Cardiovascular nursing (CVN) is rapidly developing and has accumulated a large amount of evidence to support interventions aimed at reducing suffering and hastening recovery. However, knowledge of the extent and content of CVN training in Sweden is lacking. The aim of this study was therefore to identify and describe CVN in the Swedish RN education as well as in higher education, with reference to type of course and credits, content, area and target group. A nationwide survey was carried out in Sweden at all university level nursing schools (N=26) by means of a 25-item questionnaire, which was analysed by descriptive statistics. The findings show that 69% and 23% of the schools awarded 0-1 credits [0-1.5 European Credit Transfer and Accumulation System (ECTS)] and 2-3 credits (3-4.5 ECTS), respectively for cardiology/CVN in the RN education. Target areas outside the hospital setting reported by 23% and 19% of nursing schools were primary health care and community care, respectively. Special target groups in addition to the general public were the elderly (42%) and women (58%). Advanced courses in CVN comprising 10-40 credits (15-60 ECTS) were held by 27% of nursing schools, but no school had a specialist or Master level education. Important educational implications from the study of the RN education are the establishment of a minimum credit figure and to reach out into primary health care.
Clinical placements play an important role in learning a new profession, but students report about poor placement experiences. Standards have been laid down for improvements within clinical training in Prehospital Emergency Nursing programmes in Sweden, but no studies have been carried out in this field in a Swedish context. The purpose of this study was thus to describe the experiences of Prehospital Emergency Nursing (PEN) students of their clinical placement and the effect on their learning process. Data were collected in 28 individual interviews and analyzed in accordance with Flanagan's Critical Incident Technique. Three main areas emerged: the professional clinical supervisor, the clinical placement setting and the learning strategy. All these areas played a significant role in the PEN students' learning progress and development into a new professional role. The choice of clinical supervisor (CS) and clinical placement is important if PEN students' learning is to be an effective and positive experience. The prehospital environment is unique and can have positive and negative effects on student learning depending on the support and structure given during their clinical placement. A learning strategy based on reflective dialogue, CS continuity and a learning structure based on the prehospital environment is presented.
BACKGROUND: Participation in cardiac rehabilitation programmes (CRPs) allows patients to increase their knowledge of the importance of established risk factors to help them maintain healthy lifestyle changes after coronary heart disease (CHD). AIM: To explore perceived importance and knowledge of known risk factors for CHD among non-attendees in CRPs. METHOD: Consecutive non-attendees in CRPs (n=106) answered a questionnaire focusing on patients' attitudes towards risk factors and cardiac rehabilitation. RESULTS: The non-attendees lacked knowledge of non-physical characteristics such as depression and social isolation. They also had poor knowledge about biological causes and hereditary factors. However, those who said they knew enough about CHD to prevent recurrent illness did have sufficient knowledge about the established risk factors. CONCLUSION: There is a lack of knowledge about social isolation and depression and their importance in the development of CHD among the non-attendees. They show greater knowledge about biological risk factors than the importance of companionship, joy and happiness. CHD and loneliness are intimately correlated, so creating a sense of belonging must not be underestimated as a measure to prevent CHD.
Following myocardial infarction (MI), patients often have unanswered questions about resuming sexual activity. Coronary care nurses can play an important role in counselling. However, this sensitive area is frequently neglected in nursing practice. This article discusses patient and nurse perceptions of such discussions and explores ways to increase nurses' awareness, so that they might offer sexual counselling to patients post-MI. Health professionals representing 18 Swedish coronary care units answered two open-ended questions, and their answers were analysed and categorized by content. Two main categories were identified: 'Difficulties and challenges' and 'Future needs'. These two categories were further divided into sub-categories respectively: 'Information flow', 'Patients' responsibility', 'Information to partners' and 'Cooperating with other experts'; and 'Preparing information tools' and 'Highlighting sexual issues'. It was found that when sexual concerns arise, contact with medical social workers, urologists and gynaecologists is scarce. It was also found that the current written information is insufficient. Responsibility currently falls on patients to ensure that both they and their partners have been adequately informed regarding any sexual concerns. It is essential that health professionals are well-educated and have the necessary skills to inform patients and their partners about sexual issues following MI.
Three years after providing an oral health education program (OHEP) to nursing personnel, the authors analyzed the effect of the program on knowledge of the importance of oral health and on perception among the nurses of the possibility to implement oral care in patient care. The study was based on a cross-sectional survey of all nursing personnel (N = 2,901) in five municipalities in the Southwestern Sweden, of whom 950 had attended four one-hour lessons during an OHEP in 1996. The response rate to the survey questionnaire was 67% (1,930 subjects). Statistical analysis was performed by means of descriptive and analytical statistics. The program was shown to have an independent effect on the dependent variables "knowledge of oral health" and "assessment of implementation possibilities," This study has given further evidence of the feasibility of an educational program to improve both knowledge and implementation of oral health care.
This paper is a report of a study of factors which influence mothers' sense of security during the first postnatal week.
Mothers' sense of security the first postnatal week is not thoroughly elucidated in the literature.
An interview study with a qualitative descriptive design was carried out, using thematic content analysis. Fourteen mothers from three hospital uptake areas in Southern Sweden were interviewed using focus group discussions and individual interviews between May 2008 and March 2009.
Postnatal sense of security was dependent on support from staff, support from family and the capacity and health of the woman and the baby, and these themes had categories and sub-categories, including: Being met as an individual, being given relevant information, being prepared for the time after birth and having someone to turn to--knowing who to ask, having partner and/or significant others close at hand, mother's and the baby's own resources, being assured that her own physical health was good, and having planned follow-up regarding the baby's health after discharge.
Staff attitudes should be continually discussed at all units providing maternity care. These discussions should include attitudes towards the father and the significance of his presence for the wellbeing of the family. Continued postbasic staff education in, for example, counselling and communication is necessary if services are to be improved so that parents' individual needs can be met. Preparation for the early postpartum period is important and all information given must be consistent, in particular information about breastfeeding.
To describe facilitators and barriers from a patient perspective in communications between patients with obstructive sleep apnoea syndrome and healthcare personnel during the first meeting when continuous positive airway pressure is initiated.
Adherence to continuous positive airway pressure treatment tends to be poor, especially at the initial phase of treatment. Communication between the patient and healthcare personnel has not been studied from the patient perspective, as either a barrier or facilitator for adherence.
A descriptive design using qualitative content analysis was used. Interviews with 25 patients with obstructive sleep apnoea syndrome took place after their initial visit at four continuous positive airway pressure clinics. A deductive analysis based on The 4 Habits Model (i.e. emphasise the importance of investing in the beginning of the consultation, elicit the patient's perspective, demonstrate empathy and invest in the end of the consultation) was conducted.
Building confidence (i.e. structure building, information transfer, commitment) or hindering confidence (i.e. organisational insufficiency, stress behaviour, interaction deficit) was associated with investing in the beginning. Motivating (i.e. situational insight, knowledge transfer, practical training) or demotivating (i.e. expectations, dominance and power asymmetry, barriers) was associated with eliciting the patient's perspective. Building hope (i.e. awareness, sensitivity, demonstration of understanding) or hindering hope (i.e. unprepared, uncommitted, incomprehension) was associated with showing empathy. Agreement (i.e. confirmation, responsibilities, comprehensive information) or disagreement (i.e. structural obscurity, irresponsibility, absent-mindedness) was associated with investing in the end.
Understanding of facilitators and barriers, as described by patients, can be used to improve contextual conditions and communication skills among healthcare personnel.
A patient-centred communication technique should be used in relation to all stages of The 4 Habits Model to facilitate shared decision-making and improve adherence to continuous positive airway pressure treatment.
The aim of this study was to design an appearance programme in order to prevent the misuse of androgenic anabolic steroids among adolescents and to evaluate the adolescents' perception of this programme. The study was performed in all schools in a primary health care area on the south west coast of Sweden. The intervention targeted all 16- and 17-year-old males and females (n = 921). The intervention and evaluation were completed by 451 boys. The strategy of the appearance programme was to create awareness of and to discuss attitudes towards steroid hormones among these adolescents. Youth leaders and health workers, who discussed these subjects with adolescents over a period of 2 years, carried out the intervention programme. The perception of the programme was analysed anonymously using questionnaires. Effects on the total population of youths were assessed by two cross-sectional surveys. The intervention programme was well received by the adolescents. The misuse of androgenic anabolic steroids had a tendency to decrease after the appearance programme. We demonstrated a method for involving the community in an appearance programme to reduce misuse of anabolic steroids and showed that youth were sensitive to our discussions about appearance and attitudes. This study indicates that drug abuse among adolescents can be decreased by health promotion activities, such as group discussions. Controlled studies are needed before the results of this appearance programme can be generalized.
The aim of the present study was to investigate gender differences in students' health habits and motivation for a healthy lifestyle. The sample of students comprised a probability systematic stratified sample from each department at a small university in the south-west of Sweden (n = 479). A questionnaire created for this study was used for data collection. Self-rated health was measured by number of health complaints, where good health was defined as having less than three health complaints during the last month. A healthy lifestyle index was computed on habits related to smoking, alcohol consumption, food habits, physical activity and stress. Female students had healthier habits related to alcohol consumption and nutrition but were more stressed. Male students showed a high level of overweight and obesity and were less interested in nutrition advice and health enhancing activities. The gender differences are discussed in relation to the impact of stress on female students' health, and the risk for male students in having unhealthy nutritional habits in combination with being physically inactive and drinking too much alcohol.
After a myocardial infarction (MI), many patients and their partners experience problems with marital and sexual life.
A Swedish national survey was carried out to obtain knowledge on the information provided by cardiac health care professionals on the subject of sexual function and coexistence after an MI. It consisted of a questionnaire that was designed, tested, and sent to 121 coronary care units.
The coronary care unit teams rarely provided oral or written information about sexual function and coexistence to patients with MI or their partners. The health care professionals lacked competence in these areas.
It is essential that health care professionals are educated on and inform the patient with MI about the significance of sexual function and coexistence. Further research is required regarding patients' and their partners' need for information and support in this area.