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A negative relationship between mathematics anxiety (MA) and mathematics performance is well documented. One suggested explanation for this relationship is that MA interferes with the cognitive processes needed when solving mathematics problems. A demand for using more cognitive effort (e.g., when performing harder mathematics problems), can be traced as an increase in pupil dilation during the performance. However, we lack knowledge of how MA affects this relationship between the problem difficulty and cognitive effort. This study investigated, for the first time, if MA moderates the effect of arithmetic (i.e., multiplication) problem difficulty on cognitive effort. Thirty‐four university students from Norway completed multiplication tasks, including three difficulty levels of problems, while their cognitive effort was also measured by means of pupil dilation using an eye tracker. Further, the participants reported their MA using a questionnaire, and arithmetic competence, general intelligence, and working memory were measured with paper‐pencil tasks. A linear mixed model analysis showed that the difficulty level of the multiplication problems affected the cognitive effort so that the pupil dilated more with harder multiplication problems. However, we did not find a moderating effect of MA on cognitive effort, when controlling for arithmetic competence, general intelligence, and working memory. This suggests that MA does not contribute to cognitive effort when solving multiplication problems. [ABSTRACT FROM AUTHOR]

BACKGROUND: Schools are important arenas for the promotion of critical health literacy (CHL) among adolescents. Key domains of CHL are information appraisal, understanding social determinants of health, and abilities to act on determinants of health. In this paper, we examine the psychometric properties of the Critical Health Literacy for Adolescents Questionnaire (CHLA‐Q). METHODS: A cross‐sectional survey study was performed at 5 schools in Norway. Respondents included 522 pupils aged 13‐15 years old. Confirmatory factor analysis (CFA) was conducted to examine the structural validity. Internal reliability was assessed using ordinal Cronbach's alpha. RESULTS: The estimated model had acceptable closeness of fit. Five of 6 scales displayed adequate internal reliability. CONCLUSION: The results indicate acceptable fit of the CHLA‐Q framework and that 5 of the 6 scales are applicable to inform future research and interventions. More research is needed on measurement of the second domain of CHL. [ABSTRACT FROM AUTHOR]

This paper explores a change process in the Central Norway Regional Health Authority that was brought about by the implementation of a new economics and logistics system. The purpose of this paper is to contribute to understanding of how employees' attitudes towards change develop over time and how attitudes differ between the five health trusts under this authority. In this paper, we argue that a process‐oriented focus through a longitudinal diary method, in addition to action research and feedback loops, will provide greater understanding of the evaluation of organizational change and interventions. This is explored through the assumption that different units will have different perspectives and attitudes towards the same intervention over time because of different contextual and time‐related factors. The diary method aims to capture the context, events, reflections and interactions when they occur and allows for a nuanced frame of reference for the different phases of the implementation process and how these phases are perceived by employees. Copyright © 2016 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Aim: This paper reports associations among socio‐demographic variables, stressor experience, self‐efficacy and life satisfaction among Norwegian adolescents aged 15–21 years and the potential moderating role of self‐efficacy on the association between stressor experience and life satisfaction. Methods: The cross‐sectional school‐based survey study involved 1816 upper‐secondary school students from Mid‐Norway. Data were analysed with independent samples t test, Pearson's product moment correlation and multiple linear regression analysis. Results: Bivariate results showed that boys scored higher than girls on life satisfaction and self‐efficacy, whereas girls scored higher than boys on all stressor domains. Multiple linear regression analysis showed that life satisfaction declined weakly with age, whereas stronger family economy and having parents who work full‐time associated with higher life satisfaction. Stress with teacher interaction, peer pressure, home life, school attendance, school–leisure conflict and school performance were all negatively associated with life satisfaction, whereas self‐efficacy associated positively and strongly with life satisfaction. Self‐efficacy moderated the association between both interpersonal and school‐related stressors and life satisfaction. Conclusion: The results provide support for the unique role of stressor experience and self‐efficacy in association with adolescents' life satisfaction as well as self‐efficacy as a stress moderator in relation to life satisfaction. [ABSTRACT FROM AUTHOR]

This paper surveys the prevalence and correlates of anabolic androgenic steroids (AAS) use among Norwegian adolescents, and examines the degree to which sports participation is a mediating or moderating factor to well-known correlations between AAS use and problem behaviour. The data come from the "Ungdata" study, a cross-national youth survey system offered to all municipalities in Norway (response rate: 74%, N= 77,572). The study demonstrates a lifetime prevalence of AAS use of 1.27% and a higher prevalence among boys (1.81%) than girls (0.76%). The analyses show that AAS use is clearly related to problem behaviour such as violence and other substance use. When controlling for problem behaviour, there are no correlations between AAS use and exercising in a sports club or on one's own, whilst there is a weak positive correlation between AAS use and exercising in a gym or engaging in other forms of physical exercise such as dancing or martial arts. These patterns are more or less the same for boys and for girls. We conclude that adolescent AAS use is a low-prevalence phenomenon that primarily takes place in smaller subgroups of individuals who engage in other forms of problem behaviour as well. [ABSTRACT FROM AUTHOR]

Introduction: People should have access to healthcare services that are effective, safe and secure, patient‐centred, and coordinated and continuous. One group that has consistently reported negative experiences and feels dissatisfied with services are patients with Myalgic Encephalomyelitis (ME)/Chronic Fatigue Syndrome (CFS). The objective of this study was to develop a deeper understanding of the experiences of dissatisfaction among ME/CFS patients and explore the reasons for such dissatisfaction. Methods: We conducted in‐depth interviews with 48 people from 24 households (comprising patients and family members), providing insight into the experiences of 37 ME/CFS sufferers in Norway. The participants were purposively sampled and included persons of different ages, genders, time since having the condition (3–30 years), and severity. Results: Four main themes were developed: (1) 'Nonexistent services' cover patients' experience that healthcare services had nothing to offer them after receiving their ME/CFS‐diagnosis. (2) 'Nonpersonalised services' documents experiences where patients did receive services, which in theory was appropriate for relieving a specific health problem, but in practice were experienced as inappropriate because they were not adapted to the patient's need. (3) 'Slow services' address patients' experience of getting services too late (or too little) to be useful. (4) 'Wrong services' comprise patients' experiences of being offered and/or 'forced' to accept services that they felt were inappropriate for their health problems. Conclusions: Providers' lacking knowledge of the condition and lack of precise recommendations for follow up may partly explain unsatisfactory experiences. Providers' belief (or disbelief) in the condition could furthermore influence caregiving. Also, systemic issues in the healthcare sector, like high workloads and bureaucracy, can negatively affect care provision. Finally, users' unsatisfactory experiences may also be due to a lack of patient involvement in the design of such services. Further research should investigate how patients can be involved in service design, and also providers' perspectives on caregiving and the barriers they experience for providing high‐quality care. Patient or Public Contribution: The ME‐patient organisation suggested research topics to the call from which this study got funding. Patients and caregivers provided feedback during analysis and interpretation of data. [ABSTRACT FROM AUTHOR]

Background Studies on Norwegian nursing homes have shown that the general care is at a relatively high level, while the level of physical and social activities is relatively low. As a response to these findings, the Norwegian government has stressed the importance of activities in various white papers and circulars and, in recent years, has launched several campaigns specifically aimed at increasing the level of activities. Aim The aim of the study was to examine the following: (i) how the government has succeeded in increasing the level of physical and social activities in Norwegian nursing homes; (ii) how the level of activities compares to the general care; and (iii) how the level of activities and the general care are influenced by the following facility characteristics: residents' mobility level, total staffing levels, ratio of RNs, ratio of unlicensed staff and ward size. Method A cross-sectional survey of forty nursing home wards throughout Norway was used to collect the data. Results On a scale ranging from 1 to 7, the staff members assess the activity dimension to be 4.31 and the general care dimension to be 5.66. The activity dimension was significantly negatively correlated with the ratio of unlicensed staff, the ratio of Registered Nurses and the residents' mobility level, while the general care dimension was significantly negatively correlated with the ratio of unlicensed staff. Conclusion The study shows that the level of physical and social activities offered to the residents is relatively low, while the general care level is significantly higher, in line with earlier studies. Consequently, the government has not succeeded with its current policy to increase the level of activities in nursing homes. The relationship between the two quality dimensions and the explanatory variables shows that nursing home quality is a complicated phenomenon. [ABSTRACT FROM AUTHOR]

Aims The purpose of this study was to develop and validate a survey to investigate parents' satisfaction with neonatal wards in a population of parents of children with a gestation age of ≥24 weeks to 3 months after full-term birth. Method We explored the literature and conducted three focus groups: two with expert health personnel and one with parents. We tested the survey in a parent population ( N = 105) and report the different stages in the validation process along with the full survey, the Neonatal Satisfaction Survey - 13 categories ( NSS-13). Results We found 13 subcategories in the Neonatal Satisfaction Survey. The subcategories measure parents' satisfaction with neonatal units based on staff, admission, nurses, anxiety, siblings (parents' perceptions of caring for the siblings of the newborn), information, timeout, doctors, facilities, nutrition, preparation for discharge, trust and visitors. Each subcategory showed acceptable internal consistency. The full version of the Neonatal Satisfaction Survey presents 69 items, and each subcategory contains two to eleven items. Conclusion The Neonatal Satisfaction Survey seems suitable to measure parents' satisfaction with neonatal units and can be used in full, but it can also measure subcategories. Parents' satisfaction with neonatal units can be used to improve the quality in such wards. We consider this study as the first in a series to validate the NSS-13. The full survey with subcategories is presented in this paper. [ABSTRACT FROM AUTHOR]

Aiming at preventing excessive weight gain during pregnancy, 10 specific dietary recommendations are given to pregnant women in the intervention arm of the Norwegian Fit for Delivery (FFD) study. This paper presents the rationale and test-retest reliability of the food frequency questionnaire (FFQ) and a dietary score measuring adherence to the recommendations. The study is part of the ongoing FFD study, a randomised, controlled, intervention study in nulliparous pregnant women.A 43-item FFQ was developed for the FFD study.A dietary score was constructed from 10 subscales corresponding to the 10 dietary recommendations.Adding the subscales yielded a score from 0 to 10 with increasing score indicating healthier dietary behaviour.The score was divided into tertiles, grouping participants into low, medium and high adherence to the dietary recommendations. Pregnant women attending ultrasound screening at about week 19 of pregnancy were asked to complete the FFQ twice, 2 weeks apart. Of 154 pregnant women completing the first questionnaire, 106 (69%) completed the form on both occasions and was included in the study.The test-retest correlations of the score and subscales were r = 0.68 and r = 0.56-0.84, respectively (both P ⩽ 0.001). There was 68% test-retest correct classification of the score and 70-87% of the subscales. In conclusion, acceptable test-retest reliability of the FFQ and the dietary score was found. The score will be used in the FFD study to measure adherence to the dietary recommendations throughout pregnancy and in the following year post-partum. [ABSTRACT FROM AUTHOR]

The aim of this paper is to study: (1) the prevalence of flight anxiety among Norwegian airline passengers; (2) situations that may be of concern during flights and situations not related to flying; (3) whether passengers feel more afraid after the terror act of September 11, 2001; and (4) whether passengers were more afraid in 2002 than in 1986.A questionnaire was distributed during domestic flights in Norway in 1986 and 2002. To asses flight anxiety, a six point scale was used, from 0 = not afraid at all, to 5 = always very afraid, and sometimes avoid flying because of that. A 10-cm visual analogue scale ( VAS) was used to measure the degree of anxiety. There were 50.8% who were not afraid at all. There were 12 women (5.2%) and one man (0.4%) with flight phobia. However, 22 (4.5%) had cancelled flights because of anxiety during the last two years. Situations that caused most concern during flights were turbulence and fear of terrorism and highjacking. After September 11, 48% were not more afraid, 38% a little more, 10% moderately, 3% rather much and 2% very much. The passengers, however, were not more afraid of flying in 2002 than in 1986. About 3% of Norwegian airline passengers have a flight phobia. Women are significantly more concerned than men. The impact of the terror act September 11, 2001 was rather moderate. The level of flight anxiety among Norwegian airline passengers was not significantly different in 2002 and 1986. [ABSTRACT FROM AUTHOR]

Alzheimer's disease is the most commonly known neurocognitive disorder characterized by deterioration in areas such as memory, attention, and activities of daily living. From a behavioral perspective, memory and attentional deficits may be described as deterioration of stimulus control. This paper provides a case study of discrimination behavior in a patient with neurocognitive disorder. The purpose of the current study was twofold: (i) to study the effect of using presumed familiar pictures in arbitrary matching-to-sample tasks and (ii) to study variables that affect stimulus control in a patient diagnosed with vascular dementia. There were 12 conditional discrimination experimental conditions with various types of stimuli, from familiar pictures to identity matching. The results showed that the participant's responses were not in accord with experimenter-defined stimulus classes when using familiar pictures. However, intact stimulus control by sample stimulus was established following systematic procedural changes in the conditional discrimination tasks. Copyright © 2014 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

In three experimental studies, with managers and students as participants, we explore in this paper the relation between two kinds of responsibility judgments, called Responsibility 1 (R1) and Responsibility 2 (R2). Decision makers can be viewed as being more or less responsible for their choice and its consequences (R1). Their actions can also be evaluated, from a normative point of view, as instances of more or less responsible behavior (R2). Experiment 1 showed that managers who depart from the default or 'normal' course of action, by choosing a new (versus familiar) alternative, changing (versus sticking to) an initial decision, or going against (versus following) the advice of a management team, are rated as more responsible (R1) for the outcomes of their decision. At the same time, they are perceived to act in a less responsible way (R2). Experiment 2 compared decision makers choosing between more or less risky options. High risk takers were held more responsible (R1) for their choice and for its consequences, but were again viewed as behaving in a less responsible way (R2) than low risk takers. In Experiment 3, participants judged decision makers who followed or opposed others' advice by choosing either a high or a low risk option. Opposing others' advice led to higher R1 and lower R2 scores, especially when choosing the high risk option, moderated by outcome (successful decisions appearing more responsible than those that went wrong). Thus R1 and R2 judgments should be distinguished as having different and sometimes even opposite determinants. [ABSTRACT FROM AUTHOR]

This paper examines the prevalence of multiple symptoms and the relationships between future expectations and multiple symptoms in a cross-sectional study of 100 patients with chronic obstructive pulmonary disease. A questionnaire was used to examine the patients' symptoms of breathlessness, anxiety, depression, sleeplessness, fatigue, and pain, and their outlook for the future. All patients reported breathlessness, 64% anxiety, 69% depression, 28% sleeplessness, 72% fatigue, and 45% pain. Those with anxiety reported significant depression ( P < 0.001), and those with fatigue reported significant depression ( P = 0.004). Patients who reported pain also reported significant sleeplessness ( P = 0.022). A negative outlook for the future was reported by 42% of patients who also reported significantly more anxiety, depression, sleeplessness, fatigue, and pain ( P ≤ 0.049). Multiple symptoms are common in chronic obstructive pulmonary disease, and patients with a pessimistic view of the future reported more symptoms. Those with multiple symptoms and a negative outlook toward the future may benefit from interventions to help them achieve a more positive outlook for the future, which may relieve symptom burden. [ABSTRACT FROM AUTHOR]

The aim of this paper was to investigate whether psychosocial functioning in adulthood (e.g., friends support, cohabitation, community connectedness and work satisfaction) could be predicted by mental health, subjective well-being, social relations and behavior problems in adolescence, and whether gender was a moderator in these associations. Data were obtained from a major population-based Norwegian study, the Nord-Trøndelag Health Study ( HUNT), in which 517 men and 819 women completed an extensive self-report questionnaires at baseline (mean age 14.4 years) and at follow-up (mean age 26.9 years). Community connectedness as well as work satisfaction were predicted by subjective well-being. Cohabitation was predicted by male gender and frequency of meeting friends in adolescence, and friends support was predicted by frequency of meeting friends. Gender had a minor effect as a moderator. Frequency of meeting friends and subjective well-being seemed to be the strongest adolescent predictors of psychosocial functioning in young adulthood. These findings may have implications both for prevention and intervention in adolescence, as well as for future research. [ABSTRACT FROM AUTHOR]

Moksnes, U. K. & Espnes, G. A. (2012). Self-esteem and emotional health in adolescents - gender and age as a potential moderators. Scandinavian Journal of Psychology 53, 483-489. The present paper investigates possible gender and age differences on emotional states (depression and anxiety) and self-esteem as well as the association between self-esteem and emotional states. The cross-sectional sectional sample consists of 1,209 adolescents 13-18 years from public elementary and secondary schools in mid-Norway. The results showed that girls reported higher scores on state anxiety and state depression, whereas boys consistently scored higher on self-esteem in all age groups. Self-esteem was strongly and inversely associated with both state depression and state anxiety. An interaction effect of gender by self-esteem was found on state depression, where the association was stronger for girls than for boys. The associations found give support for the positive role of self-esteem in relation to adolescents' emotional health and well-being. [ABSTRACT FROM AUTHOR]

Objective This paper aims to study long-term bone mineral development in former patients with an onset of anorexia nervosa during childhood and adolescence. Methods Bone mineral density (BMD) in lumbar spine and total hip was measured in 39 female participants (mean age = 23.1 years, SD 3.5) an average of 8.1 (±3.3) years after treatment start. Results At follow-up, seven participants (17.9%) still suffered from an eating disorder. Mean BMD in the former patients was within the normal range in the hip but significantly reduced in the spine. Fourteen (36%) of the participants had osteopenia, and three (8%) had osteoporosis in the spine and/or hip. Amenorrhea for more than two years was associated with reduced BMD in the spine, whereas low weight at follow-up was associated with low BMD in both the spine and the hip. Conclusion A large minority of these former patients had low bone mass in young adulthood. In accordance with other studies, our findings support the importance of weight restoration for future bone health in young patients with anorexia nervosa. Copyright © 2012 John Wiley & Sons, Ltd and Eating Disorders Association. [ABSTRACT FROM AUTHOR]

Depression is a major problem for mental health. Empirical studies and clinical observations have shown that the symptoms of depression occur across four main domains-emotional, cognitive, somatic and interpersonal. However, commonly used depression assessment scales fail to address the evaluation of interpersonal symptoms, as summarized in this paper. Therefore, a new depression assessment scale, which aimed to evaluate all four domains of depressive symptomatology, was developed. In an initial analysis, a pilot 85-item questionnaire containing possible depressive symptoms was distributed for evaluation to experts from different mental health professions, from which 52 items were subsequently selected for the new multidimensional depression assessment scale. One hundred community participants completed the questionnaire along with the Beck Depression Inventory-II. The results indicated that the new depression scale had good psychometric properties. It was found to be reliable and valid for the assessment of depression severity and symptomatology, though it is emphasized that these data are only preliminary and based on a relatively healthy sample. Copyright © 2012 John Wiley & Sons, Ltd. Key Practitioner Message [ABSTRACT FROM AUTHOR]

This longitudinal study examined the dynamic relationship between work engagement (vigour and dedication) and symptoms of anxiety and depression. A sample of 3475 respondents from eight different occupational groups (lawyers, physicians, nurses, teachers, church ministers, bus drivers, people working in advertising and people working in information technology) in Norway supplied data at two points in time with a 2-year time interval. The advantages of longitudinal design were utilized, including testing of reversed causation and controlling for unmeasured third variables. In general, the results showed that the hypothesized normal causal relationship was superior to a reversed causation model. In other words, this study supported the assumption that work engagement is more likely to be the antecedent for symptoms of depression and anxiety than the outcome. In particular, the vigour facet of work engagement provides lower levels of depression and anxiety 2 years later. However, additional analyses modelling unmeasured third variables indicate that unknown third variables may have created some spurious effects on the pattern of the observed relationship. Implications of the findings are discussed in the paper. Copyright © 2011 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Although some attempts are being made to increase children's participation in Norwegian child protection cases, much needs to be done in order to comply with the participation principle in the United Nations Convention on the Rights of the Child. This paper reports on a study of factors that are likely to predict if social workers will attempt to give children an effective voice in decision making processes. 53 child protection case managers and 33 social work students participated in a questionnaire survey in which they were asked to agree or disagree with 20 statements about child participation. Statistical factor analysis was used in order to identify underlying factors in the dataset. The results suggest three main reasons for children not being allowed to participate: communication difficulties (communication factor); because child participation was not deemed necessary (participation advocacy factor); or that participation was considered inappropriate because it might be harmful (protectionism factor). This research suggests that, if we are to improve participation within the child protection system, formal regulations and guidelines need to be accompanied by a greater attention to development of social work skills in working with children through participatory processes. Copyright © 2010 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Aims: The aim of this study was to assess the paediatric and adult diabetes care provided to adolescents and young adults with childhood‐onset type 1 diabetes during the transition. Methods: This nationwide population‐based cohort study included 776 individuals with type 1 diabetes who were last registered in the Norwegian Childhood Diabetes Registry (NCDR) between 2009 and 2012 and had received adult health care for at least 2 years. The patients' experiences were reported in a validated questionnaire. Clinical data from the annual registrations in the NCDR were coupled with data from the medical records in adult diabetes care. The longitudinal measures of glycaemic control were analysed using a growth mixture model. Results: A total of 321 young people answered the questionnaire and provided written informed consent for the collection of their data from their medical records. The mean age at transfer was 18.0 years (range = 15.0–23.5 years), and the mean age at participation was 22.7 years (range = 20.9–26.7 years). Significant differences (p < 0.001) in patient experiences were found between paediatric and adult diabetes care in several areas: contact with health‐care personnel, continuity of care, interval between consultations and overall satisfaction. Registry and medical records data confirmed the patient‐reported experiences. The longitudinal analyses identified two groups with distinctly different trajectories of glycaemic outcome over time. Patient–provider continuity and perceived preparedness for transfer were the most influential predictors. Conclusions: This study highlights several areas to be addressed for improving health care and the transition to adult diabetes care in adolescents and young adults with type 1 diabetes, including provider continuity, individualised care and involvement of multidisciplinary teams. [ABSTRACT FROM AUTHOR]

Adolescents with a visible difference to the face or body (e.g., due to a congenital condition, illness, or injury), may be at risk of elevated psychological distress. Young Person's Face IT (YPF), a web‐based psychosocial intervention, has displayed effectiveness, but no previous study has specifically evaluated its cost‐effectiveness. The aim of our study was to investigate whether YPF could be a cost‐effective alternative for psychosocial support to adolescents distressed by a visible difference, relative to care‐as‐usual (CAU). Within the context of a randomized controlled trial in Norway, 102 participants (43% boys) were allocated to intervention (n = 55) or waiting list control group (n = 47). Mean age was 13.9 years (SD = 1.71; range 11–18), and all self‐identified as experiencing distress related to a visible difference. Participants answered questionnaires including measures of health‐related quality of life and social anxiety at baseline and 3‐month follow‐up. A health economic evaluation using the method of cost‐utility analysis was performed, including quality‐adjusted life‐years (QALYs). Results indicated that the incremental cost‐effectiveness of YPF was 63,641 Norwegian kroner per QALYs gained, which is well within the acceptability threshold in the Norwegian healthcare sector. Hence, YPF could potentially be considered a cost‐effective intervention for adolescents experiencing distress related to a visible difference, but more research is needed that includes comparisons of YPF to other health‐ and societal resources and long‐term follow‐ups. Our study also constitutes an addition to research as, compared to interventions for somatic diseases, there is a lack of studies exploring the cost‐effectiveness of psychological interventions. [ABSTRACT FROM AUTHOR]

The ability to measure pain across diverse cultures is important for understanding the universal aspects of pain and expediting nursing intervention. The McGill Pain Questionnaire (MPQ) is the most valid and reliable single multidimensional pain instrument available for measuring pain. Although it has been translated in several languages, most efforts, including two Norwegian translations, have resulted in a variety of new versions, all lacking sufficient faithfulness to the original MPQ to allow qualitative or quantitative cross-cultural comparisons. There is a need for direct translations that maintain the original denotation, connotation and numerical value of the MPQ and thus provide a base for future cross-cultural studies of pain. This paper reports on the development and initial testing of a direct translation of the McGill Pain Questionnaire into Norwegian (NMPQ). The translation process involved three phases: translation, back-translation and consensual. In order to evaluate its performance and validity, the NMPQ was administered to a group of adult surgical patients at two different points in time during the postoperative period. The NMPQ was examined for its feasibility, its sensitivity in detecting decreases in intensity of pain postoperatively and for construct validity. A visual analogue scale was used to check for converging validity, and Spielberger's state anxiety scale was used to assess discriminate validity. The initial testing of the NMPQ with adult surgical patients suggests that the NMPQ is culturally acceptable, relevant, sensitive to fluctuations in pain and numerically consistent with the original MPQ. The moderate levels of validity attained lend considerable assurance to the instrument's readiness for use in cross-cultural studies of pain. [ABSTRACT FROM AUTHOR]

In child welfare policies, as in contemporary society in general, great attention has been given to parenting roles and investing in 'positive' parenting practices. Several studies have suggested that socio‐economic factors frame parenting practices. There is broad evidence of a significant correlation between socio‐economic inequalities and child welfare intervention rates. Nevertheless, few studies have investigated parenting practices in a child welfare population. The aim of the present study was to investigate the association between socio‐economic status (SES) and parenting practices in a Norwegian child welfare population. The study was based on a cross‐sectional survey conducted in 2018–2019. The sample consisted of 256 parents (71.5% females). Linear regression analysis, adjusting for potential confounding and intermediate factors, was conducted. Lower SES was associated with higher levels of positive parenting/involvement practices (b = 0.146, CI: 0.026–0.266, P = 0.018), indicating an inverse pattern compared with the general population. When adjusting for symptoms of anxiety and depression, the association was slightly attenuated but remained statistically significant. No significant association was found between SES and inconsistent discipline/other disciplinary practices. The present study offers insights that should be useful in practice and further large‐scale studies. [ABSTRACT FROM AUTHOR]

Background: People with Parkinson's disease (PD) often experience symptoms that affect their ability to eat. This may contribute to weight loss and increased risk of malnutrition. The present study aimed to quantify the extent of nutrition impact symptoms (NIS) in the population and a scoring system of NIS was incorporated in the tool used to identify malnutrition. Methods: In this cross‐sectional study, members of the Norwegian Parkinson's Association, with any PD diagnosis and stage of illness, were invited to respond to an online 24‐item questionnaire. Questions from two validated questionnaires, comprising the abridged Patient‐Generated Subjective Global Assessment (aPG‐SGA) and the Radboud Oral Motor Inventory for Parkinson's disease (ROMP), were adapted to an online format. Results: The questionnaire was sent to 3047 members, of which 508 persons (17%) responded (61% men). In total, 59% were categorised as well‐nourished, 34% at risk of malnutrition and 6.5% as malnourished. One quarter of all participants reported symptoms that affected food intake. The most frequent symptoms were constipation (14.2%) and dry mouth (13.4%). Malnourished participants reported a mean ± SD of 3.4 ± 1.4 symptoms versus 0.1 ± 0.3 per well‐nourished participant. Malnourished participants had more swallowing problems than well‐nourished participants, with a mean ± SD total ROMP score of 15.5 ± 6.0 versus 9.0 ± 2.9 (p < 0.001). As the number of points in the ROMP score increased by one, the points in the aPG‐SGA score increased with 37% (95% confidence interval = 0.309–0.428). Conclusions: Risk of malnutrition was largely related to NIS, especially dysphagia in people with PD. Symptoms affecting food intake should be systematically mapped and treated in conjunction with PD to prevent malnutrition. Highlights: Symptoms affecting the food intake, malnutrition risk and malnutrition are commonly seen in patients with Parkinson's disease (PD).The present study highlights the fact that, despite being common, malnutrition may be unrecognised, under‐reported and untreated in PD patients.The results suggest that swallowing problems in PD are important for the development of malnutrition risk and malnutrition.Nutrition impact symptoms and weight loss should be systematically assessed in patients with PD.There is a need for more research investigating the relationship between malnutrition and nutritional impact symptoms in PD patients. [ABSTRACT FROM AUTHOR]

Background: Norwegian social educator students' attitudes towards addressing sexual health are unknown, even if their future clients often have needs related to sexual issues. Purpose: To investigate social educator students' readiness to address sexual health in their future profession. Methods: In 2019, 213 social educator students (response rate 34%) responded to the Students' Attitudes towards addressing Sexual Health Extended online questionnaire. Results: Most of the social educator students felt comfortable and ready to address sexual health in their future profession, but thought they had insufficient competence and education concerning sexual health. There were gender and age differences when discussing sexual health among persons with intellectual disabilities. Conclusion: Despite most Norwegian social educator students feeling ready to address sexual health, they needed additional competences and education. Further research is needed concerning the effectiveness of educational interventions targeting competence in sexual health, to ensure sufficient support for clients in this field. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the recovery of physical function, health related quality of life (HRQoL), and pain for people following hip fracture for the initial 12 months, and to examine whether postoperative outcome measures of physical function, HRQoL, and pain can predict physical function at 3 and 12 months. Design: A prospective single‐center observational study, as part of the HIPFRAC trial. Settings: One hospital with two associated municipalities in Norway. Subjects: 207 participants with hip fracture included in the study (140 participants transferred to a short‐term nursing home placement and 67 transferred directly home at discharge from hospital). Method: Outcome measures were Short Physical Performance Battery (SPPB), Timed Up & Go (TUG), Stair climbing test (SC), Numeric Rating Scale (NRS) for pain at rest and in activity, and EQ‐5D‐5L index and health score. Data were analysed by repeated measures of variance and multivariate regression analyses. Results: There were statistically significant improvements in physical function (SPPB total score and TUG), NRS‐pain in activity, and HRQoL (EQ‐5D‐5L) from hospital discharge to 3‐month follow‐up for the whole cohort and the two groups (p < 0.001). However, the largest improvements occurred within the first 3 months. Further statistically significant improvements occurred between 3 and 12 months (p < 0.05). The strongest predictors of physical function at 3 and 12 months post‐fracture were physical function (SPPB) at hospital discharge and pre‐fracture requirement of a walking aid. Conclusion: The recovery of physical function, HRQoL, and pain in participants after hip fracture indicates gradual improvements during the initial 12‐month follow‐up, with the largest improvements within the first 3 months. [ABSTRACT FROM AUTHOR]

This study aims to test the nomological validity of the People Performance Scales (PPS) using the job demands‐resources (JD‐R) model. All employees at two large companies in Norway (a governmental agency and a worker's union) were invited to complete the PPS questionnaire electronically. A total of 2,469 respondents completed the questionnaire, resulting in an 87 percent response rate. Data was analyzed Structural Equation Modelling. First, all 15 scales included in the PPS showed excellent internal and construct validity. PPS was also found to have configural‐, construct‐level metric‐ and scale‐level metric invariance across age groups and genders. Second, findings indicate that the PPS can be used for both research and consultancy based upon the JD‐R model, while simultaneously assessing constructs of particular importance in Norwegian and Scandinavian legislation. The PPS represents a short and efficient questionnaire which measures the most relevant working environment constructs in a reliable and distinct way. The questionnaire has great psychometric characteristics and is well suited for use in organizations to measure employees' experience of working environment factors, allowing organizations to identify areas of improvement and to support organizational development. [ABSTRACT FROM AUTHOR]

Aim: To estimate the prevalence of sexual dysfunction in women with type 1 diabetes (T1D) compared with women without diabetes and to analyse associations between sexual dysfunction and the presence of chronic physical diabetes complications, diabetes distress and depression in women with T1D. Methods: This cross‐sectional study was conducted in Norway, and 171 women with T1D and 60 controls completed the Female Sexual Function Index (FSFI) and the Hospital Anxiety and Depression Scale (HADS). Diabetes distress was assessed with the Problem Areas in Diabetes (PAID) scale. Data on diabetes complications were retrieved from medical records. We performed logistic regression to estimate differences in the prevalence of sexual dysfunction (defined as FSFI ≤26.55) between women with T1D and women without diabetes and to examine associations of sexual dysfunction with chronic diabetes complications, diabetes distress and depression in women with T1D. Results: The prevalence of sexual dysfunction was higher in women with T1D (50.3%) compared with the controls (35.0%; unadjusted odds ratio [OR] 1.89 [95% confidence interval (CI) 1.06–3.37]; adjusted OR 1.93 [1.05–3.56]). In women with T1D, sexual dysfunction was associated with both diabetes distress (adjusted OR 1.03 [1.01–1.05]) and depression (adjusted OR 1.28 [1.12–1.46]), but there were no clear associations with chronic diabetes complications (adjusted OR 1.46 [0.67–3.19]). Conclusions: This study suggests that sexual dysfunction is more prevalent in women with T1D compared with women without diabetes. The study findings emphasize the importance of including sexual health in relation to diabetes distress and psychological aspects in diabetes care and future research. [ABSTRACT FROM AUTHOR]

Youth within the child welfare system (CWS) have often experienced adverse life events, and many need support from health services. This study aimed to compare mental health problems and health service use among adolescents receiving in‐home services (IHS), living in foster care (FC) and general population youth (GP). Data stem from the youth@hordaland survey, a population‐based study of adolescents (N = 10,257, age 16–19) conducted in 2012 in Hordaland County, Norway. The adolescents provided self‐reported data on CWS contact, health service use, adverse life events and multiple instruments assessing mental health problems. The IHS and FC groups had significantly higher symptom scores across most mental health measures than peers from the GP. Youth receiving IHS had significantly higher scores on measures of general internalizing and externalizing problems, attention deficit hyperactivity disorder (ADHD) and depression compared with peers in FC. Those receiving IHS reported the highest health service use. Adverse life events accounted for a substantial part of the differences between the groups. Mental health problems are frequent among older adolescents within the CWS, especially among youth receiving IHS. Service providers and policymakers should be aware of the present and likely continued challenges faced by many of these youth. [ABSTRACT FROM AUTHOR]

Background and purpose: Reduced balance and musculoskeletal pain are frequently reported among patients with long‐lasting dizziness. However, the association between musculoskeletal function and postural sway among these patients has not been examined. The objective of this study was to examine if there is an association between aspects of musculoskeletal function and postural balance in patients with long‐lasting dizziness. Methods: This was a cross‐sectional study, using data of 105 outpatients with long‐lasting dizziness. Aspects of musculoskeletal function was assessed by examining body flexibility, grip strength, preferred and fast walking speed, in addition to musculoskeletal pain. Musculoskeletal pain was evaluated using the Subjective Health Complaints questionnaire. Postural balance was assessed by path length of postural sway by using a balance platform on both firm and soft surfaces, with eyes open and closed. The association between musculoskeletal function and postural sway was assessed using linear regression analyses. Results: When adjusting for age and gender we found that on a firm surface, there was an association between increased musculoskeletal pain and increased postural sway measured with eyes open (p = 0.038). In addition, there was an association between decreased body flexibility and decreased postural sway with eyes open (p = 0.025). On a soft surface, decreased fast walking speed was associated with increased postural sway with eyes open (p = 0.027). In addition, decreased grip strength was associated with increased postural sway on a soft surface with eyes closed (p = 0.015). Discussion: The findings from this study imply that musculoskeletal function may associate with postural sway in patients with long‐lasting dizziness, although the associations were weak. [ABSTRACT FROM AUTHOR]

Background: There have been inconsistent findings from studies examining factors associated with quality of life (QoL) for children affected by parental illness. Aim: The aim of this study was to explore factors associated with self‐reported QoL in children affected by parental illness or parental substance abuse. Design: A cross‐sectional multicentre study. Methods: The sample included 246 families with children 8–18 years recruited via ill parents who received treatment for severe physical illness, mental illness or substance abuse in specialised health services. We performed multiple linear regression analyses to examine factors associated with the children's self‐reported QoL. Main outcome measure: KIDSCREEN‐27. Results: The children's self‐reported QoL was positively associated with the ill parent's self‐reported physical health, the children's self‐reported social skills, the degree to which other adults took over the ill parent's responsibilities, provision of sibling care, provision of health care for the ill parent and positive outcome of caregiving. The children's QoL was negatively associated with the children's self‐reported responsibilities due to parental illness, provision of emotional care for the ill parent, negative outcomes of caregiving and external locus of control. The model explained 63% of the variance (adjusted R2) in children's total QoL. Study limitations: Sampling bias may have occurred during recruitment. Conclusions: The findings suggest factors of importance for the children's QoL. Clinicians should assess whether an ill parent's physical health may influence negatively on their ability to perform daily responsibilities at home and care for their children, and clinicians can use children's self‐reported QoL to identify children who are most negatively affected. [ABSTRACT FROM AUTHOR]

Aim: To translate The Clinical Learning Environment Comparison Survey (CLECS) into Norwegian and to evaluate the psychometric properties of the Norwegian version. Design: A cross‐sectional survey including a longitudinal component. Methods: The CLECS was translated into Norwegian following the World Health Organization guidelines, including forward translation, expert panel, back‐translation, pre‐testing and cognitive interviewing. Nursing students at a Norwegian university college were invited to participate in the study (psychometrical testing) based on informed consent. Reliability and validity of the translated version of CLECS were investigated using a confirmatory factor analysis (CFA), Cronbach's alpha and test–retest analysis. Results: A total of 122 nursing students completed the questionnaire and Cronbach alphas for the CLECS subscales ranged from 0.69 to 0.89. CFA goodness‐of‐fit indices (χ2/df = 1.409, CFI = 0.915, RMSEA = 0.058) showed acceptable model fit. Test–retest ICC ranged from 0.55 to 0.75, except for two subscales with values below 0.5 [ABSTRACT FROM AUTHOR]

Iodine deficiency during pregnancy and in the post‐partum period may lead to impaired child development. Our aim is to describe iodine status longitudinally in women from pregnancy until 18 months post‐partum. Furthermore, we explore whether iodine status is associated with dietary intake, iodine‐containing supplement use and breastfeeding status from pregnancy until 18 months post‐partum. We also assess the correlation between maternal iodine status 18 months post‐partum and child iodine status at 18 months of age. Iodine status was measured by urinary iodine concentration (UIC) during pregnancy (n = 1,004), 6 weeks post‐partum (n = 915), 6 months post‐partum (n = 849), 12 months post‐partum (n = 733) and 18 months post‐partum (n = 714). The toddlers' UIC was assessed at 18 months of age (n = 416). Demographic variables and dietary data (food frequency questionnaire) were collected during pregnancy, and dietary data and breastfeeding practices were collected at all time points post‐partum. We found that iodine status was insufficient in both pregnant and post‐partum women. The UIC was at its lowermost 6 weeks post‐partum and gradually improved with increasing time post‐partum. Intake of milk and use of iodine‐containing supplements significantly increased the odds of having a UIC above 100 μg/L. Neither the mothers' UIC, vegetarian practice, nor exclusion of milk and dairy products were associated with the toddlers UIC 18 months post‐partum. Women who exclude milk and dairy products from their diets and/or do not use iodine‐containing supplements may be at risk of iodine deficiency. The women possibly also have an increased risk of thyroid dysfunction and for conceiving children with nonoptimal developmental status. [ABSTRACT FROM AUTHOR]

The measurement of user experience has gained international attention as a tool for improving quality of care. Because foster families have a high need for service support, we examined quality of care from the foster parent's perspective and associated characteristics. We collected information about type and frequency of service use in the last 2 years and standardized measures of user‐reported experiences and outcomes from foster parents of youths aged 11–18 years in Norway (N = 290). We analysed the data using descriptive statistics, independent samples t‐tests and multiple regressions. Overall, foster parents had positive service experiences, and around half reported improvement in youth condition and function compared with before the service contact. The foster parents gave similar evaluations of child welfare services and specialized mental health services but indicated different strengths and weaknesses of the providers. Younger age, more frequent service contact and less waiting time were associated with positive service experiences, while less mental health problems and fewer years in current foster home were related to positive perceptions of outcomes. Our results indicate focus areas for increasing quality of care from the user perspective, for example, sharing information, cooperation between services, having frequent enough service contact and reducing waiting time. [ABSTRACT FROM AUTHOR]

Introduction: The present study aimed first to investigate the change in prevalence of major levator ani muscle (LAM) defects, also called avulsions, from 6 weeks to 1 year postpartum, and second to assess maternal and obstetric risk factors for having persistent major LAM defects/avulsions at 1 year postpartum.Material and Methods: This is a secondary analysis of data from a prospective cohort study including 300 nulliparous women at 17-19 weeks of gestation. Major LAM defects were diagnosed at 6 weeks and 1 year postpartum using transperineal ultrasonography. We defined persistent major LAM defects as a defect diagnosed both at 6 weeks and 1 year postpartum. Maternal and obstetric data were obtained from the hospital's electronic birth records. Pelvic floor muscle function was measured vaginally by manometer at 21 weeks of gestation. The main outcome measurement was change in prevalence of major LAM defects. Maternal and obstetric risk factors for having persistent major LAM defect were also assessed.Results: Prevalence of major LAM defects was 19.4% at 6 weeks and 10.4% at 1 year postpartum. No new major LAM defects were diagnosed at 1 year postpartum. Persisting major LAM defects were associated with longer second stage of labor (median 74.5 minutes vs median 48.0 minutes, P = .012) and higher neonatal birthweight (mean difference of 232.3 g, 95% confidence interval [CI] 21.5-443.1). Vacuum delivery was independently associated with persistent major LAM defects, adjusted OR 3.0 (95% CI 1.0-9.0).Conclusions: There was a 50% reduction of sonographically diagnosed major LAM defects from 6 weeks to 1 year postpartum. This finding suggests that assessment of the major LAM 6 weeks postpartum may be too early to diagnose defects/avulsions. Long second stage of labor, high neonatal birthweight and vacuum delivery were associated with persistent major LAM defects/avulsions. [ABSTRACT FROM AUTHOR]

Perceived supervisor support (PSS) has been found to predict employee in-role and extra-role performance at the individual level of analysis. With respect to the unit level of analysis, the research on the predictive role of PSS remains limited. In particular, calls have been made for research on the role of leadership in facilitating perceived HR practices at the business-unit level and on the role of line managers as implementers of such systems. In response to such calls, this study investigated the associations between PSS climate, perceived investment in employee development (PIED) climate, and business-unit performance among 75 gas stations located in Norway. The results showed that the PSS climate was positively related to both the PIED climate and the business-unit performance. This study contributes to research on PSS by extending the prior findings at the individual level to the unit level of analysis. Also, the study contributes to the research on perceived HR practices by demonstrating the facilitative role of the PSS climate. Finally, the study contributes to the research on shared perceptions of HR practices generally and the concept of the 'strength' of the HRM system in particular. Implications for practice and future research are discussed. © 2012 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

At present there is no validated tinnitus questionnaire available in Norway. The aim of the present study was to psychometrically evaluate and report on a Norwegian translation of the Tinnitus Sample Case History Questionnaire (TSCHQ). Furthermore, the results were compared to those of a recent Swedish validation of TSCHQ. More than two hundred (N = 218) participants with tinnitus participated in the study, of which 78% completed the Norwegian TSCHQ on two occasions so that test‐retest reliability could be evaluated. Results show that the Norwegian TSCHQ has acceptable test‐retest reliability with the exception of 10 items, which is slightly better than the recent Swedish validation of TSCHQ. At the item level, there were both similarities and differences between the Norwegian and Swedish validation studies. It is concluded that the Norwegian TSCHQ is an appropriate measure of patients' history and experience of tinnitus, and while we recommend further validation of the Norwegian TSCHQ, we encourage Norwegian researchers and clinicians to use the Norwegian translation of TSCHQ. [ABSTRACT FROM AUTHOR]

Key Practitioner Messages: The COVID‐19 pandemic has resulted in negative consequences for children exposed to violence and abuse.Domestic violence refuge staff were greatly concerned about children both living outside and inside refuges.Domestic violence refuges have played a pivotal role during the COVID‐19 pandemic and should receive wider acknowledgement and greater support for their work. [ABSTRACT FROM AUTHOR]

Introduction: While shared decision‐making (SDM) training programmes for health professionals have been developed in several countries, few have been evaluated. In Norway, a comprehensive curriculum, "klar for samvalg" (ready for SDM), for interprofessional health‐care teams was created using generic didactic methods and guidance to tailor training to various contexts. The programmes adapted didactic methods from an evidence‐based German training programmes (doktormitSDM). The overall aim was to evaluate two particular SDM modules on facilitating SDM implementation into clinical practice. Method: A descriptive mixed methods study using questionnaires and a focus group guided by the Medical Research Council Complex Interventions Framework. The training was provided as two different applications (module AB [introduction and SDM‐basics] and module ABC [introduction, SDM‐basics and interactive training]) with differing learning objectives, extent of interactivity, and duration (1 vs 2 hours). Groups of participants were recruited consecutively based on requests for health professional SDM training in university/college‐ and hospital‐settings. By a focus group and a self‐administered questionnaire comprehensibility, relevance and acceptance were assessed and qualitative feedback collected after the training. Data passed descriptive and content analysis, respectively. Knowledge was assessed twice using five multiple‐choice items and analysed using paired t‐tests. Results: In 11 (six AB and five ABC) training sessions, 357/429 (296 AB and 133 ABC) eligible nurses, physicians and health professional students with varying clinical backgrounds and previous levels of SDM‐knowledge participated. SDM‐knowledge increased from 25‐78% (range pretest) to 85‐95% (range post‐test) (P ≤.001). The training was rated easy to understand, acceptable and relevant for practice. Findings to improve the education suggest higher emphasis on interprofessional teaching methods. Conclusions: The two SDM training modules met the basic requirements for use in a broader SDM implementation strategy and can even improve knowledge. [ABSTRACT FROM AUTHOR]

Routine Outcome Monitoring (ROM) is recommended as a psychotherapy procedure to serve as clinical feedback in order to improve client treatment outcomes. ROM can work as a warning signal to the therapist if the client shows signs of no change or deterioration. This study has investigated whether any difference in outcome could be detected between those clients in couple and family therapy who used the Systemic Therapy Inventory of Change (STIC) feedback system (ROM condition) versus those who were offered treatment without the use of STIC ("treatment as usual" or TAU condition). A sample of 328 adults seeking couple and family therapy in Norway was randomly assigned to ROM versus TAU conditions. Outcome measures were The Outcome Questionnaire–45 and The Revised Dyadic Adjustment Scale. The results demonstrated no significant differences in outcomes between the ROM and TAU. Possible explanations of this result related to design and implementation issues are discussed. [ABSTRACT FROM AUTHOR]

Background: Post‐traumatic stress (PTS) symptoms following intensive care unit (ICU) treatment can lead to post‐traumatic stress disorder and represent a severe health burden. In trauma patients, a strong sense of coherence (SOC) is associated with fewer PTS symptoms. However, this association has not been investigated in a general ICU sample. Aims and objectives: To examine the occurrence of PTS symptoms in general ICU patients early after ICU discharge and to assess possible associations between PTS symptoms and SOC, ICU memory, pain, and demographic and clinical characteristics. Design: This was a cross‐sectional study. Methods: Adult patients aged ≥18 years admitted for ≥24 hours to five ICUs between 2014 and 2016 were recruited. PTS symptoms and SOC were measured at the ward within the first week after discharge from the ICU using the Posttraumatic Stress Scale‐10 and Sense of Coherence Scale‐13. Multiple linear regression analysis was used to identify associations between PTS symptoms and SOC and the selected independent variables. Results: A total of 523 patients were included (17.8% trauma patients; median age 57 years [range 18‐94]; 53.3% male). The prevalence of clinically significant PTS symptoms was 32%. After adjustments for gender and age, lower SOC (P < 0.001), more ICU delusional memories (P < 0.001), greater pain interference (P < 0.001), not being a trauma patient (P = 0.02), and younger age (P = 0.03) were significantly associated with more PTS symptoms. Conclusions: One third of patients experienced clinically relevant PTS symptoms early after discharge from the ICU. In the present study, SOC, delusional memory, pain interference, younger age, and not being a trauma patient were factors associated with more PTS symptoms. Relevance to clinical practice: Early individual follow up after ICU discharge focusing on pain relief and delusional memory may reduce PTS symptoms, with a potential of improving rehabilitation. [ABSTRACT FROM AUTHOR]

Background: Correct electrode placement and proper skin preparation for cardiac telemetry monitoring of patients at risk for arrhythmias increase the quality of the arrhythmic surveillance. Inconsistent arrhythmia surveillance can compromise patient safety and care outcomes. An inspection of international literature demonstrates that nurses generally do not adhere to cardiac monitoring standards. Aim: The aims of this study were to determine cardiovascular nurses' knowledge of and adherence to practice standards for cardiac surveillance and whether their knowledge and practice improves over time. Study design: A comparative study design was applied, and data were obtained by survey methodology. Methods: Nurse delegates at the Annual National Congress on Cardiovascular Nursing in Norway completed surveys in 2011 and 2017 (delegates from 44 and 38 hospitals, respectively). Results: In total, 363 cardiac nurses (70%) responded to the questionnaires. Of these, 95% were female, with a mean age of 41 years. In 2011, 97% of participants were unaware of international practice standards. However, by 2017 unawareness decreased to 78% (P <.001). Despite their lack of knowledge of practice standards, 94% of participants often or always prepared patients' skin for telemetry; this improved from 2011 to 2017 (P =.001). Overall, 73% of nurses never or seldom scrubbed or washed the patients' skin before electrode placement, and 38% of the electrodes were misplaced. In 2011, 49% of nurses used protective telemetry covers; this increased to 80% in 2017 (P <.001). Overall, 64% always informed patients of the purpose of cardiac monitoring. Conclusion: A significant percentage of nurses fail to adhere to recommendations for electrode placement, skin preparation and providing patients with telemetry information. In order to raise the quality of arrhythmic surveillance, investment in educational programmes in cardiac telemetry monitoring is required. Relevance to Clinical Practice: Improved in‐hospital telemetry practice is required to ensure patient safety and better care outcomes. [ABSTRACT FROM AUTHOR]

Objective: This study explored experiences Norwegian public health nurses (PHNs) have with using interventions from the Public Health Intervention Wheel (PHIW). Design and Sample: The researchers used both quantitative and qualitative measures to explore how Norwegian PHNs use PHIW interventions in their practice. Data were gathered from six focus group meetings with 15 school and 16 family health nurses in Norway. Method: Instruments included: (a) demographic data form, (b) the Public Health Intervention Questionnaire developed by the researchers, and (c) focus group questions. Results: Following discussion of PHIW interventions in focus groups, PHNs reported they had a clearer understanding of each intervention and they had performed activities in their practice consistent with each of the Wheel interventions. Conclusion: Descriptions of the Wheel interventions provided the PHNs with the terminology and language to identify and explain their work in public health nursing practice. Although there are some differences between the United States and Norway in the structure of public health nursing practice, the PHIW is a framework that is applicable to the work of PHNs in Norway. [ABSTRACT FROM AUTHOR]

Purpose: This study illustrates the huge untapped potential of quantifying the impact of culture in making meaningful comparisons across groups. Our focus is on cross‐national differences in nurses' reports of their relations with physicians, and how the measurement of this complex construct and the evaluation of true differences are related to dimensions of national culture. Design: We examine across 14 European countries the association between indices of national culture from the seminal work of Hofstede and 39,435 nurses' ratings of their relations with physicians. Multilevel confirmatory factor analysis was used to evaluate strong factorial invariance across countries and to examine the influence of power distance and masculinity. Findings: There was wide variation across countries in nurses' reports of their relations with physicians. Strong factorial invariance was shown for a one‐factor model, which confirmed that across countries the seven survey items measure a common factor of physician‐nurse relations. This model showed no country bias for any of the seven survey items, which suggests that differences across countries reflect true differences. These true differences were significantly associated with variation in country values of power distance, which showed a significant negative correlation with physician–nurse relations. Conclusions: Continuously pursuing a better understanding of characteristics that impact the studied indicators, such as national culture, is elementary to better understand the construct under study. In this application, country values of power distance negatively impacted nurse‐reported relations with physicians, which strongly varied across countries. Clinical Relevance: Better nurse‐reported relations between nurses and physicians link to higher nurse job satisfaction, lower emotional exhaustion, better nurse‐perceived quality of care, and lower patient mortality. The Practice Environment Scale of the Nursing Work Index is an excellent instrument to characterize variation in working relations between nurses and physicians as well as physicians' professional posture towards nurses. [ABSTRACT FROM AUTHOR]

The study assessed risk factors for traumatic dental injuries (TDI) using experiences along the life course. A retrospective longitudinal study, including historical clinical data, was conducted on 16‐yr‐old pupils in western Norway. All first‐grade pupils born in 1997 and attending public high schools were invited to participate (n = 5,184). Participants responded to an electronically administered closed‐ended questionnaire (39.6%, n = 2,055). Information on the occurrence of TDI and events during the life course (categorized as socio‐economic, biological, psychosocial, and behavioural indicators) was collected. Variables with a significant bivariate association with three different dependent variables (TDI, severity of TDI, and multiple episodes of TDI) were tested in a hierarchical logistic regression analysis. Traumatic dental injuries were more frequent among boys, adolescents of higher socio‐economic status, and adolescents with adverse psychosocial and behavioural scores. Moderate and severe TDIs were more frequent among adolescents with adverse psychosocial and behavioural scores and among adolescents participating in the sport of wrestling. Multiple episodes of TDI were more frequent among adolescents with adverse psychosocial and behavioural scores and among adolescents participating in sports activities. Incorporation of different life‐course indicators is important in evaluating TDI severity and repeated incidents. [ABSTRACT FROM AUTHOR]

Participation in organized sports is a popular and important part of the lives of children and adolescents and is associated with improved psychological and social health, as well as an increased likelihood of meeting physical activity (PA) recommendations. Changes in modern society, including increased car ownership and use of technology and electronic media, have led to an additional focus on the importance of health‐enhancing PA among children and adolescents. The aim of this article was to study the secular changes in self‐reports of participation in organized sports clubs and leisure‐time vigorous physical activity (LVPA), and whether the relationship between participation in organized sports clubs and LVPA has changed from 1985 to 2014. Questionnaire data were collected in two cross‐sectional samples of Finnish and Norwegian 11‐, 13‐ and 15‐year‐olds in 1985/1986 (n = 7137) and 2014 (n = 9218). Overall, participation in organized sports clubs and level of LVPA appears to have changed in the same direction in the two Nordic countries. The proportion of 11‐year‐olds reporting to be participants in organized sports clubs increased from 1985/1986 to 2014. There was an overall increase in self‐reported LVPA. The association between participation in sports clubs and LVPA was stronger in 2014 than in 1985/1986. The findings indicated subgroup differences, in particular with regard to a steeper increase in LVPA and participation in sports clubs among Finnish girls. We suggest that attention should be given to the role of organized sports to better understand secular changes in PA. [ABSTRACT FROM AUTHOR]

Background: In most maternity wards in Norway, early discharge (<48 hour) is the norm. To monitor newborns' and women's health during the first week after delivery, most maternity wards offer early check‐ups, where families return to the hospital (standard care). However, a few municipalities offer home visits by midwives (domiciliary care) to ensure seamless services for the family. Aim: The primary aim of this study was to explore whether different follow‐up strategies were differently associated with maternal depression and breastfeeding habits, 6 weeks and 6 months postpartum. The secondary aim was to investigate whether families at risk of postpartum depression were included in the home visiting programme in the municipality that offered both follow‐up strategies. Method: This study draws on data from the 'Little in Norway' (LIN) study, which followed families from pregnancy until the child was 18 months. This study used data from two different well‐baby clinics in two municipalities, where one offered standard care (n = 95) and the other domiciliary (n = 64) and standard care (n = 17). The Edinburg Postnatal Depression Scale (EPDS) was used to measure maternal depression. Breastfeeding habits were measured using a self‐report questionnaire. The Life Stress subscale of the Parenting Stress Index (PSI) was used to identify women at risk of postpartum depression. Results: There were no differences in maternal depressive symptoms or breastfeeding habits at neither 6 weeks nor 6 months postpartum between women who received standard or domiciliary care in the two municipalities. Within the municipality that offered both follow‐up strategies, a higher number of women scoring high on prenatal life stress were included in domiciliary – compared to standard care. Conclusion: Differential follow‐up strategies in the first week after birth did not impact on maternal depression or breastfeeding habits. However, domiciliary care seems to be regarded as supportive and nonstigmatising for women at risk of postpartum depression. [ABSTRACT FROM AUTHOR]

Background: The use of measurement scales to assess pain in neonates is considered a prerequisite for effective management of pain, but these scales are still underutilised in clinical practice. Aim: The aim of this study was to describe and compare pain assessment practices including the use of pain measurement scales in Norwegian and Swedish neonatal care units. Methods: A unit survey investigating practices regarding pain assessment and the use of pain measurement scales was sent to all neonatal units in Sweden and Norway (n = 55). All Norwegian and 92% of Swedish units responded. Results: A majority of the participating units (86.5%) assessed pain. Swedish units assessed and documented pain and used pain measurement scales more frequently than Norwegian units. The most frequently used scales were different versions of Astrid Lindgren's Pain Scale (ALPS) in Sweden and Echelle Douleur Inconfort Noveau‐Ne (EDIN), ALPS and Premature Infant Pain Profile (PIPP) in Norway. Norwegian head nurses had more confidence in their pain assessment method and found the use of pain measurement scales more important than their Swedish colleagues. Conclusion: The persisting difference between Swedish and Norwegian units in pain assessment and the use of pain measurement scales are not easily explained. However, the reported increased availability and reported use of pain measurement scales in neonatal care units in both countries may be seen as a contribution towards better awareness and recognition of pain, better pain management and potentially less suffering for vulnerable neonates. [ABSTRACT FROM AUTHOR]

Rationale: Previous studies have shown that children may take on higher extents of caring activities if their parents are affected by severe illness or disability, especially when their parents lack access to formal and informal care. Aims and objectives: This study examined the extent and nature of caring activities done by patients’ children; differences in caring activities between different types of parental illness; factors associated with caring activities. Design: An explorative cross‐sectional multicentre study. Methods: Parents as patients in specialised healthcare services, and their children, were recruited from five health trusts in Norway. The sample included 246 children aged 8–17 years and their 238 parents with severe physical illness (neurological disease or cancer) (n = 135), mental illness (n = 75) or substance abuse (n = 28). Main outcome measure: Multidimensional Assessment of Caring Activities (MACA‐YC18). Results: A large number of children with ill parents are performing various caring activities. Increased caring activities among children due to their parent's illness were confirmed by their parents, especially with regard to personal care. We found no significant differences in the extent of caring activities between illness types, but there were some differences in the nature of these activities. Factors significantly associated with the extent and nature of caring activities were as follows: better social skills and higher external locus of control among the children; and poorer physical parental health. Parent's access to home‐based services was limited. Study limitations: In recruitment of participants for the study, a sampling bias may have occurred. Conclusion: To promote coping and to prevent inappropriate or extensive caring activities among children with ill parents, there is a need for increased access to flexible home‐based services adapted to the type of parental illness. [ABSTRACT FROM AUTHOR]

Background: Chronic illness health interventions aim to strengthen individuals' wellness resources, in addition to their ability to handle their condition. This presupposes a partnership between patients and professionals and flexibility in care organization. Aim: This study aims to investigate possible changes in individuals' sense of coherence while living with long‐term illness as they engage in a broadly applicable health promotion intervention developed in specialist care settings that was later implemented in the community care context. Method: This study had a pre–postdesign. Sense of coherence was measured using the SOC‐29 questionnaire at baseline and within 14 days of programme completion. The total baseline sample included 108 Norwegian adults (aged 21–89) with chronic illness. Data were analysed using paired samples t‐tests. Results: In both clinical sites, the total sample's mean SOC score changed positively from the baseline to the follow‐up 4 months later. This change was larger for the participants in the community care context. Manageability increased significantly for women. Significant positive changes in SOC score and the manageability dimension were also identified among participants who had children. Similar findings were found for those who were living with a partner, as well as for public transfer payment recipients. Conclusion: The intervention contributed to a positive change in participants' SOC while living with illness. The findings revealed that the intervention is a flexible health promotion tool across age, diagnostic categories and clinical sites. The community participants' SOC changed the most, which indicates that the intervention is especially relevant in the follow‐up of persons living with long‐term illness within the community. The intervention contributes to a shift of perspectives in health care towards strenght‐based care and health within illness. [ABSTRACT FROM AUTHOR]