This discussion paper highlights the necessity of norm-critical and norm-creative approaches in nursing education to address healthcare inequalities. Traditional curricula have inadequately engaged with intersectional perspectives, marginalizing various social groups. By integrating norm-conscious pedagogy, nursing students can critically analyze power structures and develop inclusive healthcare solutions. The “Breaking Fences” project introduces innovative tools, such as the norm-lab+, to foster reflexivity and challenge discriminatory norms. Emphasizing social justice, sustainability and self-awareness, this approach equips future nurses to recognize and counter biases, ultimately promoting equitable healthcare practices. Implementing norm-conscious education is crucial for advancing inclusivity and social responsibility in nursing. 

The world is facing the highest number of people to have been forced from their homes due to war and conflict. Providing a framework for integrated action is a common societal solution to managing the challenges of integration policy programmes. These programmes are intended to standardise services provided by a diverse set of agencies and areas, and are usually delivered by civil servants and volunteers.

The aim of this study was to describe factors, as reported by civil servants and volunteers in a policy programme, that enable or hinder them in helping newly arrived immigrants to establish themselves in Swedish society. The results show that the participants have the prerequisites to enable newly arrived immigrants to make their own choices, strengthen their own motivation and develop their own social networks within their new situation. However, the participants were hindered from influencing the newly arrived immigrants’ housing situation. No consensus was achieved regarding more structural prerequisites such as societal efforts to counteract segregation, or more general community-based welfare solutions. The results support the view that there is a need for a more tailored approach with consideration for each person’s unique living situation.

Communication between healthcare professionals and patients is a key element of quality healthcare. Prejudices and stereotypes influence the perception of the other person, the way of interaction and the quality of information transfer. This paper focuses on the role of biases in health communication, their impact on the healing process and ways to eliminate them.

The concept of "normality" is shaped by cultural, social and institutional factors. People automatically judge others based on first impressions; the resulting image shapes the view of the other person and influences the way we communicate with them. Prejudices can cause an underestimation of a person's communication and cognitive abilities and lead, for example, to "elderspeak" in the elderly.

As part of the Breaking Fences project, which aims to raise awareness of prejudice through educational programmes for students and healthcare staff, pilot research has been carried outinto patients' prejudices towards young healthcare and social care staff. Methods: Young health and social care workers were encouraged to reflect on the perceived prejudice against them in work and its intensity, which they expressed through their signatures for each type of prejudice.

Data: Data were collected from 79 individuals aged 20-25 years and analysed. Results: The highest level of prejudice was perceived in the area of young professionals' low age and lack of experience (92% of respondents). Prejudice towards their ability to express themselves verbally and communicate effectively was felt by 45% of respondents, and prejudice due to dialect or accent was identified by 35% of respondents.

The need for health professionals to self-reflect, validate their own impressions and respect individual patient preferences may contribute to the development of more effective and empathetic health communication.

Background: Despite a variety of literature reviews, there is limited understanding of the learning strategies healthcare professionals use to help patients adopt and maintain effective foot care practices.

Aim: To explore learning processes and educational strategies for persons with diabetes focusing on foot care and examine how different learning processes influence these strategies.

Method: The scoping review followed the methodological framework established by Arksey and O'Malley and refined by Levac et al. Additionally, the PRISMA-ScR checklist was followed. A literature search was conducted in the PubMed, CINAHL, MEDLINE and Academic Search Premier databases, using specific search terms related to diabetic foot care and learning strategies. The selection process involved screening 906 articles based on inclusion criteria such as relevance to diabetic foot care, learning processes, and educational strategies, and excluded studies that were not written in English. The data were charted and quantitative and qualitative data were synthesised and thematically analysed to identify key learning strategies.

Results:The analysis identified two main themes: learning insights for comprehensive understanding and self-efficacy, and increased practical knowledge leads to improved footcare. Subthemes included integrative and reflective learning, motivational and collaborative learning, task-oriented and procedural learning, and feedback and reinforcement-based learning.

Conclusion: Effective diabetic foot care education should be multifaceted, incorporating deep learning, practical skills, and motivational elements. Early learning plays a central role in this process. Tailoring educational interventions to personal learning styles and providing continuous support can significantly improve patients' foot care outcomes. A framework for understanding the progressive stages of patient learning and self-management is presented as a starting point. Future research should focus on developing and evaluating educational models that address diverse learning needs, ultimately contributing to better management and prevention of diabetic foot complications.

The role of nurses in identifying and responding to family violence and violence against women has long been established. However, nurses’ readiness to fully assume this role remains low due to various barriers and the sensitive nature of the subject. As part of capacity building to address this problem, an additional national qualitative learning target, i.e., to “show knowledge about men’s violence against women and violence in close relationships”, was introduced into the Swedish Higher Education Ordinance for nursing and seven other educational programs between 2017 and 2018.

The aim of this paper is to describe how the national qualitative learning target is incorporated into the undergraduate nursing curriculum at the Swedish Red Cross University College. An overview of relevant teaching and learning activities and how they are organized is first presented, followed by the presentation of a proposed didactic model: Dare to Ask and Act! The model details a step-by-step progression from facts and figures, including the role of gender norms, to recognizing signs of abuse in complex clinical situations, as well as developing skills that enhance the courage to ask and act.

Due to the sensitive nature of violence victimization, the proposed model reflects the importance of making the subject a reoccurring theme in undergraduate nursing education in order to boost nursing students’ interests and confidence to “Dare to Ask and Act!”. The model also shows that making the subject a recurring theme can be achieved with minimal disruptions to and without overcrowding an existing curriculum.

BACKGROUND: Patients who are suffering may be commonly encountered in health care. The growing use of telehealth implies that encounters with patients who are suffering may increasingly take place at a distance. "Distant suffering" is a concept coined within sociology to describe the suffering of far-away others. It is conceptualized as a paradox, as distance changes the relation between the witness of suffering and the suffering encountered. Impacts may include a potential detriment to the sufferer and ethical implications for the witness.

OBJECTIVE: To explore the concept of distant suffering and any relevance, implications, or important avenues for potential research within the healthcare sciences.

DESIGN: Rodgers' evolutionary concept analysis.

DATA SOURCES: Databases of Web of Science, Medline, CINAHL and PsycInfo were searched for the terms "distant suffering" or "mediated suffering".

REVIEW METHOD: Attributes, surrogate or related terms, antecedents, consequences, and uses of the concept were extracted and synthesized.

RESULTS: Thirty articles published within the past ten years were selected for review from the search results. "Distant suffering" was characterized as comprising 1) mediated far-away suffering, 2) a "recognizer" or witness, and 3) a potential role of a moderator. Antecedents include shared understandings and socially-influenced responses. Consequences include responses like empathy, compassion, pity, also indifference, cynicism and compassion fatigue.

CONCLUSIONS: Further research to explore distant suffering from healthcare sciences' perspective could uncover valuable insights for those suffering, for healthcare workers, and any who are exposed to it. An improved understanding of how distant suffering is conveyed and moderated could enable targeted reduction of exposure or improve response to distant suffering. Such knowledge could help diminish negative consequences for those suffering, for healthcare workers who are caring at a distance for those suffering, or for others who encounter distant suffering in their occupations or in daily life via media, social media, or digital communications.

TWEETABLE ABSTRACT: New analysis finds that exposure to distant suffering may have important implications for health and health care.

Fashion is a way to express identity and affiliations with specific social networks, and sociocultural organisations of health care facilities are no exception. Employees in hospitals must adhere to strictly regulated dress code policies, albeit shoes are one of few markers that are not regulated.

The aim of this study was to analyse the expressed team identity among healthcare staff by studying signs of personality traits they share with colleagues, as found in their choice of footwear. A total of 213 images of hospital footwear, posted on Instagram, were analysed utilising thematic content analysis.

The results show that choice of footwear signals seven different personality traits: the anonymous, an understated conformist; the discreet standout, a subtle individualist; the doer on the move, an active and ready contributor; the naturist, a barefoot  enthusiast; the superior  tourist,  a  temporarily  elite  visitor;  the  outsider,  an unconventional maverick; and the legend, a battle-scarred veteran.

Background

The COVID-19 pandemic has made visible the scale of health disparities in society, highlighting how the distribution of infection and deaths differs between population subgroups within countries. Asylum seekers represent a potentially vulnerable group; early in the pandemic, concerns were raised about their housing situation, usually involving overcrowded, camp-like accommodations, and the effects of COVID-19 in relation to this. Hence, this study aimed to explore asylum seekers’ experiences of the COVID-19 pandemic while living at accommodation centers.

Methods

In this qualitative study, 14 semi-structured interviews were conducted with asylum seekers at two accommodation centers in Sweden. Participants represented a diverse group of asylum seekers in regard to age, educational background, and gender. Data were analyzed using qualitative content analysis.

Results

Experiences related to COVID-19 were highly dependent on the living situation at the accommodation centers and the experience of feeling unsafe in shared spaces. This was enhanced by the experiences of a challenging mix of COVID-19 messages where different understandings of COVID-19 and related measures existed, together with a feeling of loss of control and safety in shared rooms. Additionally, participants felt more isolated from the outside society and missed prior social activities. Adding to this experience of isolation was an increasing mistrust regarding the authorities’ pandemic response.

Conclusion

This study highlights the importance of understanding the specific challenges and vulnerabilities of asylum seekers at accommodation centers during the pandemic, shaped by their housing situation and legal status. The findings underscore the need for context-specific support, holistic disease prevention approaches, and tailored health communication strategies using diverse formats. Additionally, the findings emphasize the crucial need to identify and mobilize existing community resources in planning and implementing pandemic control measures. Furthermore, the study emphasizes governmental responsibility in providing secure housing, and to address long-term vulnerabilities beyond pandemics.

The child perspective, i.e. an adult understanding and viewing of a child, is frequently being discussed. However, it is open to individual interpretation as the concept is only vaguely defined. This paper focuses on factors characterising the child perspective held by adults in an organisation which treats and supports adults and children who endure mental illness as a result of war, torture, and/or life as refugees. A cross-sectional descriptive design involving qualitative data was used. Data were gathered at the Health and care department, Swedish Red Cross, through open-ended questions in a web-based questionnaire answered by 69 employees. Additionally, ten semi-structured interviews were conducted with key individuals who represented a variety of professional functions within the department. The data were combined to form a united data set used for analysis. A thematic analysis was undertaken, based on the descriptions by Braun and Clarke, and three major themes emerged. Two of these described the professionals’ perceptions in terms of a child perspective. The first, Considering the child as an individual, focused on how a child perspective encouraged the employees to create a friendly atmosphere and to seek out children’s perspectives. The second, Acknowledging the child’s rights, highlighted a view of the child perspective as involving the safeguarding of children and the provision of “voice”. The third theme, Ambiguity in implementation, described the operationalisation of the child perspective in daily work, illustrating both favourable and problematic factors. To conclude, the understanding gained by this paper could be used to raise awareness of, concretise and operationalise a child perspective in other organisations in which adults encounter children. Likewise, this understanding could be used for ongoing research, knowledge development and further discussions in terms of child-focused work and rights-related initiatives involving children.  

People use the Web to seek health-related information and to discuss health issues with peers. Netnography, a qualitative research methodology, has gained the attention of researchers interested in people’s health and health issues. However, no previous reviews have accounted for how netnography is used in nursing research. The purpose of this mapping review was to generate a map of netnographic research in nursing. The search was conducted in PubMed, Academic Search Elite, the Cumulative Index to Nursing and Allied Health Literature, Medline, PsycINFO, Scopus, and Web of Science. Data were extracted from 53 original articles. The results show an increasing trend in published netnographies over time; 34% of the total sample was published in 2021. Of the total, 28% originated from Sweden, and 81% had used a covert approach. In studies in which the researchers used more participatory designs, the time spent on online forums ranged between 4 weeks and 20 months. Informed consent is found to be an issue in netnographic studies. We discuss the fact that nursing researchers have used netnography to address a wide range of research topics of concern and interest, from self-care support in an online forum for older adults to nursing students’ perspectives on effective pedagogy. In line with the digital transformation in society in general, we discuss the fact that netnography as a research methodology offers great opportunities for nurse researchers to monitor new spaces and places that presuppose online methodological knowledge.