Maria Björk

Student nurses' experiences of the clinical learning environment in relation to the organization of supervision: A questionnaire survey

AIMnThe aim was to investigate student nurses experiences of the clinical learning environment in relation to how the supervision was organized.nnnBACKGROUNDnThe clinical environment plays an essential part in student nurses learning. Even though different models for supervision have been previously set forth, it has been stressed that there is a need both of further empirical studies on the role of preceptorship in undergraduate nursing education and of studies comparing different models.nnnMETHODnA cross-sectional study with comparative design was carried out with a mixed method approach. Data were collected from student nurses in the final term of the nursing programme at three universities in Sweden by means of a questionnaire.nnnRESULTSnIn general the students had positive experiences of the clinical learning environment with respect to pedagogical atmosphere, leadership style of the ward manager, premises of nursing, supervisory relationship, and role of the nurse preceptor and nurse teacher. However, there were significant differences in their ratings of the supervisory relationship (p<0.001) and the pedagogical atmosphere (p 0.025) depending on how the supervision was organized. Students who had the same preceptor all the time were more satisfied with the supervisory relationship than were those who had different preceptors each day. Students comments on the supervision confirmed the significance of the preceptor and the supervisory relationship.nnnCONCLUSIONnThe organization of the supervision was of significance with regard to the pedagogical atmosphere and the students relation to preceptors. Students with the same preceptor throughout were more positive concerning the supervisory relationship and the pedagogical atmosphere.

The process of striving for an ordinary, everyday life, in young children living with cancer, at six months and one year post diagnosis

PURPOSEnHealth care focus is shifting from solely looking at surviving cancer to elements of attention relating to living with it on a daily basis.The young childs experiences are crucial to providing evidence based care. The aim of this study was to explore the everyday life of young children as expressed by the child and parents at six months and one year post diagnosis.nnnMETHODSnInterviews were conducted with children and their parents connected to a paediatric oncology unit in Southern Sweden. A qualitative content analysis of interview data from two time points, six months and one year post diagnosis, was carried out.nnnRESULTSnThe process of living with cancer at six months and at one year post diagnosis revealed the childs striving for an ordinary, everyday life. Experiences over time of gaining control, making a normality of the illness and treatment and feeling lonely were described.nnnCONCLUSIONnNurses have a major role to play in the process of striving for a new normal in the world post-diagnosis, and provide essential roles by giving the young child information, making them participatory in their care and encouraging access to both parents and peers. Understanding this role and addressing these issues regularly can assist the young child in the transition to living with cancer. Longitudinal studies with young children are vital in capturing their experiences through the cancer trajectory and necessary to ensure quality care.

Striving to Make a Positive Difference: School Nurses’ Experiences of Promoting the Health and Well-Being of Adolescent Girls

In Sweden, school nurses are part of the School Health Service with the main objective of health promotion to support students’ health and attainment of educational goals. The aim in this phenomenological study was to illuminate the experiences of school nurses in promoting the health and well-being of adolescent girls. Seventeen school nurses were interviewed, both in groups and individually, to facilitate personal disclosure and expressions from their lived experiences. To achieve their goal of improving the health of adolescent girls, school nurses require flexibility in their approach and in endeavoring to make a positive difference they experience many challenges. This study concluded that school nurses can tactfully provide adolescent girls with knowledge and health guidance adjusted to individual needs and empowering the individual girl to participate in her own health process.

Health and functioning in the everyday lives of young children with cancer: documenting with the International Classification of Functioning, Disability and Health - Children and Youth (ICF-CY)

BACKGROUNDnHealth care focus is shifting for children from surviving childhood cancer to living with it on a daily basis. There is a need to document health and function in the everyday lives of young children with cancer using the multidimensional framework and language of the International Classification of Functioning, Disability and Health--Children and Youth (ICF-CY).nnnAIMSnThe aims of this study were (1) to document health and functioning in the everyday lives of young children with cancer using ICF-CY codes and (2) to identify a comprehensive code set that can aid clinical assessment.nnnMETHODnInterviews with children diagnosed with cancer and their parents, were transcribed, reviewed for content and coded to the ICF-CY using linking procedures.nnnRESULTSnA comprehensive code set (n = 70) for childhood cancer was identified. The majority of content identified to codes was related to activity and participation describing social relations with family, peers and professionals, preschool attendance and play, as well as issues related to support and independence.nnnCONCLUSIONSnThe ICF-CY can be used to document the nature and range of characteristics and consequences of cancer experienced by children. The identified comprehensive code set could be helpful to health care professionals, parents and teachers in assessing and supporting young childrens health and everyday life through the cancer trajectory. The comprehensive code set could be developed as a clinical assessment tool for those caring for young children with cancer. The universal language of the ICF-CY means that the utility of a clinical assessment tool based on identified codes can have wide reaching effects for the care of young children with cancer.

Living an Everyday Life Through a Child’s Cancer Trajectory Families’ Lived Experiences 7 Years After Diagnosis

The aim of this study was to illuminate the lived experiences of families where a child had survived 7 years from a diagnosis of childhood cancer. This article describes one part of an inductive and longitudinal research project that included 17 families. Four families whose child was diagnosed with cancer 7 years previously were interviewed using a hermeneutical phenomenological approach. The families lived experience was described in one essential theme, “Living an everyday life through the child’s cancer trajectory,” further illuminated in 3 related themes: “Leaving the disease behind yet feeling its presence,” “Being the same yet always different,” and “Feeling stronger yet vulnerable.” The results suggest that family members feel vulnerable even if a long period of time has passed since completion of treatment. To varied degrees they still may need support. When moving forward in life, the family members are helped if they can reconcile their memories and experiences derived from the childhood cancer trajectory.

An Analytic Review of Clinical Implications From Nursing and Psychosocial Research Within Swedish Pediatric Oncology

The purpose of this manuscript is to analyze researchers suggestions for clinical implications of their findings as stated in recent published articles on nursing and psychosocial research within the setting of Swedish pediatric oncology. Identified categories included staff awareness of the effects of child illness on families; systems for care improvement; provision of quality of care, education and support; and empowerment of children and families. In order to be able to realize these clinical suggestions, expanded research is needed as well as continued education and support for staff.

A Swedish perspective on nursing and psychosocial research in paediatric oncology: A literature review.

PURPOSEnA dramatic improvement in outcomes of survival rates of childhood cancer has been seen. Caring science research is central in providing skills and knowledge to the health care sector, but few overviews of the content of published research have been carried out. The aim of this review was to investigate the content and methodology of published studies in paediatric oncology relevant to caring science, and also to compare possible differences in content and method of the published studies from the nursing and psychosocial perspectives.nnnMETHODnA systematic literature review was performed of 137 published articles on paediatric oncology relevant to caring science in Sweden.nnnRESULTSnThe results show that most of the studies were descriptive or comparative ones with a quantitative design. Most of them focused on parents (43%) or children (28%). Most of the studies investigated wellbeing (88%), using questionnaires (54%) or interviews (38%). Several different measurement instruments had been used. While the results were often clearly presented, the clinical implications were more diffuse. The most acknowledged research fund was the Swedish Childhood Foundation (75%).nnnCONCLUSIONSnTo reflect the children perspectives in paediatric oncology require that future researchers take on the challenge of including children (even young ones) in research. The use of a limited number of agreed measurement instruments is desirable. The biggest challenge for the future is to make a shift from explorative to intervention studies. There is an urgent need to transform research results into clinical practice.

A literature Review of the Results from Nursing and Psychosocial Research within Swedish Pediatric Oncology

The body of research-based knowledge in paediatric caring science has been increasing leading to dramatic improvements in treatment. The purpose of this manuscript was to analyze results as stated by the researchers, in recently published articles on nursing and psychosocial research, within Swedish pediatric oncology setting. This was done through a review of 137 published articles about paediatric oncology related to caring science in Sweden. The result shows that the illness has affected, in both positive and negative ways, the wellbeing of everyone coming into contact with the child. The cancer also causes distress related to all aspects of life including physical, psychological, existential and social. Mediating factors for the experience of distress and wellbeing are: disease and treatment severity, age, gender and ethnicity of the participant, time since diagnosis, the use of internal and external support, and the identity of the person reporting the data. Health promoting aspects frequently reported are: family togetherness, coping strategies, engaging in normal life and activities, and quality of care which includes emotional support, information and family participation in care. The hospital staff has to be aware of the psychosocial issues experienced by children with cancer and their families, and they have to acknowledge the value of formal interventions, reporting benefits for children, families, and themselves.

Following Young Children’s Health and Functioning in Everyday Life Through Their Cancer Trajectory

Background: Knowledge of living with childhood cancer, through the trajectory, is sparse. Aim: The aim of this study was to follow young children’s health and functioning in everyday life through their cancer trajectory. Methods: Data were gathered longitudinally from a group of 13 young children and their parents connected to a pediatric oncology unit in Sweden. The International Classification of Functioning, Disability and Health for Children and Youth structure was used to identify difficulties in health and functioning in everyday life, in interview and questionnaire data. Descriptive statistical analysis was performed to show patterns of difficulty over a 3-year period from diagnosis. Results: Difficulties experienced by children declined and changed over time. An increase in difficulties with personal interactions with others and access to and support from health care professionals was seen 2 to 3 years after diagnosis and start of treatment. Similar patterns are seen within individual children’s trajectories in relation to diagnosis but individual patterns were seen for each child. Conclusions and Clinical Implications: Health care professionals need to plan for ongoing contact with school services and information and support pathways, beyond the treatment period. A person-centered philosophy of care is required throughout the cancer trajectory.

Person-centred information to parents in paediatric oncology (the PIFBO study): A study protocol of an ongoing RCT.

BackgroundParents of children with cancer experience a demanding situation and often suffer from psychological problems such as stress. Trying to coping with the complex body of information about their child’s disease is one factor that contributes to this stress. The aim of this study is to evaluate an intervention for person-centred information to parents of children with cancer that consists of four sessions with children’s nurses trained in the intervention method.Methods/DesignThis is a multi-centre RCT with two parallel arms and a 1:1 allocation ratio. The primary outcome is illness-related parental stress. Secondary outcomes are post-traumatic stress symptoms, anxiety, depression, satisfaction with information, expected and received knowledge, and experiences with health care providers. A process evaluation is performed to describe experiences and contextual factors. Data are collected using web questionnaires or paper forms according to the parents’ preference, audio recording of the intervention sessions, and qualitative interviews with parents and the intervention nurses.DiscussionFew studies have evaluated information interventions for parents of children with cancer using large multi-centre RCTs. This intervention is designed to be performed by regular staff children’s nurses, which will facilitate implementation if the intervention proves to be effective.Trial registrationClinical trials NCT02332226 (December 11, 2014).