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.
unique cell division machinery in the Archaea Lindås, Ann-Christin; Karlsson, Erik A; Lindgren, Maria T ...
Proceedings of the National Academy of Sciences - PNAS,
12/2008, Letnik:
105, Številka:
48
Journal Article
Recenzirano
Odprti dostop
In contrast to the cell division machineries of bacteria, euryarchaea, and eukaryotes, no division components have been identified in the second main archaeal phylum, Crenarchaeota. Here, we ...demonstrate that a three-gene operon, cdv, in the crenarchaeon Sulfolobus acidocaldarius, forms part of a unique cell division machinery. The operon is induced at the onset of genome segregation and division, and the Cdv proteins then polymerize between segregating nucleoids and persist throughout cell division, forming a successively smaller structure during constriction. The cdv operon is dramatically down-regulated after UV irradiation, indicating division inhibition in response to DNA damage, reminiscent of eukaryotic checkpoint systems. The cdv genes exhibit a complementary phylogenetic range relative to FtsZ-based archaeal division systems such that, in most archaeal lineages, either one or the other system is present. Two of the Cdv proteins, CdvB and CdvC, display homology to components of the eukaryotic ESCRT-III sorting complex involved in budding of luminal vesicles and HIV-1 virion release, suggesting mechanistic similarities and a common evolutionary origin.
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.
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.
Background
Family caregivers' experiences of formal care when caring for persons with dementia through the process of the disease is sparsely investigated.
Aims
To investigate family caregivers' ...experiences of formal care when caring for a person with dementia, through the stages of the disease.
Design
A qualitative approach with focus group interviews.
Methods
Four focus group interviews were conducted in October 2011 with 23 spouses and adult children of persons with dementia and analysed with content analysis.
Results
The participants' experiences of formal care when caring for a person with dementia were captured in the theme ‘Family caregiving requires collaboration with formal care to get support adjusted to needs specific to the stages of dementia’. This can be broken down into the categories ‘The dementia diagnosis – entry into formal care as a novice family caregiver’, ‘Needing expanded collaboration with formal care to continue care at home’ and ‘Being dependent on a nursing home and trying to maintain involvement’.
Conclusion
Family caregiving requires collaboration with formal care to get support adjusted to the individual's needs, specific to the stages of dementia. Caregivers experience a transition process with three main turning points: the dementia diagnosis; when they realise increased need for formal care to continue caring at home; and when the person with dementia is moved into a nursing home. The interviewed caregivers experience formal care reactive to their needs and this often promoted unhealthy transitions. Formal care needs to be proactive and deliver available care and support early on in the dementia trajectory. Interventions should focus on facilitating a healthy transition for family caregivers through the trajectory of the dementia disease to ensure their well‐being.
The aim was to explore why registered nurses (RNs) in Sweden choose to quit their jobs in hospitals, also in relation to experienced patient safety. Previous research has shown that nurse turnover, ...especially in hospital settings, is a serious challenge for society and health care globally. Insufficient staffing of RNs is linked to poorer patient outcomes and a general patient safety at risk. It is, therefore, important to continually explore how nurses describe their reasons for quitting their jobs. The study was conducted using a qualitative descriptive design, based on 11 semistructured interviews with RNs. The analysis generated four categories describing the results: Feeling that the profession is not valued; Psychological and physical symptoms related to work; An insufficient and unsupportive organization; and Unsatisfying leadership and teamwork. Specifically, the RNs participating in this study described a range of reasons for quitting, where the feeling of not being valued and treated as a respected and autonomous profession was a common thread throughout the results. RNs experienced that, overall, the insufficient work conditions, also resulting in lower patient safety, ultimately led to their decision to quit. The findings highlight the crucial need for employers to develop working conditions for RNs, to make sure that the profession is valued according to professional standards and provide the potential for autonomous nursing practice. To reduce nurse turnover, and instead attract and retain nurses, leadership and management in nursing need to be adjusted to meet the demands of a modern academic profession.
Purpose: The purpose of the study was to illuminate the experience of caring touch in intensive care from the perspectives of patients, next-of-kin, and healthcare professionals. Design and Method: ...This study was explorative, and data were collected through qualitative observations ( n = 9) with subsequent interviews ( n = 27) at two general intensive care units. An inductive approach was embraced to be open-minded to the participants’ experiences. Findings: The results are presented in one generic category—caring touch creates presence—which generated five subcategories: to touch and be touched with respect, touch as guidance and communication, touch causes suffering, touch creates compassion, and touch creates security. Conclusion: When the ability to communicate with words is lost, it is body language that reveals what a person is trying to express. Nurses create a way of being present with the patients by touching them, to communicate I am here for you. Caring touch is a tool to show compassion and respect and to protect the integrity of the lived body. The caring touch is soothing and comforting for the patient and next-of-kin and creates security. It also helps to awaken the motivation to get healthy, which is needed in an environment that is foreign.
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