Mari Wolff Skaalvik

Development and Testing of the Norwegian Version of the Clinical Learning Environment, Supervision and Nurse Teacher (CLES+T) Evaluation Scale

Abstract Several instruments have been developed to monitor nursing students’ subjective evaluation of clinical placement. The Clinical Learning Environment, Supervision and Nurse Teacher (CLES+T) evaluation scale measures five dimensions. The purpose of this study was to translate and test the construct validity and internal consistency of the evaluation scale within a Norwegian context. The questionnaire was distributed to all students in four university colleges (n=1229) in 2009 with a response rate of 41.6 % (n=511). Only students from institutional practice settings (n=407) were included in the analysis. The instrument has properties suitable for evaluation also within a Norwegian context, despite some minor differences in factor structure, indicating common underlying properties regarding students’ evaluation of the clinical learning environment and how they rate the premises of nursing on the ward.

The experience of self and threats to sense of self among relatives caring for people with Alzheimer’s disease

This study explored how the relatives of people with Alzheimer’s disease expressed Self 2 and Self 3 according to Harré’s social constructionist theory of selfhood. Having a relative with Alzheimer’s disease affects one’s life. In this study, we concentrated on how close relatives of people with Alzheimer’s disease experienced their sense of self. This study was descriptive and qualitative. Interviews were conducted with 20 relatives of 10 people with Alzheimer’s disease from 2009 to 2011. The data were analysed according to Harré’s social constructionist theory of selfhood including Selves 2 and 3. Participants reported that Alzheimer’s disease challenged their personal attributes, relations and positioning. Understanding how Alzheimer’s disease affects the sense of self among close relatives is important, as this knowledge is pivotal for supporting these relatives who are often informal caregivers in ways that enable a fulfilling and meaningful life.

Decentralized nursing education in Northern Norway: towards a sustainable recruitment and retention model in rural Arctic healthcare services.

Introduction Decentralized nursing education (DNE) was established at Tromsø University College in 1990 and has since become a part of the bachelor programme in nursing at UiT The Arctic University of Norway. The objective of the study was to investigate whether and to what degree the first DNE programme established in Norway has contributed to recruitment and retention of registered nurses (RNs) in rural healthcare services. Methods The quantitative survey took place in 2012. A questionnaire was distributed to 315 former students who had graduated from the DNE programme from 1994 to 2011. Results The primary finding of this study is that the DNE successfully recruits students from rural areas of Northern Norway. Nearly, 87.5% have their first employment in community healthcare services. They continued to work in the rural areas and 85% still worked as nurses in 2012. The DNE programme has been successful regarding recruitment and retention of RNs to community healthcare services. Fifty-six percent have attended a variety of postgraduate programmes. Conclusion The DNE programme demonstrates itself as a successful study model regarding recruitment and retention of RNs to rural and remote areas.

How do people in the early stage of Alzheimer's disease see their future?

Older people fear Alzheimer’s disease. Central to the fear of the disease is the dread of the loss of identity or self. The aim of this study is to investigate the thoughts people in an early stage of Alzheimer’s disease have about their future selves, and the consequences these thoughts have for their temporary lives. The concepts of future and self are understood in terms of the concepts ‘possible selves’ and ‘selfhood’. The participants in the study are two men in their early 60 s. The data consist of four individual interviews and 11 facilitated family conversations including two of their next of kin. The data were collected over a two-year period. The data were interpreted using a hermeneutic analysis inspired by Gadamer. The main findings were the efforts made by the participants to live in the present and their worries about a future as ‘living dead’.

Expressions of Sense of Self Among Individuals With Alzheimer's Disease

Recent research has challenged the previously held view that people with Alzheimer’s disease (AD) lack a sense of self, with several studies demonstrating that the sense of self is partially preserved, even in late stages of AD. The aim of this study was to examine how people with AD express their sense of self (Self 1–3) using the social constructionist theory of selfhood described by Harré (1998). Personal interviews were analyzed deductively. The participants narrated fragments of their life stories and expressed the fear of becoming a burden to family members and of nursing home placement. They expressed Self 1 (personal singularity or personal identity) without any problems, whereas their Self 2 (self-concept) attributes had undergone changes that they had learned to live with. The participants expressed surprisingly few problems with their narratives of Self 3 (social personae), that is, their accounts of interactions with other people. They reported being received positively when they were open about their diagnosis. These results provide further nuances that broaden our understanding of the process of preserving the sense of self, that is, simultaneously being the same and a different person.

Decentralized nursing education in Northern Norway: a basis for continuing education to meet competence needs in rural Arctic healthcare services

Background Ensuring a sufficient nursing workforce, with respect to both number and relevant professional competencies, is crucial in rural Arctic regions in Norway. This study examines the continuing education (CE) of nurses who graduated from a decentralized nursing programme between 1994 and 2011. Objective This study aims to measure the extent to which the decentralized nursing education (DNE) in question has served as a basis for CE that is adapted to current and future community health care service needs in rural Arctic regions in northern Norway. More specifically, the study aims to investigate the frequency and scope of CE courses among the graduates of a DNE, the choice of study model and the degree of employment with respect to the relevant CE. Design This study is a quantitative survey providing descriptive statistics. Results The primary finding in this study is that 56% of the participants had engaged in CE and that they were employed in positions related to their education. The majority of students with decentralized bachelors degrees engaged in CE that was part time and/or decentralized. Conclusions More than half of the population in this study had completed CE despite no mandatory obligation in order to maintain licensure. Furthermore, 31% of the participants had completed more than one CE programme. The findings show that the participants preferred CE organized as part time and or decentralized studies.

Psychometric validation of the Carers of Older People in Europe Index among family caregivers of older persons with dementia

Objectives: The Carers of Older People in Europe Index is a first-stage assessment tool to detect family caregivers in need of support. This instrument assesses caregivers’ subjective perceptions of their caregiving circumstances. The present study examines the psychometric properties of the Norwegian version of the Carers of Older People in Europe Index among family caregivers for older persons with dementia living at home. Methods: Cross-sectional survey data were collected from 430 dementia caregivers. The sample was randomly split as follows: the first half of the sample was used to identify the measurement model using an exploratory factor analysis, and the second half of the sample was used to cross-validate the model using a confirmatory factor analysis. The criterion validity and reliability (internal consistency and test–retest reliability) of the Carers of Older People in Europe Index were also examined. Results: Using an exploratory factor analysis, we extracted three factors that were consistent with previous findings: negative impact of caregiving, positive values of caregiving and quality of support. This model fit the data well using a confirmatory factor analysis. Moreover, a second-order model could replace the three-factor correlated model without sacrificing the model fit, supporting the use of a global impact of caregiving score. The three factors and the global factor correlated with the criteria measures in the expected directions. The internal consistency was assessed using Cronbach’s alpha and was good for the negative impact (α = 0.86) and the quality of support (α = 0.76) factors. The positive values factor was less consistent (α = 0.64). The test–retest reliability was examined using Spearman’s rank order correlation and was good for all three factors. Conclusion: The psychometric properties of the Norwegian version of the Carers of Older People in Europe Index are good. The instrument assesses dementia caregivers’ situations across three primary factors or alternatively validly summarizes the factors in a global impact of caregiving score.

Den gamle kroppen : sykepleierstudenters tanker om eldreomsorg som fremtidig arbeidsplass

Artikkelens hensikt og mal er a beskrive hvordan sykepleierstudenter erfarer at sykepleierutdanningen pavirker deres holdninger til gamle mennesker, og til den kommunale eldreomsorgen som fremtidig arbeidsplass. Studentuttalelsene danner grunnlag for diskusjon om hvordan innholdet i sykepleierutdanningen kan bidra til a utvikle studentenes holdninger til eldreomsorg som karrierevei. Artikkelen er basert pa forsteforfatterens masteroppgave der kvalitative intervjuer ble gjennomfort med fire tredjearsstudenter ved en norsk sykepleierutdanning. I analysen av datamaterialet ble et fenomenologisk- hermeneutisk perspektiv lagt til grunn. Informantene fremhever at geriatri har statt sentralt i undervisningen om gamle, og at perspektivet om kroppen som levd liv ikke oppleves a ha hatt en sentral plass. Informantens utsagn tolkes til at de savner dette perspektivet i undervisningen.