The lived experiences of young people living with type 1 diabetes: A hermeneutic study

Aims

The aim of this hermeneutic study was to explore and elucidate the lived experiences of young people living with type 1 diabetes in terms of their everyday life and school in Sweden.

Design

A qualitative interview study with a hermeneutic approach inspired by Gadamer's thinking.

Methods

Interviews were conducted with a purposive sample of seven girls and three boys with type 1 diabetes between January and September 2017 and analysed with a hermeneutic method.

Results

Young peoples' everyday lives were transformed and re‐organized by their illness and they parodically live a double‐edged everyday life. To support young people's healthcare personnel, headmasters and teachers must understand this double‐edged situation.

Student perspectives on health dialogues: how do they benefit?

The vast majority of students in Sweden are healthy and live good lives, but rising health problems and declining academic performance pose risks to the country’s student population. School health services (SHS) in Sweden have a long tradition of hosting health dialogues (HD) with students to support their health and its repercussions on their learning.

Purpose: To describe experiences from 6- to 16-year-old students participating in the health dialogue in school.

Method: Descriptive qualitative design. Data were collected from 734 open-ended responses on a questionnaire distributed among students ranging in age from 6 to 16. The data were subjected to qualitative content analysis.

Findings: The analysis identified five categories: Important to identify health and health problems, School nurse, a key profession, School environment important for both health and learning, Importance of health screening and Important to have a healthy lifestyle. The findings revealed that students aged 6 to 16 years old consider health and health problems, school environment, health screening and healthy lifestyle to be important areas for health and learning School nurses were identified as key persons in HD and for student’s experience of health and learning.

Conclusion: HD is an opportunity for students to participate and influence decisions concerning their health and education, to actively engage in their own health and learning in areas that affect them for example, the school environment.

Being Facilitators in a Challenging Context-School Personnel's Experiences of Caring for Youth with Diabetes Type 1

PURPOSE

The purpose of the study was to describe school personnel's experiences of caring for youth with diabetes type 1.

DESIGN AND METHODS

A qualitative design was chosen for this study. Data were collected with individual interviews that were subjected to inductive qualitative content analysis. The sample consisted of 24 school personnel (teachers, principals and school nurses) from Swedish schools. All had experience with youth aged 6 to 18 years old with diabetes type 1.

RESULTS

School personnel experienced caring for youth with diabetes type 1 as "Being facilitators in a challenging context" and described establishing trusting relationships, finding strategies to support self-care, feeling uncertain and incapable in need of education, and dealing with unclear responsibility.

CONCLUSIONS

School personnel (teachers, principals and school nurses) are key professionals supporting youth with diabetes type 1 and self-care in school. Lack of education and unclear responsibility created feelings of uncertainty and insecurity for school personnel and a need for mandatory education of school personnel regarding T1DM and self-care, including legislation was identified.

IMPLICATIONS

Mandatory education should be provided for all school personnel regarding diabetes type 1, self-care and current legislation. A liason position in form of a nurse specialist should manage the education.

Ward visits- one essential step in intensive care follow-up. An interview study with critical care nurses' and ward nurses'

OBJECTIVE

The aim of this study was to describe critical care nurses' and ward nurses' perceptions of the benefits and challenges with a nurse-led follow-up service for intensive care-survivors at general wards.

BACKGROUND

Patients recently transferred from intensive care to the general ward are still vulnerable and require complex care. There are different models of intensive care follow-up services and some include ward visits after transfer from intensive care. Research methodology/design: This study had a qualitative design. Data from 13 semi-structured interviews with Swedish critical care nurses and ward nurses were analysed using qualitative content analysis.

FINDINGS

The findings consisted of one theme, namely, "Being a part of an intra-organisational collaboration for improved quality of care", and four subthemes: "Provides additional care for the vulnerable patients, "Strengthens ward-based critical care", "Requires coordination and information", and "Creates an exchange of knowledge". The nurse-led follow-up service detected signs of deterioration and led to better quality of care. However, shortage of time, lack of interaction, feedback and information about the function of the follow-up service led to problems.

CONCLUSION

The findings indicate that ward visits should be included in the intensive care follow-up service. Furthermore, intra-organisational collaboration seems to be essential for intensive care survivors' quality of care.

Nurses' experiences of prehospital care encounters with children in pain

BACKGROUND

Pain relief in children is a complex issue, partly an ethical dilemma and due to a lack of nursing competence. There are few studies regarding prehospital care encounters with children in pain.

AIM

The aim of this study was to describe nurses' experiences in prehospital care encounters with children in pain and the specific related challenges.

METHOD

This study has a qualitative design. Eighteen Swedish nurses participated in three focus group interviews analysed using qualitative content analysis.

FINDINGS

The findings consist of a theme, "A challenge to shift focus and adjust to the child", and three categories describing prehospital care encounters with children in pain: "Being receptive and focusing on care," "Developing a trusting relationship," and "Providing professional nursing care." Caring for children in pain was stressful for the nurses. The nurses described how they had to shift focus and used different methods to build trust, such as playfulness, making eye contact, attracting curiosity, and using the parents to create trust. The also had to adjust to the child regarding dosages and materials.

CONCLUSION

Nurses has to be practically, mentally, and theoretically prepared to care for children with prehospital pain. It is essential to evaluate the administration of adequate pain relief to children, and more evidence-based knowledge is necessary concerning the different modes of administering pain-relieving drugs to prehospital children.

Learning to manage vasoactive drugs-A qualitative interview study with critical care nurses

OBJECTIVE

Being a nurse in an intensive care unit entails caring for seriously ill patients. Vasoactive drugs are one of the tools that are used to restore adequate circulation. Critical care nurses often manage and administer these potent drugs after medical advice from physicians.

AIM

To describe the experiences of critical care nurses learning to manage vasoactive drugs, and to highlight the competence required to manage vasoactive drugs.

RESEARCH METHODOLOGY/SETTING

Twelve critical care nurses from three hospitals in Sweden were interviewed. Qualitative content analysis was applied.

RESULTS

The theme "becoming proficient requires accuracy, practice and precaution" illustrated how critical care nurses learn to manage vasoactive drugs. Learning included developing cognitive, psychomotor, and effective skills. Sources for knowledge refers to specialist education combined with practical exercises, collegial support, and accessible routine documents. The competence required to manage vasoactive drugs encompassed well-developed safety thinking that included being careful, in control, and communicating failures. Specific skills were required such as titrating doses, being able to analyse and evaluate the technological assessments, adapting to the situation, and staying calm.

CONCLUSION

Learning to manage vasoactive drugs requires a supportive introduction for novices, collegial support, lifelong learning, and a culture of safety.

Transitions in the Swedish school system and the impact on student's positive self-reported-health

Background

To explore three school based transitions and their impact on positive self- reported- health (SRH), pre-school to elementary school (6–10 y), elementary school to junior high school (10-13y), and junior high school to upper secondary school/high school (13-16y), in a long-term longitudinal population based study.

Methods

The study followed three cohorts through one school transition each.

A longitudinal study with data from 6693 Health Dialogue questionnaires were used. Data were collected in the middle of Sweden during 2007–2012 with school children age 6–16 years old.

Results

Several significant factors were identified with an impact for a positive self-reported-health among children age 6-16y; not feeling sad or depressed, afraid or worried, positive school environment (schoolyard and restrooms), not bullied, good sleep, daily physical activity and ability to concentrate. There was no single factor identified, the factors differed according to gender and age.

Conclusion

The study have identified several gender and age specific factors for successful school transitions relevant for a positive SRH. This is valuable information for school staff, parents and school children and provides a possibility to provide support and assistance when needed.

Electronic supplementary material

The online version of this article (doi:10.1186/1471-2458-14-1045) contains supplementary material, which is available to authorized users.