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Schröder J, Riiser K, Holmen H. The needs of healthcare personnel who provide home-based pediatric palliative care: a mixed method systematic review. BMC Health Serv Res 2024; 24:45. [PMID: 38195519 PMCID: PMC10777650 DOI: 10.1186/s12913-023-10495-7] [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: 05/10/2023] [Accepted: 12/19/2023] [Indexed: 01/11/2024] Open
Abstract
BACKGROUND Families with children who have life-limiting or life-threatening illnesses often prefer to receive care at home to maintain a sense of normalcy. However, caring for children at home is different from caring for them in a hospital, and we do not know enough about the needs of healthcare personnel who provide home-based pediatric palliative care. AIM The aim of this review was to systematically summarize, appraise and synthesize available quantitative, qualitative, and mixed methods research to identify the needs of healthcare personnel in home-based pediatric palliative care. METHODS We used the Joanna Briggs Institute methodology for mixed method systematic reviews and searched systematically in Medline, Embase, PsycINFO, CINAHL, Web of Science, AMED, and the Cochrane Library. Quantitative, qualitative and mixed methods studies from 2012 to 2021 reporting on healthcare personnel's needs, experiences, perspectives, coping strategies, and/or challenges related to home-based pediatric palliative care were eligible for inclusion. The screening was conducted independently in pairs. The quantitative data were transformed into qualitative data and analyzed using thematic synthesis. RESULTS Overall, 9285 citations were identified, and 21 studies were eligible for review. Most of the studies were qualitative and interview-based. Few studies included healthcare personnel other than doctors and nurses. Three analytical themes were developed: (1) being connected and engaged with the child and family, (2) being part of a dedicated team, and (3) ensuring the quality of home-based pediatric palliative care services. Healthcare personnel strived to deliver high-quality, home-based pediatric palliative care. Establishing a relationship with the child and their parents, collaborating within a committed team, and having sufficient resources were identified as important needs influencing healthcare personnel when providing home-based pediatric palliative care. CONCLUSION The findings underscore the importance of building trusting relationships among healthcare personnel, children, and families. It also emphasizes the significance of interdisciplinary collaboration that is effective, along with the presence of enough skilled personnel to ensure high-quality home-based pediatric palliative care. Further research is necessary to include healthcare personnel beyond doctors and nurses, as palliative care requires a team of professionals from various disciplines. Addressing the needs of healthcare personnel can ensure safe and professional palliative care for children at home.
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Affiliation(s)
- Judith Schröder
- Faculty of Health Sciences, Department of Nursing and Health Promotion, Oslo Metropolitan University, P.O. Box 4, Oslo, NO-0130, Norway.
| | - Kirsti Riiser
- Faculty of Health Sciences, Department of Rehabilitation Science and Health Technology, Oslo Metropolitan University, Oslo, Norway
| | - Heidi Holmen
- Faculty of Health Sciences, Department of Nursing and Health Promotion, Oslo Metropolitan University, P.O. Box 4, Oslo, NO-0130, Norway
- Division of Technology and Innovation, Intervention Centre, Oslo University Hospital, Oslo, Norway
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Holmen H, Flølo T, Tørris C, Løyland B, Almendingen K, Bjørnnes AK, Albertini Früh E, Grov EK, Helseth S, Kvarme LG, Malambo R, Misvær N, Rasalingam A, Riiser K, Sandbekken IH, Schippert AC, Sparboe-Nilsen B, Sundar TKB, Sæterstrand T, Utne I, Valla L, Winger A, Torbjørnsen A. Unpacking the Public Health Triad of Social Inequality in Health, Health Literacy, and Quality of Life-A Scoping Review of Research Characteristics. Int J Environ Res Public Health 2023; 21:36. [PMID: 38248501 PMCID: PMC10815593 DOI: 10.3390/ijerph21010036] [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] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Revised: 12/13/2023] [Accepted: 12/21/2023] [Indexed: 01/23/2024]
Abstract
Social inequalities in health, health literacy, and quality of life serve as distinct public health indicators, but it remains unclear how and to what extent they are applied and combined in the literature. Thus, the characteristics of the research have yet to be established, and we aim to identify and describe the characteristics of research that intersects social inequality in health, health literacy, and quality of life. We conducted a scoping review with systematic searches in ten databases. Studies applying any design in any population were eligible if social inequality in health, health literacy, and quality of life were combined. Citations were independently screened using Covidence. The search yielded 4111 citations, with 73 eligible reports. The reviewed research was mostly quantitative and aimed at patient populations in a community setting, with a scarcity of reports specifically defining and assessing social inequality in health, health literacy, and quality of life, and with only 2/73 citations providing a definition for all three. The published research combining social inequality in health, health literacy, and quality of life is heterogeneous regarding research designs, populations, contexts, and geography, where social inequality appears as a contextualizing variable.
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Affiliation(s)
- Heidi Holmen
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, 0130 Oslo, Norway; (T.F.); (C.T.); (B.L.); (K.A.); (A.K.B.); (E.A.F.); (E.K.G.); (S.H.); (L.G.K.); (R.M.); (N.M.); (A.R.); (K.R.); (I.H.S.); (A.C.S.); (B.S.-N.); (T.K.B.S.); (T.S.); (I.U.); (L.V.); (A.W.); (A.T.)
- Intervention Centre, Oslo University Hospital, 4950 Oslo, Norway
| | - Tone Flølo
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, 0130 Oslo, Norway; (T.F.); (C.T.); (B.L.); (K.A.); (A.K.B.); (E.A.F.); (E.K.G.); (S.H.); (L.G.K.); (R.M.); (N.M.); (A.R.); (K.R.); (I.H.S.); (A.C.S.); (B.S.-N.); (T.K.B.S.); (T.S.); (I.U.); (L.V.); (A.W.); (A.T.)
- Department of Surgery, Voss Hospital, Haukeland University Hospital, 5704 Voss, Norway
| | - Christine Tørris
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, 0130 Oslo, Norway; (T.F.); (C.T.); (B.L.); (K.A.); (A.K.B.); (E.A.F.); (E.K.G.); (S.H.); (L.G.K.); (R.M.); (N.M.); (A.R.); (K.R.); (I.H.S.); (A.C.S.); (B.S.-N.); (T.K.B.S.); (T.S.); (I.U.); (L.V.); (A.W.); (A.T.)
| | - Borghild Løyland
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, 0130 Oslo, Norway; (T.F.); (C.T.); (B.L.); (K.A.); (A.K.B.); (E.A.F.); (E.K.G.); (S.H.); (L.G.K.); (R.M.); (N.M.); (A.R.); (K.R.); (I.H.S.); (A.C.S.); (B.S.-N.); (T.K.B.S.); (T.S.); (I.U.); (L.V.); (A.W.); (A.T.)
| | - Kari Almendingen
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, 0130 Oslo, Norway; (T.F.); (C.T.); (B.L.); (K.A.); (A.K.B.); (E.A.F.); (E.K.G.); (S.H.); (L.G.K.); (R.M.); (N.M.); (A.R.); (K.R.); (I.H.S.); (A.C.S.); (B.S.-N.); (T.K.B.S.); (T.S.); (I.U.); (L.V.); (A.W.); (A.T.)
| | - Ann Kristin Bjørnnes
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, 0130 Oslo, Norway; (T.F.); (C.T.); (B.L.); (K.A.); (A.K.B.); (E.A.F.); (E.K.G.); (S.H.); (L.G.K.); (R.M.); (N.M.); (A.R.); (K.R.); (I.H.S.); (A.C.S.); (B.S.-N.); (T.K.B.S.); (T.S.); (I.U.); (L.V.); (A.W.); (A.T.)
| | - Elena Albertini Früh
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, 0130 Oslo, Norway; (T.F.); (C.T.); (B.L.); (K.A.); (A.K.B.); (E.A.F.); (E.K.G.); (S.H.); (L.G.K.); (R.M.); (N.M.); (A.R.); (K.R.); (I.H.S.); (A.C.S.); (B.S.-N.); (T.K.B.S.); (T.S.); (I.U.); (L.V.); (A.W.); (A.T.)
| | - Ellen Karine Grov
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, 0130 Oslo, Norway; (T.F.); (C.T.); (B.L.); (K.A.); (A.K.B.); (E.A.F.); (E.K.G.); (S.H.); (L.G.K.); (R.M.); (N.M.); (A.R.); (K.R.); (I.H.S.); (A.C.S.); (B.S.-N.); (T.K.B.S.); (T.S.); (I.U.); (L.V.); (A.W.); (A.T.)
| | - Sølvi Helseth
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, 0130 Oslo, Norway; (T.F.); (C.T.); (B.L.); (K.A.); (A.K.B.); (E.A.F.); (E.K.G.); (S.H.); (L.G.K.); (R.M.); (N.M.); (A.R.); (K.R.); (I.H.S.); (A.C.S.); (B.S.-N.); (T.K.B.S.); (T.S.); (I.U.); (L.V.); (A.W.); (A.T.)
| | - Lisbeth Gravdal Kvarme
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, 0130 Oslo, Norway; (T.F.); (C.T.); (B.L.); (K.A.); (A.K.B.); (E.A.F.); (E.K.G.); (S.H.); (L.G.K.); (R.M.); (N.M.); (A.R.); (K.R.); (I.H.S.); (A.C.S.); (B.S.-N.); (T.K.B.S.); (T.S.); (I.U.); (L.V.); (A.W.); (A.T.)
| | - Rosah Malambo
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, 0130 Oslo, Norway; (T.F.); (C.T.); (B.L.); (K.A.); (A.K.B.); (E.A.F.); (E.K.G.); (S.H.); (L.G.K.); (R.M.); (N.M.); (A.R.); (K.R.); (I.H.S.); (A.C.S.); (B.S.-N.); (T.K.B.S.); (T.S.); (I.U.); (L.V.); (A.W.); (A.T.)
| | - Nina Misvær
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, 0130 Oslo, Norway; (T.F.); (C.T.); (B.L.); (K.A.); (A.K.B.); (E.A.F.); (E.K.G.); (S.H.); (L.G.K.); (R.M.); (N.M.); (A.R.); (K.R.); (I.H.S.); (A.C.S.); (B.S.-N.); (T.K.B.S.); (T.S.); (I.U.); (L.V.); (A.W.); (A.T.)
| | - Anurajee Rasalingam
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, 0130 Oslo, Norway; (T.F.); (C.T.); (B.L.); (K.A.); (A.K.B.); (E.A.F.); (E.K.G.); (S.H.); (L.G.K.); (R.M.); (N.M.); (A.R.); (K.R.); (I.H.S.); (A.C.S.); (B.S.-N.); (T.K.B.S.); (T.S.); (I.U.); (L.V.); (A.W.); (A.T.)
| | - Kirsti Riiser
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, 0130 Oslo, Norway; (T.F.); (C.T.); (B.L.); (K.A.); (A.K.B.); (E.A.F.); (E.K.G.); (S.H.); (L.G.K.); (R.M.); (N.M.); (A.R.); (K.R.); (I.H.S.); (A.C.S.); (B.S.-N.); (T.K.B.S.); (T.S.); (I.U.); (L.V.); (A.W.); (A.T.)
- Department of Rehabilitation Science and Health Technology, Faculty of Health Sciences, Oslo Metropolitan University, 0130 Oslo, Norway
| | - Ida Hellum Sandbekken
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, 0130 Oslo, Norway; (T.F.); (C.T.); (B.L.); (K.A.); (A.K.B.); (E.A.F.); (E.K.G.); (S.H.); (L.G.K.); (R.M.); (N.M.); (A.R.); (K.R.); (I.H.S.); (A.C.S.); (B.S.-N.); (T.K.B.S.); (T.S.); (I.U.); (L.V.); (A.W.); (A.T.)
| | - Ana Carla Schippert
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, 0130 Oslo, Norway; (T.F.); (C.T.); (B.L.); (K.A.); (A.K.B.); (E.A.F.); (E.K.G.); (S.H.); (L.G.K.); (R.M.); (N.M.); (A.R.); (K.R.); (I.H.S.); (A.C.S.); (B.S.-N.); (T.K.B.S.); (T.S.); (I.U.); (L.V.); (A.W.); (A.T.)
| | - Bente Sparboe-Nilsen
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, 0130 Oslo, Norway; (T.F.); (C.T.); (B.L.); (K.A.); (A.K.B.); (E.A.F.); (E.K.G.); (S.H.); (L.G.K.); (R.M.); (N.M.); (A.R.); (K.R.); (I.H.S.); (A.C.S.); (B.S.-N.); (T.K.B.S.); (T.S.); (I.U.); (L.V.); (A.W.); (A.T.)
- Faculty of Medicine and Health, Örebro University, 701 82 Örebro, Sweden
| | - Turid Kristin Bigum Sundar
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, 0130 Oslo, Norway; (T.F.); (C.T.); (B.L.); (K.A.); (A.K.B.); (E.A.F.); (E.K.G.); (S.H.); (L.G.K.); (R.M.); (N.M.); (A.R.); (K.R.); (I.H.S.); (A.C.S.); (B.S.-N.); (T.K.B.S.); (T.S.); (I.U.); (L.V.); (A.W.); (A.T.)
| | - Torill Sæterstrand
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, 0130 Oslo, Norway; (T.F.); (C.T.); (B.L.); (K.A.); (A.K.B.); (E.A.F.); (E.K.G.); (S.H.); (L.G.K.); (R.M.); (N.M.); (A.R.); (K.R.); (I.H.S.); (A.C.S.); (B.S.-N.); (T.K.B.S.); (T.S.); (I.U.); (L.V.); (A.W.); (A.T.)
| | - Inger Utne
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, 0130 Oslo, Norway; (T.F.); (C.T.); (B.L.); (K.A.); (A.K.B.); (E.A.F.); (E.K.G.); (S.H.); (L.G.K.); (R.M.); (N.M.); (A.R.); (K.R.); (I.H.S.); (A.C.S.); (B.S.-N.); (T.K.B.S.); (T.S.); (I.U.); (L.V.); (A.W.); (A.T.)
| | - Lisbeth Valla
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, 0130 Oslo, Norway; (T.F.); (C.T.); (B.L.); (K.A.); (A.K.B.); (E.A.F.); (E.K.G.); (S.H.); (L.G.K.); (R.M.); (N.M.); (A.R.); (K.R.); (I.H.S.); (A.C.S.); (B.S.-N.); (T.K.B.S.); (T.S.); (I.U.); (L.V.); (A.W.); (A.T.)
- Regional Centre for Child and Adolescent Mental Health, Eastern and Southern Norway (RBUP), 0484 Oslo, Norway
| | - Anette Winger
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, 0130 Oslo, Norway; (T.F.); (C.T.); (B.L.); (K.A.); (A.K.B.); (E.A.F.); (E.K.G.); (S.H.); (L.G.K.); (R.M.); (N.M.); (A.R.); (K.R.); (I.H.S.); (A.C.S.); (B.S.-N.); (T.K.B.S.); (T.S.); (I.U.); (L.V.); (A.W.); (A.T.)
| | - Astrid Torbjørnsen
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, 0130 Oslo, Norway; (T.F.); (C.T.); (B.L.); (K.A.); (A.K.B.); (E.A.F.); (E.K.G.); (S.H.); (L.G.K.); (R.M.); (N.M.); (A.R.); (K.R.); (I.H.S.); (A.C.S.); (B.S.-N.); (T.K.B.S.); (T.S.); (I.U.); (L.V.); (A.W.); (A.T.)
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Haugen ALH, Esser-Noetlichs M, Riiser K, Hatlevik OE. Understanding Critical Health Literacy Among Adolescents: Psychometric Properties of the CHLA Questionnaire in Lower Secondary Schools in Norway. J Sch Health 2023; 93:1119-1128. [PMID: 37300410 DOI: 10.1111/josh.13352] [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] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 03/08/2023] [Accepted: 05/21/2023] [Indexed: 06/12/2023]
Abstract
BACKGROUND Schools are important arenas for the promotion of critical health literacy (CHL) among adolescents. Key domains of CHL are information appraisal, understanding social determinants of health, and abilities to act on determinants of health. In this paper, we examine the psychometric properties of the Critical Health Literacy for Adolescents Questionnaire (CHLA-Q). METHODS A cross-sectional survey study was performed at 5 schools in Norway. Respondents included 522 pupils aged 13-15 years old. Confirmatory factor analysis (CFA) was conducted to examine the structural validity. Internal reliability was assessed using ordinal Cronbach's alpha. RESULTS The estimated model had acceptable closeness of fit. Five of 6 scales displayed adequate internal reliability. CONCLUSION The results indicate acceptable fit of the CHLA-Q framework and that 5 of the 6 scales are applicable to inform future research and interventions. More research is needed on measurement of the second domain of CHL.
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Affiliation(s)
- Anders L Hage Haugen
- Faculty of International Studies and Teacher Education, Oslo Metropolitan University, 0130, Oslo, Norway
| | - Marc Esser-Noetlichs
- Faculty of International Studies and Teacher Education, Oslo Metropolitan University, 0130, Oslo, Norway
| | - Kirsti Riiser
- Faculty of Health Science, Oslo Metropolitan University, 0130, Oslo, Norway
| | - Ove Edvard Hatlevik
- International Studies and Teacher Education, Oslo Metropolitan University, 0130, Oslo, Norway
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Holmen H, Winger A, Steindal SA, Riiser K, Castor C, Kvarme LG, Mariussen KL, Lee A. Patient-reported outcome measures in children, adolescents, and young adults with palliative care needs-a scoping review. BMC Palliat Care 2023; 22:148. [PMID: 37798706 PMCID: PMC10557323 DOI: 10.1186/s12904-023-01271-9] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 09/27/2023] [Indexed: 10/07/2023] Open
Abstract
BACKGROUND Measuring outcomes facilitates evaluation of palliative services for children, adolescents, and young adults (CAYAs) with life-limiting and/or life-threatening (LL/LT) conditions. Implementation of patient-reported, proxy-reported, or patient-centered outcome measures (hereafter PROMs) is recommended to ensure palliative services. The purpose of this scoping review was to provide an overview of PROMs relevant for CAYAs living with LL/LT conditions eligible for pediatric palliative care (PPC). METHODS Arksey and O'Malley's 6-stage scoping review framework was used to guide the review. The identified citations had to report on PROMs in any context including CAYAs with LL/LT conditions up to 25 years of age. A systematic search of Medline, EMBASE, CINAHL, APA PsycInfo, Health and Psychosocial Instruments, and AMED took place in January 2021 and was updated in June 2022. Citations were screened independently by pairs of researchers. The scoping review protocol was registered, and peer-review published. RESULTS Of 3690 identified citations, 98 reports were included, of which the majority were from Western countries and about PROMs in CAYAs living with cancer or organ failure. A total of 80 PROMs were identified, assessing a range of phenomena, where quality of life and symptoms (especially pain) during the stage of ongoing care were the most frequent. There were only a few reports about outcome measures at time of diagnosis or in end-of-life care. CAYAs self-reported on the PROMs or collaborated with their parents in about half of the reports, while the remaining had proxies answering on behalf of the CAYAs. In the identified reports, PROMs were used to characterize a sample through cross-sectional or longitudinal research, and less often to assess effects of interventions. CONCLUSION The identified PROMs in the CAYA population eligible for PPC is characterized by studies in high-income countries during ongoing care, primarily in patients with cancer or organ failure. More research is needed in patients living with other LL/LT conditions, and during different stages of the disease course, especially at time of diagnosis, during transition to adulthood, and in end-of-life care. This scoping review of PROMs relevant for young patients eligible for PPC may inform future research about patient-/proxy-reported or patient-centered outcome measures in PPC. TRIAL REGISTRATION Review registration: ( https://osf.io/yfch2/ ) and published protocol (Holmen et al. Syst Rev. 10:237, 2021).
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Affiliation(s)
- Heidi Holmen
- Department of Nursing and Health Promotion, Oslo Metropolitan University, St. Olavs Place, Post Box 4, 0130, Oslo, Norway.
| | - Anette Winger
- Department of Nursing and Health Promotion, Oslo Metropolitan University, St. Olavs Place, Post Box 4, 0130, Oslo, Norway
| | - Simen A Steindal
- Lovisenberg Diaconal University College, Lovisenberggt, 15B, 0456, Oslo, Norway
- Faculty of Health Studies, VID Specialized University, Oslo, Norway
| | - Kirsti Riiser
- Department of Rehabilitation Science and Health Technology, Oslo Metropolitan University, St. Olavs Place, Post Box 4, 0130, Oslo, Norway
| | - Charlotte Castor
- Department of Health Sciences, Lund University, Box 157, 221 00, Lund, Sweden
| | - Lisbeth Gravdal Kvarme
- Department of Nursing and Health Promotion, Oslo Metropolitan University, St. Olavs Place, Post Box 4, 0130, Oslo, Norway
| | - Kari L Mariussen
- Lovisenberg Diaconal University College, Lovisenberggt, 15B, 0456, Oslo, Norway
| | - Anja Lee
- Division of Pediatric and Adolescent Medicine, Oslo University Hospital HF, Nydalen, Box 4950, 0424, Oslo, Norway
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Riiser K, Kalleson R, Holmen H, Torbjørnsen A. Integrating research in health professions education: a scoping review. BMC Med Educ 2023; 23:653. [PMID: 37684582 PMCID: PMC10492286 DOI: 10.1186/s12909-023-04615-4] [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] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Accepted: 08/26/2023] [Indexed: 09/10/2023]
Abstract
BACKGROUND Integrating teaching and research may boost students' learning and improve future clinical practice when incorporated into education. Explorations of health professions students' involvement in the research processes and their learning outcomes are sparse. Thus, the purpose of this scoping review is to explore the existing scientific literature on courses involving students from health professions education in research activities. The research questions are: Which parts of the research process are the health professions students involved in, and what are the students' main learning outcomes related to the research process reported to be? METHODS A scoping review following the six-step approach of Arksey and O'Malley was undertaken. We searched four electronic databases to identify studies focusing on research-based teaching in health professions education. Inspired by content analysis, we identified key concepts relating to the research process and learning outcomes. RESULTS We screened 1084 abstracts, reviewed 95 full-text reports, and included 24 for analysis. Overall, the students were more involved in conducting and disseminating research than in the planning phases. Learning outcomes were most frequently reported as specific research skills, such as conducting literature reviews, writing academically, and presenting results, but also as improved understanding of research in general as well as improved motivation and confidence in conducting research. CONCLUSIONS The heterogeneity of educational programs, study designs, and measures makes it difficult to draw conclusions across the studies included in the review. More research is needed to conclude whether health professions students who actively engage in research gain a better understanding of the research process, become more likely to pursue research in their practice, or are more motivated to choose an academic career.
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Affiliation(s)
- Kirsti Riiser
- Department of Rehabilitation Science and Health Technology, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, PO Box 4, St. Olavsplass, Oslo, N-0130, Norway.
| | - Runa Kalleson
- Department of Rehabilitation Science and Health Technology, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, PO Box 4, St. Olavsplass, Oslo, N-0130, Norway
| | - Heidi Holmen
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, Oslo, Norway
- Division of Technology and Innovation, Intervention Center, Oslo University Hospital, Oslo, Norway
| | - Astrid Torbjørnsen
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, Oslo, Norway
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Paulsen H, Ljungblad UW, Riiser K, Evensen KAI. Early neurological and motor function in infants born moderate to late preterm or small for gestational age at term: a prospective cohort study. BMC Pediatr 2023; 23:390. [PMID: 37553581 PMCID: PMC10408141 DOI: 10.1186/s12887-023-04220-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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 07/30/2023] [Indexed: 08/10/2023] Open
Abstract
BACKGROUND There are inconsistent findings regarding neurological and motor development in infants born moderate to late preterm and infants born small for gestational age at term. The primary aim of this study was to compare neurological and motor function between preterm, term SGA and term AGA infants aged three to seven months corrected age using several common assessment tools. The secondary aim was to investigate their motor function at two years. METHODS In this prospective cohort study, we included 43 infants born moderate to late preterm with gestational age 32-36 + 6 weeks, 39 infants born small for gestational age (SGA) at term with a birthweight ≤ 10th centile for gestational age, and 170 infants born at term with appropriate weight for gestational age (AGA). Neurological and motor function were assessed once in infancy between three to seven months corrected age by using four standardised assessment tools: Hammersmith Infant Neurological Examination (HINE), Test of Infant Motor Performance, General Movements Assessment and Alberta Infant Motor Scale. The Ages and Stages Questionnaire (ASQ-2) was used at two years. RESULTS At three to seven months corrected age, mean age-corrected HINE scores were 61.8 (95% confidence interval (CI): 60.5 to 63.1) in the preterm group compared with 63.3 (95% CI: 62.6 to 63.9) in the term AGA group. Preterm infants had 5.8 (95% CI: 2.4 to 15.4) higher odds for HINE scores < 10th percentile. The other test scores did not differ between the groups. At two years, the preterm group had 17 (95% CI: 1.9 to 160) higher odds for gross motor scores below cut-off on ASQ-2 compared with the term AGA group. CONCLUSIONS The present study found subtle differences in neurological function between preterm and term AGA infants in infancy. At two years, preterm children had poorer gross motor function. The findings indicate that moderate prematurity in otherwise healthy infants pose a risk for neurological deficits not only during the first year, but also at two years of age when compared with term AGA children.
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Affiliation(s)
- Henriette Paulsen
- Department of Physiotherapy and Rehabilitation, Vestfold Hospital Trust, Post box 1068, Tønsberg, NO-3103, Norway.
- Department of Rehabilitation Science and Health Technology, Oslo Metropolitan University, Oslo, Norway.
| | | | - Kirsti Riiser
- Department of Rehabilitation Science and Health Technology, Oslo Metropolitan University, Oslo, Norway
| | - Kari Anne I Evensen
- Department of Rehabilitation Science and Health Technology, Oslo Metropolitan University, Oslo, Norway
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
- St. Olavs Hospital, Children's Clinic, Trondheim University Hospital, Trondheim, Norway
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Veshovda S, Eik H, Andersen MH, Jahre H, Riiser K. Health literacy and musculoskeletal disorders in adolescents: a scoping review. BMJ Open 2023; 13:e072753. [PMID: 37369418 PMCID: PMC10410916 DOI: 10.1136/bmjopen-2023-072753] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 06/07/2023] [Indexed: 06/29/2023] Open
Abstract
OBJECTIVES Health literacy (HL) related to musculoskeletal disorders (MSDs) in adolescents is a field with limited previous evidence. This study aimed to review and synthesise studies on MSDs and HL as well as various dimensions of HL in adolescents. DESIGN Scoping review in accordance with Arksey and O'Malleys framework and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. SEARCH STRATEGY The search strategy was performed in the following databases in November 2021 (initial search) and December 2022 (updated search); Medline, EMBASE, PsychINFO, Cochrane, CINAHL, ERIC, Web of Science and Google Scholar. Eligible studies involving MSDs and HL or either of the HL dimensions related to finding, understanding, appraising or applying health information in adolescents were considered. Any dimension of HL studied, the outcome measure(s) used to assess HL and the type of MSD examined were charted, reviewed and synthesised. A directed content analysis was used for the subjective interpretation of text data. RESULTS A total of 16 841 studies were identified and 33 were eligible for inclusion. Ten articles presented HL with a definition or description in the theoretical background. The remaining 23 studies involved finding, understanding, appraising or applying health information, without using the term 'health literacy'. Most of the studies addressed how adolescents understand (n=32), and apply (n=23) health information, while few studies focused on how they find (n=11) and appraise (n=7) musculoskeletal health information. CONCLUSION Few studies have addressed HL and MSDs in adolescents explicitly, while most studies have considered dimensions of HL. Our findings suggest that there is important work to be done to align conceptual understandings with the measurement of HL in adolescents and that further research should be carried out to explore how HL is distributed among adolescents with MSDs and how adolescents living with MSDs report their HL.
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Affiliation(s)
- Solveig Veshovda
- Faculty of Health Sciences, Department of Rehabilitation Science and Health Technology, Oslo Metropolitan University, Oslo, Norway
| | - Hedda Eik
- Faculty of Health Sciences, Department of Rehabilitation Science and Health Technology, Oslo Metropolitan University, Oslo, Norway
- Faculty of Medicine, Institute of Health and Society, Department of Interdisciplinary Health Sciences, University of Oslo, Oslo, Norway
| | - Marit Helen Andersen
- Faculty of Medicine, Institute of Health and Society, Department of Interdisciplinary Health Sciences, University of Oslo, Oslo, Norway
- Department of Transplantation Medicine, Oslo University Hospital, Oslo, Norway
| | - Henriette Jahre
- Faculty of Health Sciences, Department of Rehabilitation Science and Health Technology, Oslo Metropolitan University, Oslo, Norway
| | - Kirsti Riiser
- Faculty of Health Sciences, Department of Rehabilitation Science and Health Technology, Oslo Metropolitan University, Oslo, Norway
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Haugen ALH, Riiser K, Esser-Noethlichs M, Hatlevik OE. Fostering pupils' critical health literacy: examining the potential of physical education in lower secondary school. Front Sports Act Living 2023; 5:1205716. [PMID: 37383063 PMCID: PMC10294679 DOI: 10.3389/fspor.2023.1205716] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 05/30/2023] [Indexed: 06/30/2023] Open
Abstract
Background In Norway, the introduction of an interdisciplinary subject named Public Health and Life skills has brought about renewed attention to how health is conceptualized and taught within and across school subjects. Physical education (PE) is one subject that has traditionally been linked to health outcomes. However, a narrow focus on increased physical activity as the main outcome of PE could be counterproductive in the pursuit of health. Critical health literacy (CHL) is put forward as a resource for health that can be nurtured in the PE context; this study hypothesizes that academic achievement in PE is positively associated with some aspects of CHL. Methods This cross-sectional study included 521 pupils aged 13-15 years old from five lower secondary schools in Norway. Structural equation models were used as the primary statistical analysis to test the hypothesis. The study controlled for parents' education, leisure physical activity, and participation in sports club activities. Results The results confirm the hypothesis, showing a positive and significant association between PE and CHL. The association remains when controlling for parents' education, leisure physical activity, and participation in sports club activities (β^PE→CHL-C1 = 0.264, p = 0.001; β^PE→CHL-C2 = 0.351, p < 0.000). Conclusion In our sample, academic achievement in PE was associated with higher levels of CHL. This study contributes to the ongoing discussion on the health benefits of PE. We argue that a resource-based health perspective can produce the appropriate aims for health in PE contexts and that the CHL concept contributes to illuminating key areas, promoting suitable teaching strategies, and bringing balance between an individual and collective focus for future health education, both within PE and across different subjects in school contexts.
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Affiliation(s)
- Anders L. Hage Haugen
- Faculty of Teacher Education and International Studies, Oslo Metropolitan University, Oslo, Norway
| | - Kirsti Riiser
- Faculty of Health Science, Oslo Metropolitan University, Oslo, Norway
| | - Marc Esser-Noethlichs
- Faculty of International Studies and Teacher Education, Oslo Metropolitan University, Oslo, Norway
| | - Ove Edvard Hatlevik
- Faculty of International Studies and Teacher Education, Oslo Metropolitan University, Oslo, Norway
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Riiser K, Holmen H, Winger A, Steindal SA, Castor C, Kvarme LG, Lee A, Lorentsen VB, Misvaer N, Früh EA. Stories of paediatric palliative care: a qualitative study exploring health care professionals' understanding of the concept. BMC Palliat Care 2022; 21:187. [PMID: 36273144 PMCID: PMC9587603 DOI: 10.1186/s12904-022-01077-1] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 10/04/2022] [Accepted: 10/10/2022] [Indexed: 11/30/2022] Open
Abstract
Background By sharing patient stories, health care professionals (HCPs) may communicate their attitudes, values and beliefs about caring and treatment. Previous qualitative research has shown that HCPs usually associate paediatric palliative care (PPC) with death or dying and that they find the concept challenging to understand and difficult to implement. Attending to HCPs’ stories may provide a richer account of their understanding of PPC. Thus, the aim of this study was to explore PPC stories narrated by HCPs to gain increased insight into their understanding of what PPC entails. Methods This qualitative study collected data from four focus group interviews with 21 HCPs from different units in two Norwegian hospitals. Stories told by the HCPs to illustrate their comprehension of PPC were analysed following thematic analysis procedures. Results Four themes were identified illustrating what PPC meant to the participants: creating spaces for normality, providing tailored support for the family, careful preparations for saying goodbye and experiencing dilemmas and distress. The stories centred on family care, particularly relating to dramatic or affective situations when the death of a child was imminent. Conclusion The stories reflect how the HCPs view PPC as a specific field of health care that requires particular professional sensitivity, including good communication, collaboration and planning. Thus, the HCPs in this study demonstrated knowledge about the core qualities needed to succeed in PPC. However, similar to previous research, the stories illustrate that how HCPs speak about PPC is strongly associated with end-of-life care, and by that the HCPs do not capture the breadth of the PPC concept. The findings highlight the importance of increasing knowledge about the meaning and content of PPC among HCPs in order to maintain quality of life for all children with life-limiting or life-threatening conditions throughout their illness trajectory.
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Affiliation(s)
- Kirsti Riiser
- Department of Rehabilitation Science and Health Technology, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, St. Olavs plass, NO-0130, Oslo, PO Box 4, Norway.
| | - Heidi Holmen
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, St. Olavs plass, NO-0130, Oslo, PO Box 4, Norway
| | - Anette Winger
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, St. Olavs plass, NO-0130, Oslo, PO Box 4, Norway
| | - Simen A Steindal
- Lovisenberg Diaconal University College, Lovisenberggt. 15b, NO-0456, Oslo, Norway
| | - Charlotte Castor
- Department of Health Sciences, Faculty of Medicine, Lund University, SE-221 00, Lund, Box 157, Sweden
| | - Lisbeth Gravdal Kvarme
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, St. Olavs plass, NO-0130, Oslo, PO Box 4, Norway
| | - Anja Lee
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, NO-0424, Ullevål, Nydalen, Oslo, PO Box 4950, Norway
| | - Vibeke Bruun Lorentsen
- Department of Nursing, Faculty of Health Studies, VID Specialized University, NO-0319, Vinderen, Oslo, PO Box 184, Norway
| | - Nina Misvaer
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, St. Olavs plass, NO-0130, Oslo, PO Box 4, Norway
| | - Elena Albertini Früh
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, St. Olavs plass, NO-0130, Oslo, PO Box 4, Norway
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Flølo TN, Gjeilo KH, Andersen JR, Haraldstad K, Hjelmeland IHH, Iversen MM, Løyland B, Norekvål TM, Riiser K, Rohde G, Urstad KH, Utne I, Beisland EG. The impact of educational concerns and satisfaction on baccalaureate nursing students' distress and quality of life during the Covid-19 pandemic; a cross-sectional study. BMC Nurs 2022; 21:185. [PMID: 35820841 PMCID: PMC9274954 DOI: 10.1186/s12912-022-00962-7] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 06/22/2022] [Indexed: 11/10/2022] Open
Abstract
Background High levels of psychological distress and poor overall quality of life (QOL) have been identified among nursing students during the COVID-19 pandemic. The pandemic necessitated improvised reconstructions of educational curriculums and restrictions in clinical placement and training at campuses, possibly reducing educational quality. Objectives We explored whether baccalaureate nursing students’ concerns and satisfaction with the educational curriculum, focusing on the conduct of clinical training, were associated with perceived psychological distress and overall QOL. Methods Baccalaureate nursing students (N=6088) from five Norwegian universities were invited to an internet-based, cross-sectional survey during the second wave of the pandemic. The survey included COVID-19 specific questions on health, education and clinical training, the Fear of COVID-19 scale (FCV-19S), The Hopkins Symptom Checklist (SCL-5) and overall QOL. Data from national surveys on satisfaction with the educational curriculum, before and during the pandemic were used for comparison. Results In total, 2605 (43%) students responded, of whom 1591 (61%) had been engaged in clinical training during the pandemic. Overall, 53% were either satisfied or fully satisfied with their educational curriculum, with the level of satisfaction being significantly lower than pre-pandemic reference values. Also, 79% were concerned or highly concerned about the educational quality. In multiple regression analyses for all students, lower levels of satisfaction and higher levels of quality concerns were associated with worse SCL-5 scores. Furthermore, satisfaction with the educational curriculum was positively associated with overall QOL. For students engaged in clinical training, only concerns about infecting others were additionally associated with psychological distress. None of the items related to clinical training were associated with overall QOL. Conclusion Nursing students’ educational satisfaction and quality concerns may significantly impact perceived psychological distress and overall QOL during a pandemic. However, with necessary adaptations implemented, concerns regarding the conduct of clinical training account for little of these associations.
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Affiliation(s)
- Tone Nygaard Flølo
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, P.O. Box 4, St. Olavs plass, NO-0130, Oslo, Norway. .,Department of Surgery, Voss Hospital, Haukeland University Hospital/The Western Norway Health Region Authority, Sjukehusvegen 16, 5704, Voss, Norway.
| | - Kari Hanne Gjeilo
- Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, NO-7491, Trondheim, Norway.,Department of Cardiology and Department of Cardiothoracic Surgery, St. Olav Hospital, Trondheim University Hospital, NO-7006, Postbox 3250, Torgarden, Trondheim, Norway
| | - John Roger Andersen
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Inndalsveien 28, 5063 Kronstad, Bergen, Norway.,Førde Hospital Trust, Post Office Box 1000, N-6807, Førde, Norway
| | - Kristin Haraldstad
- Department of Health and Nursing Sciences, University of Agder, P.O Box 422, 4604, Kristiansand, Norway
| | - Inger Helene Hardeland Hjelmeland
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Inndalsveien 28, 5063 Kronstad, Bergen, Norway
| | - Marjolein Memelink Iversen
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Inndalsveien 28, 5063 Kronstad, Bergen, Norway
| | - Borghild Løyland
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, P.O. Box 4, St. Olavs plass, NO-0130, Oslo, Norway
| | - Tone Merete Norekvål
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Inndalsveien 28, 5063 Kronstad, Bergen, Norway.,Department of Heart Disease, Haukeland University Hospital, Jonas Lies vei 65, NO-5021, Bergen, Norway
| | - Kirsti Riiser
- Department of Physiotherapy, Faculty of Health Sciences, Oslo Metropolitan University, P.O. Box 4, St. Olavs plass, NO-0130, Oslo, Norway
| | - Gudrun Rohde
- Department of Health and Nursing Sciences, University of Agder, P.O Box 422, 4604, Kristiansand, Norway.,Department of Clinical Research, Sorlandet Hospital, SSHF, P.O. Box 416, 4604, Kristiansand, Norway
| | - Kristin Hjortland Urstad
- Department of Quality and Health Technology, University of Stavanger, Kjell Arholms gate 41, 4021, Stavanger, Norway
| | - Inger Utne
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, P.O. Box 4, St. Olavs plass, NO-0130, Oslo, Norway
| | - Elisabeth Grov Beisland
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Inndalsveien 28, 5063 Kronstad, Bergen, Norway
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Riiser K, Richardsen KR, Haraldstad K, Helseth S, Torbjørnsen A. "It's hard to keep a distance when you're with someone you really care about"-A qualitative study of adolescents' pandemic-related health literacy and how Covid-19 affects their lives. PLoS One 2022; 17:e0266510. [PMID: 35363837 PMCID: PMC8975157 DOI: 10.1371/journal.pone.0266510] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Accepted: 03/22/2022] [Indexed: 11/18/2022] Open
Abstract
PURPOSE The aim of this study was to explore how adolescents accessed, understood, appraised, and applied information on pandemic preventive measures, how their lives were impacted by long-lasting regulations and how they described their quality of life. METHODS A qualitative design with focus group interviews was used to elaborate on the quantitative survey results obtained and analyzed in a previous survey study from the first phase of the Covid-19 pandemic. Five focus groups with seventeen adolescents were conducted digitally during the second pandemic phase in November and December 2020. The interview data were analyzed with directed content analysis. RESULTS The adolescents reported using traditional media and official websites as sources for Covid-19 information. They engaged in preventive behavior, and washing hands and keeping a distance from strangers had become a habit. However, not being physically close to friends felt strange and unpleasant. The measure most frequently discussed was limiting social contact, which was a constant struggle. No one disputed the authorities' guidelines and rules, but the social restrictions caused boredom and despair, particularly due to interrupted schooling and missed opportunities to engage in life events, and freely socialize with friends. CONCLUSION The adolescents gave an overall impression of being health literate, which corresponds well with the results from our previous survey study. Their descriptions of how they translated protective measures into their everyday lives demonstrate that they took responsibility and accepted personal costs for the collective good. However, life with social restrictions decreased their quality of life.
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Affiliation(s)
- Kirsti Riiser
- Department of Physiotherapy, Faculty of Health, OsloMet–Oslo Metropolitan University, Oslo, Norway
- * E-mail:
| | - Kåre Rønn Richardsen
- Department of Physiotherapy, Faculty of Health, OsloMet–Oslo Metropolitan University, Oslo, Norway
| | - Kristin Haraldstad
- Department of Health and Nursing Sciences, Faculty of Health and Sports Sciences, University of Agder, Kristiansand, Norway
| | - Sølvi Helseth
- Department of Nursing and Health Promotion, Faculty of Health, OsloMet–Oslo Metropolitan University, Oslo, Norway
| | - Astrid Torbjørnsen
- Department of Nursing and Health Promotion, Faculty of Health, OsloMet–Oslo Metropolitan University, Oslo, Norway
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Winger A, Früh EA, Holmen H, Kvarme LG, Lee A, Lorentsen VB, Misvær N, Riiser K, Steindal SA. Making room for life and death at the same time - a qualitative study of health and social care professionals' understanding and use of the concept of paediatric palliative care. BMC Palliat Care 2022; 21:50. [PMID: 35410275 PMCID: PMC9004044 DOI: 10.1186/s12904-022-00933-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 11/30/2021] [Accepted: 03/21/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The concept of pediatric palliative care (PPC) is applied differently within the healthcare system and among healthcare professionals (HCPs). To our knowledge, no studies have investigated how multidisciplinary HCPs understand the concept of PPC and the aim of this study was to explore the concept of PPC from the view of HCP in a paediatric setting. METHODS We employed an explorative and descriptive design and conducted four focus groups with a total of 21 HCPs working in hospitals with children in palliative care. The data were analysed using qualitative content analysis. RESULTS The data analysis of the concept of pediatric palliative care resulted in two themes. The first theme "A frightening concept that evokes negative emotions," contains categories to explore the meaning, named "An unfamiliar and not meaningful concept, "A concept still associated with death and dying" and "Healthcare professionals' responsibility for introducing and using the concept and, to obtain a common meaning." The second theme was named "A broad and complementary concept," containing the categories "Total care for the child and the family," "Making room for life and death at the same time" and "The meaning of alleviation and palliative care." CONCLUSIONS The included HCPs reflected differently around PPC but most of them highlighted quality of life, total care for the child and the child's family and interdisciplinary collaboration as core elements. Attention to and knowledge among HCPs might change the perception about PPC from a frightening concept to one that is accepted by all parties, implemented in practice and used as intended. However, our study reveals that there is still some work to do before PPC is understood and accepted by all those involved.
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Affiliation(s)
- Anette Winger
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, P.O. Box 4, St. Olavs plass, NO-0130, Oslo, Norway.
| | - Elena Albertini Früh
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, P.O. Box 4, St. Olavs plass, NO-0130, Oslo, Norway
| | - Heidi Holmen
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, P.O. Box 4, St. Olavs plass, NO-0130, Oslo, Norway
| | - Lisbeth Gravdal Kvarme
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, P.O. Box 4, St. Olavs plass, NO-0130, Oslo, Norway
| | - Anja Lee
- Oslo University Hospital, Oslo, Norway
| | | | - Nina Misvær
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, P.O. Box 4, St. Olavs plass, NO-0130, Oslo, Norway
| | - Kirsti Riiser
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, P.O. Box 4, St. Olavs plass, NO-0130, Oslo, Norway
| | - Simen A Steindal
- VID Specialized University, Oslo, Norway.,Lovisenberg Diaconal University College, Oslo, Norway
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Tveten KM, Strand LI, Riiser K, Nilsen RM, Dragesund T. The ability of the Ages and Stages Questionnaire (ASQ) to indicate motor difficulties in infants in primary care. Physiother Theory Pract 2022:1-7. [PMID: 35321635 DOI: 10.1080/09593985.2022.2056553] [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] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Delayed achievement of motor milestones may be an early indicator of motor difficulties. Parent-reported questionnaires may serve as an efficient, low-cost screening to identify infants in need of further clinical assessment, and thus be a helpful tool in busy health care centers. PURPOSE To examine the ability of the Ages and Stages Questionnaire, second edition (ASQ-2) to indicate motor difficulties in infants using the Infant Motor Profile (IMP) as the reference standard. METHODS A cross-sectional design was applied to examine the correlation between parent-reported data of the ASQ-2 and data from physiotherapist assessment using IMP. Included were 432 mainly low-risk infants aged 3-12 months from primary care. RESULTS Overall, ASQ-2 gross and fine motor scores did not correlate well with the IMP total or domain scores. The ASQ-2 gross motor cut point (> 2SD below the mean), showed 34.3% sensitivity and 96.7% specificity using the 15th percentile from IMP performance domain as reference standard. The positive predictive value to indicate motor difficulties was 48%. CONCLUSION The motor domains of ASQ-2 have poor ability to identify infants with motor difficulties as indicated by their IMP scores in low-risk infants.
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Affiliation(s)
- Kine Melfald Tveten
- Department of Health and Functioning, Western Norway University of Applied Sciences, Bergen, Norway
| | - Liv Inger Strand
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Kirsti Riiser
- Department of Physiotherapy, Oslo Metropolitan University, Oslo, Norway
| | - Roy Miodini Nilsen
- Department of Health and Functioning, Western Norway University of Applied Sciences, Bergen, Norway
| | - Tove Dragesund
- Department of Health and Functioning, Western Norway University of Applied Sciences, Bergen, Norway
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Haugen ALH, Riiser K, Esser-Noethlichs M, Hatlevik OE. Developing Indicators to Measure Critical Health Literacy in the Context of Norwegian Lower Secondary Schools. Int J Environ Res Public Health 2022; 19:ijerph19053116. [PMID: 35270807 PMCID: PMC8910382 DOI: 10.3390/ijerph19053116] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 03/02/2022] [Accepted: 03/03/2022] [Indexed: 01/27/2023]
Abstract
A critical health literacy (CHL) approach is recommended for promoting health in the school context. This construct is complex and includes three interconnected domains: (A) appraisal of critical information, (B) awareness of the social determinants of health (SDH), and (C) collective action to promote health and well-being. In recent literature reviews, no measurement instrument that covers all three domains of CHL in the school-context was found. Our aim was to develop self-reported measurement scales for each domain of CHL. The development process reported in this study was conducted in two stages. In the first stage, an initial item pool was generated based on literature reviews and focus group interviews (N = 15) with adolescents (steps 1–2). In the next steps, items were adjusted and removed based on the feedback from an expert panel and from representatives from the target group (steps 3–5). In stage two, we aimed to reduce the number of items and develop scales for each domain. We then piloted the current draft, which consists of 28 items (N = 114). A sub-sample (N = 10) of the participants were interviewed after they completed the survey to examine the instrument’s face validity. Cronbach’s α was used to assess the internal reliability of the scales; the reliability was promising for scales A (α = 0.83) and C (α = 0.85) but was below the recommended value for scale B (α = 0.61). The model fit indices were promising (TLIscaleA = 0.97, RSMEAscaleA = 0.055, TLIscaleB = 1.05, RMSEAscaleB = 0.00, TLIscaleC = 0.95, RMSEAscaleC = 0.074). The piloted version of scales A and C were positively correlated with subjective health literacy, health-related quality of life, and subjective health; however, we found no such correlations for scale B. The post-survey group interviews led to some adjustments in scales A and B. The revised version of CHLA-Q must be tested using a larger sample; this will enable more robust statistical testing of the properties of the items and the scale.
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Affiliation(s)
- Anders L. Hage Haugen
- Faculty of International Studies and Teacher Education, Oslo Metropolitan University, 0130 Oslo, Norway; (M.E.-N.); (O.E.H.)
- Correspondence: ; Tel.: +47-9588-0099
| | - Kirsti Riiser
- Faculty of Health Science, Oslo Metropolitan University, 0130 Oslo, Norway;
| | - Marc Esser-Noethlichs
- Faculty of International Studies and Teacher Education, Oslo Metropolitan University, 0130 Oslo, Norway; (M.E.-N.); (O.E.H.)
| | - Ove Edvard Hatlevik
- Faculty of International Studies and Teacher Education, Oslo Metropolitan University, 0130 Oslo, Norway; (M.E.-N.); (O.E.H.)
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Holmen H, Winger A, Steindal SA, Castor C, Kvarme LG, Riiser K, Mariussen KL, Lee A. Patient-reported outcome measures in pediatric palliative care-a protocol for a scoping review. Syst Rev 2021; 10:237. [PMID: 34454605 PMCID: PMC8403431 DOI: 10.1186/s13643-021-01791-6] [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] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 08/10/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND In pediatric palliative care (PPC), there is a need to involve the child's voice in situations regarding their symptoms and care needs. Patient-reported outcome measures (PROMs) can be tools to systematically gather data reported from the child or a proxy if the child is not capable to self-report in order to provide the services they need. There has been a rapid development in PROM research the last decade, and there is a need for an overview of current knowledge and experiences in the field. Thus, we aim to explore and summarize what is known from the published research about PROMs in PPC. METHODS We propose a scoping review following the framework by Arksey and O'Malley and the PRISMA Extension for Scoping Reviews checklist. A systematic search will be performed in the following databases: Medical Literature Analysis and Retrieval System Online (Medline), Excerpta Medica database (EMBASE), Cumulative Index to Nursing and Allied Health Literature (CINAHL), American Psychological Association (APA) PsycInfo, Health and Psychosocial Instruments (HaPI), and Allied and Complementary Medicine Database (AMED). The search will be followed by snowballing to identify key papers and significant researchers for additional citations. Covidence will facilitate the independent review of eligible citations, and data will be extracted and presented descriptively, and thematically analyzed using NVivo. DISCUSSION The scoping review suggested in this protocol will identify PROMs which have been proposed in PPC and clarify the experiences with their use. The findings of this review will be relevant for researchers and healthcare personnel caring for children and adolescents in PPC. In addition, by highlighting knowledge gaps about the use of PROMs in PPC, this review will point out future needs within this field of research, which is crucial for improving quality of care in PPC. SYSTEMATIC REVIEW REGISTRATION: https://osf.io/yfch2/ .
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Affiliation(s)
- Heidi Holmen
- Department of Nursing and Health Promotion, Oslo Metropolitan University, Post Box 4, St. Olavs Place, 0130 Oslo, Norway
| | - Anette Winger
- Department of Nursing and Health Promotion, Oslo Metropolitan University, Post Box 4, St. Olavs Place, 0130 Oslo, Norway
| | - Simen A. Steindal
- Lovisenberg Diaconal University College, Lovisenberggt, 15b, 0456 Oslo, Norway
- Faculty of Health Studies, VID Specialized University, Oslo, Norway
| | - Charlotte Castor
- Department of Health Sciences, Lund University, Box 157, 221 00 Lund, Sweden
| | - Lisbeth Gravdal Kvarme
- Department of Nursing and Health Promotion, Oslo Metropolitan University, Post Box 4, St. Olavs Place, 0130 Oslo, Norway
| | - Kirsti Riiser
- Department of Physiotherapy, Oslo Metropolitan University, Post Box 4, St. Olavs Place, 0130 Oslo, Norway
| | - Kari L. Mariussen
- Lovisenberg Diaconal University College, Lovisenberggt, 15b, 0456 Oslo, Norway
| | - Anja Lee
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital HF, Box 4950, Nydalen, 0424 Oslo, Norway
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Beisland EG, Gjeilo KH, Andersen JR, Bratås O, Bø B, Haraldstad K, Hjelmeland IHH, Iversen MM, Løyland B, Norekvål TM, Riiser K, Rohde G, Urstad KH, Utne I, Flølo TN. Quality of life and fear of COVID-19 in 2600 baccalaureate nursing students at five universities: a cross-sectional study. Health Qual Life Outcomes 2021; 19:198. [PMID: 34412630 PMCID: PMC8374118 DOI: 10.1186/s12955-021-01837-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [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: 05/12/2021] [Accepted: 08/06/2021] [Indexed: 12/20/2022] Open
Abstract
Background The COVID-19 pandemic has caused significant disruptions in the implementation of programs across educational institutions. Nursing students, being both young adults and by practical training, part of the health care system, may be particularly vulnerable during the COVID-19 pandemic. The purpose of this study was to explore the associations between self-reported fear of COVID-19, general health, psychological distress and overall quality of life (QoL) in a sample of Norwegian baccalaureate nursing students compared to reference data.
Methods The survey targeted baccalaureate nursing students from five universities in February 2021. An electronic questionnaire consisted of the Fear of COVID-19 Scale (FCV-19S), the Hopkins Symptom Checklist 5 (SCL-5), one general health and one overall QoL question. The respondents’ mean scores were compared to reference data. Hierarchical regression analyses were conducted, and effect sizes (Cohen’s d) were evaluated. Results In total, 2605 out of 6088 (43%) students responded. Their FCV-19S scores (mean 2.45, CI 2.42, 2.48) were significantly higher than those of the reference population (mean 1.8, P < 0.001). Nursing students scores showed significantly lower general health (mean 3.50 ± 0.93 SD, population mean = 3.57, Cohen’s d = 0.07), higher levels of psychological distress (mean 2.68 ± 1.03 SD, population mean = 2.12, Cohen’s d = 0.55) and lower overall QoL (mean 5.50 ± 2.16 SD, population mean = 8.00, Cohen’s d = 1.16) compared to pre-pandemic reference data. FCV-19S scores were significantly associated with levels of general health (Cohen’s d = 0.26), psychological distress (Cohen’s d = 0.76) and overall QoL (Cohen’s d = 0.18). Conclusions Baccalaureate nursing students reported worse outcomes during the Covid-19 pandemic on general health, psychological distress and overall QoL compared to the reference population. Level of fear of Covid-19, however, accounted for few of these differences. Other factors related to the pandemic may have reduced nursing students’ overall QoL. Supplementary Information The online version contains supplementary material available at 10.1186/s12955-021-01837-2.
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Affiliation(s)
- E G Beisland
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Inndalsveien 28, 5063, Kronstad, Bergen, Norway.
| | - K H Gjeilo
- Department of Public Health and Nursing, Norwegian University of Science and Technology, NTNU, 7491, Trondheim, Norway.,Department of Cardiology and Department of Cardiothoracic Surgery, St. Olav Hospital, Trondheim University Hospital, Postbox 3250, 7006, Torgarden, Trondheim, Norway
| | - J R Andersen
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Inndalsveien 28, 5063, Kronstad, Bergen, Norway.,Førde Hospital Trust, Post Office Box 1000, 6807, Førde, Norway
| | - O Bratås
- Department of Public Health and Nursing, Norwegian University of Science and Technology, NTNU, 7491, Trondheim, Norway
| | - B Bø
- Department of Quality and Health Technology, University of Stavanger, Kjell Arholms gate 41, 4021, Stavanger, Norway
| | - K Haraldstad
- Department of Health and Nursing Sciences, University of Agder, P.O Box 422, 4604, Kristiansand, Norway
| | - I H H Hjelmeland
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Inndalsveien 28, 5063, Kronstad, Bergen, Norway
| | - M M Iversen
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Inndalsveien 28, 5063, Kronstad, Bergen, Norway
| | - B Løyland
- Department of Nursing and Health Promotion, Oslo Metropolitan University, St. Olavs plass, P.O. Box 4, 0130, Oslo, Norway
| | - T M Norekvål
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Inndalsveien 28, 5063, Kronstad, Bergen, Norway.,Department of Heart Disease, Haukeland University Hospital, Jonas Lies vei 65, 5021, Bergen, Norway
| | - K Riiser
- Department of Physiotherapy, Oslo Metropolitan University, St. Olavs plass, P.O. Box 4, 0130, Oslo, Norway
| | - G Rohde
- Department of Health and Nursing Sciences, University of Agder, P.O Box 422, 4604, Kristiansand, Norway.,Department of Clinical Research, SSHF, P.O. Box 416, 4604, Kristiansand, Norway
| | - K H Urstad
- Department of Quality and Health Technology, University of Stavanger, Kjell Arholms gate 41, 4021, Stavanger, Norway
| | - I Utne
- Department of Nursing and Health Promotion, Oslo Metropolitan University, St. Olavs plass, P.O. Box 4, 0130, Oslo, Norway
| | - T N Flølo
- Department of Nursing and Health Promotion, Oslo Metropolitan University, St. Olavs plass, P.O. Box 4, 0130, Oslo, Norway.,Department of Surgery, Voss Hospital, Haukeland University Hospital/The Western Norway Health Region Authority, Sjukehusvegen 16, 5704, Voss, Norway
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17
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Holmen H, Riiser K, Løyland B, Sandbekken IH, Almendingen K, Andenæs R, Bjørnnes AK, Fagerlund BH, Früh EA, Helseth S, Kvarme LG, Leegaard M, Misvær N, Pallesen S, Rasalingam A, Ravn I, Ribu L, Rostad HM, Sparboe-Nilsen B, Sæterstrand TM, Torbjørnsen A, Utne I, Valeberg BT, Valla L, Winger A, Grov EK. Students' top 10 priorities of research uncertainties on students' sleep: a pragmatic James Lind Alliance approach. BMJ Open 2021; 11:e043697. [PMID: 33500290 PMCID: PMC7839855 DOI: 10.1136/bmjopen-2020-043697] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Inspired by the James Lind Alliance (JLA) user involvement approach, the aim of the present study was to identify the top 10 uncertainties for sleep research raised by students in higher education, and to discuss our experiences with adapting the JLA method to a student population. DESIGN The study design is a pragmatic JLA approach, including a priority setting partnership within the field of sleep, collection of sleep-related research uncertainties as reported by students in higher education, sorting of the uncertainties and a final identification of the top 10 uncertainties through collaborative work between researchers, students, stakeholders and experts in the field. Uncertainties were collected using a one-question online survey: 'as a student, which question(s) do you consider to be important with regards to sleep?'. A variety of approaches were applied to promote the survey to the students, including social media, radio, the university website, stands in university cafeterias and a sleep stunt. NVivo V.12 was used to code and sort the questions. SETTING A higher education institution in Norway. PARTICIPANTS 555 students. RESULTS The data collection provided 608 uncertainties, and the following prioritised top 10: (1) screen time, (2) stress, (3) educational achievements, (4) social relations, (5) mental health, (6) physical activity, (7) indoor environment, (8) substance abuse, (9) shift work and (10) sleep quality. Despite successful data collection, we found sleep to be a broad topic, and defining specific questions throughout the sorting and verification process proved difficult. CONCLUSIONS We identified the prioritised top 10 research uncertainties as reported by students in higher education, ranking screen time first. However, the process was time and resource consuming. The research uncertainties addressed by the students showed great diversity, characterised by heterogeneity and a lack of specificity, making verification of the uncertainties challenging.
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Affiliation(s)
- Heidi Holmen
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Kirsti Riiser
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Borghild Løyland
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Ida Hellum Sandbekken
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Kari Almendingen
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Randi Andenæs
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Ann Kristin Bjørnnes
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Bettina Holmberg Fagerlund
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Elena Albertini Früh
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Sølvi Helseth
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Lisbeth Gravdal Kvarme
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Marit Leegaard
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Nina Misvær
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Ståle Pallesen
- University of Bergen Faculty of Social Sciences, Bergen, Norway
| | - Anurajee Rasalingam
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Ingrid Ravn
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Lis Ribu
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Hanne Marie Rostad
- Centre for Care Research, Norwegian University of Science and Technology, Gjovik Campus, Gjovik, Norway
| | - Bente Sparboe-Nilsen
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
- Department of Hospitality, Culinary Arts and Meal Science, Örebro Universitet, Campus Grythyttan, Grythyttan, Sweden
| | - Torill Margaret Sæterstrand
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Astrid Torbjørnsen
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Inger Utne
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Berit Taraldsen Valeberg
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Lisbeth Valla
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Anette Winger
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Ellen Karine Grov
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
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Riiser K, Helseth S, Christophersen KA, Haraldstad K. Confirmatory factor analysis of the proxy version of Kidscreen-27 and relationships between health-related quality of life dimensions and body mass index and physical activity in young schoolchildren. Prev Med Rep 2020; 20:101210. [PMID: 32995148 PMCID: PMC7516181 DOI: 10.1016/j.pmedr.2020.101210] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 04/02/2020] [Revised: 09/09/2020] [Accepted: 09/13/2020] [Indexed: 11/28/2022] Open
Abstract
The full Kidscreen-27 should be used with caution for young children. Physical activity was positively associated with physical well-being. Body mass was negatively associated with physical well-being. Compared to older children, the youngest may have more negative school experiences.
The aim of the study was to perform a confirmatory factor analysis (CFA) to investigate the psychometric properties of the proxy version of Kidscreen-27 in order to determine whether the instrument can be used to assess health-related quality of life (HRQoL) in young children (five to six years of age). Furthermore, we aimed to examine the relationships between the HRQoL dimensions and the body mass index (BMI), physical activity (PA), age, and gender. Altogether, 276 children from schools in eastern Norway were included (September 2016). HRQoL was measured using the Kidscreen-27 proxy version. CFA was conducted to examine the factorial validity of the five-dimension instrument. Structural equation modelling was used to estimate the relationship between the independent variables and the HRQoL subscales that showed an acceptable fit; physical well-being, social support and peers, and school environment. PA was positively, and BMI negatively associated with physical well-being (p < 0.5). Parents of the youngest children reported more negatively on the school environment subscale (p < 0.5). The full 27-item proxy version of Kidscreen should be used with caution for children as young as five to six years as two of the subscales were found to have unsatisfactory factor loadings. The physical well-being, the social support and peers, and the school environment subscales can provide valid and valuable data for research and practice. Even though the associations are small, it is worrying that adverse relationships between PA and BMI and physical well-being are detectable in such a young sample as included here.
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Affiliation(s)
- Kirsti Riiser
- Department of Physiotherapy, Faculty of Health, OsloMet - Oslo Metropolitan University, PO Box 4 St. Olavsplass, N-0130 Oslo, Norway
| | - Sølvi Helseth
- Department of Nursing and Health Promotion, Faculty of Health, OsloMet - Oslo Metropolitan University, PO Box 4 St. Olavsplass, N-0130 Oslo, Norway
| | | | - Kristin Haraldstad
- Department of Health and Nursing Sciences, University of Agder, PO Box 422, N-4604 Kristiansand, Norway
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19
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Riiser K, Helseth S, Haraldstad K, Torbjørnsen A, Richardsen KR. Adolescents' health literacy, health protective measures, and health-related quality of life during the Covid-19 pandemic. PLoS One 2020; 15:e0238161. [PMID: 32857806 PMCID: PMC7454983 DOI: 10.1371/journal.pone.0238161] [Citation(s) in RCA: 111] [Impact Index Per Article: 27.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 08/11/2020] [Indexed: 12/05/2022] Open
Abstract
PURPOSE First, to describe adolescents' health information sources and knowledge, health literacy (HL), health protective measures, and health-related quality of life (HRQoL) during the initial phase of the Covid-19 pandemic in Norway. Second, to investigate the association between HL and the knowledge and behavior relevant for preventing spread of the virus. Third, to explore variables associated with HRQoL in a pandemic environment. METHODS This cross-sectional study includes survey data from 2,205 Norwegian adolescents 16-19 years of age. The participants reported on their health information sources, HL, handwashing knowledge and behavior, number of social interactions, and HRQoL. Associations between study variables and specified outcomes were explored using multiple linear and logistic regression analyses. RESULTS Television (TV) and family were indicated to be the main sources for pandemic-related health information. Handwashing, physical distancing, and limiting the number of social contacts were the most frequently reported measures. HL and handwashing knowledge and HL and handwashing behavior were significantly associated. For each unit increase on the HL scale, the participants were 5% more likely to socialize less with friends in comparison to normal. The mean HRQoL was very poor compared to European norms. Being quarantined or isolated and having confirmed or suspected Covid-19 were significantly negatively associated with HRQoL, but seeing less friends than normal was not associated. HL was significantly positively associated with HRQoL, albeit of minor clinical importance. CONCLUSION Adolescents follow the health authorities' guidelines and appear highly literate. However, high fidelity requires great sacrifice because the required measures seem to collide with certain aspects that are important for the adolescents' HRQoL.
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Affiliation(s)
- Kirsti Riiser
- Department of Physiotherapy, Faculty of Health, OsloMet—Oslo Metropolitan University, Oslo, Norway
| | - Sølvi Helseth
- Department of Nursing and Health Promotion, Faculty of Health, OsloMet—Oslo Metropolitan University, Oslo, Norway
| | - Kristin Haraldstad
- Department of Health and Nursing Sciences, University of Agder, Kristiansand, Norway
| | - Astrid Torbjørnsen
- Department of Nursing and Health Promotion, Faculty of Health, OsloMet—Oslo Metropolitan University, Oslo, Norway
| | - Kåre Rønn Richardsen
- Department of Physiotherapy, Faculty of Health, OsloMet—Oslo Metropolitan University, Oslo, Norway
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20
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Valla L, Slinning K, Kalleson R, Wentzel-Larsen T, Riiser K. Motor skills and later communication development in early childhood: Results from a population-based study. Child Care Health Dev 2020; 46:407-413. [PMID: 32191337 DOI: 10.1111/cch.12765] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 01/21/2020] [Accepted: 03/05/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND Motor milestones in infancy are important developmental markers, not only for later motor skills but also for more widespread social, cognitive, and communication development. The aim of the current study was to investigate the relationships between fine and gross motor development in infants at 6 and 12 months of age and communication skills at 24 months of age. METHODS The Ages & Stages Questionnaire (ASQ-II) was used to measure gross motor, fine motor, and communication skills in a large population-based sample of 1,555 infants, recruited from well-baby clinics in five municipalities in South-Eastern Norway. Of these, 557 children had valid values of gross and fine motor scores at 6 and 12 months and for communication score at 24 months. The relationships between motor skills at 6 and 12 months and communication skills at 24 months were analysed using a linear regression analysis. RESULTS Gross motor skills at 6 months were positively associated with communication skills at 24 months (coefficients 0.09, p = 0.036) and fine motor skills at 12 months were positively associated with communication skills at 24 months (coefficient 0.23, p < 0.001). We did not find clear evidence for a relationship between gross motor skills at 12 months and communication skills at 24 months (coefficient 0.05, p = 0.126) or between fine motor skills at 6 months and communication skills at 24 months (coefficient 0.08, p = 0.098). CONCLUSION The present study supports previous research showing associations between early motor development and later communication development in infancy. Targeted intervention should be considered with at-risk infants.
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Affiliation(s)
- Lisbeth Valla
- Regional Centre for Child and Adolescent Mental Health, Eastern and Southern Norway (RBUP), Oslo, Norway.,Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Kari Slinning
- Regional Centre for Child and Adolescent Mental Health, Eastern and Southern Norway (RBUP), Oslo, Norway
| | - Runa Kalleson
- Department of Physiotherapy, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Tore Wentzel-Larsen
- Regional Centre for Child and Adolescent Mental Health, Eastern and Southern Norway (RBUP), Oslo, Norway.,Norwegian Centre for Violence and Traumatic Stress Studies (NKVTS), Oslo, Norway
| | - Kirsti Riiser
- Department of Physiotherapy, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
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21
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Sundar TKB, Riiser K, Småstuen MC, Opheim R, Løndal K, Glavin K, Helseth S. Health-related quality of life among 13-14 year old adolescents with overweight-a mixed methods approach. Health Qual Life Outcomes 2020; 18:161. [PMID: 32471437 PMCID: PMC7260808 DOI: 10.1186/s12955-020-01413-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 12/18/2019] [Accepted: 05/19/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Overweight and obesity are public concerns with risk of adverse health outcomes. Health-related quality of life (HRQoL) is lower in adolescents than children in general. An increase in body mass index (BMI) is associated with a decrease in HRQoL. The purpose of this study was to measure and explore the HRQoL among adolescents with overweight or obesity who had participated in an intervention study, Young & Active, with the aim of increasing physical activity (PA), reducing BMI and promoting HRQoL. METHODS Mixed methods, with a convergent design, were used to investigate how different methodological approaches could expand our understanding of the adolescents' HRQoL. Quantitative post-intervention data on HRQoL were collected among the 84 intervention participants, aged 13-14 years, using the KIDSCREEN 52 questionnaire. The data were compared with a Norwegian reference population of 244 individuals, and analysed using a non-parametric Mann-Whitney test. Qualitative semi-structured interviews were conducted with 21 adolescents from the intervention. A directed approach to content analysis was adopted, using the ten sub-scales from KIDSCREEN 52. RESULTS HRQoL in the intervention sample was significantly reduced on the sub-scale of physical well-being compared to the reference population. The reference population scored significantly lower than the intervention sample on the sub-scale of parent relation and home life. No significant differences were found on the other sub-scales. The qualitative data supported the quantitative findings on the sub-scale of physical well-being, but showed that perceptions of fitness, energy level or health could vary. Regarding parent relations, the interviewees extended this to include relationships to other family members as equally important. Most of the interviewees expressed a negative view of their bodies, but not their clothing or accessories. This may explain why no statistically significant differences were found on these aspects in the results from the KIDSCREEN questionnaire. CONCLUSION The use of the KIDSCREEN 52 instrument gave important indications about the adolescents' HRQoL and need for additional follow up. The qualitative data provided an in-depth understanding that nuanced the findings and widened our knowledge of the adolescents HRQoL. Combining methods enabled a comprehensive approach to research on HRQoL.
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Affiliation(s)
- T K B Sundar
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, P.O. Box 4, St. Olavs plass, NO-0130, Oslo, Norway.,Department of Nursing Science, Institute of Health and Society, University of Oslo, P. O. Box 1130, Blindern, N-0318, Oslo, Norway
| | - K Riiser
- Department of Physiotherapy, Faculty of Health Sciences, Oslo Metropolitan University, P.O. Box 4, St. Olavs plass, N-0130, Oslo, Norway
| | - M C Småstuen
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, P.O. Box 4, St. Olavs plass, NO-0130, Oslo, Norway
| | - R Opheim
- Department of Nursing Science, Institute of Health and Society, University of Oslo, P. O. Box 1130, Blindern, N-0318, Oslo, Norway
| | - K Løndal
- Department of Primary and Secondary Teacher Education, Faculty of Education and International Studies, Oslo Metropolitan University, P.O. Box 4, St. Olavs plass, N-0130, Oslo, Norway
| | - K Glavin
- VID Specialized University, Faculty of Health Studies, P.O. Box 184, Vinderen, NO-0319, Oslo, Norway
| | - S Helseth
- Faculty of Health Sciences, Oslo Metropolitan University, P.O. Box 4, St. Olavs plass, N-0130, Oslo, Norway.
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Riiser K, Richardsen KR, Haugen ALH, Lund S, Løndal K. Active play in ASP -a matched-pair cluster-randomized trial investigating the effectiveness of an intervention in after-school programs for supporting children's physical activity. BMC Public Health 2020; 20:500. [PMID: 32295569 PMCID: PMC7161268 DOI: 10.1186/s12889-020-08645-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 11/24/2019] [Accepted: 04/02/2020] [Indexed: 11/22/2022] Open
Abstract
Background Interventions directed at after school programs (ASPs) have the potential to support physical activity (PA) in young children. Research has indicated that interventions that emphasize competence building among the ASP staff can lead to increased PA among the children. The present study evaluates the effectiveness of the Active Play in ASP intervention—a program for ASP staff aimed at supporting physical activity among first graders in ASP. Methods We used a matched-pair cluster randomized design and included 456 first graders from 14 schools in Norway. From these, 7 ASPs received the intervention (N = 229), while 7 acted as controls (N = 227). Measurements were taken at baseline, immediately post intervention (7 month follow-up) and after a year (19 month follow-up). The primary outcome was moderate to vigorous physical activity (MVPA), which was estimated with predefined cut points of counts per minute (CPM) and expressed as minutes/hour. Secondary outcomes were vigorous and light intensity physical activity (VPA and LPA) and sedentary behavior. The analyses of intervention effects were based on between-group differences in outcome changes between the 3 measurement points and were conducted using a mixed-effects model for repeated measures using categorical time. In exploratory analyses, we investigated gender, baseline body mass index, and baseline CPM as potential effect modifiers. Results No significant intervention effects was observed on MVPA (0.55 min/hour [99% CI -0.55:1.64]) or on the secondary outcomes, min/hour of LPA, VPA or sedentary behavior. Exploratory analyses indicated that among the 50% least physically active children at baseline, children in intervention ASPs reduced sedentary time from baseline to 19 months follow up by 1.67 min/hour (95% CI -3.12:-0.21) compared to the controls. Conclusions Although the intervention did not significantly increase the mean MVPA among the children in the intervention ASPs compared to controls, it did seem to have a small effect by reducing sedentary behavior time among the least active children. An even stronger emphasis on how to identify less active children and support their activity may be needed in order to increase their PA and further reduce sedentary behavior time. Trial registration ClinicalTrials; NCT02954614, Registered 3 November 2016, −Retrospectively registered, first participant enrolled August 2016
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Affiliation(s)
- Kirsti Riiser
- Department of Physiotherapy, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, PO Box 4, St. Olavs plass, N-0130, Oslo, Norway.
| | - Kåre Rønn Richardsen
- Department of Physiotherapy, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, PO Box 4, St. Olavs plass, N-0130, Oslo, Norway
| | - Anders L H Haugen
- Department of Primary and Secondary Teacher Education, Faculty of Education and International Studies, OsloMet - Oslo Metropolitan University, PO Box 4, St. Olavs plass, N-0130, Oslo, Norway
| | - Siv Lund
- Department of Primary and Secondary Teacher Education, Faculty of Education and International Studies, OsloMet - Oslo Metropolitan University, PO Box 4, St. Olavs plass, N-0130, Oslo, Norway
| | - Knut Løndal
- Department of Primary and Secondary Teacher Education, Faculty of Education and International Studies, OsloMet - Oslo Metropolitan University, PO Box 4, St. Olavs plass, N-0130, Oslo, Norway
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Holmen H, Riiser K, Winger A. Home-Based Pediatric Palliative Care and Electronic Health: Systematic Mixed Methods Review. J Med Internet Res 2020; 22:e16248. [PMID: 32130127 PMCID: PMC7070344 DOI: 10.2196/16248] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 11/05/2019] [Accepted: 12/14/2019] [Indexed: 01/23/2023] Open
Abstract
Background Children and families in pediatric palliative care depend on close contact with health care personnel, and electronic health (eHealth) is suggested to support care at home by facilitating their remote interactions. Objective This study aimed to identify and review the use of eHealth to communicate and support home-based pediatric palliative care and appraise the methodological quality of the published research. Methods We conducted a convergent, systematic mixed methods review and searched Medical Literature Analysis and Retrieval System Online (Medline), EMBASE, PsycINFO, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science, and Scopus for eligible papers. Studies evaluating 2-way communication technology for palliative care for children aged ≤18 years and applying quantitative, qualitative, or mixed methods from 2012 to 2018 were eligible for inclusion. Quantitative and qualitative studies were equally valued during the search, screening, extraction, and analysis. Quantitative data were transformed into qualitative data and analyzed using a thematic analysis. Overall, 2 independent researchers methodologically appraised all included studies. Results We identified 1277 citations. Only 7 papers were eligible for review. Evaluating eHealth interventions in pediatric palliative care poses specific methodological and ethical challenges. eHealth to facilitate remote pediatric palliative care was acknowledged both as an intrusion and as a support at home. Reluctance toward eHealth was mainly identified among professionals. Conclusions The strengths of the conclusions are limited by the studies’ methodological challenges. Despite the limitless possibilities held by new technologies, research on eHealth in home-based pediatric palliative care is scarce. The affected children and families appeared to hold positive attitudes toward eHealth, although their views were less apparent compared with those of the professionals. Trial Registration PROSPERO CRD42018119051; https://tinyurl.com/rtsw5ky
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Sundar TKB, Løndal K, Riiser K, Lagerløv P, Glavin K, Helseth S. Adolescents With Overweight or Obesity: A Qualitative Study of Participation in an Internet-Based Program to Increase Physical Activity. SAGE Open Nurs 2019; 5:2377960819884786. [PMID: 33415257 PMCID: PMC7774389 DOI: 10.1177/2377960819884786] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 10/03/2019] [Indexed: 11/21/2022] Open
Abstract
Adolescents who are overweight or obese are reported to be less active than their peers. Motivation is a critical factor in sustaining physical activity and thereby positive health outcomes. This qualitative study explores how participation in a 12-week Internet-based intervention study, Young & Active, influenced the participants' short-term and long-term motivation to increase and sustain physical activity. The overall purpose of Young & Active was to design, test, and evaluate a health-promoting Internet-based program for use in the school health services in Norway. The program was informed by self-determination theory and motivational interviewing. Two postintervention qualitative research interviews were conducted with 21 adolescents, aged 13 to 14 years, with a 9- to 12-month interval. The adolescents were recruited from a total of 84 participants from the Young & Active study intervention group. Data were analyzed using qualitative content analysis. Self-determination theory was used as a theoretical and explanatory framework. Following the motivational continuum from self-determination theory, all adolescents showed changes in motivation, from extrinsic toward more intrinsic motivation, and for some, a reversal after completing the program. Analysis of the adolescents' utterances formed patterns that could be divided into four main categories: (a) reinforcement of a habit, (b) promotion of competence and enjoyment, (c) boost of temporary change, and (d) reinforcement of adverse habits. An Internet-based intervention may help adolescents increase and sustain physical activity if participation is based on self-choice and if they have sufficient support in their social environments. The intervention alone is not enough to support adolescents who are less motivated or have other challenges in life and may even provoke resistance and reinforce negative health behavior. Such a program may be used together with face-to-face counseling in school health services, provided that it is further refined on a larger scale and that the counseling is performed by qualified health service professionals.
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Affiliation(s)
| | | | | | - Per Lagerløv
- Department of General Practice, Institute of Health and Society,
University of Oslo, Norway
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Riiser K, Helseth S, Ellingsen H, Fallang B, Løndal K. Active Play in After-school Programmes: development of an intervention and description of a matched-pair cluster-randomised trial assessing physical activity play in after-school programmes. BMJ Open 2017; 7:e016585. [PMID: 28780558 PMCID: PMC5629685 DOI: 10.1136/bmjopen-2017-016585] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION Interventions delivered in after-school programmes (ASPs) have the potential to become a means of ensuring adequate physical activity among schoolchildren. This requires a motivational climate, allowing for self-determined play. If trained, ASP staff may represent a valuable resource for supporting such play. Increasing knowledge and supportive skills among ASP staff may also potentially increase their motivation for work. The purpose of this article is to describe the development of the 'Active Play in ASP' intervention, which aims to promote physical activity among first graders attending ASP, and to present a protocol for a matched-pair cluster-randomised trial to evaluate the intervention. METHODS AND ANALYSIS Informed by experiences from practice, evidence-based knowledge and theory, the intervention was developed in a stepwise process including focus group meetings and a small-scale pilot test. The intervention contains a course programme for ASP staff to increase their skills in how to support physical activity through play. In a cluster randomised controlled trial, the ASPs will be matched and randomly allocated to receive the 7-month intervention or to a control group. Outcomes will be assessed at baseline, after 7 and 19 months. First graders attending the ASPs included are eligible. The primary outcome will be accelerometer-determined minutes in moderate to vigorous physical activity in the ASP. The study uses a mixed methods approach including observations and interviews to provide rich descriptions of the concept of children's physical activity in ASP. Moreover, the trial will assess whether the ASP staff benefits from participation in the intervention in terms of increased work motivation. Lastly, process evaluations of programme fidelity, satisfaction and suggestions on improvement will be performed. ETHICS AND DISSEMINATION The study is approved by the Data Protection Official for Research (reference no 46008). Results will be presented in conferences and peer-reviewed journals. TRIAL REGISTRATION NUMBER Clinical Trials (NCT02954614), pre-results.
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Affiliation(s)
- Kirsti Riiser
- Department of Physiotherapy, Faculty of Health, Oslo and Akershus University College of Applied Sciences, Oslo, Norway
| | - Sølvi Helseth
- Department of Nursing and Health Promotion, Faculty of Health, Oslo and Akershus University College of Applied Sciences, Oslo, Norway
| | - Hanna Ellingsen
- Department of Family Health Services, Municipality of Sandefjord, Sandefjord, Norway
| | - Bjørg Fallang
- Department of Physiotherapy, Faculty of Health, Oslo and Akershus University College of Applied Sciences, Oslo, Norway
| | - Knut Løndal
- Department of Primary and Secondary Teacher Education, Faculty of Education and International Studies, Oslo and Akershus University College of Applied Sciences, Oslo, Norway
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Helseth S, Riiser K, Holmberg Fagerlund B, Misvaer N, Glavin K. Implementing guidelines for preventing, identifying and treating adolescent overweight and obesity-School nurses’ perceptions of the challenges involved. J Clin Nurs 2017; 26:4716-4725. [DOI: 10.1111/jocn.13823] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2017] [Indexed: 01/12/2023]
Affiliation(s)
- Sølvi Helseth
- Department of Nursing and Health Promotion; Faculty of Health; Oslo and Akershus University College of Applied Sciences; Oslo Norway
| | - Kirsti Riiser
- Department of Physiotherapy; Faculty of Health; Oslo and Akershus University College of Applied Sciences; Oslo Norway
| | - Bettina Holmberg Fagerlund
- Department of Nursing and Health Promotion; Faculty of Health; Oslo and Akershus University College of Applied Sciences; Oslo Norway
| | - Nina Misvaer
- Department of Nursing and Health Promotion; Faculty of Health; Oslo and Akershus University College of Applied Sciences; Oslo Norway
| | - Kari Glavin
- Department of Nursing and Health Promotion; Faculty of Health; Oslo and Akershus University College of Applied Sciences; Oslo Norway
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Riiser K, Løndal K, Ommundsen Y, Småstuen MC, Misvær N, Helseth S. The outcomes of a 12-week Internet intervention aimed at improving fitness and health-related quality of life in overweight adolescents: the Young & Active controlled trial. PLoS One 2014; 9:e114732. [PMID: 25478791 PMCID: PMC4257715 DOI: 10.1371/journal.pone.0114732] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Accepted: 11/05/2014] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Overweight and obesity among adolescents may have consequences, with potentially lasting effects on health and health-related quality of life (HRQoL). Excess weight is also associated with decreases in physical activity and cardiorespiratory fitness. The aim of the current study was to investigate the short-term effects of a 12-week Internet intervention in a primary care setting intended to increase cardiorespiratory fitness and HRQoL among overweight and obese adolescents. METHODS In this controlled trial, participants (13-15 years) were non-randomly allocated to an intervention- or a control group. The intervention group received 12-weeks access to an online program providing tailored physical activity counseling based on principles from Self-determination Theory and Motivational Interviewing. The control group received standard follow-up by the school nurses. The primary outcome measure of cardiorespiratory fitness was determined using a shuttle run test. The secondary outcomes: HRQoL, leisure time exercise, body image and self-determined motivation for physical activity and exercise, were assessed by self-report measures. Age- and gender-adjusted body mass index (BMI) was calculated based on measurements of height and weight. To compare pre-to post intervention differences within groups, a paired samples t-test was used while crude differences between groups were analyzed with an independent samples t-test. RESULTS Of the 120 participants, 108 completed the study, 75 in the intervention group and 33 in the control group. Exposure to the intervention had a small effect on cardiorespiratory fitness (0.14; 95% CI [0.01;0.28]; P = 0.04), and a moderate effect on HRQoL (5.22; 95% CI [0.90; 9.53]; P = 0.02). Moreover, the control group increased significantly in BMI, yielding a moderate preventive effect on BMI (-0.39; 95% CI [-0.74;-0.03]; P = 0.03) for the intervention group. CONCLUSION The results suggest that the Internet intervention with tailored physical activity counseling can have beneficial short-term effect on cardiorespiratory fitness, HRQoL and BMI among adolescents with overweight and obesity. TRIAL REGISTRATION ClinicalTrials.gov NCT01700309.
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Affiliation(s)
- Kirsti Riiser
- Norwegian School of Sport Sciences, Oslo, Norway
- Oslo and Akershus University College of Applied Sciences, Oslo, Norway
- * E-mail:
| | - Knut Løndal
- Oslo and Akershus University College of Applied Sciences, Oslo, Norway
| | | | | | - Nina Misvær
- Oslo and Akershus University College of Applied Sciences, Oslo, Norway
| | - Sølvi Helseth
- Oslo and Akershus University College of Applied Sciences, Oslo, Norway
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Riiser K, Ommundsen Y, Småstuen MC, Løndal K, Misvær N, Helseth S. The relationship between fitness and health-related quality of life and the mediating role of self-determined motivation in overweight adolescents. Scand J Public Health 2014; 42:766-72. [PMID: 25269792 DOI: 10.1177/1403494814550517] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
AIM To examine the relationship between cardiorespiratory fitness (CRF) and health-related quality of life (HRQoL) among overweight adolescents and to test whether this relationship is mediated by body image (BI) and self-determined motivation for physical activity (PA) and exercise. METHODS One hundred and twenty adolescents identified as overweight or obese were recruited through the school health service. The participants completed self-report instruments measuring HRQoL, BI and self-determined motivation for physical activity and exercise in addition to a 20 m shuttle-run test, and body mass index was calculated. Confirmatory factor analysis was conducted to evaluate the hypothesised five-dimensional structure of the Behavioural Regulation in Exercise Questionnaire-2 (BREQ-2) used to measure self-determined motivation. Associations between the study variables were explored using univariate linear regression. Mediation was tested by a multistage regression approach. RESULTS The five-dimensional model of BREQ-2 showed acceptable fit for the data. We revealed a statistically significant association between cardiorespiratory fitness and HRQoL (4.16 [0.3-8.02]; p < .05). CRF failed to affect BI in the first mediation equation. Hence, body image was excluded from further analyses. However, self-determined motivation proved to mediate the relationship between CRF and HRQoL. CONCLUSIONS The results of this study suggest that the motivational mechanisms related to fitness can contribute to explain the association between CRF and HRQoL in overweight adolescents. The findings are important from a public health point of view and should be taken into account in the development of PA interventions for overweight and obese adolescents for the potential enhancement of their physical and psychosocial well-being.
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Affiliation(s)
- Kirsti Riiser
- Institute of Nursing, Faculty of Health, Oslo and Akershus University College of Applied Sciences, Oslo, Norway Department of Coaching and Psychology, Norwegian School of Sport Sciences, Oslo, Norway
| | - Yngvar Ommundsen
- Department of Coaching and Psychology, Norwegian School of Sport Sciences, Oslo, Norway
| | - Milada Cvancarova Småstuen
- Institute of Nursing, Faculty of Health, Oslo and Akershus University College of Applied Sciences, Oslo, Norway
| | - Knut Løndal
- Department of Primary and Secondary Teacher Education, Faculty of Education and International Studies; Oslo and Akershus University College of Applied Sciences, Oslo, Norway
| | - Nina Misvær
- Institute of Nursing, Faculty of Health, Oslo and Akershus University College of Applied Sciences, Oslo, Norway
| | - Sølvi Helseth
- Institute of Nursing, Faculty of Health, Oslo and Akershus University College of Applied Sciences, Oslo, Norway
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Riiser K, Løndal K, Ommundsen Y, Misvær N, Helseth S. Targeting and tailoring an intervention for adolescents who are overweight: some ethical concerns. Nurs Ethics 2014; 22:237-47. [PMID: 24714048 DOI: 10.1177/0969733014524761] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
There are important ethical issues to be examined before launching any public health intervention, particularly when targeting vulnerable groups. The aim of this article is to identify and discuss ethical concerns that may arise when intervening for health behavior change among adolescents identified as overweight. These concerns originate from an intervention designed to capacitate adolescents to increase self-determined physical activity. Utilizing an ethical framework for prevention of overweight and obesity, we identified three ethical aspects as particularly significant: the attribution of responsibility for health behavior, liberty to choose, and the effect on the participants' psychosocial well-being. It is discussed whether and how measures can be taken to deal with these aspects. It seems evident that the ethical aspects are mainly concerned with the vulnerability of adolescents identified as overweight. However, we claim that when individual feedback and counseling is provided, tailored interventions have a unique potential to empower adolescents to make ethically anchored decisions about their own health behavior.
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Affiliation(s)
- Kirsti Riiser
- Oslo and Akershus University College of Applied Sciences, Norway; Norwegian School of Sport Sciences, Norway
| | - Knut Løndal
- Oslo and Akershus University College of Applied Sciences, Norway
| | | | - Nina Misvær
- Oslo and Akershus University College of Applied Sciences, Norway
| | - Sølvi Helseth
- Oslo and Akershus University College of Applied Sciences, Norway
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Riiser K, Løndal K, Ommundsen Y, Sundar T, Helseth S. Development and usability testing of an internet intervention to increase physical activity in overweight adolescents. JMIR Res Protoc 2013; 2:e7. [PMID: 23612506 PMCID: PMC3628161 DOI: 10.2196/resprot.2410] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2012] [Revised: 12/10/2012] [Accepted: 12/12/2012] [Indexed: 11/16/2022] Open
Abstract
Background Internet interventions may provide opportunities for low threshold counseling using feedback to guide and support health behavior, including increased physical activity. Research shows that overweight and obese adolescents are less physically active than their peers of normal weight. There are good reasons to believe that Internet-based interventions may be particularly suitable for motivating adolescents to increase physical activity, but we need to gain further knowledge of what features are effective and how to design such interventions. Objective To describe the process of development and evaluation of usability of a Web-based program for increasing physical activity in overweight adolescents. Methods Informed by the self-determination theory, motivational interviewing, and perspectives on self-regulation, this intervention was developed in a stepwise process by an interdisciplinary team of researchers, designers, developers, and representatives from the target group. An iterative qualitative usability testing approach (observation, survey, and interview) was applied in 2 sequences, first in the lab and second in the field, to assess how adolescents (aged 12-16 years) used and experienced the program and to make adjustments to the program based on evaluation of their response. Results The following components were included in the program: self-monitoring through planning and registration of physical activity and graphical response on progress, autonomy supportive individual Web-based counseling, forum for social support, and relevant age-adjusted information about physical activity. The first usability test resulted in adjustments related mainly to making the content and aim of the different features more visible and explicit. The second test evaluated the program with adjustments from the first test, revealing that the program was well accepted by the participants and only small aesthetic adjustments had to be made to complete the final version of the Internet program, Young & Active. Conclusions Thorough preparation, with clear theory foundation and close monitoring in the developmental phase, as well as contribution and iterative evaluation from the target group, is essential to create a user-friendly and engaging program. The efficacy of the program will be evaluated in a controlled trial.
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Affiliation(s)
- Kirsti Riiser
- Institute of Nursing, Faculty of Health, Oslo and Akershus University College of Applied Sciences, Oslo, Norway.
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