Personer med typ 2-diabetes ökar världen över. Enligt en ny studie vill patienterna att vården utgår från deras unika behov och resurser. Utöver kunskap om kost, motion och medicinering önskar de även få stöd kring känslomässiga och psykosociala aspekter av sjukdomen.

AIM: The aim of the present study was to describe nurse managers' perceptions of the provision of mentoring for newly graduated registered nurses (NGRNs) and its contribution to the work environment in a hospital setting.

BACKGROUND: Nurse managers are responsible for the work environment and for supporting the staff's professional development, which includes giving NGRNs organizational support during their introduction to the workplace. Mentorship is one common way to provide support, but there is a lack of knowledge about how nurse managers view this support.

DESIGN/METHOD: This was a qualitative descriptive study, using a semi-structured interview guide. Fifteen individual interviews with nurse managers were performed in hospital settings. The interview transcripts were analysed using qualitative content analysis. The COREQ guidelines and checklist were used.

RESULTS: The results describe the nurse managers' perceptions of the provision of mentoring in three themes: Ensuring and sustaining mentoring for new nurses' needs is a struggle in the harsh reality of healthcare, Identifying mentors who are willing and possess the necessary competence for the assignment and Promoting a secure and attractive workplace by mentoring new nurses.

CONCLUSIONS: Our study confirms that nurse managers are important in the provision of mentoring for NGRNs' learning and professional development. Mentoring has a positive spillover effect on the entire unit as a sustainable approach to securing and improving the work environment. Our study also identifies challenges for nurse managers to structure mentoring provision.

IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: This study highlights the importance of investment in mentoring for the NGRNs' professional development and for patient care. Support is needed from the top level of the organization, but how mentoring should be structured and facilitated needs to be investigated further.

OBJECTIVE: The objective of this study was to explore patients' learning and support needs within contemporary diabetes care to help them deal with daily life challenges.

DESIGN: A qualitative descriptive design was used following the Consolidated Criteria for Reporting Qualitative Studies. The 15 individual face-to-face interviews were analysed using qualitative content analysis.

SETTING: Participants were drawn from three healthcare centres in rural and urban regions of West Sweden.

PARTICIPANTS: The study involved 15 patients (8 men, 7 women) with T2DM who experienced contemporary diabetes care.

RESULTS: Patients expressed a strong desire for access to person-centred, multidimensional learning, with a focus on genuine partnership, tailored education, and emotional engagement. Digital tools were seen as valuable aids in their self-care efforts. Sub-themes were 'Desiring genuine partnership and tailored patient education' and 'Needing support related to altered perspectives on life and awareness of care standards but with finite care resources'.

CONCLUSION: The findings suggest that integrating person-centred, multidimensional learning strategies into diabetes care could be beneficial, particularly when addressing both practical and emotional needs. Encouraging active patient engagement through flexible digital solutions and providing support for emotional well-being may improve the overall patient experience. However, further research and practical application are needed to fully understand how these strategies could be effectively implemented to support patients with T2DM in managing their daily health challenges.

With the advent of digital transformation in healthcare, the use of digitally-enabled devices and services is rising, heralding a promising new era in diabetes treatment. This shift in healthcare consumption necessitates the development of new working patterns and recognises the need for lifelong learning (Carlsson et al., 2022) and digital literacy. Our study, therefore, delves into the realm of Continuing Professional Development (CPD) for Diabetes Specialist Nurses (DSNs), who play a pivotal role in integrating technology into clinical practice. While DSNs acknowledge the potential of digitalisation for learning, they also express reservations about its impact on the currency of their knowledge and the delivery of person-centred care (PCC) (Öberg et al., 2018). The quality of workplace learning is crucial for CPD, yet there is a gap in how much workplaces promote learning and CPD (Deutscher & Braunstein, 2023) to maintain PCC. 

Our study comprehensively explores the associations between workplace learning potential and the extent of PCC among DSNs. To gather data, we conducted a cross-sectional online survey with 157 DSNs to assess their perceptions of learning opportunities and PCC within their workplace that promotes CPD. 

The findings of our study bear significant implications. We found a positive association between workplace learning potential and PCC practice. Nurses who perceive workplace learning support are more likely to uphold PCC principles. The finding underscores the need to create supportive learning environments within healthcare organisations to facilitate learning and PCC. It is crucial to highlight the importance of nurses being prepared to adapt to changes in healthcare service delivery and deliver PCC in line with the patient's abilities and needs in the face of digital transformation. Striking a balance between the rapid digital transformation in healthcare and PCC is crucial for nurses to remain competent and compassionate practitioners, and this balance can be promoted by providing ample learning opportunities that promote CPD. 

References:

Carlsson, M., Alm, A. K., & Rising, M. H. (2022). An evaluation of registered nurses’ experiences of person-centered care and competence after participating in a course in digital competence in care. BMC Nursing, 21(1), 368. https://doi.org/10.1186/s12912-022-01151-2 

Deutscher, V., & Braunstein, A. (2023). Measuring the quality of workplace learning environments–a qualitative meta synthesis of employee questionnaires. Journal of Workplace Learning, 35(9), 134-161. 

Öberg, U., Orre, C. J., Isaksson, U., Schimmer, R., Larsson, H., & Hörnsten, Å. (2018). Swedish primary healthcare nurses’ perceptions of using digital ehealth services in support of patient self‐management. Scandinavian Journal of Caring Sciences, 32(2), 961-970. https://doi.org/10.1111/scs.12534 

INTRODUCTION: Research indicates that newly graduated registered nurses struggle to develop practical skills and clinical understanding and to adapt to their professional role. To ensure quality of care and support new nurses, it is vital that this learning is elucidated and evaluated. Aim The aim was to develop and evaluate the psychometric properties of an instrument assessing work-integrated learning for newly graduated registered nurses, the Experienced Work-Integrated Learning (E-WIL) instrument.

METHOD: The study utilized the methodology of a survey and a cross-sectional research design. The sample consisted of newly graduated registered nurses (n = 221) working at hospitals in western Sweden. The E-WIL instrument was validated using confirmatory factor analysis (CFA).

RESULTS: The majority of the study participants were female, the average age was 28 years, and participants had an average of five months' experience in the profession. The results confirmed the construct validity of the global latent variable E-WIL, "Transforming previous notions and new contextual knowledge into practical meaning," including six dimensions representing work-integrated learning. The factor loadings between the final 29 indicators and the six factors ranged from 0.30 to 0.89, and between the latent factor and the six factors from 0.64 to 0.79. The indices of fit indicated satisfactory goodness-of-fit and good reliability in five dimensions with values ranging from α = 0.70 to 0.81, except for one dimension showing a slightly lower reliability, α = 0.63, due to the low item number. Confirmatory factor analysis also confirmed two second-order latent variables, "Personal mastering of professional roles" with 18 indicators, and "Adapting to organisational requirements" with 11 indicators. Both showed satisfactory goodness-of-fit, and factor loading between indicators and the latent variables ranged from 0.44 to 0.90 and from 0.37 to 0.81, respectively.

CONCLUSION: The validity of the E-WIL instrument was confirmed. All three latent variables could be measured in their entirety, and all dimensions could be used separately for the assessment of work-integrated learning. The E-WIL instrument could be useful for healthcare organisations when the goal is to assess aspects of newly graduated registered nurses' learning and professional development.

By giving a brief overview of the metaconcepts in nursing, with a focus on environment, we sketch a theoretical framework for an emancipatory perspective in nursing care practice. To meet the requirements of equality in care and treatment, we have in our theoretical framework added a critical lifeworld perspective to the antioppressive practice, to meet requirements of equity in health care encounter. The proposed model of emancipatory nursing goes from overall ideological structures to ontological aspects of the everyday world. Based on the model, nurses could identify what kind of theoretical critical knowledge and thinking they require to conduct equal care and encounter the person behind the patient role.

Introduction: After treatment for myocardial infarction (MI) quite a few persons will experience different symptoms, including fatigue, during the recovery phase. The aim of the present study was to construct the multidimensional Post-Myocardial Infarction Fatigue (PMIF) scale, based on empirical data gathered in coronary heart disease contexts. Methods: The construction of the post-MI fatigue scale was conducted in seven steps, ending in a psychometric evaluation of the internal structure of the scale, using confirmatory factor analysis, as well as testing of convergent and discriminant validity, using correlational analysis, in a sample of 141 persons treated for MI. Results: The results showed that the PMIF scale represents three dimensions: physical, cognitive and emotional fatigue. It was also found that the scale is suitable for summing the items to obtain a total score representing a post-MI global fatigue dimension. Conclusion: The PMIF is a brief and easily completed scale for identifying persons experiencing post-MI fatigue. Early identification of fatigue, together with health behavior support, might prevent progression toward a more severe state of fatigue.

Introduction: Lower health-related quality of life (HRQoL) is associated with fatigue, poor mental and poor gastrointestinal health during the first three months after colorectal cancer (CRC) treatment. Research indicates that maintaining usual activities has a positive impact on HRQoL after treatment for CRC. Illness perceptions have been associated with HRQoL in other cancer diseases, and self-efficacy has been associated with HRQoL in gastrointestinal cancer survivors. Our knowledge about illness perceptions and self-efficacy in relation to maintaining everyday activities and HRQoL following CRC treatment is incomplete. Aim: To explore associations between HRQoL, fatigue, mental health, gastrointestinal health, illness perceptions and self-efficacy in relation to maintaining everyday activities, three months after surgical CRC treatment. A further aim was to test the Maintain Function Scale in a CRC population. Method: The study was cross-sectional. Forty-six persons participated. Data were collected using questionnaires. Descriptive and analytical statistics were used. Results: Persons who were more fatigued, depressed, worried, and had more diarrhea were more likely to report lower HRQoL. Increased fatigue and diarrhea were associated with decreased HRQoL. Concerning illness perceptions, persons who reported negative emotions and negative consequences of CRC were more likely to report lower HRQoL. Persons scoring higher on self-efficacy were more likely to report higher HRQoL. Increased self-efficacy was associated with increased HRQoL. The Maintain Function Scale was suitable for assessing self-efficacy in relation to maintaining everyday activities. Conclusions: Nursing support to improve self-efficacy and illness perceptions and to minimize symptoms during recovery should have a favorable impact on HRQoL.

AIMS AND OBJECTIVES: The aim of the present study was twofold: 1) to measure changes in health-related quality of life (HRQoL), two dimensions of illness perceptions (i.e., consequences and emotional representations), fatigue and self-efficacy in persons treated for CRC during the first year after surgical treatment, and 2) to study how fatigue, illness perceptions and self-efficacy measured at 3 months affect HRQoL at 12 months post-surgery.

BACKGROUND: There are fluctuations in HRQoL during the first year after treatment for colorectal cancer (CRC), and fatigue may negatively influence HRQoL. Illness perceptions (consequences and emotional representations) and self-efficacy have been shown to be associated with HRQoL in other cancer diagnoses. Concerning CRC, there is a lack of knowledge concerning how illness perceptions and self-efficacy change during recovery, and how these variables and fatigue at 3 months relate to HRQoL at 12 months.

DESIGN: A prospective longitudinal design.

METHODS: Thirty-nine persons surgically treated for colorectal cancer, of whom 17 had a colostoma, participated. HRQoL, fatigue, illness perceptions and self-efficacy were assessed using QLQ-C30, the Revised Illness Perception Questionnaire and the Maintain Function Scale. Descriptive and analytical statistics were used.

RESULTS: No changes were reported in levels of HRQoL, fatigue, or illness perceptions. Self-efficacy was lower at 12 months compared to 3 months. Fatigue and one dimension of illness perceptions mediated the effect of self-efficacy at 3 months on HRQoL at 12 months.

CONCLUSION: Persons treated for CRC who have lower self-efficacy 3 months post-surgery are inclined to have more negative illness perceptions concerning emotions and to experience more fatigue.

RELEVANCE TO CLINICAL PRACTICE: Nurses need to support persons with fatigue and negative illness perceptions concerning emotions and to bolster their self-efficacy, i.e., carry out follow-up consultations focusing on illness management, symptoms, emotions and information on ways to increase self-efficacy. This article is protected by copyright. All rights reserved.

Background Single ventricle defects are among the most complex congenital heart defects and the development of advanced surgical procedures in recent decades has created the first generation of adolescents and young adults living with this condition. Yet little is known about how these individuals experience life and what impact the heart defect has on their life in general. Objective The aim was to illuminate and gain a deeper understanding of adolescents’ and young adults’ experiences of living with a surgically palliated univentricular heart. Design Seven open-ended in-depth interviews were conducted, transcribed, and analyzed according to the henomenological hermeneutical method. All adolescents and young adults operated before 1995 according to the Fontan procedure or the total cavo-pulmonary connection procedure at one pediatric cardiology unit were included in the study. They were 17–32 years of age (median age 22 years). Results The interpretation of the interview transcripts showed that the participants experienced living with a surgically palliated univentricular heart in terms of feeling exceptional, strong, and healthy. This was supported by two structural analyses, where three themes emerged: happiness over being me, focusing on possibilities, and being committed to life. Conclusion Living with a Fontan circulation included negative experiences but the analyses clearly demonstrated a feeling of being strong and healthy. An appreciation of having survived and being committed to life was found to be an integral part of the development of the interviewees’ existential growth. This probably strengthens them further in their ability to balance expectations and hurdles in life. This study provides valuable insights into the experience of patients after the Fontan procedure and the importance of a positive health care environment throughout their lives.