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This study explored the experiences of public health nurses (PHN) in preventing obesity in preschool children and following national guidelines. We used a descriptive qualitative design with an online open-ended questionnaire based on vignettes describing fictitious practical situations during the follow-up of children presenting with overweight issues in child health clinics. Following qualitative content analysis, we identified one main theme: Strong but complex feelings of responsibility toward supporting parents in preventing obesity in preschool children and adhering to the guidelines. We also identified four subthemes: (a) Difficulties in deciding if the child's weight is a concern. (b) Challenges with meeting children's healthcare needs when weight is a concern. (c) Approaches for engagement and caring weight talks with parents. (d) The need for resources and interdisciplinary collaboration. PHNs suggested improvements for preventing childhood obesity and called for municipal prioritizing of organizational and personnel-related resources to ensure PHNs can efficiently follow national guidelines. [ABSTRACT FROM AUTHOR]

Although pro re nata medications (PRNM) are widely used among older patients in long-term care, current knowledge about nurses' PRNM management is scarce. The study aim was to describe which knowledge sources nurses working in sheltered housing for older people use when making decisions regarding PRNM. This was a qualitative interview study with registered nurses (n = 4) and assistant nurses (n = 4) working in sheltered housings in mid and eastern Norway. Data analysis was based on qualitative and abductive content analysis, where evidence-based practice (EBP) was used in the abduction. The COREQ checklist was followed. Several knowledge sources are used when making decisions regarding PRNM, that represent the four elements of EBP. 'Practitioner experience and judgement' was a prominent source of knowledge among the nurses, while 'Evaluated external evidence' was less emphasized in PRNM decision-making. The results support previous research on EBP in nursing, and bring new knowledge regarding PRNM in the context of sheltered housing. To achieve appropriate and safe management of PRNM, there is a need to support nurses' decision-making process, e.g. through PRNM guidelines and systems for documentation and information exchange. EBP in PRNM decision processes should be given attention, utilizing all elements including 'Evaluated external evidence' as a knowledge source. [ABSTRACT FROM AUTHOR]

Traditional care immediately after very preterm birth separates the mother and child by the transfer of the infant to the neonatal intensive care unit. A nonseparation approach is currently being considered, allowing early skin-to-skin contact in the delivery room/postoperative care unit. This study aimed to explore mothers' experiences of early skin-to-skin contact and traditional care. A qualitative study using individual semi-structured interviews with five mothers from each of the two groups was conducted. Content analysis revealed that both groups' experiences were characterized by (i) mothers' need to be affirmed of their infants' vitality, (ii) bonding challenges, and (iii) benefits of skin-to-skin contact. We suggest that early skin-to-skin contact after very preterm births is crucial for the bonding process and mothers' feelings of safety and well-being. When early skin-to-skin contact is infeasible, our findings reveal the significance of photos, information, and the father's presence at the time of postpartum separation. [ABSTRACT FROM AUTHOR]

In long-term care, ethical challenges are becoming increasingly apparent as the number of older patients with complex care needs increases, in parallel with growing demands for more cost-efficient care. Scarce resources, cross-pressure and value conflicts are associated with missed care, moral stress and nurses wanting to leave the profession. Through five focus group interviews, this study aimed to explore how nurses working in nursing homes and homecare services perceive, experience and manage ethical challenges in everyday work. Content analysis revealed three main themes: striving to do good; failing and being let down and getting rid of frustrations and learning from experiences. The nurses' morality was mainly expressed through emotions that arose in specific situations. Dedicated spaces for ethical reflection and leaders who recognize that organizational conditions affect the individual nurse-patient relationship are required. Facilitating ethical reflection is an important leadership responsibility, which may also require leaders to actually participate. [ABSTRACT FROM AUTHOR]

Traditional care immediately after very preterm birth separates the mother and child by the transfer of the infant to the neonatal intensive care unit. A nonseparation approach is currently being considered, allowing early skin-to-skin contact in the delivery room/postoperative care unit. This study aimed to explore mothers' experiences of early skin-to-skin contact and traditional care. A qualitative study using individual semi-structured interviews with five mothers from each of the two groups was conducted. Content analysis revealed that both groups' experiences were characterized by (i) mothers' need to be affirmed of their infants' vitality, (ii) bonding challenges, and (iii) benefits of skin-to-skin contact. We suggest that early skin-to-skin contact after very preterm births is crucial for the bonding process and mothers' feelings of safety and well-being. When early skin-to-skin contact is infeasible, our findings reveal the significance of photos, information, and the father's presence at the time of postpartum separation. [ABSTRACT FROM AUTHOR]

Background: Healthcare personnel in the municipal healthcare systems experience many ethical challenges in their everyday work. In Norway, 243 municipalities participated in a national ethics project, aimed to increase ethical competence in municipal healthcare services. In this study, we wanted to map out what participants in ethics reflection groups experienced as promoters or as barriers to successful reflection. Objectives: To examine what the staff experience as promoters or as barriers to successful ethics reflection. Research design: The study has a qualitative design, where 56 participants in municipal healthcare participated in 10 different focus-group interviews. Ethical considerations: The data collection was based on the participants' informed consent and approved by the Data Protection Official of the Norwegian Centre for Research Data. Results: The informants had different experiences from ethics reflection group. Nevertheless, we found that there were several factors that were consistently mentioned: competence, facilitator's role, ethics reflection groups organizing, and organizational support were all experienced as promoters and as a significant effect on ethics reflection groups. The absence of such factors would constitute important barriers to successful ethics reflection. Discussion: The results are coincident with other studies, and indicate some conditions that may increase the possibility to succeed with ethics reflection groups. A systematic approach seems to be important, the systematics of the actual reflections, but also in the organization of ethics reflection group at the workplace. Community healthcare is characterized by organizational instabilities as many vacancies, high workloads, and lack of predictability. This can be a hinder for ethics reflection group. Conclusion: Both internal and external factors seem to influence the organization of ethics reflection group. The municipalities' instabilities challenging this work, and perceived as a clear inhibitor for the development. The participants experienced that the facilitator is the most important success factor for establishing, carrying out, and to succeed with ethics reflection groups. [ABSTRACT FROM AUTHOR]

In Norway the nurse practitioner (NP) role is still in its infancy. To succeed with implementation of this new role stakeholder involvement is important, and there should be an explicit need for change. The aim of this study was to explore registered nurses' understanding of how the NP role could contribute to meeting patients' needs for care in the emergency care context, and nurses' perceptions about the implementation process. The study is a qualitative interview study. The interviews were analysed by means of qualitative content analysis. Two themes presented themselves: the NP role being an autonomous role suitable for non-urgent patients, and the NP role being diffuse as well as a threat to colleagues and organizational structures. The results indicate that the NP role can make a valuable contribution to meet current challenges in the emergency care context. However, for successful implementation, the management team plays an important role in leading change and engaging co-workers to be part of the process. In further research, it is recommended to evaluate the forthcoming implementation process and, later on, to evaluate the outcomes of NP practice in the emergency care context in Norway. [ABSTRACT FROM AUTHOR]

Building trustworthy relationships that promote equal participation is a fundamental feature of daily living in dementia care. Creating a social community is thus a key component of quality of life for residents in dementia special care units. The aim of this study was to explore healthcare personnel’s experiences of enhancing social community in common spaces in dementia special care units. A qualitative descriptive design consisted of four focus-group interviews with 15 healthcare personnel. The transcribed interviews were analyzed inductively using qualitative content analysis. The findings revealed that healthcare personnel’s experiences of enhancing social community in common spaces were related to three main themes, expressed as dilemmas between knowing versus not knowing each other, safety versus unsafety and presence versus absence. Our analysis indicates that to enhance social community, it is essential for healthcare personnel to be able to create different forms of proximity to residents: physical, narrative and moral. Moreover, the meaning and role of ‘proximity’ in dementia care should be further explored as organizational context influences spatial-structural practices and may disrupt proximity in dementia care. [ABSTRACT FROM AUTHOR]

The number of nurses in Norway educated outside of the European Union is increasing. The purpose of this study is to explore how immigrant nurses, all educated as nurses in their home countries, experience working as a nurse in Norway. The study has a qualitative design with a social constructivist perspective and is based on written narratives from open-ended questions representing 144 nurses from 18 different counties. Two main themes based on patterns from the participants' text were constructed: 'conscientious and proud as nurses' and 'impressed but challenged as strangers'. The findings are discussed in relation to research in cultural understanding. Immigrant nurses contribute with important knowledge and cultural competence to nursing and the Norwegian healthcare system, but there are also challenges. More knowledge is needed in education, research and in individual institutions about the contributions and challenges immigrant nurses bring with them. [ABSTRACT FROM AUTHOR]

Have the nature of printed news stories changed in competition with new media? Our content analysis of Norway’s largest morning newspaper Aftenposten in four time cuts between 1950 and 2008 revealed that the length of news stories had increased until 2008 when the newspaper had changed to the tabloid format with a mixture of both brief and lengthy articles. News stories tended to have broader time frames in more recent years. The frequency of simpler forms of news stories like reports of meetings and social events had diminished considerably. In the last 20 years, journalists have also become more visible in the text. We will look at these findings against a historical background. [ABSTRACT FROM PUBLISHER]

The large number of individuals affected by dementia entails major challenges for home health care (HHC) and dementia-affected families. The aim of the study was to explore and describe relatives’ experiences of people with dementia living at home and to reveal the relatives’ needs for support. Focus group interviews (10 people) were used for data collection. The analysis was qualitative content analysis. The results show that relatives are unable to escape the situation and that the dignity of the person with dementia is threatened. Relatives experience a sense of powerlessness due to fragmented services. The continuity of HHC services constitutes a major challenge. Personnel should focus more on ethical considerations and on dialogue between formal and informal caregivers. [ABSTRACT FROM AUTHOR]