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Aim: Evaluate for differences in demographic and clinical characteristics and subjective and objective measures of cognitive function (CF) between younger older adults (YOA, 60–69 years) and older adults (OA, ≥70 years). Design: Cross-sectional. Methods: Older oncology patients (n = 139) completed subjective (Attentional Function Index, European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire (EORTC) CF scale) and objective (Montreal Cognitive Assessment, Trail Making Test (TMT) A & B) measures of CF prior to chemotherapy. Data were analyzed using parametric and nonparametric tests. Results: No differences were found between the two groups for any of the subjective or objective CF measures, except that OA patients had higher TMT B scores. Compared with the general population, OAs had significantly higher EORTC CF scores and YOAs had significantly worse scores for all of the objective tests. Clinically meaningful difference between group differences was found for the TMT B test. This work was supported by grant from Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, Oslo, Norway.

Cognitive impairment has a negative impact on older patients with cancer.The aim of this study was to evaluate for interindividual differences in 2 subjective measures of cognitive function in older patients (n = 112), as well as determine which demographic, clinical, and symptom characteristics, and levels of physical function, were associated with initial levels and with the trajectory of each of these 2 measures.Cognitive function was assessed using the cognitive function scale from the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 and the Attentional Function Index at the initiation of chemotherapy and at 1, 3, 6, 9, and 12 months after its initiation. Hierarchical linear modeling was used to assess for interindividual differences in and characteristics associated with initial levels and changes in cognitive function.Characteristics associated with decreases in Quality of Life Questionnaire Core 30 scores at the initiation of chemotherapy were longer time since the cancer diagnosis and higher depression scores. Characteristics associated with poorer Attentional Function Index scores at enrollment were lower levels of education and higher depression scores. No characteristics were associated with worse trajectories of either cognitive function measure.Some older patients undergoing chemotherapy experience decrements in cognitive function.Our findings suggest that clinicians need to assess for depressive symptoms in older patients before the initiation of chemotherapy. Evidence-based interventions (eg, cognitive stimulation, increased physical activity) can be recommended to maintain and increase cognitive function in older oncology patients.

Background The main goal of pediatric palliative care (PPC) is to improve or maintain the best possible quality of life (QoL) for the child and their family. PPC can be provided in community health centres, within the specialist health care service and/or in the child’s home. Home is often the preferred place for families, and recommendations state that, whenever possible, the family home should be the centre of care for the child. The aim of this study is to systematically review the experiences and needs of families with children receiving palliative care at home. Methods We conducted a systematic review and searched the peer-reviewed databases CINAHL, Embase, PsycInfo and MEDLINE for articles published between January 2000 and October 2019. We included 23 studies emphasising the experience of family members when their child (0–18 years) received palliative care at home. We used a thematic analysis to identify relevant themes in the literature, and synthesised the findings from the different studies. Results The review represents the experiences of the families of almost 300 children with life-limiting (LL) and life-threatening (LT) conditions receiving palliative care at home. In general, the children’s mothers are interviewed, and seldom the sick children themselves or their siblings. Most families preferred staying at home since it made it easier to maintain a normal family life, was less stressful for the sick child, and meant that siblings could still attend school and be with friends. Families experienced a range of challenges due to the coordination of care, including a lack of support and adequately skilled staff with appropriate experience. Respite care was needed in order to cope with everyday life. Some studies were not specific concerning the place of care, and some relevant papers may have been omitted. Conclusions Families receiving PPC need organised, individualised support from a skilled PPC team. Respite care is necessary in order to manage a demanding home-care situation and parents need support for siblings. Privacy to be a family is a need, and many families need financial support. Future studies should focus on PPC at home in the perspectives of sick children and their siblings.

Background High levels of psychological distress and poor overall quality of life (QOL) have been identified among nursing students during the COVID-19 pandemic. The pandemic necessitated improvised reconstructions of educational curriculums and restrictions in clinical placement and training at campuses, possibly reducing educational quality. Objectives We explored whether baccalaureate nursing students’ concerns and satisfaction with the educational curriculum, focusing on the conduct of clinical training, were associated with perceived psychological distress and overall QOL. Methods Baccalaureate nursing students (N=6088) from five Norwegian universities were invited to an internet-based, cross-sectional survey during the second wave of the pandemic. The survey included COVID-19 specific questions on health, education and clinical training, the Fear of COVID-19 scale (FCV-19S), The Hopkins Symptom Checklist (SCL-5) and overall QOL. Data from national surveys on satisfaction with the educational curriculum, before and during the pandemic were used for comparison. Results In total, 2605 (43%) students responded, of whom 1591 (61%) had been engaged in clinical training during the pandemic. Overall, 53% were either satisfied or fully satisfied with their educational curriculum, with the level of satisfaction being significantly lower than pre-pandemic reference values. Also, 79% were concerned or highly concerned about the educational quality. In multiple regression analyses for all students, lower levels of satisfaction and higher levels of quality concerns were associated with worse SCL-5 scores. Furthermore, satisfaction with the educational curriculum was positively associated with overall QOL. For students engaged in clinical training, only concerns about infecting others were additionally associated with psychological distress. None of the items related to clinical training were associated with overall QOL. Conclusion Nursing students’ educational satisfaction and quality concerns may significantly impact perceived psychological distress and overall QOL during a pandemic. However, with necessary adaptations implemented, concerns regarding the conduct of clinical training account for little of these associations.

Aims and objectives To use nursing students to observe hand hygiene adherence in nursing homes and to explore whether the students' reflections after observing hand hygiene practices gives them a deeper understanding of the subject matter. Background Residents in nursing homes worldwide have low tolerance for healthcare-associated infections that require antibiotics, and hand hygiene is the single most effective action to reduce infections. Design Observational study using (a) World Health Organization's (WHO) "Five moments for hand hygiene" validated tool to record indications and adherence and (b) an exploratory study of individual reflection notes from students conducted during and after observations. Methods From February 12-15, 2018, 26 nursing students in their second semester of a 3-year bachelor programme participated as observers in five wards in four nursing homes in the Oslo metropolitan area. This study was performed according to the STROBE statement. Results Hand hygiene was performed for 57.2% of the 2,393 indications observed and recorded. Adherence differed significantly by type of personnel and by location. Four thematic categories emerged from the reflection notes: (a) practical awareness and introspection; (b) visualisation and enhancement of understanding of practice learning; (c) incorrect hand hygiene practices; and (d) stimulation to increase essential knowledge. Conclusion Hand hygiene adherence was too low to prevent healthcare-associated infections and to reduce the use of antibiotics. The students' reflection notes indicated more "insight and understanding of the complexity of hand hygiene." We suggest using nursing students in clinical placement as a means of incorporating different interventions as part of their learning skills and become "living reminders" of the importance of hygiene and infection prevention. Relevance for clinical practice Improving the student's activity about hygiene and infection prevention in clinical placement may help to raise awareness by healthcare workers in nursing homes.

Purpose To evaluate for inter-individual differences in two subjective measures of functional status in older patients (n = 112), as well as to determine which demographic, clinical, and symptom characteristics, and levels of cognitive function, were associated with initial levels and with the trajectory of the two measures. Methods Functional status was assessed using self-report measures of physical function (PF) and role function (RF) from the European Organization for Research and Treatment of Cancer Core Quality-of-Life Questionnaire at the initiation of chemotherapy and at 1, 3, 6, 9, and 12 months after its initiation. Hierarchical linear modeling was used to assess inter-individual differences in and characteristics associated with initial levels and changes in PF and RF. Results Characteristics associated with decreases in PF at the initiation of chemotherapy were higher numbers of comorbidities and higher depression, pain, and dyspnea scores. For initial levels of poorer RF, lower Karnofsky Performance Status scores and higher pain and fatigue scores were the associated characteristics. Characteristic associated with worse trajectories of PF was not having had surgery. For RF, worse trajectories were associated with lower cognitive function and higher RF at enrollment. Characteristic associated with both lower initial levels and improved trajectories of PF was having lower performance status at enrollment. Conclusions Older patients undergoing chemotherapy experience reduced functional performance. Characteristics associated with decrements in PF and RF need to be assessed and interventions implemented to maintain and increase functional status in older oncology patients.

Background The maintenance of physical function (PF) is an extremely important outcome for elderly people. Objective The aims of this study were to identify differences in the subjective and objective measures of PF between younger older adults (YOAs, 60-69 years of age) and older adults (OA, ≥70 years of age), to compare the PF scores with age-matched samples from the general population, and to evaluate for associations between the subjective and objective measures of PF. Methods Patients (n = 139) were assessed using subjective (ie, European Organization for Research and Treatment of Cancer Core Quality-of-Life Questionnaire) and objective (ie, Short Physical Performance Battery [SPPB]) measures prior to chemotherapy (CTX). Data were analyzed using parametric and nonparametric tests. Results No differences were found between the 2 age groups in any of the subjective or objective measures of PF. Compared with the age-matched general population, both YOAs and OAs had significantly lower scores in both measures of PF. Large effect sizes were found for differences in European Organization for Research and Treatment of Cancer Core Quality-of-Life Questionnaire role function, SPPB balance, and SPPB total scores between the YOA group and the age-matched general population samples. Correlations between the subjective and objective measures were low. Conclusions Older patients with cancer have lower PF than their age-matched general population prior to CTX. Longitudinal studies are warranted to evaluate for changes in PF during and following CTX. Implications for Practice Nurses need to perform routine assessments of PF in older oncology patients prior to CTX. Our findings suggest that SPPB gait speed may be a useful screening measure for PF in older patients.

Background The COVID-19 pandemic has caused significant disruptions in the implementation of programs across educational institutions. Nursing students, being both young adults and by practical training, part of the health care system, may be particularly vulnerable during the COVID-19 pandemic. The purpose of this study was to explore the associations between self-reported fear of COVID-19, general health, psychological distress and overall quality of life (QoL) in a sample of Norwegian undergraduate nursing students compared to reference data. Methods The survey targeted baccalaureate nursing students from five universities in February 2021. An electronic questionnaire consisted of the Fear of COVID-19 Scale (FCV-19S), the Hopkins Symptom Checklist 5 (SCL-5), one general health and one overall QoL question. The respondents’ mean scores were compared to reference data. Hierarchical regression analyses were conducted, and effect sizes (Cohen’s d) were evaluated. Results In total, 2605 out of 6088 (43%) students responded. Their FCV-19S scores (mean 2.45, CI: 2.42, 2.48) were significantly higher than those of the reference population (mean 1.8, P< 0.001). Nursing students scores showed significantly lower general health (mean 3.50 ± 0.93 SD, population mean = 3.57, Cohen’s d = 0.07), higher levels of psychological distress (mean 2.68 ± 1.03 SD, population mean = 2.12, Cohen’s d = 0.55) and lower overall QoL (mean 5.50 ± 2.16 SD, population mean = 8.00, Cohen’s d = 1.16) compared to pre-pandemic reference data. FCV-19S scores were significantly associated with levels of general health (Cohen’s d = 0.26), psychological distress (Cohen’s d = 0.76) and overall QoL (Cohen’s d = 0.18).Conclusions Baccalaureate nursing students reported worse outcomes during the Covid-19 pandemic on general health, psychological distress and overall QoL compared to the reference population. Level of fear of Covid-19, however, accounted for few of these differences. Other factors related to the pandemic may have reduced nursing students’ overall QoL.

Background The COVID-19 pandemic has caused significant disruptions in the implementation of programs across educational institutions. Nursing students, being both young adults and by practical training, part of the health care system, may be particularly vulnerable during the COVID-19 pandemic. The purpose of this study was to explore the associations between self-reported fear of COVID-19, general health, psychological distress and overall quality of life (QoL) in a sample of Norwegian baccalaureate nursing students compared to reference data. Methods The survey targeted baccalaureate nursing students from five universities in February 2021. An electronic questionnaire consisted of the Fear of COVID-19 Scale (FCV-19S), the Hopkins Symptom Checklist 5 (SCL-5), one general health and one overall QoL question. The respondents’ mean scores were compared to reference data. Hierarchical regression analyses were conducted, and effect sizes (Cohen’s d) were evaluated. Results In total, 2605 out of 6088 (43%) students responded. Their FCV-19S scores (mean 2.45, CI 2.42, 2.48) were significantly higher than those of the reference population (mean 1.8, P Conclusions Baccalaureate nursing students reported worse outcomes during the Covid-19 pandemic on general health, psychological distress and overall QoL compared to the reference population. Level of fear of Covid-19, however, accounted for few of these differences. Other factors related to the pandemic may have reduced nursing students’ overall QoL.

Whether university teaching on campus with infection control measures in place is associated with higher risk of COVID-19 than online instruction, is unknown. We will assess this by conducting repeated surveys among students at universities and university colleges in Norway, where some instruction is given in-person, and some is provided online (hybrid model). We will ask about the students’ COVID-19 status, and how much in-person and online instruction they are getting. We will estimate the association between in-person instruction and COVID-19-risk using multivariate regression, controlling for likely confounders. We will also assess whether type of instruction is associated with how satisfied the students are with the instruction, their quality of life, and learning outcomes.

Aim: Mental diseases and pain are serious public health problems and are a leading cause of disability worldwide. The aim of this study is to describe how pain and psychological distress separately and in combination are associated with four income trajectories over nine years in a cohort of long-term social assistance recipients (LTRs). Methods: A cohort of 456 LTRs from 14 municipalities in Norway were divided into four groups based on the presence or absence of pain and/or psychological distress. These were surveyed in 2005, and later linked by personal identification numbers to high-quality longitudinal administrative data covering the period 2005–2013. Methods include calculation of income statuses based on main sources of income, and multinomial logistic regression analysis. Results: In the group without pain and psychological distress, earnings from work as main source of income (14.6–38.0%) and disability benefits (2.9–16.1%) increased over the period. In the ‘double burden’ group the proportions who had social assistance as main income decreased (68.2–21.5%) and the proportions with disability benefits increased over time (5.6–36.6%). Only 27.2% of the total sample had earnings from work as their main income in 2013. Conclusion: LTRs are extra burdened by pain and psychological distress, and this has consequences for their life opportunities and income trajectories. This study indicates that the primary goal of the social assistance system, to make the clients self-sufficient, is hard to achieve. A better co-operation between health services and work-related services is needed. The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The Norwegian Directorate of Labour and Welfare.

Aims and objectives To elucidate knowledge available on parents' experience and perception of sleep when they stay overnight in hospital together with their sick children. Background In Nordic countries, children are entitled to have at least one parent with them during hospitalisation. Parents' sleep, when accommodated at the hospital during the child's admission, may be a challenge. Design A systematic literature search was conducted in EMBASE, MEDLINE and PsycINFO; period is restricted from 1 January 2007 to 1 April 2019. Studies included were those in which parents were accommodated in hospital with their child, 0-18 years of age, for at least one night. Original peer-reviewed scientific research papers conducting qualitative, quantitative or mixed designs were included. Systematic reviews were not included. This systematic integrative review was registered in PROSPERO and performed according to the PRISMA guidelines. All authors participated in study selection, data extraction and quality assessment of the literature. Results Fifteen studies were included, and they varied in terms of origin, aims, design, methods used and sample size. Three overall main themes appeared: sleep quality, factors affecting sleep and consequences of sleep loss. Combined psychological factors were found to affect parents' sleep, as well as isolated psychological factors, for example, stress, anxiety, worries and difficult thoughts. Environmental and social factors were also identified, for example, privacy and caring for family. Conclusion Study of this subject is still in its exploratory phase. There is a need for the development of theory of substance in the clarification of the meaning of sleep among parents during difficult times such as children's hospitalisation. Relevance to clinical practice Understanding risk factors associated with sleep and sleep deprivation in parents staying overnight in the hospital with their sick child is important, since lack of sleep may lead to serious stress-related outcomes for the parents.

PURPOSE: While attentional function is an extremely important patient outcome for older adults, research on changes in function in this group is extremely limited. The purposes of this study were to: identify subgroups of older patients (i.e., latent growth classes) based on changes in their level of self-reported attentional function; determine which demographic and clinical characteristics were associated with subgroup membership; and determine if these subgroups differed on quality of life (QOL) outcomes. METHODS: Older oncology outpatients (n=365) who were assessed for changes in attention and working memory using the Attentional Function Index a total of six times over two cycles of chemotherapy (CTX). QOL was assessed using the Medical Outcomes Study-Short Form 12 and the QOL-Patient Version Scale. Latent profile analysis (LPA) was used to identify subgroups of older adults with distinct attentional function profiles. RESULTS: Three distinct attentional functional profiles were identified (i.e., low, moderate, and high attentional function). Compared to the high class, older adults in the low and moderate attentional function classes had lower functional status scores, a worse comorbidity profile and were more likely to be diagnosed with depression. In addition, QOL scores followed an expected pattern (low class < moderate class < high attentional function class). CONCLUSIONS: Three distinct attentional function profiles were identified among a relatively large sample of older adults undergoing CTX. The phenotypic characteristics associated with membership in the low and moderate latent classes can be used by clinicians to identify high risk patients.

Purpose Evaluate for differences in demographic and clinical characteristics between older oncology patients with low multimorbidity (

BackgroundAfter lock-down during the first wave of the COVID-19 pandemic, higher education institutions globally struggled to balance the need for infection control and educational requirements as they prepared to reopen. A particularly difficult choice was whether to offer for in-person or online teaching, since there was little or no empirical research to inform this decision. Norwegian universities and university colleges opted for a hybrid model when they reopened for the autumn semester, with some students offered more in-person teaching than others. This gave us an opportunity to study the association between different teaching modalities and COVID-19 risk, quality of life (subjective well-being), and teaching satisfaction.MethodsWe conducted a prospective, observational cohort study among students in higher education institutions in Norway. Participants were surveyed biweekly from September to December in 2020.Findings26 754 students from 14 higher education institutions provided data to our analyses. Our best estimate for the association between two weeks of in-person teaching and COVID-19 risk was −22% (95% CI −77% to 33%), compared to online teaching. Quality of life was positively associated with in-person teaching (3% relative risk difference; 95% CI 2% to 4%), as was teaching satisfaction (10%; 95% CI 8% to 11%).InterpretationThe association between COVID-19 infection and teaching modality was highly uncertain. Shifting from in-person to online teaching seems to have a negative impact on the well-being of students in higher education.FundingNone.

Higher education students are considered to belong to a population susceptible to poor sleep health; however, there is a lack of broader evidence reviews. This systematic review aims to map out and categorize the existing literature related to higher education students and sleep. The present evidence map is based on a comprehensive systematic literature search of ten electronic databases, which resulted in 15,286 unique citations. After title/abstract, and full-text screening: 515 studies were included in the final map. Most of the studies were cross-sectional ( n = 357, 69%), while 77 (15%) studies assessed the effectiveness of an intervention. Sixty-eight (13%) studies followed a cohort prospectively over time, and 8 (2%) studies utilized a qualitative design. The most frequent outcome was the proportion of sleep problems, which was reported in 226 (44%) studies. Weekday sleep duration was reported in 156 (30%) studies. Results from this mapping process suggest that evidence about students` sleep health is emerging; however, the evidence base is mostly quantitative and descriptive, and there is a lack of sleep health programs designed for students.

In the last two decades, quality of life and health-related quality of life have become commonly used outcome measures in the large number of studies evaluating healthcare and home care nursing. The objective of this systematic search and review was to evaluate studies that include self-rated generic quality of life instrument used among elderly patients receiving home care nursing. Searches were conducted in Medline, Embase, PsycINFO and Cinahl for articles published between January 2005 and June 2016, with 17 studies in eight countries meeting the inclusion criteria and assessed for quality. Overall, the review shows great variations in the included studies regarding characteristics of the participants and place of origin, the generic quality of life instruments applied and their dimensions. In this review, we raise the question of whether the generic questionnaires used to measure quality of life do in fact measure what is essential for quality of life in elderly users of home care nursing. The psychological and physical dimensions of quality of life were assessed in almost all included studies, while older-specific dimensions like autonomy, control and sensation were less frequently assessed. There is reason to believe that generic quality of life instruments frequently do not capture the dimensions that are most important for elderly people with health problems in need of home care nursing.

Purpose Quality of life (QOL) is an important concept in the field of health and medicine. QOL is a complex concept that is interpreted and defined differently within and between disciplines, including the fields of health and medicine. The aims of this study were to systematically review the literature on QOL in medicine and health research and to describe the country of origin, target groups, instruments, design, and conceptual issues. Methods A systematic review was conducted to identify research studies on QOL and health-related quality of life (HRQOL). The databases Scopus, which includes Embase and MEDLINE, CINAHL, and PsycINFO were searched for articles published during one random week in November 2016. The ten predefined criteria of Gill and Feinstein were used to evaluate the conceptual and methodological rigor. Results QOL research is international and involves a variety of target groups, research designs, and QOL measures. According to the criteria of Gill and Feinstein, the results show that only 13% provided a definition of QOL, 6% distinguished QOL from HRQOL. The most frequently fulfilled criteria were: (i) stating the domains of QOL to be measured; (ii) giving a reason for choosing the instruments used; and (iii) aggregating the results from multiple items. Conclusion QOL is an important endpoint in medical and health research, and QOL research involves a variety of patient groups and different research designs. Based on the current evaluation of the methodological and conceptual clarity of QOL research, we conclude that the majority QOL studies in health and medicine have conceptual and methodological challenges. Electronic supplementary material The online version of this article (doi:10.1007/s11136-019-02214-9) contains supplementary material, which is available to authorized users.

Purpose Evaluate how subgroups of older adults with distinct attentional function profiles differ on the severity of nine common symptoms and determine demographic and clinical characteristics and symptom severity scores associated with membership in the low and moderate attentional function classes. Methods Three subgroups of older oncology outpatients were identified using latent profile analysis based on Attentional Function Index (AFI) scores. Symptoms were assessed prior to the second or third cycle of CTX. Logistic regressions evaluated for associations with attentional function class membership. Results For trait anxiety, state anxiety, depression, sleep disturbance, morning fatigue, and evening fatigue scores, differences among the latent classes followed the same pattern (low > moderate > high). For morning and evening energy, compared to high class, patients in low and moderate classes reported lower scores. For pain, compared to moderate class, patients in low class reported higher scores. In the logistic regression analysis, compared to high class, patients with lower income, higher comorbidity, higher CTX toxicity score, and higher levels of state anxiety, depression, and sleep disturbance were more likely to be in low AFI class. Compared to high class, patients with higher comorbidity and trait anxiety and lower morning energy were more likely to be in moderate AFI class. Conclusions Consistent with the hypothesis that an increased risk for persistent cognitive decline is likely related to a variety of physical and psychological factors, for six of the nine symptoms, a “dose response” effect was observed with higher symptom severity scores associated with a progressive decline in attentional function.

Disruption of parental sleep in hospital, with frequent awakenings and poor sleep quality, limits the parents' resources to meet the child's needs and maintain parental wellbeing. The aim of the study was to explore and describe how parents perceive their sleep when staying overnight with their sick child in hospital. A further aim was to explore and describe parents’ perception of what circumstances influence their sleep in the hospital. Twenty‐two parents who were accommodated with their sick child (0–17 years) in paediatric wards in Norway and Sweden participated. Interviews were conducted during the hospital stay to elicit their perspectives. Phenomenography was used to analyse data. Two descriptive categories were found: (a) “Perceptions of sleep”, with two sub‐categories: “Sleep in the paediatric ward” and “Consequences of sleep loss”; and (b) “Circumstances influencing sleep in the paediatric ward” with three sub‐categories: “The importance of the family”, “Information and routines at the paediatric ward”, and “Accommodation facilities”. Parents’ sleep and needs must be acknowledged in paediatric wards. An individual plan of care for the upcoming night could be a valuable tool for both the parents and nurses. The child's medical needs must be met with respect to the parents’ willingness to take part in the child's care during the night, and the need for rest and sleep for both parent and child. This study was supported by Crown Princess Victoria Children's Hospital, Linköping, Sweden, Perth Children's Hospital Foundation, Nedlands, WA, and Oslo Metropolitan University, Oslo, Norway.

Bakgrunn: I Norge er det årlig cirka 15 000 sykehusinnleggelser på grunn av hjerneslag. Utenlandske studier har vist at flere kvinner enn menn rapporterer dårligere helse og funksjonsevne etter hjerneslag, men dette er lite undersøkt i Norge. Hensikt: Undersøke om det er forskjell i kvinner og menns vurdering av helse, funksjonsevne, evne til å ivareta dagliglivets aktiviteter, og bruk av helsetjenester etter hjerneslag. Metode: Tverrsnittstudie fra Helseundersøkelsen i Nord-Trøndelag (HUNT 3) innsamlet fra 2006–2008. Studien inkluderer 1190 personer som har hatt hjerneslag, 572 (48,1 prosent) kvinner og 618 (51,9 prosent) menn. Resultat: 71,5 prosent kvinner og 73 prosent menn hadde kommet seg helt etter siste hjerneslag. Kun 6,2 prosent hadde svært alvorlig, alvorlig eller moderat funksjonssvikt. Kvinner ble sjeldnere innlagt på sykehus enn menn (p

Purpose Older adults receiving cancer chemotherapy are at increased risk for decrements in physical (PF) and cognitive (CF) function. Objectives Study identified subgroups of patients with distinct PF and CF profiles; risk factors associated with subgroup membership; and impact of subgroup membership on quality of life (QOL). Methods In 366 older oncology patients, PF and CF were assessed using the Physical Component Summary (PCS) of the SF-12 and Attentional Function Index, respectively. Latent profile analysis was used to identify subgroups of older patients with distinct PF/CF profiles. Results Three distinct PF/CF profiles were identified (i.e., Very Low PF + Moderate CF (15.6%); Low PF + Low CF (39.3%), Normal PF + Normal CF (45.1%)). Compared to the both Normal class, patients in the other two classes had a lower functional status, a worse comorbidity profile, and were less likely to exercise on a regular basis. Compared to the Both Normal class, patients in the Both Low class were less likely to be married/partnered, more likely to live alone, less likely to be employed, and more likely to report depression and back pain. Compared to the other two classes, patients in the Both Low class had a lower annual household income and were receiving chemotherapy with a worse toxicity profile. Conclusion First study to use a person-centered analytic approach to identify subgroups of older adults with distinct PF/CF profiles. Fifty-five percent of the older adults had statistically significant and clinically meaningful decrements in both PF AND CF that had negative effects on all aspects of QOL.

Objective To describe hand-hygiene practices in pediatric long-term care (pLTC) facilities and to identify observed barriers to, and potential solutions for, improved infection prevention. Design Observational study using (i) the World Health Organization's ‘5 Moments for Hand Hygiene’ validated observation tool to record indications for hand hygiene and adherence; and (ii) individual logs of subjective impressions of behavioral and/or systemic barriers witnessed during direct observation. Setting Staff in three pLTC facilities (284 beds total) were observed by two trained nurses 1 day a week for 3 weeks in February and March 2015. Participants Direct providers of health, therapeutic and rehabilitative care, and other staff responsible for social and academic activities for children with complex, chronic medical conditions. Main Outcome Measures Hand-hygiene indications, adherence and barriers. Results Hand hygiene was performed for 40% of the 847 indications observed and recorded. Adherence increased at one site and decreased in the other two sites during the study period. Adherence appeared to be influenced by individuals' knowledge, attitudes, beliefs and work setting. Conclusions Poor hand-hygiene adherence was observed overall. Specific barriers were identified, which suggest a contextual approach to the interpretation of results indicated in this uniquely challenging setting. We offer some practical suggestions for overcoming those barriers or mitigating their effect. Ultimately, an adaptation of the ‘5 Moments for Hand Hygiene’ may be necessary to improve infection prevention in pLTC.

Bakgrunn:Antall krefttilfeller blant eldre øker sterkt, og i forbindelse med behandlingen kan kreftpasienter være utsatt for kognitive endringer. Mange av dem som overlever kreft, får nedsatt oppmerksomhet og konsentrasjon samt dårligere hukommelse. Attentional Function Index (AFI) er et instrument for å kartlegge kognitive prosesser, og det er utviklet i USA.Hensikt:Å redegjøre for oversettelsen og pilottestingen av den norske versjonen av AFI.Metode:Tre forskere med kunnskap om psykologi, sykepleie og kreft, en psykolog med spesialkjennskap til kognitive instrumenter og en brukerrepresentant utgjorde ekspertgruppen i oversettelse og kulturell tilpasning av instrumentet. En autorisert translatør deltok aktivt i arbeidet. I pilottesten av den norske versjonen rekrutterte vi personer > 60 år etter «snøballmetoden». I alt ble 114 personer mellom 60 og 90 år rekruttert til utprøvingen. Vi ba tolv av disse spesielt om å kommentere instrumentet.Resultat:Ekspertgruppens medlemmer kom med tilbakemeldinger basert på sin kompetanse. Brukerrepresentanten ville ha et enkelt og forståelig språk som ikke var støtende, og translatøren hadde lingvistiske innspill. Femten personer kommenterte spesielt ett av spørsmålene.Konklusjon:Å inkludere en bruker og en translatør i oversettelsesprosessen kan bedre valideringen. Vi anbefaler at slike prosesser gjøres tilgjengelige for fremtidige brukere av oversatte instrumenter.

Pathogens that cause health care-associated infections (HAIs) are known to survive on surfaces and equipment in health care environments despite routine cleaning. As a result, the infection status of prior room occupants and roommates may play a role in HAI transmission. We performed a systematic review of the literature evaluating the association between patients' exposure to infected/colonized hospital roommates or prior room occupants and their risk of infection/colonization with the same organism. A PubMed search for English articles published in 1990-2014 yielded 330 studies, which were screened by three reviewers. Eighteen articles met our inclusion criteria. Multiple studies reported positive associations between infection and exposure to roommates with influenza and group A streptococcus, but no associations were found for Clostridium difficile, methicillin-resistant Staphylococcus aureus, Cryptosporidium parvum, or Pseudomonas cepacia; findings were mixed for vancomycin-resistant enterococci (VRE). Positive associations were found between infection/colonization and exposure to rooms previously occupied by patients with Pseudomonas aeruginosa and Acinetobacter baumannii, but no associations were found for resistant Gram-negative organisms; findings were mixed for C. difficile, methicillin-resistant S. aureus, and VRE. Although the majority of studies suggest a link between exposure to infected/colonized roommates and prior room occupants, methodological improvements such as increasing the statistical power and conducting universal screening for colonization would provide more definitive evidence needed to establish causality.

Background The burden of healthcare-associated infection worldwide is considerable, and there is a need to improve surveillance and infection control practices such as hand hygiene. Objectives The aims of this study were to explore direct care providers' knowledge about infection prevention and hand hygiene, their attitudes regarding their own and others' hand hygiene practices, and their ideas and advice for improving infection prevention efforts. Methods This exploratory study included interviews with direct care providers in three pediatric long-term care facilities. Two trained nurse interviewers conducted semistructured interviews using an interview guide with open-ended questions. Two other nurse researchers independently transcribed the audio recordings and conducted a thematic analysis using a strategy adapted from the systematic text condensation approach. Results From 31 interviews, four major thematic categories with subthemes emerged from the analysis: (a) hand hygiene products; (b) knowledge, awareness, perceptions, and beliefs; (c) barriers to infection prevention practices; and (d) suggested improvements. There was confusion regarding hand hygiene recommendations, use of soap or sanitizer, and isolation precaution policies. There was a robust "us" and "them" mentality between professionals. Discussion One essential driver of staff behavior change is having expectations that are meaningful to staff, and many staff members stated that they wanted more in-person staff meetings with education and hands-on, practical advice. Workflow patterns and/or the physical environment need to be carefully evaluated to identify systems and methods to minimize cross-contamination. Further studies need to evaluate if personal sized containers of hand sanitizer (e.g., for the pocket, attached to a belt or lanyard) would facilitate improvement of hand hygiene in these facilities.

Scand J Caring Sci; 2010; 24; 808–816 Is social capital associated with coping, self-esteem, health and quality of life in long-term social assistance recipients? Background: Being a long-term social assistant recipient may in the long run have an impact on the individual’s perception of health and quality of life, which in turn may become barriers to the return to work. Aim: The purpose of this article is to explore the relationships between social capital, coping, self-esteem, health and quality of life in a sample of people receiving social assistance, living in various municipalities in Norway. Methods: The present study has a cross-sectional, questionnaire and survey design, including a sample of 451 long-term social assistance recipients from 14 municipalities in Norway (response rate 53%). Different self-reported measures assessing social capital, coping, self-esteem, health and quality of life were used. To evaluate multivariate relationships, multiple linear hierarchical regression analyses were performed. Results: The majority of the sample was men (58%), had education up to secondary school level (43%), and were married or registered partner (23%), with a mean age of 34 (SD 10.9; range 18–60). Demographic and social factors explain 7% of the variance in social capital. In the bivariate analysis, higher levels of social capital are significantly related to higher levels of coping (r = 0.30), self-esteem (r = 0.20), mental health (r = 0.30) and quality of life (r = −0.21). In the final regression model, with quality of life as the dependent variable, only coping, self-esteem and mental health are significantly related to quality of life. This model explains 40% of the variance in quality of life. Conclusion: This study indicates that social capital is associated with health and quality of life through coping and self-esteem in a sample of long-term social assistance recipients.

In Norway the employment rate amongst people with mental disorders is about half compared to the rest of the group with disabilities. The same pattern is found in other OECD countries, where on average only one in four individuals reporting a mental health condition is employed. Since there is evidence that work can improve mental health and reduce psychological distress, policymakers are looking for solutions to improve labour market participation among people with mental health problems. A large part of the public effort for activating disadvantaged groups in the labour market are directed through active labour market programmes ALMPs. The main goal of these programs is to enhance employment opportunities and employability by providing training and qualifications. Numerous evaluation studies have analyzed how these programs affect the participant’s chance of employment, and whether the effects vary for different subgroups of the disabled. There is, however, less research on the recruitment to ALMPs and the accomplishment of program participation. The aim of this paper is to identify if there are barriers that prohibits people with mental disorders in either getting vocational training, or carrying through the planned training. The paper focuses on differences between people with mental disorders and others in need of vocational training with regard to i recruitment and ii what kind of measures that are offered. In the study, we follow a group of long time recipients LTRs of social assistance benefits for eight years. These individuals are distant from the labour market; they do not qualify for social security benefits, and many have physical or mental health problems. The participants, 1 066 in all, were recruited to the study in 2005. About 50 per cent responded to a questionnaire that provided information on sociodemographic characteristics, work, health, pain, health-related quality of life, use of alcohol and narcotics, and more. This data set has recently been linked with information from a number of national administrative registers, which enables us to follow vital aspects of their life course, including participation in labour market programs, over a period of eight years, i.e. from 2005 through 2013. Preliminary analyses show that a large majority 88 per cent of LTRs has participated in an active labour market program at least once. A rather high share 40 per cent has four or more spells of ALMP participation. LTRs who in 2005 report multiple health problems, i.e. poor mental health and physical pain, participate less frequent than other subgroups: 17 per cent have never participated in an ALMP; 29 per cent has four or more ALMP spells. Further analyses will examine how LTRs participation patterns vary with what kind of health problem they have.

Long-term social assistance recipients (LTRs) struggle with numerous health issues. However, no data are available on the prevalence of chronic pain in these individuals. The purpose of this study was to determine the prevalence and characteristics of chronic pain (ie, pain3 mo) among LTRs in Norway compared to the general population (GP).In this cross-sectional study, which is part of a larger study that evaluated the health and functional abilities of LTRs in Norway, 405 LTRs of which 178 had chronic pain, were compared to a similar aged group (n=1455) from the general population. The LTRs were recruited from 14 of 433 municipalities.The LTRs were significantly younger (P0.001), more likely to be male (P0.001), and had less education (P0.001) than the GP. The prevalence of chronic pain was significantly higher in the LTR sample (44.0%) compared to the GP sample (23.9%; P0.001). A higher percentage of LTRs compared to the GP reported accidents (P=0.002) as the cause of their pain.The fact that 44.0% of the LTRs reported chronic pain, compared to only 23.9% of the GP suggests that chronic pain is a significant problem for LTRs in Norway. Additional research is warranted to determine the exact etiologies for and the impact of chronic pain on LTRs.

Background While lower socioeconomic status increases individual’s risk for chronic conditions, little is known about how long-term social assistance recipients (LTRs) with multiple chronic health problems experience chronic pain and/or psychological distress. Social assistance is the last safety net in the Norwegian welfare system and individuals have a legal right to economic assistance if they are unable to support themselves or are entitled to other types of benefits. The purposes of this study were to determine the co-occurrence of both chronic pain and psychological distress and to evaluate for differences in demographic and social characteristics, as well as health-related quality of life, among LTRs. Methods This descriptive, cross-sectional study surveyed people receiving long-term social assistance in Norway about their health and social functioning from January-November 2005. The social welfare authority offices in each of 14 municipalities in Norway were responsible to locate the LTRs who met the study’s inclusion criteria. The selected municipalities provided geographic variability including both rural and urban municipalities in different parts of the country. LTRs were included in this study if they: had received social assistance as their main source of income for at least 6 of the last 12 months; were between 18 and 60 years of age; and were able to complete the study questionnaire. In this study, 405 LTRs were divided into four groups based on the presence or absence of chronic pain and/or psychological distress. (1) Neither chronic pain nor psychological distress (32%, n = 119), (2) only chronic pain (12%, n = 44), (3) only psychological distress and (24%, n = 87), (4) both chronic pain and psychological distress (32%, n =119). Results Except for age and marital status, no differences were found between groups in demographic characteristics. Significant differences were found among the four groups on all of the items related to childhood difficulties before the age of 16, except the item on sexual abuse. LTRs with both chronic pain and psychological distress were more likely to have experienced economic problems in their childhood home; other types of abuse than sexual abuse; long-term bullying; and had more often dropped out of school than LTRs with neither chronic pain nor psychological distress. LTRs with both chronic pain and psychological distress, reported more alcohol and substance use/illicit drug use, more feelings of loneliness and a lower mental score on SF-12 than LTRs with only chronic pain. Conclusions and implications Co-occurrence of chronic pain and psychological distress is common in LTRs and problems in early life are associated with the co-occurrence of chronic pain and psychological distress in adult life. Although this study cannot assign a clear direction or causality to the association between social and demographic characteristics and chronic pain and psychological distress, the findings when examining LTRs’ problems in childhood before the age of 16, indicated that incidents in early life create a probability of chronic pain and psychological distress in the adult life of the individuals. Further studies should use life course studies and longitudinal data in to investigate these important questions in LTRs.

PurposeThe purposes of this study were to compare the health-related quality of life (HRQOL) of long-term social assistance recipients (LTRs) with and without chronic pain and determine the effect of select demographic, social, pain, alcohol, and illicit drug use characteristics on the physical and mental components of their HRQOL.MethodsIn this cross-sectional study, which is part of a larger study that evaluated the health and functional abilities of LTRs in Norway, 405 LTRs of which 178 had chronic pain were recruited from 14 of 433 municipalities.ResultsLTRs with chronic pain were older (P

Tall fra statistisk sentralbyrå viser at det i Norge ble registrert 548 selvmord i 2014. Av disse var 401 menn og 147 kvinner. Ifølge folkehelseinstituttet er det også betydelige mørketall. Selvmord og selvmordsforsøk er for de fleste endepunktet i en prosess der, indre og ytre belastninger over tid ikke har latt seg endre eller løse. Hensikten med denne oppgaven er å se på hvordan sykepleier kan bidra til å forebygge selvmord på generelt basis. Dette gjennom gode kunnskaper for å kunne identifisere en selvmordstuet menneske, etablere gode rutiner og sikre at konstruktiv kommunikasjon finner sted. Sykepleier bør kunne bygge gode relasjoner og skape håp og mestring hos pasientene. Oppgaven er i hovedsak basert på litteraturstudie, og er en systematiske gjennomgang av relevant forskning og teori. Det kommer fram i studiene at det er behov for økt kunnskap og kompetanse hos sykepleiere i møte med det selvmordsnære mennesket.

Sammendrag: På verdensbasis tar om lag 1 million mennesker livet sitt hvert år. I Norge dør i overkant av 500 mennesker av selvmord hvert år. Av disse er 70 prosent menn. I tillegg til disse tallene antar man at mellom 3 500 og 7 500 personer hvert år forsøker å ta sitt eget liv. Dette er skremmende høye tall som både er et stort samfunnsproblem samtidig som det er en stor smerte for de etterlatte. Forskning viser at dagens sykepleiere har for lite kunnskap om hvordan man møter mennesker som ønsker å ta livet sitt. Med bakgrunn i dette har jeg har valgt å ta for meg problemstillingen;” Hvordan kan sykepleieren møte det selvmordstruede mennesket og fremme håp?” Metoden som ligger til grunn for denne oppgaven er en litteraturstudie der jeg har hentet inn tidligere forskning og litteratur som belyser selvmordsproblematikken. Gjennom kvalitative forskningsartikler har jeg tilegnet meg kunnskap om hvordan sykepleieren kan møte pasienter som er i en suicidal krise og deres opplevelser rundt behandlerne (sykepleierne) som de har møtt gjennom behandlingssystemet. Funn fra forskning og litteraturen viser at sykepleieren bør møte pasienten med tillit, empati, evne til å lytte og se pasienten som et unikt individ. Hun bør også legge stor vekt på å fremme en god terapeutisk relasjon som bygger på respekt, forståelse, trygghet og åpenhet. Håp ble sett på som noe positivt som enhver sykepleier burde formidle i møtet med det selvmordstruede mennesket. Oppgavens siste del tar for seg utfordringer knyttet til møtet med det selvmordstruede mennesket der jeg drøfter funnene fra forskning og litteratur, sammen med egen erfaring.