Eva Broberger

Symptoms in patients with lung carcinoma: distinguishing distress from intensity.

The patient perspective on distress associated with lung carcinoma is important, yet understudied. Previous research on symptom experience generally had not differentiated the dimension symptom intensity/frequency from which symptoms are associated with most distress. The objective of the current study was to determine whether patterns of symptom intensity were similar to patterns of symptom distress, whether patterns were consistent at different time points, whether patterns varied by subgroups, and whether high symptom intensity was equivalent to distress.

Do internal standards of quality of life change in lung cancer patients

Background: Measurement of health-related quality of life (QOL) over time often yields results that may be difficult to understand. Patients may change their internal standards of QOL as a result of adaptation to deteriorating health, a phenomenon referred to as response shift. Objectives: To examine changes in internal standards of fatigue, global health/QOL, and physical function in patients with inoperable lung cancer at 3 months (n = 115) and 6 months (n = 89) after a baseline measurement close to diagnosis. Significant changes were expected to occur only in patients who reported improvement or deterioration in fatigue and global health/QOL. Methods: Fatigue, global health/QOL, and physical function were assessed with the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ-C30, version 3.0). At follow-up, this questionnaire was administered conventionally and as a retrospective baseline assessment (thentest). Subjective transition questions were used to form mutually exclusive patient subgroups (i.e., deterioration, stable, or improvement). Results: With respect to fatigue, significant changes occurred in patients reporting deterioration at 3 months follow-up and in patients reporting improvement after 6 months, but not in patients reporting improvement after 3 months or deterioration after 6 months. Significant changes in global health/QOL were found in patients reporting improvement at both 3 and 6 months follow-up and unexpectedly in stable patients after 3 months. No significant changes were found in patients reporting deteriorated global health/QOL at 3 and 6 months. Unexpectedly, changes occurred at both 3 and 6 months in patients reporting improved physical function. Discussion: Given these mixed findings, it cannot be concluded that changes in internal standards occurred. These severely ill patients reported high levels of symptoms at baseline and may in part have adapted to their symptoms before study entry.

Documentation of Nursing Care in Advanced Home Care

Nursing documentation in advanced home care (AHC) is essential in communication between nurses and interprofessionally for evaluation of patient care. Poor documentation could be a threat to high quality care and patient safety. The aim of this study was to describe documentation of nursing care within AHC. Sixty nursing records from two AHC-units in Sweden were collected and a content analysis was performed. The results revealed documentation from a broad spectrum of advanced nursing care, consisting of both planned and acute care. However, the documentation was often fragmented and information sometimes hard to find. Nursing documentation often described caring needs, but lacked interventions and evaluations. Further development and research on nursing documentation and its connection to evidence-based practice within AHC is needed.

It's All Connected! Nursing Students' Experiences of a New Form of Case Seminar Integrating Medical and Nursing Science.

Traditionally, nursing students learn medical subjects and nursing separately, which makes it difficult to develop an integrated understanding. This study aimed to explore nursing students’ experiences of participating in a case seminar integrating medical and nursing sciences and if, and how, it contributed to their learning. A case seminar divided into a ‘laboratory session’ and a ‘follow-up session’ was developed. The case seminar was evaluated by group interviews and an open-ended questionnaire. Forty-four third-year nursing students agreed to participate. Themes of motivation, authenticity, professional development, collaboration and integration were identified. The case seminars help nursing students to integrate medical science with nursing science, which supports them in their professional development and role as registered nurses.

How do medical and nursing students experience emotional challenges during clinical placements

Objectives To investigate which kinds of situations medical and nursing students found emotionally challenging during their undergraduate education, and how they managed their experiences. Methods This study used an exploratory research design. We gathered qualitative data using an open-ended questionnaire distributed to students in the middle and at the end of their education. In total, 49 nursing and 65 medical students participated. Also, five students were interviewed individually to acquire richer data. Data were analysed using narrative thematic analysis. Results Medical and nursing students experienced a range of situations during their undergraduate education that they found emotionally challenging, mainly during clinical placements. The students’ narratives concerned confronting patients’ illness and death, unprofessional behaviour among healthcare professionals, dilemmas regarding patient treatment, students relating to patients as individuals and not diagnoses, and using patients for their own learning. The narratives concerned both the formal and the hidden curriculum, i.e., what is included in the profession (confronting illness and death), and what is not (unprofessional behaviour among healthcare professionals). Students managed their experiences by talking to trusted peers or supervisors, and by getting used to these situations. Conclusions Despite the different knowledge, experiences, and conditions for medical and nursing students, our findings suggest that their experiences of emotional challenges are similar. Support and opportunities to talk about these experiences are important. Teachers, supervisors, and students need to be aware that students might experience emotionally difficult situations, and that the students need time for reflection and support.