Vigdis Abrahamsen Grøndahl

Purpose: The rapid digitalization of healthcare and the increasing implementation of Hospital-at-Home models place new demands on healthcare professionals’ digital competencies. The Nordic Digital Health Education (NorDigHE) program was developed to address these needs through a self-managed, digital and multimodal learning platform. The aim of this study was to evaluate the design of the NorDigHE program regarding usability, the use of simulations and learning games, and participants’ perceptions of other selected learning tools, including podcasts, videos and quizzes. Methods: A quantitative, descriptive study design was applied, targeting level 1 in the Kirkpatrick framework. Data was collected using validated questionnaires assessing usability, educational podcasts, case-based videos, simulations and game-based learning experiences, and online quizzes. Participants included students and healthcare professionals from Denmark, Norway and Sweden who had completed at least two of the five course modules. Data was analyzed using descriptive statistics in line with level 1 in Kirkpatrick’s framework for evaluation of education. Results: In total, 125 participants completed the surveys. Usability scores exceeded the established cut-off value, indicating acceptable to good usability. Podcasts and case-based videos were perceived as relevant and supportive of learning, with consistently positive item-level ratings. Simulations and learning games were evaluated as engaging and helpful for applying theory to real-life situations, although some participants reported being insufficiently challenged. Quizzes were primarily perceived as useful for reinforcing understanding and supporting achievement of learning objectives rather than for acquiring new information. Conclusion: The NorDigHE program was perceived as usable and pedagogically coherent digital learning by both students and healthcare professionals. The results support the use of a multimodal and partially gamified design approach in digital health education. Areas for further development include tailoring the level of challenge in simulations to heterogeneous learner groups. Overall, the results provide a foundation for the continued iterative development of the NorDigHE program.

Knowledge of healthcare personnel's experiences with quality in palliative care during the COVID-19 pandemic can contribute to quality improvement. The aim of this study was therefore to investigate healthcare personnel's experiences of palliative care quality by identifying strengths and areas for improvement. This study is part of a Norwegian - Swedish multicenter study (PaQC-C19). In total, 268 participants answered two open-ended questions about strengths and areas for improvement, using the Quality from Patient Perspective instrument for palliative care (QPP-PC). Data was analyzed by qualitative content analysis. The findings showed that healthcare personnel’s endeavor to maintain the palliative care quality during the COVID-19 pandemic. Prerequisites for being able to do this included categories about collaboration, access to resources and support from management. Both strengths and areas for improvement were experienced within these categories. The findings highlighted the importance of systems that support healthcare personnel during pandemics and crises and may be transferred to contexts during ordinary conditions.

Background/Objectives: Workplace violence in the healthcare sector is a growing global concern. Defined as incidents where staff are abused, threatened, or assaulted in work-related contexts, this issue affects over half of healthcare personnel worldwide, with nurses being particularly vulnerable. The consequences are far-reaching, leading to diminished service quality, workforce turnover, reduced healthcare access, and increased costs. Despite its physical and psychological impact, workplace violence remains underreported, especially in its psychological forms, which have historically been underestimated. Methods: This study applies Per Isdal’s typology of violence to analyze incident reports from a hospital setting. By doing so, it offers a structured framework for understanding the multifaceted nature of workplace violence. By categorizing and examining how different forms of violence co-occur and manifest in daily professional interactions, the study aims to contribute to more systematic documentation and theoretical understanding of the field. Results: In total, 247 incidents were analyzed. Physical violence was the most frequently reported type with 167 incidents, followed by psychological violence with 125 cases. Material violence accounted for 28 reports, sexual violence for 10, and latent violence for 4, indicating that physical and psychological aggression dominates the spectrum of workplace violence in this context. Conclusions: The prevalence and complexity of violent incidents targeting healthcare personnel highlight the pressing need for actionable policies and evidence-based interventions that prioritize staff safety and psychological well-being. Establishing clear definitions of violence, alongside fostering a culture of reporting, is essential to create safer and more resilient healthcare environments.

This study protocol outlines the test evaluation of the design of a comprehensive Nordic hospital at home (HaH) digital education program entitled “the Nordic Digital Health and Education” program (NorDigHE). The NorDigHE program aims to prepare healthcare professionals for healthcare provision in a HaH context. The program, developed by a Nordic consortium, spans five modules over 3.5 weeks of full-time study, equivalent to 5 ECTS, and employs various learning tools, eg, text, videos, learning games, and simulations. The design evaluation will involve 120 healthcare students and professionals across Denmark, Norway, and Sweden, focusing on their perceptions and experiences with the different educational tools utilized in the education. To be included in the study, the participants need to have completed at least four semesters of bachelor level studies in medicine, nursing or other registered healthcare professions. Each of the participants will test two of the five modules at their own pace during the design evaluation. Evaluation data will be collected through established instruments measuring student motivation, quiz functionality, videos’ effectiveness, and the educational platform’s usability assessments. The outcomes of this study will be used to refine the education and the learning tools employed. Ultimately, the results will help optimize the structure and contents of the NorDigHE education program, to better prepare healthcare professionals and students with essential skills to navigate the evolving landscape of digital health and remote patient healthcare effectively.

Background/Objectives: There is a rising global demand to educate independent and reflective nurses capable of addressing the evolving needs of healthcare systems and diverse populations. The Indonesian Nursing Act solidifies the professional status of nurses, although challenges persist including discrepancies between practice and educational standards. There is a need to increase the competence of Indonesian nurse educators and their ability to facilitate learning that can strengthen the nursing programs’ quality and improve the nurses’ ability to address various health issues in the population. The aim of the study was to describe the nurse educators’ experiences with developing student-active methods in nursing education in Indonesia. Methods: This study is part of an Erasmus+ project: Capacity Building in Nursing Education in Indonesia (CABNEI). A three-year educational program for nursing educators in Indonesia was developed. The current study used a qualitative, descriptive design with a questionnaire containing four open-ended questions focusing on the educators’ experiences with developing student-active methods and conditions affecting this process. Data were collected between January and November 2022 and analyzed using qualitative content analysis. Results: A total of 32 educators from two universities and two nursing schools in Indonesia participated. The analysis revealed the theme “A change of pedagogical approaches to nursing students’ learning” with three categories: “Setting the stage for pedagogical development in the nursing education”, “From correction to reflection”, and “Factors affecting the educators’ learning process”. Conclusions: The nursing educators’ experiences with developing student-active methods in Indonesia were positive. They reported incorporating additional pedagogical tools into their teaching methods and nursing programs. Management is vital in facilitating active-learning strategies. It is important to foster collaborative opportunities for educators and enhance their pedagogical skills to meet the healthcare system’s evolving needs and society’s demands for sustainable nursing expertise.

Background: Providing quality palliative care during a pandemic was challenging. Both specialist and community healthcare services cared for patients that faced life-threatening illness and who were influenced by the restrictions of the COVID-19 pandemic. Little knowledge has yet been provided on how registered nurses (RNs) experienced the palliative care quality during the COVID-19 pandemic. The aim of this study was to explore RN’s experiences of providing palliative care quality during the COVID-19 pandemic. Methods: This qualitative study had a descriptive design. Semi-structured individual interviews were conducted between November 2021 and January 2022 with 18 RNs who worked in intensive care units in hospitals, dementia care or palliative care units in nursing homes in Norway during the pandemic. Data were analysed by using qualitative content analysis. The study was conducted and reported according to the COREQ’s checklist. Results: Analysis of the data resulted in an overall theme: ‘Striving to achieve control’. This theme comprised six categories: (1) when the toolbox does not fit; (2) protective equipment—social distance and opportunities for closeness; (3) unpredictable workday; (4) the right person to the right assignment at the right time; (5) presence and absence of relatives and friends; and (6) situations that required creativity. RNs had various experiences regarding how the quality of care was perceived; being worse, preserved, or in some cases even better than before the pandemic. Conclusions: The provision of quality palliative care was experienced by RNs as challenging during the pandemic. The pandemic forced them to be creative and to strive for control to provide the best palliative care possible given the situation. The results of this study may contribute to important knowledge for leaders, policy makers and RNs to learn from the COVID-19 pandemic and planning for future pandemics or crises. Especially to optimise factors perceived by RNs to be important for the palliative care quality, related to the specific situation and care context, to include the perspectives of those involved and take into consideration the time perspective of the pandemic.

Background: Despite trends towards greater professionalisation of the nursing profession and an improved public image in certain countries, studies also show that large proportions of the public still do not fully appreciate nurses’ competencies. Mapping differences in the societal and professional recognition of nurses allows for benchmarking among countries. Aim: To investigate the level of societal recognition of the nursing profession in nine European countries, and the level of professional recognition perceived by European nurses themselves; to compare levels of recognition between countries; and to identify influencing factors. Methods: A cross‐sectional study was conducted. Through an online survey, the study surveyed both the general public and nurses from various healthcare settings across nine countries between December 2022 and June 2023. The instrument used was a combination of self‐developed questions on societal and professional recognition, the Work Motivation Scale and an adapted version of the Multidimensional Work Motivation Scale. Data were analysed using SPSS v.29.0, with socioeconomic prestige scores for the public and work environment/work motivation scores for nurses calculated accordingly. Results: A total of 1618 adult citizens and 2335 nurses participated. The public predominantly characterised nurses with attributes such as friendliness, warmth, empathy and compassion. The mean socioeconomic prestige score assigned to nurses was 7.2/10 (SD 1.9), with Portugal having the highest score ( M 7.5/10, SD 2.0) and Norway the lowest ( M 5.8/10, SD 1.4; p < 0.001). Professional recognition experienced by nurses was generally low (54% indicated rather low, 17% very low). Slovenia, the Netherlands and Belgium had slightly higher mean scores (all M 1.4/3) compared to other countries ( p < 0.001). High professional recognition could be predicted for 33% by work environment score (OR = 1.21; 95% CI [1.19–1.24]), work motivation score (OR = 1.02; 95%CI[1.01–1.02]), expertise outside the hospital (OR = 1.57; 95% CI [1.25–1.97]) and work experience (OR = 1.01; 95% CI [1.00–1.02]) corrected for country. Conclusion: The study highlights the need for targeted interventions to improve the professional and public image of the nursing profession while addressing disparities in professional recognition between countries. Longitudinal studies are recommended to monitor changes in public perception and professional recognition among nurses.

Background: Hospitals are complex environments that bring together diverse aspects of technology, society, medicine, and architecture. The aim of this qualitative study was to examine how a hospital design with originally only single bedrooms and technological innovations affect nursing. Methods: Twelve interviews were conducted with registered nurses working in a hospital in Norway. Data were analyzed using conventional content analysis. Results: Results show that a layout with single bedrooms allows nurses to be present and improve patient care, but also complicates patient monitoring, leading to adverse events and patient isolation. Nurses may struggle to find colleagues, experiencing loneliness at work. Additionally, the use of technology, long corridors, and poorly positioned clinical support spaces can contribute to nurses’ mental and physical absence. Conclusions: This study provides knowledge that nurses working in a hospital environment designed with single bedrooms must modify their workflow and communication strategies. Technological advancements are necessary to support nurses’ presence and patient safety, and systems and clinical support spaces must be adequately adapted. Technologically advanced hospitals with only single bedrooms can make nurses feel both present and absent in patient care. This understanding holds significance in practical terms, offering insights to guide future hospital design and nursing practices.

Implementation of pharmaceutical care for the benefit of patients and health services has been highlighted worldwide. Interprofessional collaboration between nurses, pharmacists, and physicians may contribute to raising awareness of pharmacological challenges, increasing quality, and minimising errors in pharmaceutical care. This study aimed to investigate how nurses, pharmacists, and physicians experience interprofessional collaboration in pharmaceutical care within community healthcare in Norway. The study had an explorative and descriptive design with a qualitative approach. Individual interviews were conducted with 12 healthcare personnel with key roles in pharmaceutical care within community healthcare services. The data were analysed using systematic text condensation. The results revealed three categories and four subcategories: The category “Professional challenges” contained the subcategories “Blurred responsibilities” and “The importance of trust and continuity”. The category “Organisational barriers” contained the subcategories “Lack of information exchange and suitable communications channels” and “Lack of time and meeting places”. The third category was “Nurses—the important link”. This study reveals challenges to and factors of success in increasing high-quality and safe pharmaceutical care, knowledge that can be used in quality work in the community health services and as input in curriculum development for the three professions.