Kirsten Frederiksen

Aims: To investigate the effect of nurse-led telephone follow-up (TFU) on medication adherence after screen-detected cardiovascular disease (CVD). Methods and results: We conducted a randomized controlled trial evaluating the effect on adherence of nurse-led TFU at 1, 3, and 6 months, compared with usual care. The primary outcome was medication adherence after 1 year. Secondary outcomes were quarterly point prevalence time after the recommendation. Participants, aged 67 years, were recruited from the Danish Viborg Screening Programme (VISP) cohort between May 2017 and April 2022. Participants (n = 406) with screen-detected abdominal aortic aneurysm, peripheral arterial disease, and/or carotid plaque and recommended anti-platelets and/or lipid-lowering therapy were randomized 1:1 to intervention (n = 202) or control group (n = 204). The intention-to-treat principle was applied. Pearson’s χ2 and logistic regression analysis were used. We found no significant inter-group differences concerning medication adherence after 1 year. Anti-platelet adherence was 59% in the intervention group; 62%, in the control group. Lipid-lowering medication adherence was 70% in both groups. Adjusted analysis showed no intervention effect for lipid-lowering medication [odds ratio (OR): 1.06, 95% confidence interval (CI): 0.69–1.63, P = 0.800] or anti-platelets (OR: 0.93, 95% CI: 0.62–1.39, P = 0.732). No group differences were observed at point prevalence time. We found no association between sex, marital status, occupation, education, smoking, comorbidities, medication use, and adherence after 1 year. Conclusion: Nurse-led TFU did not improve CVD preventive medication adherence compared with usual care; facilitating adherence may require more than phone calls. Further research is needed to tailor interventions to individual adherence barriers. Registration: The study is nested within the VISP study: ClinicalTrials.gov (NCT03395509).

Background: The field of Advanced Practice Nursing (APN) has developed over the past six decades. However, the definition of roles and responsibilities of APN nurses seem to be contested due to both a lack of a clear definition of the concept and to institutional and cultural barriers that restrict the nurses' opportunities to practise to the full extent of their competencies.Aim: The objective of this scoping review was to identify, examine and conceptually map the available literature on APN nurses' core competencies for general health assessment in primary health care.Method: We performed a scoping review, following the methodological guidance for reporting as it is described by the Joanna Briggs Institute (JBI). Furthermore, the PRISMA‐ScR statement and checklist for reporting scoping reviews were followed. Guiding the initial process for the search, we used the Population, Concept and Context mnemonic (PCC) to clarify the focus and context of the review.Results: We found three areas of core competencies on which APN nurse draw in performing general health assessments in primary health care: (1) ‘Collaborative, leadership and management skills’ (2) ‘Person‐centred nursing care skills’ and (3) ‘Academic and educational skills’. Furthermore, we found that the three areas are interrelated, because it is crucial that APN nurses draw on collaborative competencies related to leadership and management to meet the service users' needs and deliver high‐quality and person‐centred care.Conclusion: There is a need for a more specific investigation into how APN nurses' core competencies play a role during general health assessments of patients in primary care. We suggest an evaluation of what works for whom in what circumstances looking into the interrelation between competencies, skills and knowledge when an APN nurse performs a general health assessment in a primary healthcare setting.

Intersectoral collaboration (IC) plays a significant role in the delivery of diabetes care and treatment of patients with type 2 diabetes (DM2), as the treatment and care of these patients take place in both primary care and specialist settings. The collaboration involves a large number of actors from primary and secondary healthcare sectors, who are expected to fulfil various roles when they engage in IC. We explored the actors' roles by applying the framework of positioning theory with the aim of revealing seemingly embedded understandings of such roles. The empirical data consisted of individual and focus group interviews. Our results indicate that naturalised understandings of the roles of actors interact with the way in which health professionals, patients, managers and relatives strive to develop IC that aims to help and guide patients who live with DM2.

Aim and objective: To evaluate evidence that examined nurses' work experiences in hospital wards with single rooms. The research question was ‘What does the research tell us about nurses’ work experiences in hospital wards with single rooms?’Background: In the last decades, new hospital builds have moved towards including a high proportion of single rooms. Yet, single rooms create ‘complex environments’ that impact the nurses.Design: A structured integrative review was undertaken of empirical evidence.Methods: Original, peer‐reviewed articles, written in English, were sourced from four databases: CINAHL, PubMed, Embase and Web of Science. The initial searches were performed in April 2021 and repeated in December 2022. Quality appraisal was undertaken using the Mixed Methods Appraisal Tool. A narrative synthesis approach was used to analyse the data. Reporting was guided by the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) statement.Results: Twelve studies, published between 2006 and 2022, with an international origin, and representing n = 826 nurses, were included in this review. The synthesis revealed mixed perspectives about nurses' work experiences in wards with single rooms. Whilst single rooms are ‘all good in theory (and) a good idea’, the reality was quite different. Synthesised findings are presented in four categories: (i) aesthetics and the physical space, (ii) privacy vs. isolation, (iii) safety, which includes situational awareness and (iv) communication and collaboration.Conclusion: This review describes how single rooms affects nurses' work experience. Whilst nurses shared multiple concerns about single rooms and the challenges they also acknowledged patient preference for the privacy and space afforded by single rooms.Relevance to Clinical Practice: Findings from this review highlight the need for careful planning to maintain and strengthen teamwork, prevent nurses' sense of working in isolation, as well as creating opportunities for mentorship, and collaboration among nurses when working in single‐room settings.

Nowadays, it is common that newly built hospitals are designed with single‐room accommodation, unlike in the past, where shared accommodation was the favoured standard. Despite this change in hospital design, very little is known about how single‐room accommodation affects nurses' work environment and nursing care. This study evaluates how the single‐room design affects nurses and nursing care in the single‐room hospital design. Nurses working in the single‐room design predominantly work alone with little opportunity for peer training, interaction and reflection. In addition, the single‐room design affects the nurses' work environment due to changes in sensory stimulation and increased walking distances. Furthermore, a change in the discourse, namely, regarding the single room as the patient's home, makes the nurses react to queries, demands and tasks in a new way. Overall, the new hospital design forces the nurses into a more reactive role and affect their way of providing nursing care. Despite this, the nurses find single‐room accommodation beneficial for the patients and their nursing care.

Aims and Objectives: Drawing on ethnographic fieldwork exploring various head and neck cancer treatment pathways of patients with low socio‐economic status being treated with radiation therapy in Denmark, our aim was to explore how and why inequality in this treatment pathway might occur in the encounter between these patients and Danish healthcare.Background: In recent years, inequality in cancer treatment of patients with a low socio‐economic status has been a growing concern worldwide. The majority of patients with head and neck cancer have a relatively low socio‐economic status and are at risk of experiencing inequality in their cancer treatment.Design/Methods: Using a method proposed by Robert Yin, we performed a multiple case study of five treatment pathways of patients with a low socio‐economic status. The case studies consisted of participant observations and interviews with patients, relatives and health professionals. We applied Herbert Blumer's theory of symbolic interaction as a framework for our analysis.Results: We identified three concepts that all blocked joint action because patients and health professionals had different perceptions of what interaction required of them in terms of (1) Understanding information; (2) Assuming responsibility for managing practical tasks; and (3) Coordinating one's own treatment pathway.Conclusions: We identified how different situations challenged the patients' abilities to assume participation in their own treatment pathway. In their encounter with patients, healthcare professionals did not know which situational impediments to joint action patients were facing.Relevance to clinical practice: We argue that being aware of how challenges unfold in the interaction with patients with low socio‐economic status may serve as a starting point for changing practice to reduce inequality in the treatment of these patients.Reporting method: This study is reported using consolidated criteria for reporting Qualitative research (SRQR). We used the theory and method of Robert Yin of performing a multi‐case study and we applied Herbert Blumer's theory of Symbolic interactionism as a framework for understanding data.Patient or public contribution: No patient or public contribution.

Ethnic minority patients have been discussed and problematised in Western health literature. Drawing on an interpretation of central parts of the French philosopher Michel Foucault's authorship, we analysed a broad selection of materials to identify mechanisms through which the truth about ethnic minority patients is constructed. We identified a single, yet consistent discursive strategy that we termed ‘figure of inconvenience’ in which ethnic minority patients were classified and assigned a specific subjection illustrating them as ‘inconvenient’ to the nurse's practice. Concurrently, their relatives were afforded the position of substitutes. The discourse exemplifies how the behaviour or appearances of ethnic minority patients cannot be reconciled with the traits of ethnic Danish patients. Finally, we discussed implications that such a strategy may have for the provision of healthcare services for ethnic minority patients in Denmark.