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  • 101. Nolbris, Margaretha
    et al.
    Enskär, Karin
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD.
    Hellström, Anna-Lena
    Siblings of a child on or off treatment of cancer2005Inngår i: Pediatric blood & cancer Volume 45 Issue 4: Abstracts of the 37th Annual Conference of the International Society of Paediatric Oncology (SIOP), Vancouver, Canada, 21-24 September 2005, 2005, s. 399-400Konferansepaper (Annet vitenskapelig)
  • 102. Nolbris, Margaretha
    et al.
    Enskär, Karin
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD.
    Hellström, Anna-Lena
    Thoughts about life, death and grief related to the experience of being a sibling of a child with cancer2008Inngår i: NOBOS: Linköping, Sweden, 10-13 maj 2008, 2008Konferansepaper (Fagfellevurdert)
  • 103.
    Olsson, Maria
    et al.
    Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden.
    Enskär, Karin
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD.
    Steineck, Gunnar
    Division of Clinical Cancer Epidemiology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden.
    Wilderäng, Ulrica
    Division of Clinical Cancer Epidemiology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden.
    Jarfelt, Marianne
    Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden.
    Self-Perceived physical attractiveness in relation to scars among adolescent and young adult cancer survivors: A population-based study2018Inngår i: Journal of Adolescent and Young Adult Oncology, ISSN 2156-5333, Vol. 7, nr 3, s. 358-366Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: Cancer treatment may result in various effects that last long after treatment has been concluded. The purpose of this study was to explore to what extent scars affect adolescents and young adults postcancer treatment.

    METHODS: In this population-based study, a study-specific questionnaire was developed by a method used in several previous investigations carried out by our research group, Clinical Cancer Epidemiology. Question development involved expert validation by professionals from oncology units, midwives, epidemiologists, and statisticians. The questionnaire was developed in collaboration with adolescent and young adult cancer survivors. The topics covered in the questionnaire were as follows: psychosocial health, body image and sexuality, fertility, education, work, and leisure. The web-based questionnaire was sent to teenage and young adult cancer survivors and matched controls in Sweden.

    RESULTS: In this study, the relative risk of feeling less attractive due to scars was higher both for female cancer survivors RR 1.48, CI 1.05-2.08 and male cancer survivors RR 1.90, CI 1.15-3.13 compared to controls. The feeling of attractiveness was negatively related to the size of scars in both cancer and control groups. In a logistic regression analysis, significant associations were found between age, education, exercise, depression, and the feeling of low attractiveness due to scars.

    CONCLUSIONS: The results of this study provide a basis for care interventions for teenage and young adult cancer patients during and after cancer treatment. Further research is needed on care interventions to reduce, if possible, the impact of scars.

  • 104.
    Olsson, Maria
    et al.
    Department of Pediatrics, Institute of Clinical Sciences, University of Gothenburg, Sahlgrenska Academy, Sweden.
    Jarfelt, Marianne
    Department of Pediatrics, Institute of Clinical Sciences, University of Gothenburg, Sahlgrenska Academy, Sweden.
    Pergert, Pernilla
    Childhood Cancer Research Unit, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
    Enskär, Karin
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD.
    Experiences of teenagers and young adults treated for cancer in Sweden2015Inngår i: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 19, nr 5, s. 575-581Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    PURPOSE: Approximately 600 teenagers and young adults, TYAs (ages 15-29), are newly diagnosed with cancer in Sweden every year and treated in many different units. The knowledge about TYAs is limited and there might be a need for a new approach in the care for this particular age group. The purpose of this study was to identify requirements TYAs in Sweden acknowledge as important to them.

    METHODS: 44 participants aged 15-29 who were treated at either pediatric or adult cancer units in Sweden, participated in focus group interviews. They were interviewed in groups based on whether they were treated in pediatric (14-18 years old) or adult units (18-29). The focus group interviews were recorded, transcribed, and analyzed using qualitative content analysis.

    RESULTS: Results of the study can be summarized into four categories: personal professional interaction, knowledge and participation, age-appropriate environment, and support. Important TYA care needs vary over time due to individual situations. The time line of the cancer experience can be described as a continuum; at diagnosis, during treatment, and in life-after cancer treatment.

    CONCLUSIONS: TYAs treated in Sweden have special needs that are not being satisfied, whether at pediatric or adult units. Areas that need closer attention are: close relatives' participation in the care, information on sex and fertility, age-appropriate social physical environments during treatment, and psychosocial support after treatment. In Sweden, there is a demand for increased knowledge on the special needs for TYAs in clinical practice.

  • 105.
    Olsson, Maria
    et al.
    Institute of Clinical Sciences, Department of Paediatrics, Sahlgrenska Academy, University of Gothenburg, Sweden.
    Steineck, Gunnar
    Department of Oncology, Division of Clinical Cancer Epidemiology, Sahlgrenska Academy, University of Gothenburg, Sweden.
    Enskär, Karin
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD.
    Wilderäng, Ulrica
    Department of Oncology, Division of Clinical Cancer Epidemiology, Sahlgrenska Academy, University of Gothenburg, Sweden.
    Jarfelt, Marianne
    Institute of Clinical Sciences, Department of Paediatrics, Sahlgrenska Academy, University of Gothenburg, Sweden.
    Adolescent and young adult cancer survivors' perceptions of participating in a survey - Ethical and methodological considerations2019Inngår i: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 39, s. 55-61Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    PURPOSE: The aim of this study was to understand patient-reported perception of participation in a population-based web-survey focusing on sensitive issues for adolescent and young adult cancer survivors.

    METHOD: A population-based web survey for adolescent and young adult cancer survivors including a matched control group. Adolescent and young adult cancer survivors from the population-based Swedish National Cancer Registry from four of the six register holders at Regional Cancer Centers in Sweden. Controls were randomly identified from the Swedish National Population registry, from the same register holders.

    RESULT: Of 729 eligible participants, 540 completed the survey i.e. 74% participation rate. The study population included 285 adolescent and young adult cancer survivors and 255 matched controls. None of the participants answered that the survey had a very negative impact on them and a minority of 43 (7.9%) of the 540 responded that they were mildly negatively affected by their participation in the study. There was a no significant difference between patients and controls regarding the negative effect of the participation (p = 0.29). Positive experiences of participating in the study were widely expressed and most participants (95%) found the study valuable.

    CONCLUSIONS: These findings suggest that the benefits clearly outweigh the risks when adolescent and young adult cancer survivors participate in surveys including sensitive and trauma-related aspects, given that the study design is ethically sound and participants are approached carefully. We also present a modified ethical protocol for epidemiological surveys on adolescents and young adult cancer survivors.

  • 106.
    Olsson, Maria
    et al.
    Institute of Clinical Sciences, Department of Pediatrics, Sahlgrenska Academy, University of Gothenburg, Sweden.
    Steineck, Gunnar
    Institute of Clinical Sciences, Division of Clinical Cancer Epidemiology, Sahlgrenska Academy, University of Gothenburg, Sweden.
    Enskär, Karin
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD.
    Wilderäng, Ulrica
    Institute of Clinical Sciences, Division of Clinical Cancer Epidemiology, Sahlgrenska Academy, University of Gothenburg, Sweden.
    Jarfelt, Marianne
    Institute of Clinical Sciences, Department of Pediatrics, Sahlgrenska Academy, University of Gothenburg, Sweden.
    Sexual function in adolescent and young adult cancer survivors - a population-based study2018Inngår i: Journal of cancer survivorship, ISSN 1932-2259, E-ISSN 1932-2267, Vol. 12, nr 4, s. 450-459Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    PURPOSE: Previous research has established that treatments for cancer can result in short- and long-term effects on sexual function in adult cancer patients. The purpose was to investigate patient-reported physical and psychosexual complications in adolescents and young adults after they have undergone treatment for cancer.

    METHODS: In this population-based study, a study-specific questionnaire was developed by a method used in several previous investigations carried out by our research group, Clinical Cancer Epidemiology. The questionnaire was developed in collaboration with adolescent and young adult cancer survivors (15-29 years) and validated by professionals from oncology units, midwives, epidemiologists, and statisticians. The topics covered in the questionnaire were psychosocial health, body image, sexuality, fertility, education, work, and leisure. The web-based questionnaire was sent to adolescent and young adult cancer survivors and matched controls in Sweden.

    RESULTS: In this study, adolescent and young adult cancer survivors (15-29 years) showed low satisfaction regarding sexual function compared to controls (P < 0.01). Female adolescent and young adult cancer survivors had a statistically significant lower frequency of orgasm during sexual activity than the controls (P < 0.01). Male adolescent and young adult cancer survivors had statistically significant lower sexual desire than the controls (P = 0.04).

    CONCLUSIONS: We found that adolescent and young adult cancer survivors perceived themselves as being less satisfied with their sexual function than matched population-based controls.

    IMPLICATIONS FOR CANCER SURVIVORS: Adolescent and young adult cancer survivors need psychological rehabilitation support from the health care profession during and after cancer treatment to help them to reduce their reported poor sexual function to enhance a good sexual quality of life.

  • 107.
    Pergert, Pernilla
    et al.
    Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
    Af Sandeberg, Margareta
    Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
    Andersson, Nina
    Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
    Márky, Ildikó
    Department of Paediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Enskär, Karin
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD.
    Confidence and authority through new knowledge: An evaluation of the national educational programme in paediatric oncology nursing in Sweden2016Inngår i: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 38, s. 68-73Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: There is a lack of nurse specialists in many paediatric hospitals in Sweden. This lack of competence is devastating for childhood cancer care because it is a highly specialised area that demands specialist knowledge. Continuing education of nurses is important to develop nursing practice and also to retain them.

    OBJECTIVES: The aim of this study was to evaluate a Swedish national educational programme in paediatric oncology nursing.

    SETTINGS AND PARTICIPANTS: The nurses who participated came from all of the six paediatric oncology centres as well as from general paediatric wards. At the time of the evaluation, three groups of registered nurses (n=66) had completed this 2year, part-time educational programme.

    DESIGN AND METHODS: A study specific questionnaire, including closed and open-ended questions was sent to the 66 nurses and 54 questionnaires were returned. Answers were analysed using descriptive statistics and qualitative content analysis.

    RESULTS: The results show that almost all the nurses (93%) stayed in paediatric care after the programme. Furthermore, 31% had a position in management or as a consultant nurse after the programme. The vast majority of the nurses (98%) stated that the programme had made them more secure in their work. The nurses were equipped, through education, for paediatric oncology care which included: knowledge generating new knowledge; confidence and authority; national networks and resources. They felt increased confidence in their roles as paediatric oncology nurses as well as authority in their encounters with families and in discussions with co-workers. New networks and resources were appreciated and used in their daily work in paediatric oncology.

    CONCLUSIONS: The programme was of importance to the career of the individual nurse and also to the quality of care given to families in paediatric oncology. The national educational programme for nurses in Paediatric Oncology Care meets the needs of the highly specialised care.

  • 108. Pergert, Pernilla
    et al.
    Ekblad, Solveig
    Enskär, Karin
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD.
    Björk, Olle
    Nurses reactions to overwhelming emotional expressions of parents in transcultural care2007Inngår i: Pediatric blood & cancer Vol. 49 Issue 4: Abstracts of the 39th Annual Congress of the International Society of Paediatric Oncology (SIOP), November 1-3, 2007, Mumbai, India., 2007, s. 560-Konferansepaper (Fagfellevurdert)
  • 109. Pergert, Pernilla
    et al.
    Ekblad, Solveig
    Enskär, Karin
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD.
    Björk, Olle
    Nurses reactions to owerwhelming emotional expressions of parents in transcultural care2008Inngår i: NOBOS: Linköping, Sweden, 10-13 maj 2008, 2008Konferansepaper (Fagfellevurdert)
  • 110. Pergert, Pernilla
    et al.
    Ekblad, Solveig
    Enskär, Karin
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD.
    Björk, Olle
    Protecting professional composure in transcultural pediatric nursing2008Inngår i: Qualitative Health Research, ISSN 1049-7323, E-ISSN 1552-7557, Vol. 18, nr 5, s. 647-57Artikkel i tidsskrift (Fagfellevurdert)
  • 111. Pergert, Pernilla
    et al.
    Ekblad, Solveig
    Enskär, Karin
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD.
    Björk, Olle
    Protecting Professional Cool: A Grounded Theory of Multicultural Pediatric Nursing2007Inngår i: The Grounded Theory Seminar Reader, Mill Valley, Calif.: Sociology Press , 2007, s. 383-399Kapittel i bok, del av antologi (Annet vitenskapelig)
  • 112. Pergert, Pernilla
    et al.
    Ekblad, Solveig
    Enskär, Karin
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD.
    Björk, Olle
    Protecting professional cool: Nurses strategies to deal with overwhelming emotional expressions of parents2008Inngår i: NOBOS: Linköping, Sweden, 10-13 maj 2008, 2008Konferansepaper (Fagfellevurdert)
  • 113. Pergert, Pernilla
    et al.
    Ekblad, Solveig
    Enskär, Karin
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD.
    Björk, Olle
    Protecting professional cool: Nurses strategies to deal with owerwhelming emotional expressions of parents2007Inngår i: Pediatric blood & cancer Vol. 49 Issue 4: Abstracts of the 39th Annual Congress of the International Society of Paediatric Oncology (SIOP), November 1-3, 2007, Mumbai, India., 2007, s. 557-558Konferansepaper (Fagfellevurdert)
  • 114.
    Pergert, Pernilla
    et al.
    Childhood Cancer Research Unit, Department of Women's and Children's Health, Karolinska Institutet, Astrid Lindgren Children's Hospital.
    Ekblad, Solvig
    Department for Learning, Informatics, Management and Ethics (LIME), Center for Medical Education (CME), Karolinska Institutet.
    Björk, Olle
    Childhood Cancer Research Unit, Department of Women's and Children's Health, Karolinska Institutet, Astrid Lindgren Children's Hospital.
    Enskär, Karin
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD.
    Andrews, Tom
    School of Nursing and Midwifery, Brookfield Health Science Complex, University College Cork, Cork, Ireland.
    Protecting family interests: an interview study with foreign-born parents struggling on in childhood cancer care2012Inngår i: International journal of pediatrics, ISSN 1687-9759, Vol. 2012, nr 681301Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Sweden's population is gradually changing to become more multiethnic and diverse and that applies also for recipients of health care, including childhood cancer care. A holistic view on the sick child in the context of its family has always been a cornerstone in childhood cancer care in Sweden. The purpose of this study was to gain knowledge about the experiences and main concern of foreign-born parents in the context of paediatric cancer care. Interviews were performed with eleven foreign-born parents and data were analysed using a classic grounded theory approach. Foreign-born parents often feel in a position of powerless dependence, but family interests are protected in their approaches to interaction with healthcare staff, through cooperation, contesting, and reluctant resigning. Healthcare staff need to listen to foreign-born parents and deal with their concerns seriously to prevent powerless-dependence and work for trustful cooperation in the common fight against childhood cancer.

  • 115.
    Pergert, Pernilla
    et al.
    Karolinska Institutet.
    Ekblad, Solvig
    Karolinska Institutet.
    Björk, Olle
    Karolinska Institutet.
    Enskär, Karin
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD.
    Andrews, Tom
    University College Cork, Ireland.
    Resourcing: An approach used by foreign-born parents struggling on in childhood cancer care2016Inngår i: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 23, s. 1-7Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    PURPOSE: To gain knowledge about foreign-born parents' experiences of dealing with their child's illness and treatment in the context of pediatric cancer care.

    METHOD: Data from 11 individual interviews with foreign-born parents were analyzed using qualitative inductive constant comparative analysis.

    RESULTS: To struggle on in childhood cancer care, foreign-born parents engaged in resourcing using various strategies including: information-monitoring, staying strong, support-seeking and concern-focusing. Parents experienced obstacles to information-monitoring and support-seeking related to their foreign background.

    CONCLUSIONS: The results provide a framework for understanding how foreign-born parents try to deal with childhood cancer care and can be used by health care staff to support their resourcing. Even though preconditions might differ, the strategies presented might also be used by native-born parents however further studied are needed.

  • 116.
    Pergert, Pernilla
    et al.
    Högskolan i Jönköping.
    Ekblad, Solvig
    Enskär, Karin
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD.
    Björk, Olle
    Bridging obstacles to transcultural caring relationships: Tools discovered through interviews with staff in pediatric oncology care.2008Inngår i: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 12, nr 1, s. 35-43Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    In this qualitative study we explored how health-care staff continuously resolve ‘‘obstacles to transcultural caring relationships’’ as they care for families with an immigrant background within the context of pediatric oncology care. A constant comparative method was used and data collection included 5 focus group interviews and 5 complementary individual interviews with health-care staff within pediatric oncology care. Bridging emerged as the way that health-care staff deal with obstacles to transcultural caring relationships. Bridging is a process in which various tools may be used and combined, including communicational tools, transcultural tools and organizational tools. Failure to use tools, or to use and combine them insufficiently, can bring the caring relationship to a halt, which leads to inequity in care. In order to ensure the provision of high-quality care despite differences in religion, culture, language and social situation, health-care staff need to bridge obstacles to transcultural caring relationships. & 2007 Elsevier Ltd. All rights reserved.

  • 117. Pergert, Pernilla
    et al.
    Ekblad, Solvig
    Enskär, Karin
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD.
    Björk, Olle
    Obstacles to transcultural caring relationships: experiences of health care staff in pediatric oncology.2007Inngår i: Journal of Pediatric Oncology Nursing, ISSN 1043-4542, E-ISSN 1532-8457, Vol. 24, nr 6, s. 314-328Artikkel i tidsskrift (Fagfellevurdert)
  • 118.
    Petersson, Christina
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD.
    Huus, Karina
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD.
    Enskär, Karin
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD.
    Hanberger, Lena
    Department of Medical and Health Sciences and Division of Nursing, Faculty of Medicine and Health Sciences, Linköping University, Sweden.
    Samulesson, Ulf
    Department of Medicine and Health Sciences, Linköping University, Sweden.
    Åkesson, Karin
    Högskolan i Jönköping, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare. Futurum, Academy for Health and Care, Sweden.
    Impact of type 1 diabetes on health-related quality of life among 8–18-year-old children2016Inngår i: Comprehensive Child and Adolescent Nursing, ISSN 2469-4193, Vol. 39, nr 4, s. 245-255Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Measuring the health-related quality of life (HRQOL) is one way to understand an individual’s perspective on health, and, more specifically, how type 1 diabetes (T1D) affects a child’s everyday life. Early detection of poor HRQOL is considered a crucial factor for identifying children who are at risk of psychosocial problems. The aim of this study was to describe the differences in the HRQOL of children with T1D according to age, gender, and metabolic control (HbA1c). Cross-sectional data were collected from children with T1D using the DISABKIDS Chronic Generic Measure-37 (DCGM-37) and the diabetes specific module (DM-10). Non-parametric tests were used to investigate differences. There were differences between girls and boys, and girls reported lower HRQOL than boys (HRQOL total score: mean 74 and 67 respectively; p = .005). Adolescents described more worries and fears about the future compared with younger children. Children with poor metabolic control reported a lower HRQOL than those with better metabolic control (HRQOL total score:mean 68 and 76 respectively; p = .006), but the social dimensions were not affected. The findings of the present study elucidate the importance for paediatric nurses to explore potential problems in children with T1D and use this knowledge in clinical practice. Assessment of the HRQOL can provide the patient’s perspective on the quality of diabetes care. The HRQOL is correlated with HbA1c, gender, and age, and the HRQOL as well as HbA1c levels should be regularly assessed to establish a comprehensive care for children with T1D.

  • 119.
    Petersson, Christina
    et al.
    Högskolan i Jönköping, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare. Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD.
    Huus, Karina
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD. Högskolan i Jönköping, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare.
    Åkesson, Karin
    Högskolan i Jönköping, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare. Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD.
    Enskär, Karin
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD.
    Children's experiences about a structured assessment of health-related quality of life during a patient encounter2016Inngår i: Child Care Health and Development, ISSN 0305-1862, E-ISSN 1365-2214, Vol. 42, nr 3, s. 424-432Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background

    It has been stated that care for children with chronic health conditions tends to focus on condition-specific issues rather than how these children experience their health and everyday life functioning.

    Aim

    The aim of this study was to explore children's experiences about a structured assessment of health-related quality of life applied during a patient encounter.

    Methods

    Prior to the start of the study, a clinical intervention based on the questionnaire DISABKIDS Chronic Generic Measure (DCGM-37) was performed. A qualitative explorative design was chosen, and 25 children between 10–17 years of age were interviewed after the consultation at four different paediatric outpatient clinics. Data were analysed according to qualitative content analysis.

    Results

    The results were twofold: children experienced that the assessment was providing them with insights about their health, which motivated them to make lifestyle changes. When outcomes were discussed and requested, the children felt encouraged.

    Conclusions

    The use of an assessment of health-related quality of life may promote insights about health and encourage children with chronic health conditions to discuss their outcomes with healthcare professionals.

  • 120.
    Petersson, Christina
    et al.
    Högskolan i Jönköping, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare. Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD.
    Huus, Karina
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD. Högskolan i Jönköping, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare.
    Åkesson, Karin
    Högskolan i Jönköping, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare. Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD.
    Enskär, Karin
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD.
    Golsäter, Marie
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD.
    To promote child involvement – healthcare professionals' use of a health-related quality of life assessment tool during paediatric encounters2017Inngår i: European Journal for Person Centered Healthcare, ISSN 2052-5648, E-ISSN 2052-5656, Vol. 5, nr 1Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Children and healthcare professionals should be provided with easy-to-use tools which could lead to actionable results.

    Objectives: There is increasing interest in the use of patient reported outcomes to aid management of individual care; therefore, the use of health-related qualityof life (HRQOL) assessments during consultations need to be studied. The aim of this study was to explore how healthcare professionals use a HRQOL assessment tool during paediatric encounters.

    Design: A descriptive, explorative design with a qualitative approach based on video recordings was chosen.

    Methods: Twenty-one video recordings, from nine different healthcare professionals’ consultations where an assessment tool of HRQOL were used were analysed by content analysis.

    Results: The healthcare professionals were using different strategies and when they combined these strategies three approaches emerged. The instructing approach was characterized by healthcare professionals giving a summary of the results, leading to children becoming passive bystanders in the encounter. Based on an inviting approach, the children’s perceptions of their situation were requested while the items were explored. This resulted in involving the children in the conversations. In the engaging approach, an open dialogue and a common interpretation were sought to guide further care which was interpreted as children becoming actively involved.

    Conclusions: The child’s involvement could be facilitated depending on which approach is being used. When an inviting and engaging approach is used, actions in a non-linear set of interactions is co-produced with the child.

    Relevance to practice: The use of an HRQOL assessment tool change the management during consultations and could promote child involvement dependent on which approach the healthcare professionals are using.

  • 121.
    Petersson, Christina
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD. Högskolan i Jönköping, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare.
    Simeonsson, Rune J.
    Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD.
    Enskär, Karin
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD.
    Huus, Karina
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD.
    Comparing children's self-report instruments for health-related quality of life using the International Classification of Functioning, Disability and Health for Children and Youth (ICF-CY)2013Inngår i: Health and Quality of Life Outcomes, ISSN 1477-7525, E-ISSN 1477-7525, Vol. 11, nr 1, s. 1-10, artikkel-id 75Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Children with chronic conditions often experience a long treatment which can be complex and negatively impacts the child's well-being. In planning treatment and interventions for children with chronic conditions, it is important to measure health-related quality of life (HrQoL). HrQoL instruments are considered to be a patient-reported outcome measure (PROM) and should be used in routine practice. Purpose: The aim of this study was to compare the content dimensions of HrQoL instruments for children's self-reports using the framework of ICF-CY. Method: The sample consist of six instruments for health-related quality of life for children 5 to 18 years of age, which was used in the Swedish national quality registries for children and adolescents with chronic conditions. The following instruments were included: CHQ-CF, DCGM-37, EQ-5D-Y, KIDSCREEN-52, Kid-KINDL and PedsQL 4.0. The framework of the ICF-CY was used as the basis for the comparison. Results: There were 290 meaningful concepts identified and linked to 88 categories in the classification ICF-CY with 29 categories of the component body functions, 48 categories of the component activities and participation and 11 categories of the component environmental factors. No concept were linked to the component body structures. The comparison revealed that the items in the HrQoL instruments corresponded primarily with the domains of activities and less with environmental factors. Conclusions: In conclusion, the results confirm that ICF-CY provide a good framework for content comparisons that evaluate similarities and differences to ICF-CY categories. The results of this study revealed the need for greater consensus of content across different HrQoL instruments. To obtain a detailed description of children's HrQoL, DCGM-37 and KIDSCREEN-52 may be appropriate instruments to use that can increase the understanding of young patients' needs.

  • 122. Runeson, I
    et al.
    Enskär, Karin
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD.
    Elander, G
    Hermerén, G
    Professionals' perceptions of children's participation in decision making in healthcare2001Inngår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 10, nr 1, s. 70-78Artikkel i tidsskrift (Fagfellevurdert)
  • 123.
    Runeson, Ingrid
    et al.
    Högskolan i Jönköping.
    Mårtenson, Eva
    Enskär, Karin
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD.
    Children's knowledge and degree of participation in decision making when undergoing a clinical diagnostic procedure2007Inngår i: Pediatric Nursing, ISSN 0097-9805, Vol. 33, nr 6, s. 505-511Artikkel i tidsskrift (Fagfellevurdert)
  • 124.
    Ståhl, Ylva
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD.
    Enskär, Karin
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD.
    Almborg, Ann-Helene
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Institutet för gerontologi.
    Granlund, Mats
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för beteendevetenskap och socialt arbete. Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD. Högskolan i Jönköping, Högskolan för lärande och kommunikation, HLK, CHILD.
    Contents of Swedish school health questionnaires2011Inngår i: British Journal of School Nursing, ISSN 1752-2803, Vol. 6, nr 2, s. 82-88Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim: This study aims to analyse and link the content of the health information requested in questionnaires used locally in Swedish child and school health services. Background: In industrialized countries, children's health needs are changing from physical to psychosocial needs and the questionnaires used for health screening and guiding health promotion must therefore adapt to these changes. Methods: Questionnaires were analysed, together with health items linked to the International Classification of Functioning, Disability and Health for Children and Youth (ICF-CY). The inter-rater agreement for linking was 80%. Standard age groups were used to improve the comparability across different questionnaires. Results: The information requested for the youngest children focused on communication and acquiring language. For the children aged 6 years and above, health questionnaires related to mental functions, the school situation, psychosomatic symptoms and issues associated with taking care of one's health. Conclusions: The information relating to health in questionnaires revealed that interest focused on health items strongly related to the different age groups and to psychosocial health. The focus was the child as a person rather than the child within a family and school environment.

  • 125.
    Ståhl, Ylva
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD.
    Granlund, Mats
    Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD. Högskolan i Jönköping, Högskolan för lärande och kommunikation, HLK, CHILD.
    Andersson-Gäre, Boel
    Högskolan i Jönköping, Hälsohögskolan, HHJ. Kvalitetsförbättringar, innovationer och ledarskap inom vård och socialt arbete. Högskolan i Jönköping, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare.
    Enskär, Karin
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD.
    Mapping of children's health and development data on population level using the classification system ICF-CY2011Inngår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 39, s. 51-57Artikkel, forskningsoversikt (Fagfellevurdert)
    Abstract [en]

    AIM: The aim of this study was to investigate if essential health and development data of all children in Sweden in the Child Health Service (CHS) and School Health Service (SHS) can be linked to the classification system International Classification of Functioning, Disability and Health - Children and Youth (ICF-CY). Method: Lists of essential health terms, compiled by professionals from CHS and SHS, expected to be used in the national standardised records form the basis for the analysis in this study. The essential health terms have been linked to the codes of ICF-CY by using linking rules and a verification procedure. RESULTS: After exclusion of terms not directly describing children's health, a majority of the health terms could be linked into the ICF-CY with a high proportion of terms in body functions and a lower proportion in activity/participation and environment respectively. Some health terms had broad description and were linked to several ICF-CY codes. The precision of the health terms was at a medium level of detail. CONCLUSION: ICF-CY can be useful as a tool for documenting child health. It provides not only a code useful for statistical purposes but also a language useful for the CHS and SHS in their work on individual as well as population levels. It was noted that the health terms used by services mainly focused on health related to body function. This indicates that more focus is needed on health data related to child's functioning in everyday life situations.

  • 126.
    Ståhl, Ylva
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD.
    Granlund, Mats
    Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD. Högskolan i Jönköping, Högskolan för lärande och kommunikation, HLK, CHILD.
    Andersson-Gäre, Boel
    Högskolan i Jönköping, Hälsohögskolan, HHJ. Kvalitetsförbättringar, innovationer och ledarskap inom vård och socialt arbete. Högskolan i Jönköping, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare.
    Enskär, Karin
    Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD.
    Views on health information and perceptions of standardized electronic records among staff in Child and School Health Services2011Inngår i: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 19, nr 2, s. 201-208Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    AIM: To investigate how nurses and physicians in the Child and School Health Services view the documentation and transfer of health information. Another aim concerns their perceptions of a nationally standardized electronic health record.

    BACKGROUND: Problems of mental health among children and adolescents currently pose one of the greatest challenges facing all European countries. The continuity of health work demands that all health information follow the child's development, disregarding the organizational arrangement.

    METHODS: The study was descriptive and comprised 484 questionnaires to nurses and physicians in the Child and School Health Services in Sweden.

    RESULTS: More information about children's health was transferred than documented in the health record when children started school. This additional health information concerned psychosocial health and foremost family function. There was a consensus concerning the usefulness of a nationally standardized electronic health record, although there were group differences between nurses and physicians.

    CONCLUSIONS: All information about children's health is not documented although the professional's positive perceptions to electronic health records may provide a basis to improve documentation.

    IMPLICATIONS FOR NURSING MANAGEMENT: The results indicate challenges to develop a common language to document psychosocial issues necessary for providing a holistic view of children's health.

  • 127.
    Ståhl, Ylva
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD.
    Granlund, Mats
    Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD. Högskolan i Jönköping, Högskolan för lärande och kommunikation, HLK, CHILD.
    Simeonsson, Rune
    University of North Carolina at Chapel Hill, NC, USA.
    Andersson-Gäre, Boel
    Högskolan i Jönköping, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare. Högskolan i Jönköping, Hälsohögskolan, HHJ. Kvalitetsförbättring och ledarskap inom hälsa och välfärd.
    Enskär, Karin
    Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD.
    Psychosocial health information in free text notes of Swedish children's health records2013Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 27, nr 3, s. 616-623Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: High-quality documentation of children’s health is an important priority in health care given trends of declining mental health and reduced well-being in children. There is a lack of information concerning psychosocial health in the standardized part of the national health record in the Child Health Service and the School Health Service in Sweden. Further, little is known if the free text notes in the health record, besides information on physical health, also include information on children’s psychosocial health. The aim of this study was to describe what is recorded concerning children’s health and development in free text notes.

    Methods: The study was based on a retrospective analysis of text using an inductive approach for qualitative analyses of content.

    Results: The analysis of the free text notes in the health records yielded seven categories: development, family, health problems, living habits, medical issues, preschool/school and leisure, and well-being. The categories mainly covered psychosocial aspects of health and were not only about health and development problems of the child but also what was covered during the visits. The information was unevenly distributed across the ages. A stronger focus on the youngest age groups within a family and preschool setting is needed. There was novel information in the free text notes such as pain, general health, emotions, mother’s mental health and leisure activities, which was not covered in the standardized part of the health records.

    Conclusion: The free text notes mainly reflected a psychosocial perspective on health. The findings of this study suggest that requesting more information on children’s psychosocial health in the standardized part of the health records could contribute to more comprehensive and informative health records in the Child health Service and the School Health Service in Sweden.

  • 128.
    Svedberg, Petra
    et al.
    School of Health and Welfare, Halmstad University, Halmstad, Sweden.
    Einberg, Eva-Lena
    Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD. School of Health and Welfare, Halmstad University, Halmstad, Sweden.
    Wärnestål, Pontus
    School of Information Technology, Halmstad University, Halmstad, Sweden.
    Stigmar, Jennie
    Department of Pediatrics, Skåne University Hospital, Lund, Sweden.
    Castor, Anders
    Department of Pediatrics, Skåne University Hospital, Lund, Sweden.
    Enskär, Karin
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD.
    Nygren, Jens M.
    School of Health and Welfare, Halmstad University, Halmstad, Sweden.
    Support from healthcare services during transition to adulthood – Experiences of young adult survivors of pediatric cancer2016Inngår i: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 21, s. 105-112Artikkel i tidsskrift (Annet vitenskapelig)
    Abstract [en]

    PURPOSE:

    Improved survival rates of pediatric cancer have drawn attention on how to best facilitate long-term follow up and transition from pediatric to adult care. The transition process is multifactorial and necessitates the joint involvement of the patient, the family and the healthcare providers. The purpose of this study was to explore the experiences of support from healthcare services during the transition from adolescence to adulthood described by young adult survivors of pediatric cancer.

    METHODS:

    A mixed method with a convergent parallel design was used to evaluate the experiences of receiving support from healthcare services (eg pediatric oncology and pediatric clinic) during transition from adolescence to adulthood described by young adult survivors of pediatric cancer (n = 213) in a nation wide cross-sectional survey.

    RESULTS:

    A quantitative assessment of the experienced extent and satisfaction of support from healthcare services to handle physical, mental and social changes to continue life after the disease showed that a majority of the participants had received insufficient support. The qualitative analysis indicated a need for equal roles in healthcare to promote participation, a need to manage and process consequences of the disease, and a need for continuous support.

    CONCLUSIONS:

    During transition to adulthood, there's a need for a personalized care plan that takes a holistic approach towards supporting the young cancer survivor in managing life in the best way. Identifying and handling the individual needs of pediatric cancer survivors is important for providing the resources and support required to increase the likelihood of successful transition to adulthood.

  • 129. von Essen, L
    et al.
    Enskär, Karin
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD.
    Important aspects of care and assistance for siblings of children treated for cancer: a parent and nurse perspective2003Inngår i: Cancer Nursing, ISSN 0162-220X, E-ISSN 1538-9804, Vol. 26, nr 3, s. 203-210Artikkel i tidsskrift (Fagfellevurdert)
  • 130. von Essen, L
    et al.
    Enskär, Karin
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD.
    Haglund, K
    Hedström, M
    Skolin, I
    Important aspects of care and assistance for children 0-7 years of age being treated for cancer: Parent and nurse perceptions.2002Inngår i: Supportive Care in Cancer, ISSN 0941-4355, E-ISSN 1433-7339, Vol. 10, nr 8, s. 601-612Artikkel i tidsskrift (Fagfellevurdert)
  • 131. von Essen, L
    et al.
    Enskär, Karin
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD.
    Kreuger, A
    Larsson, B
    Sjödén, PO
    Self-esteem, depression and anxiety among Swedish children and adolescents on and off cancer treatment2000Inngår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 89, nr 2, s. 229-236Artikkel i tidsskrift (Fagfellevurdert)
  • 132. von Essen, L
    et al.
    Enskär, Karin
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD.
    Skolin, I
    Important aspects of care and assistance for parents of children, 0-18 years of age, on or off treatment for cancer: Parent and nurse perceptions.2001Inngår i: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 5, nr 4, s. 254-264Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Important aspects of care and assistance for parents of children (0–18 years) diagnosed with cancer were investigated. Parents (N=114) and nurses (N=121) were asked the following questions: ‘What caring aspects are important for you/the parent to feel cared for?’ and ‘What help, if any, do you/the parent need outside the hospital?’ Nurses were asked to answer for a certain parent. Data were analyzed by content analysis. The following aspects of care were identified: accessible care, clinical competence, continuity, emotional support, information, participation in care, participation in decision making, physical ambience, shift in parenting roles, social competence, temporary assistance, own child is well cared for, and time. Most parents mentioned the importance of social competence and information, most nurses mentioned the importance of information and emotional support. The following aspects of assistance were identified: accessible care, emotional support, financial support, instrumental support, and support to live a normal family/social life. A third of the parents and a fourth of the nurses were of the opinion that the parent did not need any assistance. Most parents who mentioned a need of assistance mentioned a need for emotional and instrumental support. Most nurses mentioned a parental need for emotional support and accessible care.

  • 133.
    Wu, Xi Vivien
    et al.
    Högskolan i Jönköping, Hälsohögskolan. Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore.
    Enskär, Karin
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD.
    Heng, D. G. N.
    Nursing Education, National University Hospital, Singapore.
    Pua, L. H.
    Department of Education and Practice, Nursing Service, Tan Tock Seng Hospital, Singapore.
    Wang, W.
    Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore.
    The perspectives of preceptors regarding clinical assessment for undergraduate nursing students2016Inngår i: International Nursing Review, ISSN 0020-8132, E-ISSN 1466-7657, Vol. 63, nr 3, s. 473-481Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    AIM: To explore the perspectives of preceptors about clinical assessment for undergraduate nursing students in transition to practice.

    BACKGROUND: The assessment of clinical competence is a complex process due to the diverse nature of nursing practice. As such, nurse preceptors play a crucial role in clinical assessment for nursing students. Although preceptors may enjoy the process of clinical teaching and assessment, they face challenges that need to be addressed to facilitate students' clinical learning and assessment.

    METHODS: An exploratory qualitative approach was adopted. A purposive sample of 17 preceptors from two tertiary hospitals in Singapore was recruited to participate in three focus group discussions from March to July 2014.

    FINDINGS: Five themes emerged from the data analysis: the need for a valid and reliable clinical assessment tool; meaningful reflection and feedback; varied methods in clinical assessment; high level of commitment and struggles with dual roles and the need to enhance the support system for preceptors.

    CONCLUSIONS: There is no doubt that a valid and reliable clinical assessment tool can serve as a guide for preceptors to enhance their clarity in assessment and feedback. It is essential for all stakeholders to be involved in the development of the clinical assessment tool. Workload, time, support system and formal educational programmes for preceptors influenced their preparation and self-confidence.

    IMPLICATIONS FOR NURSING AND/OR HEALTH POLICY: The themes that emerged from the focus group discussions could assist in the development of a more reliable and valid clinical assessment tool to evaluate the clinical competence of nursing students in transition to practice. Clinical and educational institutions could collaborate closely to develop an educational programme and a preceptorship handbook, focusing on pedagogical contents for clinical education and assessment.

  • 134.
    Wu, Xi Vivien
    et al.
    Högskolan i Jönköping, Hälsohögskolan. Alice Centre for Nursing Studies, Singapore.
    Enskär, Karin
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD.
    Lee, Cindy Ching Siang
    Alice Centre for Nursing Studies, Singapore.
    Wang, Wenru
    Alice Centre for Nursing Studies, Singapore.
    A systematic review of clinical assessment for undergraduate nursing students2015Inngår i: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 35, nr 2, s. 347-359Artikkel, forskningsoversikt (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: Consolidated clinical practicum prepares pre-registration nursing students to function as beginning practitioners. The clinical competencies of final-year nursing students provide a key indication of professional standards of practice and patient safety. Thus, clinical assessment of nursing students is a crucial issue for educators and administrators.

    OBJECTIVE: The aim of this systematic review was to explore the clinical competency assessment for undergraduate nursing students.

    DATA SOURCES: PubMed, CINAHL, ScienceDirect, Web of Science, and EBSCO were systematically searched from January 2000 to December 2013.

    METHODS: The systematic review was in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Published quantitative and qualitative studies that examined clinical assessment practices and tools used in clinical nursing education were retrieved. Quality assessment, data extraction, and analysis were completed on all included studies.

    RESULTS: This review screened 2073 titles, abstracts and full-text records, resulting in 33 included studies. Two reviewers assessed the quality of the included studies. Fourteen quantitative and qualitative studies were identified for this evaluation. The evidence was ordered into emergent themes; the overarching themes were current practices in clinical assessment, issues of learning and assessment, development of assessment tools, and reliability and validity of assessment tools.

    CONCLUSION: There is a need to develop a holistic clinical assessment tool with reasonable level of validity and reliability. Clinical assessment is a robust activity and requires collaboration between clinical partners and academia to enhance the clinical experiences of students, the professional development of preceptors, and the clinical credibility of academics.

  • 135.
    Wu, Xi Vivien
    et al.
    Högskolan i Jönköping, Hälsohögskolan. Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
    Enskär, Karin
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD.
    Pua, Lay Hoon
    Department of Education and Practice, Nursing Service, Tan Tock Seng Hospital, Singapore.
    Heng, Doreen Gek Noi
    Nursing Education, National University Hospital, Singapore.
    Wang, Wenru
    Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
    Clinical nurse leaders’ and academics’ perspectives on clinical assessment of final-year nursing students: a qualitative study2017Inngår i: Nursing and Health Sciences, ISSN 1441-0745, E-ISSN 1442-2018, Vol. 19, nr 3, s. 287-293Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The nature of nursing practice is diverse; therefore, clinical assessment is a complex process. This study explores the perceptions of clinical nurse leaders and academics on clinical assessment for undergraduate nursing education during transition to practice. An explorative qualitative approach was applied. Eight nurse managers, six clinical nurse educators, and eight academics from two tertiary hospitals and a university in Singapore participated in four focus group discussions. Thematic analysis was conducted. Four overriding themes were revealed: the need for a valid and reliable clinical assessment tool, preceptors' competency in clinical assessment, challenges encountered by the students in clinical assessment, and the need for close academic and clinical collaboration to support preceptors and students. Closer academic-clinical partnership is recommended to review the clinical education curriculum. Clinical and educational institutions need to work closely to design a learning program to enhance preceptors' competence in clinical pedagogy and assessment. Furthermore, a stress management program could build students' resiliency in coping with unfamiliar clinical environments. Ongoing support needs to be provided for both preceptors and students to enrich the preceptorship and learning experiences.

  • 136.
    Wu, Xi Vivien
    et al.
    Högskolan i Jönköping, Hälsohögskolan. National University of Singapore.
    Enskär, Karin
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD.
    Pua, Lay Hoon
    Tan Tock Seng Hospital, Singapore.
    Heng, Doreen Gek Noi
    National University Hospital, Singapore.
    Wang, Wenru
    National University of Singapore.
    Development and psychometric testing of Holistic Clinical Assessment Tool (HCAT) for undergraduate nursing students2016Inngår i: BMC Medical Education, ISSN 1472-6920, E-ISSN 1472-6920, Vol. 16, s. 1-9, artikkel-id 248Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background:A major focus in nursing education is on the judgement of clinical performance, and it is a complexprocess due to the diverse nature of nursing practice. A holistic approach in assessment of competency is advocated.Difficulties in the development of valid and reliable assessment measures in nursing competency have resulted in thedevelopment of assessment instruments with an increase in face and content validity, but few studies have testedthese instruments psychometrically. It is essential to develop a holistic assessment tool to meet the needs of the clinicaleducation. The study aims to develop a Holistic Clinical Assessment Tool (HCAT) and test its psychometric properties.

    Methods:The HCAT was developed based on the systematic literature review and the findings of qualitative studies.An expert panel was invited to evaluate the content validity of the tool. A total of 130 final-year nursing undergraduatestudents were recruited to evaluate the psychometric properties (i.e. factor structure, internal consistency and test-retestreliability) of the tool.

    Results:The HCAT has good content validity with content validity index of .979. The exploratory factor analysis revealsa four-factor structure of the tool. The internal consistency and test-retest reliability of the HCAT are satisfactory withCronbach alpha ranging from .789 to .965 and Intraclass Correlation Coefficient ranging from .881 to .979 for the foursubscales and total scale.

    Conclusions:HCAT has the potential to be used as a valid measure to evaluate clinical competence in nursingstudents, and provide specific and ongoing feedback to enhance the holistic clinical learning experience. In addition,HCAT functions as a tool for self-reflection, peer-assessment and guides preceptors in clinical teaching and assessment.

  • 137.
    Wu, Xi Vivien
    et al.
    Högskolan i Jönköping, Hälsohögskolan. Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore.
    Wang, Wenru
    Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore.
    Pua, Lay Hoon
    Department of Education and Practice, Nursing Service, Tan Tock Seng Hospital, Singapore.
    Heng, Doreen Gek Noi
    Nursing Education, National University Hospital, Singapore.
    Enskär, Karin
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD.
    Undergraduate nursing students' perspectives on clinical assessment at transition to practice2015Inngår i: Contemporary Nurse: health care across the lifespan, ISSN 1037-6178, E-ISSN 1839-3535, Vol. 51, nr 2-3, s. 272-285Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: Assessment of clinical competence requires explicitly defined standards meeting the national standards of the nursing profession. This is a complex process because of the diverse nature of nursing practice.

    OBJECTIVES: To explore the perceptions of final-year undergraduate nursing students regarding clinical assessment at transition to practice.

    METHODS: An exploratory qualitative approach was adopted. Twenty-four students participated in three focus group discussions. Thematic analysis was conducted.

    FINDINGS: Five themes emerged: the need for a valid and reliable clinical assessment tool, the need for a flexible style of reflection and specific feedback, the dynamic clinical learning environment, students' efforts in learning and assessment, and the unclear support system for preceptors.

    CONCLUSIONS: Workload, time, resource availability, adequate preparation of preceptors, and the provision of valid and reliable clinical assessment tools were deemed to influence the quality of students' clinical learning and assessment. Nursing leadership in hospitals and educational institutions has a joint responsibility in shaping the clinical learning environment and providing clinical assessments for the students.

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