Tore Wentzel-Larsen

Early intervention can reduce the burden of internalising problems for children and adolescents, yet access remains limited. The field must ensure preventive interventions that are both durable and...

The transition to parenthood is associated with psychological, emotional, and social changes (Allan et al., 2013; Luciano et al., 2022). From a family-system perspective, individual experiences dur...

Aims: Insomnia is an independent risk factor for coronary artery disease (CAD). Persistent sleep difficulties after percutaneous coronary intervention (PCI) may hinder recovery, however, studies investigating factors contributing to insomnia in a longitudinal perspective are scarce. Therefore, we aimed to describe and determine: (i) the prevalence of insomnia symptoms in women and men with CAD after PCI; (ii) changes in insomnia symptoms scores over time and (iii) the association between insomnia symptoms, self-reported health status and individual factors 2-, 6- and 12 months post-PCI. Methods and results: Large-scale, prospective, multicentre cohort study on patients after PCI ( N = 3,417). Patient-reported outcomes for all included patients were collected during index hospitalization after PCI prior to hospital discharge and 2-, 6-, and 12-months post-PCI (T0-T3 respectively). Insomnia symptoms were assessed with the Minimal Insomnia Symptom Scale, and self-reported health status with RAND-12 and the Seattle Angina Questionnaire. Clinical characteristics were collected from The Norwegian Registry of Invasive Cardiology and patients’ medical records. The prevalence of insomnia symptoms was high (women 47% vs. men 28%) at T0 ( p < 0.001) and remained at similar levels (T1-T3). Reduced mental health in men ( p < 0.001, T1, T2 and T3) and women ( p = 0.002 (T1), p = 0.005 (T2) and p = 0.040 (T3)) and physical health in women ( p = 0.032 (T2) and p = 0.016 (T3)) were significantly associated with more severe insomnia symptoms. Moreover, insomnia symptoms at previous timepoints were associated with insomnia symptoms at later timepoints for both sexes ( p < 0.001 for all comparisons). Conclusion: Insomnia symptoms are highly prevalent following PCI, particularly among women, persisting over time, and related to poorer mental health in men and women. Greater attention should be directed toward early screening and targeted sleep interventions in both sexes.

Peritraumatic reactions during sexual assault are central to societal rape stereotypes and may play a role in post-trauma mental health. Nevertheless, existing research is limited. In this cross-sectional study, we explored a broad spectrum of emotional, cognitive, and behavioural peritraumatic reactions and investigated their associations with assault characteristics, sexual assault history, and symptoms of post-traumatic stress and depression/anxiety. Recent sexual assault victims (N = 425, 96% female, M = 26.20 years old) completed a 23-item peritraumatic reactions questionnaire developed in collaboration with lived-experience experts. Exploratory factor analysis (EFA) was employed to identify latent peritraumatic reaction factors. Associations between factor scores, various assault characteristics, history of sexual assault, and current symptoms of post-traumatic stress and depression/anxiety were assessed with t-tests, ANOVA, correlations and linear regressions. EFA revealed six factors: Dissociation & freeze, Cognitive strategies & thought processes, Active defense behaviour, Negative emotions, Perceived life threat, and Reactive surrender. Feelings of helplessness and non-active behavioural responses, captured by the Dissociation & freeze and the Reactive surrender factors, were much more pronounced than active resistance. Perpetrator strategies involving threats and physical violence were related to higher levels of most peritraumatic reactions, apart from Dissociation & freeze. A closer victim-perpetrator relationship was associated with lower perceived life threat, whereas a history of sexual assault was associated with higher levels of Reactive surrender. All factors except Cognitive strategies & thought processes and active defense behaviour were positively correlated with post-traumatic stress and depression/anxiety symptoms, even when controlling for assault characteristics and sexual assault history. These findings highlight the heterogeneity of peritraumatic responses and challenge rape stereotypes of the actively resisting victim by identifying reactive surrender as a common survival strategy. The robust associations between diverse peritraumatic reactions and post-trauma mental health propose these acute responses as vital clinical indicators for post-trauma adjustment.

While disclosure of sexual and physical violence is crucial for providing support to violence-exposed individuals, many delay or abstain from disclosing to others. Research has examined various factors associated with disclosure, but often with a focus on either childhood or adulthood violence by specific perpetrators. This study utilized data from a telephone survey conducted with a Norwegian population-based sample of individuals aged 18 to 74 years ( N = 4,299) exposed to lifetime forcible rape ( n = 337) and severe physical violence in adulthood ( n = 1,626). We aimed to examine associations between a wide range of violence characteristics (age at onset, fear of severe injury or death, and relationship to the perpetrator) and interpersonal factors (trauma-related shame and perceived social support), and disclosure of (a) forcible rape and (b) severe physical violence was analyzed separately. Descriptive analyses showed that 81% of individuals exposed to forcible rape and 91% of those exposed to severe physical violence had disclosed to someone. Adjusted logistic regression analyses indicated that higher levels of perceived social support, and particularly fear of severe injury or death, were significantly associated with higher odds of disclosure of both sexual (Odds ratio [OR] = 7.66, 95% confidence interval [CI] [3.49, 19.40], p < .001) and severe physical violence (OR = 2.32, 95% CI [1.50, 3.69], p < .001). A close relationship to the perpetrator and older age at onset were significantly associated with increased odds of disclosing severe physical violence, but not for forcible rape. Although differences were observed between specific violence characteristics and interpersonal factors and the disclosure of sexual and physical violence, the overarching similarities indicate the presence of shared pathways to disclosure that may enhance the well-being and recovery of individuals impacted by interpersonal violence. Broadening public perceptions of violence beyond physical, and often more “stereotypical,” violence may help foster environments where individuals feel safe to disclose.

Introduction: Sexual Assault Centers (SACs) were established in several countries to improve access to more specialized and comprehensive services for people exposed to sexual assault. Although previous studies indicate that patients overall are satisfied with the service, there is limited knowledge about which factors are essential for a positive patient experience. This study investigated the associations between patient experiences of interpersonal care during the initial acute phase of care at Norwegian SACs and system-, service-, and individual-level characteristics. Methods: In a non-probability sample of N = 247 SAC patients (99% female, mean age 25,95 years, SD 8.02), we used linear regression analyses to investigate whether patient experience was associated with system level characteristics (e.g. size, turnover and follow-up routines), service level characteristics (e.g. shared decision-making and follow-up routines) and with patient and assault characteristics (e.g. age, victimization history, relationship to the perpetrator). Results: Results indicate that patients reported overall positive experiences with the centers at the acute consultation, as measured by a seven-item composite patient-experience scale. Mean scores for the seven patient experience items were high (4.25–4.46 on a 1–5 scale), with low variability across items (SD 0.82–0.93) and an overall mean score of 4.39. Patient experience with SAC was significantly associated with service-level factors: patients’ perception of having enough time to talk to the staff, being involved in choosing which examinations to carry out and receiving a follow-up appointment. No significant associations were found with system or individual level characteristics. Conclusion: Based on the specific patient experience items used in this study, the findings suggest that sufficient time for consultations, involvement in decision-making, and follow-up were associated with how patients perceived their care at SACs.

Sexual assault can lead to long-term health problems, yet many victims do not seek help from sexual assault centers. This cross-sectional observational study examined factors distinguishing help-seekers from non-help-seekers and identified factors related to concerns about help-seeking in non-help-seekers. A sample of 669 recent sexual assault victims (97.5% women; mean age 26) was recruited from sexual assault centers and social media; 251 had attended a sexual assault center and 418 had not. Multiple logistic regression was used to identify factors differentiating help-seekers and non-help-seekers. Logistic regressions identified factors associated with help-seeking, and ordinal logistic regressions examined factors related to 3 types of concerns among non-help-seekers: concerns about the incident, about the health service, and about potential negative consequences. Victims of assaults consistent with the rape stereotype (completed penetration, unknown perpetrator) were more likely to seek help. Among non-help-seekers, concerns about seeking help at a SAC were prevalent (34%-65%), while few felt they had no need (11.5%). Physical violence (OR = 0.33, 95% CI = 0.20-0.52) and higher age (OR = 0.97, 95% CI = 0.95-1.00) were linked to fewer incident-related concerns; penetration (OR = 1.73, 95% CI = 1.10-2.72) and highaer age (OR = 0.97, 95% CI = 0.94-0.99) to fewer service-related concerns; and physical violence (OR = 1.85, 95% CI = 1.18-2.90), penetration (OR = 1.95, 95% CI = 1.26-3.02), and social support (OR = 1.82, 95% CI = 0.68-0.99) to fewer concerns about negative consequences. Public information efforts highlighting the benefits of post-assault healthcare, especially for younger victims and those experiencing less stereotypical assaults, may encourage help-seeking. Support from family and friends may play an important role in victims’ decisions about seeking help.

Aims: Patients with heart failure (HF) have increased risk of sudden cardiac death, and treatment with an implantable cardioverter defibrillator (ICD) has become standard treatment for selected patient groups. HF is associated with impaired quality of life (QoL), but studies on QoL in patients with HF and ICD attending follow-up in outpatient HF clinics is sparse. Hence, this study aimed to determine QoL over time in patients with HF with and without ICD using data from the first visit (baseline) and follow-up visit in 42 outpatient HF clinics. Methods and results: Longitudinal real-world data from the National Norwegian Heart Failure Registry including 9274 patients, of which 1206 with ICD, were studied. QoL was assessed using the Minnesota Living with Heart Failure Questionnaire. Patients with ICD were younger, more often men, and had a higher frequency of coronary artery disease (all P < 0.001). At the first visit, no significant difference in QoL was found between patients with HF with and without ICD, and both groups had significant improvement in QoL from the first to the follow-up visit (P < 0.001). However, patients with HF and ICD reported significantly less improvement (P < 0.001). Conclusion: QoL in patients with ICD improves after follow-up in an outpatient HF clinic, although not to the same extent as in patients without ICD. Thus, tailored interventions through a combined HF-ICD care programme are needed to improve QoL in this subgroup of patients with both HF and ICD.

Background: Integrating evidence‐based interventions in services by midwives and public health nurses (PHNs) has the potential to improve public health. Attitudes and individual readiness to change can influence the implementation of evidence‐based interventions, but there is limited research in community nursing and maternity and child health care services (MCHCs). Aims: To examine attitudes toward evidence‐based practice and readiness to change in midwives and PHNs in MCHCs before implementing the “Mamma Mia” intervention (an evidence‐based intervention to improve maternal mental health). Methods: A survey‐based, multisite cross‐sectional study following the STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) guideline. Data were collected from 190 midwives and PHNs from 42 MCHCs across 33 municipalities in Norway (2021–2022). Six subscales of the Evidence‐Based Practice Attitude Scale (EBPAS) assessed attitudes toward evidence‐based practice, and the Brief Individual Readiness for Change Scale (BIRCS) measured individual readiness. Descriptive and inferential statistics using frequency tables, Pearson correlation coefficient, and linear regression were used for data analysis. Open‐ended responses were analyzed using content analysis. Results: Sixty‐five midwives and 125 PHNs completed the baseline survey (mean age 46.8, all female). Mean EBPAS subscales scores were 2.99 to 3.58 (SD = 0.46–0.77) mean BIRCS score was 3.16 (SD = 0.49) (possible range 0–4). Scores were slightly higher than typically reported in clinical settings, with no significant differences based on demographics (all p ‐values ≥ 0.166). EBPAS subscores and the BIRCS score showed a moderate positive association. The most frequently reported positive factors influencing readiness were “enhanced care and positive gain” (42.6%), “organizational support” (26.3%), and “receiving training and implementation support” (23.2%). Negative factors included “time constraints and workload” (58.4%), and “research participation and implementation demands” (27.9%). Linking Evidence to Action: Midwives and PHNs showed positive attitudes toward EBP and a high degree of individual readiness. Our findings align with previous research highlighting barriers such as time constraints and workload, offering insights to inform strategies for more effective EBP adoption and implementation. These results can guide nurse managers, administrators, policymakers, professional associations, implementers, and intervention developers in enhancing EBP integration into practice.