urstad KH, Karlsen B, Husebø AML. Posthospitalization Follow-Up of Patients With Heart Failure Using eHealth Solutions: Restricted Systematic Review. J Med Internet Res 2022; 24:e32946. [PMID: 35166680 PMCID: PMC8889479 DOI: 10.2196/32946] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 11/09/2021] [Accepted: 12/03/2021] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Heart failure (HF) is a clinical syndrome with high incidence rates, a substantial symptom and treatment burden, and a significant risk of readmission within 30 days after hospitalization. The COVID-19 pandemic has revealed the significance of using eHealth interventions to follow up on the care needs of patients with HF to support self-care, increase quality of life (QoL), and reduce readmission rates during the transition between hospital and home. OBJECTIVE The aims of this review are to summarize research on the content and delivery modes of HF posthospitalization eHealth interventions, explore patient adherence to the interventions, and examine the effects on the patient outcomes of self-care, QoL, and readmissions. METHODS A restricted systematic review study design was used. Literature searches and reviews followed the (PRISMA-S) Preferred Reporting Items for Systematic Reviews and Meta-Analyses literature search extension checklist, and the CINAHL, MEDLINE, Embase, and Cochrane Library databases were searched for studies published between 2015 and 2020. The review process involved 3 groups of researchers working in pairs. The Mixed Methods Appraisal Tool was used to assess the included studies' methodological quality. A thematic analysis method was used to analyze data extracted from the studies. RESULTS A total of 18 studies were examined in this review. The studies were published between 2015 and 2019, with 56% (10/18) of them published in the United States. Of the 18 studies, 16 (89%) were randomized controlled trials, and 14 (78%) recruited patients upon hospital discharge to eHealth interventions lasting from 14 days to 12 months. The studies involved structured telephone calls, interactive voice response, and telemonitoring and included elements of patient education, counseling, social and emotional support, and self-monitoring of symptoms and vital signs. Of the 18 studies, 11 (61%) provided information on patient adherence, and the adherence levels were 72%-99%. When used for posthospitalization follow-up of patients with HF, eHealth interventions can positively affect QoL, whereas its impact is less evident for self-care and readmissions. CONCLUSIONS This review suggests that patients with HF should receive prompt follow-up after hospitalization and eHealth interventions have the potential to improve these patients' QoL. Patient adherence in eHealth follow-up trials shows promise for successful future interventions and adherence research. Further studies are warranted to examine the effects of eHealth interventions on self-care and readmissions among patients with HF.
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Affiliation(s)
- Ingvild Margreta Morken
- Department of Quality and Health Technologies, University of Stavanger, Stavanger, Norway
- Research Group for Nursing and Health Sciences, Stavanger University Hospital, Stavanger, Norway
| | - Marianne Storm
- Department of Public Health, University of Stavanger, Stavanger, Norway
- Faculty of Health Sciences and Social Care, Molde University College, Molde, Norway
| | - Jon Arne Søreide
- Department of Gastrointestinal Surgery, Stavanger University Hospital, Stavanger, Norway
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Kristin Hjorthaug Urstad
- Department of Quality and Health Technologies, University of Stavanger, Stavanger, Norway
- Faculty of Health Studies, VID Specialized University, Oslo, Norway
| | - Bjørg Karlsen
- Department of Public Health, University of Stavanger, Stavanger, Norway
| | - Anne Marie Lunde Husebø
- Research Group for Nursing and Health Sciences, Stavanger University Hospital, Stavanger, Norway
- Department of Public Health, University of Stavanger, Stavanger, Norway
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10
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Husebø AML, Dalen I, Søreide JA, Bru E, Richardson A. Cancer-related fatigue and treatment burden in surgically treated colorectal cancer patients - A cross-sectional study. J Clin Nurs 2021; 31:3089-3101. [PMID: 34816519 DOI: 10.1111/jocn.16135] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 10/08/2021] [Accepted: 11/04/2021] [Indexed: 12/17/2022]
Abstract
OBJECTIVE This cross-sectional study aimed to describe cancer-related fatigue (CRF) in colorectal cancer (CRC) patients who were surgically treated with curative intent, identify subgroups at risk of elevated fatigue levels and explore associations between CRF and treatment burden. BACKGROUND CRF is a prominent symptom among cancer patients. In patients treated for CRC, CRF is associated with adjuvant treatments, low quality of life and reduced ability to self-manage. METHODS One hundred thirty-four patients with CRC treated at a Norwegian university hospital between 2016-2018 were included. The Schwartz Cancer Fatigue Scale-6 and the Patient Experience with Treatment and Self-management questionnaires were applied for data collection. Statistical analyses included descriptive statistics and non-parametric approaches to analyse correlations and identify differences between groups. The study adhered to STROBE Statement checklist for reporting of cross-sectional studies. RESULTS Median fatigue level was 10.0 (range: 7.0-13.0). Physical fatigue was higher than perceptual fatigue, with medians of 6.0 (interquartile range [IQR]: 3.0-13.0) and 4.0 (IQR: 3.0-12.0), respectively. Higher fatigue levels were associated with age <60 years, advanced cancer and adjuvant treatments. Increased CRF was significantly associated with higher treatment burden on seven of the nine dimensions, adjusted for demographic and clinical variables. The association of fatigue and treatment burden was stronger in survivors <60 years, with advanced cancer, 6-12 months since surgery or who had more comorbid conditions. CONCLUSIONS This study showed patients at risk of experiencing CRF following CRC treatment. It established proof of associations between CRF and treatment burden and identified subgroups of CRC patients where this association was stronger. RELEVANCE TO CLINICAL PRACTICE Screening of CRF in CRC patients can help clinicians provide individualized treatment and care to manage CRF. Clinicians should consider the association between CRF and treatment burden, especially in subgroups of CRF patients.
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Affiliation(s)
- Anne Marie Lunde Husebø
- Research Group of Nursing and Health Sciences, Stavanger University Hospital, Stavanger, Norway.,Department of Public Health, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Ingvild Dalen
- Department of Research, Section of Biostatistics, Stavanger University Hospital, Stavanger, Norway
| | - Jon Arne Søreide
- Department of Gastrointestinal Surgery, Stavanger University Hospital, Stavanger, Norway.,Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Edvin Bru
- Centre for Learning Environment, University of Stavanger, Stavanger, Norway
| | - Alison Richardson
- NIHR ARC Wessex, School of Health Sciences, University of Southampton, Southampton, UK.,NIHR ARC Wessex, University Hospital Southampton NHS Foundation Trust, Southampton, UK
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11
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Husebø AML. Stakeholders' Perspectives on eHealth Support in Colorectal Cancer Survivorship: Qualitative Interview Study. JMIR Cancer 2021; 7:e28279. [PMID: 34491210 PMCID: PMC8456333 DOI: 10.2196/28279] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 07/06/2021] [Accepted: 07/28/2021] [Indexed: 11/19/2022] Open
Abstract
Background eHealth interventions may represent the way forward in following up patients with colorectal cancer (CRC) after hospital discharge to support them in coping with the illness, strengthen their self-management, and increase their quality of life. By involving end users of eHealth in cocreation processes when designing eHealth solutions, an acceptable and relevant product can be secured. Stakeholders’ perspectives could aid in closing the gap between research-developed products and the implementation of eHealth services in real-life scenarios. Objective This study aims to explore the views of patients with CRC, their informal caregivers, and health care professionals (HCPs) on information technology and the design of eHealth support in CRC care. Methods A qualitative, explorative design was used to conduct 31 semistructured individual interviews with 41% (13/31) patients with CRC, 29% (9/31) informal caregivers, and 29% (9/31) HCPs recruited from the gastrosurgical ward of a university hospital in southwestern Norway. A semistructured interview guide was used for data collection, and the data were analyzed by systematic text condensation. Results Participants described the diverse experiences of patients with CRC seeking web-based information. Age and digital competence were highlighted as influencers of the use of information technology. Patients rarely received advice from HCPs about relevant and secure websites containing information on CRC diagnosis and treatment. Features of desired eHealth interventions in following up patients with CRC were patient education, health monitoring, and communication with HCPs. Conclusions Several elements affect the activities of patients with CRC seeking health information. Age, inexperience with computer technology, and lack of access to web-based health information may reduce the ability of patients with CRC to engage in decision-making processes regarding illness and treatment. An eHealth service for patients with CRC should comprise features for information, education, and support for self-management and should aim to be individually adapted to the patient’s age and digital competence. Involving end users of eHealth services is necessary to ensure high-quality tailored services that are perceived as user friendly and relevant to the end users.
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Affiliation(s)
- Anne Marie Lunde Husebø
- Research Group of Nursing and Health Sciences, Stavanger University Hospital, Stavanger, Norway.,Department of Public Health, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
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12
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Frøiland CT, Husebø AML, Akerjordet K, Kihlgren A, Laugaland K. Exploring mentorship practices in clinical education in nursing homes: A qualitative mixed-methods study. J Clin Nurs 2021; 31:895-908. [PMID: 34278645 DOI: 10.1111/jocn.15943] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 05/31/2021] [Accepted: 06/11/2021] [Indexed: 11/27/2022]
Abstract
AIMS AND OBJECTIVES To explore registered nurses' mentorship practices of first-year nursing students in nursing home placements. BACKGROUND Enabling nursing students to develop professional competence through clinical placements relies heavily on registered nurses' mentorship practices. Despite renewed interest in nursing homes as an important clinical placement setting, studies are scarce on registered nurses' mentorship practices in this context. DESIGN An exploratory, qualitative mixed-methods design. METHODS The data consisted of 126 h' observation of two registered nurse mentor-student dyads, supplemented by in-depth interviews (n = 12) with registered nurse mentors. The data were collected in three Norwegian nursing homes and analysed using content analysis. The consolidated criteria for reporting qualitative research (COREQ) checklist were used to report the findings. RESULTS The registered nurses' mentorship practices of first-year nursing students in nursing home clinical placement were characterised by (1) variability and uncertainty in pedagogical supervisory approaches, (2) lack of management support and engagement of staff members in supervision, (3) lack of supervisory continuity and (4) a peripheral role in formal assessment discussions. CONCLUSIONS A marginal nursing home context, alongside a mismatch between registered nurses' roles and first-year students' learning objectives, introduces considerable vulnerability that impedes effective mentorship practices. Targeted efforts to enhance mentorship practices in nursing homes are warranted to promote full use of the learning potential in this context. Developing and testing educational interventions is necessary to effectively enhance registered nurses' pedagogical competence, alongside engagement and support from nurse managers and nurse educators. RELEVANCE TO CLINICAL PRACTICE This study provides insight into barriers to effective mentorship practices of first-year nursing students in nursing home placements. These barriers warrant attention from nursing home managers and nurse education institutions towards improvements that enhance effective mentorship practices vital for students' learning, professional growth and future recruitment to care for older people.
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Affiliation(s)
- Christina T Frøiland
- SHARE - Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Anne Marie Lunde Husebø
- Department of Public Health, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Kristin Akerjordet
- SHARE - Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Annica Kihlgren
- School of Health Sciences, Örebro University, Örebro, Sweden
| | - Kristin Laugaland
- SHARE - Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
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13
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Nordfonn OK, Morken IM, Bru LE, Larsen AI, Husebø AML. Burden of treatment in patients with chronic heart failure - A cross-sectional study. Heart Lung 2021; 50:369-374. [PMID: 33618147 DOI: 10.1016/j.hrtlng.2021.02.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 01/27/2021] [Accepted: 02/01/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND Patients with heart failure (HF) must manage both a demanding treatment regimen and self-care, which may lead to a burden of treatment. The purpose of this study was to assess the levels of burdens from treatment and self-care and its associations with psychological distress and health-related quality of life. METHODS In this cross-sectional study we collected self-report data from 125 patients diagnosed with HF, New York Heart Association classification II and III, who received care in a nurse-led HF outpatient clinic. Clinical variables were collected from the medical records. Data analyses comprised descriptive statistics and partial correlations. RESULTS The participants mean age was 67 (±9.2), most were male (74,4%) and the majority had reduced ejection fraction (EF 35.4 ± 10.8). The highest mean burden scores emerged for insufficient medical information (34.65, range 0-86), difficulty with health care service (34.57, range 0-81), and physical and mental fatigue (34.12, range 0-90). Significant positive associations were observed between physical and mental fatigue from self-care, role and social activity limitation, and psychological distress, and health-related QoL. CONCLUSION Burden of treatment is an important aspect of HF treatment as it contributes to valuable knowledge on patient workload. This study emphasizes the need to simplify and tailor the treatment regimens to alleviate the burden.
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Affiliation(s)
- Oda Karin Nordfonn
- Department of Public Health, Faculty of Health Sciences, University of Stavanger, PB 8600 Forus, 4016 Stavanger, Norway.
| | - Ingvild Margreta Morken
- Department of Public Health, Faculty of Health Sciences, University of Stavanger, PB 8600 Forus, 4016 Stavanger, Norway; Department of Cardiology, Stavanger University Hospital, PB 8100, 4068 Stavanger, Norway
| | - Lars Edvin Bru
- Department of Public Health, Faculty of Health Sciences, University of Stavanger, PB 8600 Forus, 4016 Stavanger, Norway
| | - Alf Inge Larsen
- Department of Cardiology, Stavanger University Hospital, PB 8100, 4068 Stavanger, Norway; Department of Clinical Science, University of Bergen, PB 7800, 5020 Bergen, Norway
| | - Anne Marie Lunde Husebø
- Department of Public Health, Faculty of Health Sciences, University of Stavanger, PB 8600 Forus, 4016 Stavanger, Norway
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Husebø AML, Karlsen B, Husebø SE. Health professionals' perceptions of colorectal cancer patients' treatment burden and their supportive work to ameliorate the burden - a qualitative study. BMC Health Serv Res 2020; 20:661. [PMID: 32680491 PMCID: PMC7367378 DOI: 10.1186/s12913-020-05520-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Accepted: 07/08/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Support is pivotal for patients in managing colorectal cancer treatment, as they might be overwhelmed by the burden of treatment. There is scarce knowledge regarding health professionals' perceptions of colorectal cancer patients' burdens and supportive needs. The study aims to describe health professionals' perspectives on treatment burden among patients receiving curative surgical treatment for colorectal cancer during the hospital stay and how they support patients to ameliorate the burden. METHODS This study has a descriptive and explorative qualitative design, using semi-structured interviews with nine health professionals recruited from a gastrointestinal-surgery ward at a university hospital in Norway. Data were analysed by using systematic text condensation. RESULTS Data analysis identified the themes "capturing patients' burdens of colorectal cancer treatment" and "health professionals' support to ameliorate the burden". Patients with colorectal cancer had to face burdens related to a challenging emotional situation, treatment complications and side effects, and an extensive need for information. A trusting patient-carer relationship was therefore perceived as the essence of health professionals' support. Health professionals focused their support on safeguarding patients, motivating patients to self-manage, and involving family and peers as supporters. Patients' journey characteristics and illness severity challenged health professionals' supportive work. CONCLUSION Support from health professionals includes providing patients emotional support and relevant treatment-related information and motivating patients for early post-surgical mobilisation. Health professionals should be aware of identifying colorectal cancer patients' information needs according to the specific treatment stages, which may ameliorate the burden of colorectal cancer treatment and enable patients to self-manage.
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Affiliation(s)
- Anne Marie Lunde Husebø
- Department of Gastrointestinal Surgery, Stavanger University Hospital, N-4019, Stavanger, Norway.
- Department of Public Health, Faculty of Health Sciences, University of Stavanger, N-4036, Stavanger, Norway.
| | - Bjørg Karlsen
- Department of Public Health, Faculty of Health Sciences, University of Stavanger, N-4036, Stavanger, Norway
| | - Sissel Eikeland Husebø
- Department of Quality and Health Technology, Faculty of Health Sciences, University of Stavanger, N-4036, Stavanger, Norway
- Department of Surgery, Stavanger University Hospital, N-4011, Stavanger, Norway
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15
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Sevild CH, Niemiec CP, Bru LE, Dyrstad SM, Husebø AML. Initiation and maintenance of lifestyle changes among participants in a healthy life centre: a qualitative study. BMC Public Health 2020; 20:1006. [PMID: 32586299 PMCID: PMC7318496 DOI: 10.1186/s12889-020-09111-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 06/12/2020] [Indexed: 12/11/2022] Open
Abstract
Background Since the early 2000s, Healthy Life Centres have been established in Norway to promote physical and mental health. Yet to date, little is known about the efficacy of Healthy Life Centres in promoting health behaviour change and maintenance or the factors that underlie these processes. Accordingly, the aim of the current study was to examine the factors that participants in a Healthy Life Centre perceive as relevant for the initiation and maintenance of lifestyle changes toward more physical activity and consumption of a healthier diet. Method Participants were purposely recruited from among adherers in a 12-month multi-method research project at a Healthy Life Centre. Individual, semi-structured interviews were conducted with 8 women and 6 men who were between the ages of 20 and 61 years old. Data were analysed using Systematic Text Condensation. Results Three main themes were derived from this analysis. The first theme focused on the motives behind initiation and maintenance of lifestyle changes along with the importance of a relationally supportive environment to promote perceived competence in pursuing a healthy lifestyle. The second theme focused on strategies for coping with the challenges and potential pitfalls that were associated with various unpleasant experiences and life events. The third theme focused on several specific skills that were helpful to the initiation and maintenance of lifestyle changes. Conclusion The current study enhanced an understanding of the initiation and maintenance of lifestyle changes, although these processes were not disentangled in participants’ experiences. In line with self-determination theory, the results suggested that lifestyle change is more likely to be initiated and maintained when goals are not only achievable but also regulated with autonomous motivation and of intrinsic value. Conversely, lifestyle change is difficult to maintain when motives are external to the self. Further, cognitive and behavioural skills were valuable and necessary in coping with unpleasant emotions. Finally, the critical function of self-regulation skills for making realistic plans and prioritizations in order to balance healthy lifestyle behaviours with the routines of “daily life” while monitoring outcomes was readily apparent. Healthy Life Centres can contribute to these processes in meaningful ways.
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Affiliation(s)
- Cille H Sevild
- Department of Public Health, University of Stavanger, Stavanger, Norway. .,Center for Health Promotion, Research Unit, Stavanger, Norway.
| | - Christopher P Niemiec
- Department of Public Health, University of Stavanger, Stavanger, Norway.,Department of Psychology, University of Rochester, Rochester, USA.,Centre for Learning Environment, University of Stavanger, Stavanger, Norway
| | - Lars Edvin Bru
- Centre for Learning Environment, University of Stavanger, Stavanger, Norway
| | - Sindre M Dyrstad
- Department of Public Health, University of Stavanger, Stavanger, Norway
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16
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Nordfonn OK, Morken IM, Lunde Husebø AM. A qualitative study of living with the burden from heart failure treatment: Exploring the patient capacity for self-care. Nurs Open 2020; 7:804-813. [PMID: 32257268 PMCID: PMC7113501 DOI: 10.1002/nop2.455] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Revised: 10/25/2019] [Accepted: 01/20/2020] [Indexed: 12/20/2022] Open
Abstract
Aim To explore how patients with heart failure perceive their capacity to manage treatment and self-care. Design A qualitative descriptive study. Methods Patients (N = 17) were recruited from a nurse-led heart failure outpatient clinic from May-August 2017. Data were collected through individual semi-structured interviews and analysed using systematic text condensation. Results Three main themes were identified as follows: "Personal characteristics," "Coping strategies" and "Emotional and informative support." The first main theme contained the subthemes "inherent strength" and "maintenance of a positive attitude." The second main theme included the subthemes "selective denial," "ability to adapt by setting new goals" and "careful selection of information." The third main theme contained the subthemes "support from health professionals enhancing patient capacity," "support from next of kin in patients' self-care" and "practical support and hope from peers."
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Affiliation(s)
- Oda Karin Nordfonn
- Department of Public Health Faculty of Health Sciences University of Stavanger Stavanger Norway
- Department of Health and Caring Sciences Western Norway University of Applied Sciences Stord Norway
| | - Ingvild Margreta Morken
- Department of Public Health Faculty of Health Sciences University of Stavanger Stavanger Norway
- Department of Cardiology Stavanger University Hospital Stavanger Norway
| | - Anne Marie Lunde Husebø
- Department of Public Health Faculty of Health Sciences University of Stavanger Stavanger Norway
- Department of Gastroenterological Surgery Stavanger University Hospital Stavanger Norway
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17
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Storm M, Husebø AML, Thomas EC, Elwyn G, Zisman-Ilani Y. Coordinating Mental Health Services for People with Serious Mental Illness: A Scoping Review of Transitions from Psychiatric Hospital to Community. Adm Policy Ment Health 2020; 46:352-367. [PMID: 30604004 DOI: 10.1007/s10488-018-00918-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Effective coordination as people with serious mental illness (SMI) move between care settings is essential. We aimed to review challenges to care coordination for people with SMI and identify approaches for improving it. Sixteen articles were identified. Two main challenges emerged: people with SMI facing adjustment challenges during transitions and services struggling to provide continuity of care. Effective approaches addressed coordination challenges and resulted in better improvements in service utilization, social functioning and quality of life. Future interventions may benefit from shared decision-making, support for caregivers, and addressing the challenges associated with complicated medication regimes and accessing medications.
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Affiliation(s)
- Marianne Storm
- Department of Public Health, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway.
- Faculty of Health Sciences, Center for Resilience in Healthcare, University of Stavanger, Stavanger, Norway.
| | - Anne Marie Lunde Husebø
- Department of Public Health, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
- Department of Gastroenterological Surgery, Stavanger University Hospital, Stavanger, Norway
| | - Elizabeth C Thomas
- Department of Rehabilitation Sciences, College of Public Health, Temple University, Philadelphia, PA, 19122, USA
| | - Glyn Elwyn
- Dartmouth College, Institute of Health Policy and Clinical Practice, Lebanon, NH, 03766, USA
| | - Yaara Zisman-Ilani
- Department of Rehabilitation Sciences, College of Public Health, Temple University, Philadelphia, PA, 19122, USA
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Dombestein H, Norheim A, Lunde Husebø AM. Understanding informal caregivers' motivation from the perspective of self-determination theory: an integrative review. Scand J Caring Sci 2019; 34:267-279. [PMID: 31313852 DOI: 10.1111/scs.12735] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 06/12/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND A long-term illness is stressful both for the person with the diagnosis and for his or her informal caregivers. Many people willingly assume the caregiving role, so it is important to understand why they stay in this role and how their motivation affects their health. Self-determination theory (SDT) is a theory of human motivation that has been successfully applied in human research domains. To our knowledge, there is no literature review on the application of SDT in a caregiver context. A systematic review of the literature could improve the understanding of motivation in caregiver work and contribute to the utility of SDT. AIM To describe and explore empirical studies of caregivers' motivation from the perspective of self-determination theory. METHODS An integrative literature review according to Whittemore and Knafl was conducted with systematic repetitive searches in the MEDLINE, Scopus, PsychInfo, PsycNET, Chinal, Cochrane Library and EMBASE databases. The searches were performed from May through December 2018. The PRISMA diagram was used for study selection, and papers were assessed for quality based on the Mixed Methods Appraisal Tool. Data analysis consisted of a four-stage narrative analysis method. RESULT Of 159 articles, 10 were eligible for inclusion. All studies considered satisfaction of the three basic psychological needs for competence, autonomy and relatedness as essential in predicting the quality of caregivers' motivation and thereby their well-being. In this review, autonomous motivation was the most important determinant of caregivers' well-being. CONCLUSIONS Findings showed that SDT can be applied to identify, categorise, explain, predict, promote and support motivation among caregivers. This lends interesting support for SDT and promotes further study and application of the theory as a psychological approach to caregivers' health and health promotion.
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Affiliation(s)
- Heidi Dombestein
- Department of Quality and Health Technology, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Anne Norheim
- Department of Caring and Ethics, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Anne Marie Lunde Husebø
- Department of Public Health, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
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19
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Nordfonn OK, Morken IM, Bru LE, Husebø AML. Patients’ experience with heart failure treatment and self‐care—A qualitative study exploring the burden of treatment. J Clin Nurs 2019; 28:1782-1793. [DOI: 10.1111/jocn.14799] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 11/16/2018] [Accepted: 01/13/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Oda Karin Nordfonn
- Faculty of Health Sciences University of Stavanger Stavanger Norway
- Department of Health and Caring Sciences Western Norway University of Applied Sciences Stord Norway
| | - Ingvild Margreta Morken
- Faculty of Health Sciences University of Stavanger Stavanger Norway
- Department of Cardiology Stavanger University Hospital Stavanger Norway
| | - Lars Edvin Bru
- Faculty of Health Sciences University of Stavanger Stavanger Norway
| | - Anne Marie Lunde Husebø
- Faculty of Health Sciences University of Stavanger Stavanger Norway
- Department of Gastroenterological Surgery Stavanger University Hospital Stavanger Norway
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20
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Husebø AML, Morken IM, Eriksen KS, Nordfonn OK. The patient experience with treatment and self-management (PETS) questionnaire: translation and cultural adaption of the Norwegian version. BMC Med Res Methodol 2018; 18:147. [PMID: 30463519 PMCID: PMC6249780 DOI: 10.1186/s12874-018-0612-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Accepted: 11/06/2018] [Indexed: 11/20/2022] Open
Abstract
Background Noncommunicable diseases represents long term medical conditions, which often puts the patients under enormous demands when following treatment, exposing them to experiencing treatment burden. The Patient Experience with Treatment and Self-Management (PETS) questionnaire was developed as a patient-reported measure to identify treatment burden of chronic illness, using modern measurement theory and tested in a variety of settings. Developed in English, this set of measures had not been previously translated into Norwegian. The objective of this study was to develop a Norwegian version of the PETS and to pretest the translated measures through a cognitive debriefing methodology. Methods A rigorous translation approach was applied, guided by Functional Assessment of Chronic Illness Therapy methodology. Bilingual teams from Norway and the United States reviewed the translation to develop a provisional version, which was evaluated for test content validity with cognitive interviews by probing 12 native Norwegian patients with noncommunicable diseases. The interviews applied both concurrent and retrospective verbal probing techniques, guided by a question route. Audio-recorded interviews were transcribed verbatim and analysed using systematic text condensation. Results Assessment of translatability identified the need for cultural adaptation on several core words, balanced with the need to keep close to the original literal meaning. Seven patients with colorectal cancer and five patients with heart failure participated in cognitive testing of the Norwegian version of the PETS. The analytical process of the cognitive interviews identified two emergent main themes, ‘comprehension and readability’ and ‘relevance of the PETS’, with seven corresponding subthemes. Most items, response options and instructions were well understood by the patients. Revisions were made concerning cultural relevance. Conclusions PETS items were semantically equivalent to the original. The patients with colorectal cancer and heart failure were able to comprehend the PETS and found it to express their experience with treatment burden in chronic illness. Future work will focus on psychometric construct validation and reliability testing of the PETS.
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Affiliation(s)
- Anne Marie Lunde Husebø
- Department of Gastroenterological Surgery, Stavanger University Hospital, 4019, Stavanger, Norway. .,Faculty of Health Sciences, University of Stavanger, 4036, Stavanger, Norway.
| | - Ingvild Margreta Morken
- Faculty of Health Sciences, University of Stavanger, 4036, Stavanger, Norway.,Department of Cardiology, Stavanger University Hospital, 4019, Stavanger, Norway
| | - Kristina Sundt Eriksen
- Department of Gastroenterological Surgery, Stavanger University Hospital, 4019, Stavanger, Norway.,Faculty of Health Sciences, University of Stavanger, 4036, Stavanger, Norway
| | - Oda Karin Nordfonn
- Faculty of Health Sciences, University of Stavanger, 4036, Stavanger, Norway
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21
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Husebø AML, Storm M, Våga BB, Rosenberg A, Akerjordet K. Status of knowledge on student-learning environments in nursing homes: A mixed-method systematic review. J Clin Nurs 2018; 27:e1344-e1359. [DOI: 10.1111/jocn.14299] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Anne Marie Lunde Husebø
- Faculty of Health Sciences; University of Stavanger; Stavanger Norway
- Department of Gastroenterological Surgery; Stavanger University Hospital; Stavanger Norway
| | - Marianne Storm
- Faculty of Health Sciences; University of Stavanger; Stavanger Norway
| | - Bodil Bø Våga
- Faculty of Health Sciences; University of Stavanger; Stavanger Norway
| | - Adriana Rosenberg
- Faculty of Health Sciences; University of Stavanger; Stavanger Norway
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Abstract
INTRODUCTION While it is predicted that telecare and other information and communication technology (ICT)-assisted services will have an increasingly important role in future healthcare services, their implementation in practice is complex. For implementation of telecare to be successful and ensure quality of care, sufficient training for staff (healthcare professionals) and service users (patients) is fundamental. Telecare training has been found to have positive effects on attitudes to, sustained use of, and outcomes associated with telecare. However, the potential contribution of training in the adoption, quality and safety of telecare services is an under-investigated research field. The overall aim of this study is to develop and evaluate simulation-based telecare training programmes to aid the use of videophone technology in elderly home care. Research-based training programmes will be designed for healthcare professionals, service users and next of kin, and the study will explore the impact of training on adoption, quality and safety of new telecare services. METHODS AND ANALYSIS The study has a qualitative action research design. The research will be undertaken in close collaboration with a multidisciplinary team consisting of researchers and managers and clinical representatives from healthcare services in two Norwegian municipalities, alongside experts in clinical education and simulation, as well as service user (patient) representatives. The qualitative methods used involve focus group interviews, semistructured interviews, observation and document analysis. To ensure trustworthiness in the data analysis, we will apply member checks and analyst triangulation; in addition to providing contextual and sample description to allow for evaluation of transferability of our results to other contexts and groups. ETHICS AND DISSEMINATION The study is approved by the Norwegian Social Science Data Services. The study is based on voluntary participation and informed written consent. Informants can withdraw at any point in time. The results will be disseminated at research conferences, peer review journals, one PhD thesis and through public presentations to people outside the scientific community.
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Affiliation(s)
- Siri Wiig
- Department of Health Studies, University of Stavanger, Stavanger, Norway
| | - Veslemøy Guise
- Department of Health Studies, University of Stavanger, Stavanger, Norway
| | - Janet Anderson
- Department of Health Studies, University of Stavanger, Stavanger, Norway
- Florence Nightingale School of Nursing and Midwifery, King's College, London, UK
| | - Marianne Storm
- Department of Health Studies, University of Stavanger, Stavanger, Norway
| | | | - Ingelin Testad
- Department of Health Studies, University of Stavanger, Stavanger, Norway
- Regional Centre for Age-related Medicine, SESAM, Stavanger University Hospital, Stavanger, Norway
| | - Elsa Søyland
- Stavanger Acute Medicine Foundation for Education and Research, Stavanger, Norway
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23
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Husebø AML, Karlsen B, Allan H, Søreide JA, Bru E. Factors perceived to influence exercise adherence in women with breast cancer participating in an exercise programme during adjuvant chemotherapy: a focus group study. J Clin Nurs 2014; 24:500-10. [DOI: 10.1111/jocn.12633] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2014] [Indexed: 11/27/2022]
Affiliation(s)
| | | | - Helen Allan
- School of Health & Education; Middlesex University; London UK
| | - Jon Arne Søreide
- Department of Gastrointestinal Surgery; Stavanger University Hospital; Stavanger Norway
- Department of Clinical Medicine; University of Bergen; Bergen Norway
| | - Edvin Bru
- Norwegian Centre for Learning Environment and Behavioural Research in Education; University of Stavanger; Stavanger Norway
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