EU regulations mandating expanded clinical training in nursing education have intensified the demand for clinical placements and qualified supervision in Sweden, where nurse shortages are expected to persist for 15 years. The patient-oriented learning model, a work-integrated and student-centred supervision model, can enhance the educational environment during clinical practice. The aim of this study was to describe supervisors’ experiences of applying the supervision model of patient-oriented learning during nursing students’ clinical placements. This qualitative descriptive study included fifteen semi-structured interviews with supervisors, analysed using abductive qualitative content analysis. The analysis resulted in three key aspects that bridged campus-based education and clinical practice. First, engagement depended on management support, preparatory activities, and time. Second, the patient-oriented learning model encouraged structured, student-driven learning that promoted engagement and independence. Third, it fostered collaborative knowledge sharing, enhancing student preparedness and supervisory processes. Challenges included balancing structure and flexibility during busy periods, which affected the model’s use. Despite these issues, supervisors noted the model led to more organised, reflective, goal-oriented supervision, supporting professional identity, competence development, and improved student preparation for future roles. The patient-oriented learning model bridges campus and clinical practice, supporting student learning, professional development, and supervision. A key component is the binder documenting the learning process, aiding planning, reflection, and interplay between theory and practice. The model offers a structured, reflective approach benefiting supervisors and students. Organisational support and adaptation are needed to address inconsistent interpretation and limited preparation time, to support effectiveness of the model while strengthening supervisors’ competence and confidence.

Background

Emerging research suggests a link between attention deficit hyperactivity disorder (ADHD) and central sensitization (CS), a condition characterized by heightened sensitivity to pain and sensory stimuli. This study aimed to measure the severity of CS symptoms in children with ADHD and in their parents; compare results with those of a neurotypical group; and explore associations between CS symptoms and pain intensity as well as potential familial patterns.

Methods

Participants included 37 children with ADHD (mean age = 11.54 years; 62.2% male) and 29 neurotypical children (mean age = 13.07 years; 58.6% male). Children completed the Central Sensitization Inventory (CSI) – Child and Adolescent Version and rated their pain intensity at the time of assessment and over the past week. One parent per child completed the adult version of the CSI.

Results

Children with ADHD reported significantly higher CSI-indexed CS symptom scores than those in the comparison group (p < 0.001). In categorical analyses, neurotypical children were significantly more likely to fall into the subclinical (lowest symptom) CS range (adjusted p < 0.005). Children with ADHD also reported significantly greater pain intensity both currently (p = 0.016) and over the past week (p = 0.003). Stronger correlations between CSI-indexed CS and self-reported pain were observed in the ADHD group, particularly for current pain (ρ = 0.66, p = 0.002). Parents of children with ADHD also had elevated CS scores (p = 0.003), with the majority falling in the severe range. A moderate correlation between parent and child CSI-indexed CS scores was observed across the entire sample (ρ = 0.47, p = 0.002), while a strong correlation between parents’ CS scores and their own medical conditions was found only in the ADHD group (ρ = 0.66, p = 0.002).

Conclusions

Children with ADHD, and their parents, reported elevated CSI-indexed CS symptoms and pain intensity, suggesting that CS symptoms may represent a clinically relevant feature in some ADHD presentations. These findings support the value of considering sensory and pain-related assessments in ADHD evaluations and highlight the need for further research into potential mechanisms and integrative interventions that may improve outcomes and reduce functional impairment in pediatric neuropsychiatric conditions.