Aims
To explore Swedish adolescents' conceptual views of mental health and mental health problems.
Design
A qualitative descriptive study design.
Methods
Semi‐structured focus group interviews and ...individual interviews were conducted with, in total, 32 Swedish adolescents (15–18 years old) in October–November 2020. Data were analysed using systematic text condensation.
Results
Three themes were identified through the analysis: Mental health is about how we feel; One's mental health depends on one's situation, thoughts and ways of coping; and Mental health problems should be taken seriously and can get severe.
Conclusion
The results indicate that adolescents understand the complexity and holistic nature of mental health and mental health problems. According to the participating adolescents, positive mental health and mental health problems should be considered simultaneously to understand a young person's mental health state. Good health was described as having both absence of mental health problems and high levels of well‐being: feeling well. Mental health problems were defined as something other than normal difficulties in life, but ranging from minor difficulties to more severe conditions. However, all kinds of mental health problems were termed as feeling unwell. The results suggest that adolescents are in need of support to cope with normal difficulties in life rather than lectures about life sometimes being challenging. In addition, the results highlight the need to prevent school‐related stress and offer adolescents support for minor mental health problems.
Impact
The findings have implications for nurses and other professionals who encounter adolescents in their profession, for example specialist nurses, school nurses and public health professionals. The findings add knowledge that could be useful for communication with adolescents about their mental health and methods to assess their mental health status.
Patient or Public Contribution
The preliminary results were presented to three classes, in year nine in lower secondary school, for validation.
Aim
To evaluate the clinical usability of PURPOSE T among registered nurses in Sweden.
Background
Pressure ulcers are an adverse event and a problem worldwide. Risk assessment is a cornerstone, and a ...first step in pressure ulcer prevention is to identify possible risk patients and/or pressure ulcers. There are many pressure ulcer risk assessment instruments; however, they are not updated and/or evidence‐based. PURPOSE T has been psychometrically evaluated in the UK and in Sweden with good inter‐rater and test–retest reliability, and convergent validity was reported as moderate.
Design
A descriptive study design with a qualitative approach.
Methods
A total of six focus group interviews with 29 registered nurses were conducted. They were recruited from May 2018 to November 2018 from a university hospital and two nursing homes in Sweden. Data analysis was performed as described by Krueger. The study adheres to the COREQ guidelines.
Results
Four categories were identified: “An efficient risk assessment instrument performed at the bedside,” “Deeper understanding and awareness of risk factors,” “Benefits compared to the Modified Norton Scale” and “Necessity of integration of PURPOSE T in the electronic health record and team collaboration.”
Conclusion
The registered nurses acknowledged an overall positive perception of PURPOSE T´s clinical usability. Future research is needed to evaluate the feasibility of PURPOSE T.
Relevance to Clinical Practice
PURPOSE T has the potential to replace outdated pressure ulcers risk assessment instruments that are used today.
Aim
To describe job satisfaction in registered nurses (RNs), their intention to stay at their current workplace and in the profession and to explore patient safety in relation to these.
Background
...Nurse turnover presents a serious challenge to health care that may be predicted by factors related to the work environment.
Method
Descriptive design with 25 qualitative interviews.
Results
Five categories were identified: RNs feel satisfied when providing person‐centred care; RNs enjoy the variability of the nursing job, but want control; RNs feel frustrated when care is put on hold or left undone; RNs depend on team collaboration and the work environment to assure patient safety; intention to stay depends on the work environment and a chance for renewal.
Conclusion
Registered nurses’ job satisfaction could be described as a double‐edged sword. Although the profession is described as a positive challenge, work overload threatens both job satisfaction and patient safety.
Implications for Nursing Management
Our findings suggest that nursing leadership can increase RNs’ intention to stay by meeting their needs for appreciation, a better work environment, competence development and professional career development.
In this cross-sectional study, we aimed to I) investigate the dual-factor model of mental health by forming and describing four participant groups and II) examine associations between mental health ...status and background factors, school-related factors, stress, and resilience among adolescents in a community population in Sweden. Data were collected through a survey completed by 2,208 students in lower and upper secondary school on the Swedish island of Gotland. After missing data were removed, a total of 1,833 participants were included in the study. The survey included the Mental Health Continuum Short Form (MHC-SF) for the assessment of mental well-being and the Strengths and Difficulties Questionnaire (SDQ) for the assessment of mental health problems. These two measures were combined into a dual-factor model, forming four mental health status subgroups: Vulnerable (47.5%), Complete mental health (36.2%), Troubled (13.9%), and Symptomatic but content (2.5%). Associations between these groups were explored regarding background factors, school-related factors, stress, and resilience through chi-squared tests and logistic regressions. Girls (OR: 1.88) and participants with high stress levels (OR: 2.23) had elevated odds for Vulnerable mental health status, whereas higher resilience (OR: 0.87) and subjective social status in school (OR: 0.76) were factors associated with reduced odds for this mental health status classification. Female gender (OR: 5.02) was also associated with Troubled mental health status. Similarly, a high level of stress (ORs: 4.08 and 11.36) was associated with Symptomatic but content and Troubled mental health status, and participants with higher levels of resilience had decreased odds for being classified into these groups (ORs: 0.88 and 0.81). The findings highlight the importance of interventions to increase resilience, reduce stress, and address stereotypic gender norms as well as social status hierarchies to support adolescents' mental health.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Aim
To evaluate the psychometric characteristics of the Pressure Ulcer Risk Primary or Secondary Evaluation Tool (PURPOSE T); reliability (inter‐rater and test–retest) and validity (convergent ...validity) in a Swedish context.
Background
Pressure ulcers are considered as an adverse event and are a problem in healthcare worldwide. The first step in pressure ulcer prevention is to identify patients that are at risk. PURPOSE T is a new pressure ulcer risk assessment instrument that was developed in the UK using “golden standard” instrument method.
Design
Observational, descriptive and comparative.
Methods
A total of 235 patients and 28 registered nurses were recruited (May 2018–November 2018) from six hospital wards at a university hospital and two community nursing homes in Sweden. Blinded (ward/nursing home nurses and expert nurses) PURPOSE T assessments and follow‐up retests were undertaken. Cross‐tabulation and kappa statistics were used to examine the reliability, and phi correlation was used to test the convergent validity. The study followed the STROBE guideline.
Results
The clinical evaluation showed “very good” (kappa) inter‐rater and test–retest reliability for PURPOSE T assessment decision overall. The agreement of “at risk”/“not at risk” for both inter‐rater and test–retest was also high, at least 95.5%. The convergent validity between PURPOSE T and other traditional assessment instruments was moderate.
Conclusion
The evaluation of PURPOSE T demonstrated good psychometric characteristics. Further research is needed to evaluate PURPOSE T’s usability among registered nurses.
Relevance to clinical practice
There is a lack of evidence‐based validated pressure ulcer risk assessment instruments for use in health care. According to our findings, the Swedish version of PURPOSE T could be used in hospitals and nursing homes to identify patients in risk or with pressure ulcers.
Antioxidants in the diet and supplements are widely used to protect against cancer, but clinical trials with antioxidants do not support this concept. Some trials show that antioxidants actually ...increase cancer risk and a study in mice showed that antioxidants accelerate the progression of primary lung tumors. However, little is known about the impact of antioxidant supplementation on the progression of other types of cancer, including malignant melanoma. We show that administration of N-acetylcysteine (NAC) increases lymph node metastases in an endogenous mouse model of malignant melanoma but has no impact on the number and size of primary tumors. Similarly, NAC and the soluble vitamin E analog Trolox markedly increased the migration and invasive properties of human malignant melanoma cells but did not affect their proliferation. Both antioxidants increased the ratio between reduced and oxidized glutathione in melanoma cells and in lymph node metastases, and the increased migration depended on new glutathione synthesis. Furthermore, both NAC and Trolox increased the activation of the small guanosine triphosphatase (GTPase) RHOA, and blocking downstream RHOA signaling abolished antioxidant-induced migration. These results demonstrate that antioxidants and the glutathione system play a previously unappreciated role in malignant melanoma progression.
This study aimed to evaluate the feasibility of implementing an electronic version of PURPOSE T, a risk assessment instrument for pressure ulcers, in a Swedish hospital ward. A mixed‐method was used. ...Nursing staff received training in PURPOSE T and a record review was performed (n = 30). PURPOSE T replaced the Modified Norton Scale, and after one month another record review was performed (n = 30). Individual interviews with patients (n = 15) and focus group interviews with nursing staff (n = 23) were performed after the implementation. The results of the record review and the focus group interviews showed good clinical feasibility of PURPOSE T. The record review showed that more patients were at risk of developing pressure ulcers and more nursing interventions were prescribed with PURPOSE T compared to the Modified Norton Scale. The focus group interviews showed that all nursing staff were satisfied with PURPOSE T. The instrument contributed to increased reflection and analysis as well as the opportunity for nursing staff to draw their own conclusions regarding patients´ risk status. The documentation encouraged the prescription of more preventive actions, and the nurses were more involved at bedside. However, almost all the patients expressed not receiving any information about pressure ulcers.
Rho family proteins are prenylated by geranylgeranyltransferase type I (GGTase-I), which normally target proteins to membranes for GTP-loading. However, conditional deletion of GGTase-I in mouse ...macrophages increases GTP-loading of Rho proteins, leading to enhanced inflammatory responses and severe rheumatoid arthritis. Here we show that heterozygous deletion of the Rho family gene Rac1, but not Rhoa and Cdc42, reverses inflammation and arthritis in GGTase-I-deficient mice. Non-prenylated Rac1 has a high affinity for the adaptor protein Ras GTPase-activating-like protein 1 (Iqgap1), which facilitates both GTP exchange and ubiquitination-mediated degradation of Rac1. Consistently, inactivating Iqgap1 normalizes Rac1 GTP-loading, and reduces inflammation and arthritis in GGTase-I-deficient mice, as well as prevents statins from increasing Rac1 GTP-loading and cytokine production in macrophages. We conclude that blocking prenylation stimulates Rac1 effector interactions and unleashes proinflammatory signaling. Our results thus suggest that prenylation normally restrains innate immune responses by preventing Rac1 effector interactions.
Aim
To describe what registered nurses' experience to be important to job satisfaction in nursing home settings.
Design
This is a qualitative study based on data from individual interviews.
Methods
...Sixteen registered nurses working in nursing homes were interviewed, and their responses were analysed with systematic text condensation.
Results
A total of six categories were developed to describe various aspects of job satisfaction among registered nurses at nursing homes: meaningfulness is essential, to possess control and manageability is central, a possibility to balance daily challenges with professional development, supportive leadership is imperative, the nursing team's competence and companionship, and being confident in one's own profession.
Conclusion
In the present study, meaningfulness was essential to job satisfaction, and work was experienced to be meaningful and engaging when the demands were manageable, the workload controllable, and when the registered nurses felt supported by management and co‐workers. Conversely, if the demands were too high, the workload was beyond their control and the nurses felt unsupported, then the work felt meaningless and thus unsatisfactory.
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