Children living with chronic complex conditions (CCC) face challenges that affect their daily lives, often negatively impacting their perception of life, health, and overall well-being. A person-centered approach by healthcare professionals can facilitate better support tailored to each child’s individual needs. This approach can be applied both digitally and in person within healthcare settings; however, there is limited knowledge regarding the type of support children prefer.

This study aims to describe how children with complex chronic conditions (CCC) experience digital and in-person support, their information needs, and their perceived participation in their own healthcare. Twelve children aged 10 to 17 years were individually interviewed, using a qualitative descriptive method. The data were analyzed with manifest content analysis, where two categories were identified: “Support and involvement in one’s own healthcare” and “Receiving information in different ways.”

Findings indicate that children with CCC require personalized information and support addressing their specific needs, incorporating both professional and peer-to-peer support. This study high-lights a person-centered care in healthcare, which enhances children’s rights and encourages their active participation in their own care.

This study aimed to describe the translation and adaptation of the Dutch screening checklist for child abuse SPUTOVAMO-R into a Swedish context and to evaluate the feasibility of the Swedish screening tool SUBFI in a Peadiatric Emergency Department in Sweden. The study was performed at the Queen Silvia Children's Hospital, Sweden, in 2017–2018; SPUTOVAMO-R was translated and adapted to the Swedish context by three focus groups with 13 participants and an expert group. SUBFI, the Swedish version, was created, then tested in an 8-week pilot study at the paediatric emergency department's paediatric nurse practitioner clinic, with a follow-up feasibility evaluation. The focus groups stressed that a screening tool would provide structure and be helpful in decision-making regarding child abuse and neglect, but the original design of SPUTOVAMO-R required a cultural adaptation. The Swedish version, SUBFI, featured relevant questions for a Swedish setting. After using SUBFI in the pilot study, in which 377 children were screened, the nurses reported it to be adequately formulated and easy to use as a supportive tool, ensuring comprehensive evaluation of every child. SUBFI was experienced as a relevant and user-friendly tool supporting structured assessment of suspected child abuse in Swedish paediatric emergency care. The findings support its clinical value and indicate a need for broader implementation and research.

Aim To explore newly-graduated registered nurses' professional needs and how these needs are supported by mentors in clinical practice, at two Swedish hospital care units.

Background Previous studies show that newly-graduated registered nurses face challenges on initially starting to provide hospital care, thus needing organisational support. Experienced nurses and mentors are commonly described in the literature as facilitating this support and need to be investigated further; however, where this appears in a hospital setting.

Design/Method A qualitative study using focused ethnography was conducted between May 2024 and March 2025. Data was generated from 9 different fieldwork sessions (68 h) for mentoring that included newly-graduated registered nurses and mentors from two different care units at hospitals within one regional healthcare authority in Sweden. Data was collected by means of participant observations, shadowing, ethnographic interviews, and the use of ethnographic analysis.

Findings One main theme was identified: I'm in freefall and in need of practical, social and emotional support when navigating my new role, as well as two subthemes: (1) I am a new nurse and in need of help in comprehending and performing nursing, and (2) I am undergoing a learning process in need of a trust-based relationship. Each theme includes three subthemes.

Conclusion Newly-graduated registered nurses need consistent practical, social, and emotional support in their day-to-day work through trust-based relationships with mentors. This is a relationship crucial for their learning process, and which helps them bridge the gap between understanding and practicing nursing.

Implications for the Profession Structured mentorship can improve the learning environment of newly-graduated registered nurses and constitute a sustainable working environment for them. Decision-makers and managers can use this knowledge to implement mentoring programmes that are of interest when it comes to retaining both new and experienced nurses and providing qualitative and safe care.

Reporting Method This study conforms to the reporting of the COREQ guidelines and checklist.

Patient or Public Contributions No patient or public contributions. 

OBJECTIVES: To demonstrate how nurses in pediatric care provide information and maintain access to health care for children with complex chronic conditions utilizing e-health or in-person support methods.

METHODS: The study involved 12 nurses/specialist nurses from the medical departments at Queen Silvia Children's Hospital in Gothenburg. A qualitative method was employed, using individual interviews with a semi-structured guide and analyzed using a reflexive thematic analysis method.

RESULTS: The analysis yielded two main themes and six subthemes. The nurses employed various information methods, used alone or in combination of oral communication, written materials, digital tools, visual aids, and demonstrations. Supportive conversations were provided for the child and the whole family. Nurses ensured contact with the entire care team, tailoring support to the child's individual needs based on age, maturity, developmental level, beliefs, culture, and language barriers.

CONCLUSION: Involving children in their own care through single or mixed methods, via e-health or in-person support, protects and strengthens their right to understand their health situation and health preparedness.

PRACTICE IMPLICATIONS: Effective, customized support from healthcare staff can ensure that children with complex chronic conditions with families are actively involved, improving children's control over their care, adherence to treatment plans, self-esteem and health outcomes.

Aims

An increasing number of women with congenital heart disease (CHD) reach childbearing age. These women have a higher occurrence of cardiac events, such as heart failure and arrhythmia, than women without CHD. We aimed to illuminate women’s experiences in connection with pregnancy and how they understand and manage signs and symptoms in relation to their heart defects.

Methods and results

Semi-structured interviews were conducted with 18 women with CHD of varying complexity registered at four tertiary adult CHD centres in Sweden. The interviews were conducted by video call online via Zoom, and 30–60 min in duration. The qualitative content analysis method according to Graneheim and Lundman was used to analyse the recorded interview data.

he analysis revealed one overarching theme, Concerned but feeling safe during pregnancy, which was built up from three themes: Feeling confident, Having concerns and fear, and Understanding bodily changes. These themes emerged from seven subthemes.

Conclusion

Despite concerns, the women in this study reported feeling confident during pregnancy. They needed support throughout their pregnancy to manage the many worries and fear they experienced, both for themselves and for their unborn child.

They found it somewhat difficult to interpret symptoms, but with the establishment of regular follow-up, the need for acute and unplanned interventions might decrease since the women could recognize symptoms connected to their CHD and reportt hem earlier. The availability of a multidisciplinary team to provide support to this patient group is therefore of utmost importance.*

Aim: This study seeks to build upon a prior investigation into the impact of the COVID-19 pandemic and to evaluate the prevalence of anxiety among Brazilian children, along with its associated factors, one year after the commencement of the pandemic.

Design: A cross-sectional study.

Methods: A survey was conducted from April–May 2021 in Brazil. Children aged 6–12 and their guardians from five Brazilian regions were included. The Children’s Anxiety Questionnaire (CAQ; scores 4–12) and Numerical Rating Scale (NRS; scores 0–10) were used to measure anxiety.

Results: Of the 906 children, 53.3% were girls (average age = 8.79 ± 2.05 years). Mothers responded for 87.1% of the children, and 70.9% were from the Southeast region. Based on a CAQ score of ≥9 and an NRS score of ≥8, the anxiety prevalence was 24.9 and 34.9%, respectively. Using logistic regression, a CAQ ≥9 score was associated with older children and children with chronic disease or disability. An NRS score of ≥8 was associated with reduced family income during the pandemic, the person caring for the children, and with children with chronic disease or disability.

Conclusion: These findings suggest the need to implement public health actions aimed at children with chronic diseases and disabilities and their parents to guide them regarding the warning signs and negative emotions. This study contributes to characterizing the evolution of the pandemic in Brazil and provides a basis for comparison with the literature from other countries.

Background: A comprehensive understanding of adult congenital heart disease outcomes must include psychological functioning. Our multisite study offered the opportunity to explore depression and anxiety symptoms within a global sample.

Objectives: In this substudy of the APPROACH-IS (Assessment of Patterns of Patient-Reported Outcomes in Adults With Congenital Heart Disease–International Study), the authors we investigated the prevalence of elevated depression and anxiety symptoms, explored associated sociodemographic and medical factors, and examined how quality of life (QOL) and health status (HS) differ according to the degree of psychological symptoms.

Methods: Participants completed the Hospital Anxiety and Depression Scale, which includes subscales for symptoms of anxiety (HADS-A) and depression (HADS-D). Subscale scores of 8 or higher indicate clinically elevated symptoms and can be further categorized as mild, moderate, or severe. Participants also completed analogue scales on a scale of 0 to 100 for QOL and HS. Analysis of variance was performed to investigate whether QOL and HS differed by symptom category.

Results: Of 3,815 participants from 15 countries (age 34.8 ± 12.9 years; 52.7% female), 1,148 (30.1%) had elevated symptoms in one or both subscales: elevated HADS-A only (18.3%), elevated HADS-D only (2.9%), or elevations on both subscales (8.9%). Percentages varied among countries. Both QOL and HS decreased in accordance with increasing HADS-A and HADS-D symptom categories (P < 0.001).

Conclusions: In this global sample of adults with congenital heart disease, almost one-third reported elevated symptoms of depression and/or anxiety, which in turn were associated with lower QOL and HS. We strongly advocate for the implementation of strategies to recognize and manage psychological distress in clinical settings. (Patient-Reported Outcomes in Adults With Congenital Heart Disease [APPROACH-IS]; NCT02150603) 

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.

Background: As more women with congenital heart disease (CHD) are reaching childbearing age, it becomes more common for their symptoms to be evaluated during pregnancy. However, pregnancy-related symptoms are similar to those caused by heart disease. This study investigated the prevalence of factors associated with symptoms during pregnancy in women with CHD.

Methods: The national birth register was searched for primiparous women with CHD who were registered in the national quality register for patients with CHD.

Results: Symptoms during the third trimester were reported in 104 of 465 evaluated women. The most common symptom was palpitations followed by dyspnea. Factors associated with symptoms were tested in a univariable model; higher NYHA classification (>1) (OR 11.3, 95%CI 5.5-23.2), low physical activity (≤3 h/week) (OR 2.1 95%CI 1.3-3.6) and educational level ≤ 12 years (OR 1.9 95%CI 1.2-3.0) were associated with having symptoms. In multivariable analysis, low physical activity level (OR 2.4 95%CI 1.2-5.0) and higher NYHA class (OR 11.3 95%CI 5.0-25.6) remained associated with symptoms during pregnancy. There were no cases with new onset of impaired systemic ventricular function during pregnancy.

Conclusion: Symptoms during pregnancy are common in women with CHD but are often already present before pregnancy. Because ordinary symptoms during pregnancy often overlap with symptoms of heart disease, it is important to know if symptoms were present before pregnancy and if they became worse during pregnancy. These results should be included in pre-pregnancy counselling and considered in the monitoring during pregnancy.

Background: Parents of children with complex right ventricular outflow tract (RVOT) anomalies are con-fronted with their child’s need for heart surgery early in life and repeated reoperations later on. Preoperative assessment needs to be performed whenever an indication for reoperation is suspected. The aim was to illuminate the experiences of parents of children diagnosed with RVOT anomalies, in particular, how they experience their child’s heart disease and everyday life during the assessment and after the decision on whether to perform a reo-peration. Method: Individual interviews (n = 27) were conducted with nine parents on three occasions between 2014 and 2016 and analyzed using reflexive thematic analysis. Results: The analysis resulted in the following five main coexisting themes: The heart surgery keeps my child alive illuminates parents’ experiences during and after the assessment and emphasizes that heart surgery, although dreaded, is central for their child’s survival; Everyday struggles illuminates the different struggles parents had to face to ensure that their child would be in the best possible condition; the remaining three themes, Unconditional love, Trust in life, and Togetherness, illuminate the ways in which the parents gained inner strength and confidence in their everyday lives. Conclusion: Although the parents were grateful for the assessment and had learned to navigate among the fears it aroused, they experi-enced several distressing situations during the assessment process that should be addressed. By inviting both the parents and their child to participate in the child’s care, individualized support can take into account the needs of both parents and child. © 2023, Tech Science Press. All rights reserved.