Ann Karin Helgesen

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.

Aim: This study explores the perspectives of nurses and informal carers regarding the implementation and use of the Carer Support Needs Assessment Tool Intervention (CSNAT-I) in palliative cancer care. Background: Carers play a crucial role in supporting patients with serious illnesses, yet their own support needs often remain unmet. The CSNAT-I was developed to systematically assess, address, and follow up on the needs of carers, aiming to enhance support for them. Method: Semi-structured interviews were conducted with three oncology nurses (via telephone with detailed field notes) and one focus group with four palliative-care nurses, alongside five carer interviews. Data were collected between January and March 2021, with all carer interviews and the focus group audio-recorded and transcribed verbatim. Data were analysed using content analysis, and the study adhered to COREQ reporting guidelines. Results: Although nurses acknowledged the importance of supporting carers, the integration of CSNAT-I was hindered by time constraints, unclear implementation processes, and limited understanding of its purpose. Both nurses and carers preferred ongoing dialogue and relational continuity over structured assessments. The CSNAT-I was often perceived as a conversation starter rather than a tool to guide support systematically. While some carers received practical help after the assessment conversation, they did not necessarily associate this support with the CSNAT-I. Conclusion: The study highlights key challenges with the CSNAT-I, such as issues related to timing, workload pressures, and limited awareness of its intended purpose. Carers emphasised the importance of continuous support and consistent contact points with healthcare professionals rather than relying solely on structured assessments. While CSNAT-I appears to play a valuable role in legitimising time spent with carers, its full potential is likely to be realised better if it is embedded within person-centred pathways that include clear strategies for implementation and follow-up.

Background/Objectives: The objective of the study was to explore experiences related to ad hoc ethical reflection and how ethical reflection might be structured. There has been limited research on the topic in the context of nursing homes and health care centres. Reflection is an ongoing practice in healthcare, often linked to problem-solving and clinical decision-making. Methods: The study has an exploratory design with a qualitative approach. The researchers conducted four group interviews. The data were analysed with systematic text condensation, which entails condensing meaning units following development of code groups. Results: When health care workers (registered nurses, auxiliary nurses, or care workers) encounter ethical uncertainty or ethical issues, they may perceive these situations as challenging. Occasionally, they take the initiative to conduct ad hoc ethical reflection, where they discuss different perspectives and make decisions collectively. Hence, ethical reflection contributes to collaboration. The structure of ad hoc ethical reflection appears to be shaped by two key components: problem-solving and consensus-building, while also addressing, to some extent, the values involved. Furthermore, ethical reflection often led to health care workers supporting each other. Conclusion: Ad hoc ethical reflection can improve decision-making and foster moral awareness among nursing home health care workers. Moreover, the study identifies a need to implement practices of ad hoc ethical reflection through training programs, such as simulation training. Future research, preferably observational, may provide deeper insight into the prerequisites, structure and performance of ad hoc ethical reflection, and how its conclusions are implemented.

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.

Aim: To explore experiences of how the COVID‐19 pandemic affected nurse educators’ teaching in Indonesian contexts. Background: The shift to online teaching during the COVID‐19 pandemic affected the educational system and teaching in higher education institutions worldwide. The transition to online teaching highlighted that many educators were not sufficiently prepared, skilled and equipped to cope with online teaching. This study might add knowledge to the body of literature on innovative teaching methods. Methods: A total of 29 Indonesian nurse educators answered an open‐ended question regarding their experience of online teaching and its consequences during COVID‐19. The data were analysed using qualitative content analysis. Results: The transition from a conventional face‐to‐face educational system to online teaching had both negative and positive effects for the nurse educator role. Challenges during their daily work were worries and difficulties in assessing students’ learning outcomes and how to practise nursing skills and simulate nursing interventions. The nurse educators developed their teaching skills and digital literacy. They also became more conscious of their responsibility to activate all students. Conclusion: The transition to online teaching represents a paradigm shift that implies that nurse educators need to develop their online teaching competencies. However, not all aspects of the nursing curriculum can be covered by online teaching. How online teaching can contribute to and develop sustainable nursing education in the future needs to be discussed at a global level.

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.

Bakgrunn: Barn er blant de største pasientgruppene som vurderes på legevakt. Tidlig gjenkjenning av forverring i helsetilstand er mer komplisert hos barn enn hos voksne. Det foreligger lite forskning om bruk av kartleggingsverktøyet Pediatrisk tidlig varslingsskår (Pevs) på legevakt. Hensikt: Å kartlegge sykepleieres bruk av Pevs på legevakt. Resultater: Resultatene viser at Pevs er et nyttig verktøy i vurdering av syke barn på legevakt. Pevs bidrar til systematikk, standardisering, kontinuitet og tidlig identifisering av forverring hos barn. Pevs kan understøtte kliniske observasjoner og vurderinger, men sykepleierne må også bruke klinisk skjønn og ha kunnskap for å klare å fange opp endringer som ikke reflekteres i Pevs skår. Resultatene viser også at flertallet av sykepleierne ønsker mer opplæring, og at legene bør inkluderes i opplæringen. Konklusjon: Pevs er et nyttig verktøy og det er behov for mer opplæring i bruk av verktøyet for å sikre god samhandling og øke pasientsikkerheten.