Torill Larsen

Meeting reality: young adult cancer survivors' experiences of reentering everyday life after cancer treatment.

Background: Cancer in young adults is rare, but the intensity of cancer treatment increases the risk of physical and psychosocial impacts on patients’ entire lives. Young adult survivors are underrepresented in research, and knowledge of cancer survivors in this age group is scarce, especially knowledge of transition from cancer treatment to everyday life. Objective: The objective of this study was to explore how young adult cancer survivors experience reentering everyday life after cancer treatment. Methods: A qualitative, phenomenological approach was used and included 20 young adult survivors (aged 24–35 years) with different cancer diagnoses allocated to a rehabilitation program. Semistructured interviews were conducted, and the transcripts were analyzed qualitatively using Systematic Text Condensation method. Results: “Meeting reality” was identified as a bridging theme, explained by 4 main themes important to the informants: (1) lack of preparation, (2) late effects, (3) lack of understanding, and (4) being neither sick nor healthy. Conclusions: Informants were unprepared for reentering everyday life after cancer treatment and experienced a mismatch of their expectations with reality, particularly in the holistic impact of late effects. Moreover, reentering everyday life was characterized by a lack of understanding from their network and even healthcare providers who conducted follow-ups. The informants experienced reentering everyday life as being much harder than expected, and they felt isolated as well as neither sick nor healthy. Implications for Practice: The results suggest a major shortcoming in both preparation for survivorship, multidisciplinary follow-ups, and knowledge. A shift to a more holistic perspective in survivorship care is suggested.

Physical Activity in Schools: A Qualitative Case Study of Eight Norwegian Schools' Experiences with the Implementation of a National Policy.

Purpose – Over the past decades numerous policies, programmes and interventions have been undertaken to increase students’ participation in physical activity in school. Research shows that intervention effects are mostly related to the way in which the program or policy is implemented, nevertheless, few studies have focused on the implementation process. Thus, this paper aims to explore and identify key implementation successes and barriers as perceived by principals, project leaders, teachers and students.Design/methodology/approach – A case study of eight schools participating in the Norwegian project “Physical activity and healthy school meals” was conducted, applying a qualitative approach.Findings – Findings show that all schools managed to ensure extra time for physical activity, varying from 20 to 45 minutes per day. None managed, however, to fulfil the recommendation of 60 minutes daily. Factors promoting the implementation were related to formalisation and anchoring in terms of policy plans and e...

The importance of teachers’ feelings of self efficacy in developing their pupils’ social and emotional learning: A Norwegian study of teachers’ reactions to the Second Step program

The aim of this study was to explore teachers’ (n = 17) experience with the Second Step program (1986) as a tool for teaching social competence through semi-structured interviews. Findings suggest that use of the program had a positive influence on the teachers’ overall teaching techniques and their broader social behaviour. The majority of the teachers reported that they felt they had become more democratic and student-centred in their teaching, and more socially skilled—in particular, more aware of individuals’ needs and problems by using the program. Further, results also suggest using the program to promote better collaboration with parents.

‘It is the situation that makes it difficult’: Experiences of nursing students faced with a high-stakes drug calculation test

Test anxiety affects the learning, performance and well-being of students, and it increases as the stakes get higher. Norwegian nursing students must pass a drug calculation test with a flawless performance if they are to qualify as nurses. The aim of the current study was to investigate the test anxiety experiences of students faced with such a high-stakes test. We used a mixed methods approach where the data were collected using a survey questionnaire and a focus group interview. In total, 203 freshman nursing students completed the questionnaire, six of whom also participated in the focus group interview. The survey results showed that 44.3% of the students reported high mathematics test anxiety in the months before the drug calculation test. More than 12% of the high-anxiety students reported a low mathematics self-concept. High and medium self-concept students also experienced high test anxiety. Our analysis of the focus group interview data confirmed that the high stakes of the test increased the test anxiety dramatically.

Working Toward a Good Life as a Cancer Survivor. A Longitudinal Study on Positive Health Outcomes of a Rehabilitation Program for Young Adult Cancer Survivors

Background: Research on cancer rehabilitation targeting young adult cancer survivors (YACS) is limited, and little is known about the positive health outcomes of rehabilitation programs tailored specifically for this vulnerable group. Objective: The aim of this study was to investigate whether a complex rehabilitation program improved the health-related quality of life (HRQOL) and physical capacities of YACS. Methods: A longitudinal prospective study using Norwegian norm-based comparisons was conducted. Twenty YACS (24–35 years old) with different cancer diagnoses participated in a complex rehabilitation program lasting for 6 months, focusing on goal setting, exercise, psychoeducation, individual follow-up, and peer support. Results: Health-related quality of life was measured by EORTC QOL C-30 and the scores showed significant increases in overall HRQOL (P < .005–.001) and all functional dimensions (P < .001–.05) and a decrease in fatigue (P < .000–.05) and effect sizes between 0.72 and 1.30. Significant changes occurred within physical fitness (P < .005), lung capacity (P < .05), and left-hand strength (P < .001), but not right-hand strength and body mass index, with effect sizes between −0.04 and 0.48. The values of HRQOL were stable after a 1-year follow-up. Conclusions: A complex cancer rehabilitation program especially tailored for YACS seems to build positive health outcomes such as HRQOL and physical capacity in a long-term perspective. The content and structure of the program were feasible with high compliance. The results underline the importance of targeting rehabilitation interventions to YACS in need after cancer treatment, acknowledging rehabilitation as a process that requires adequate time and follow-up. Implications for practice: Healthcare providers should be aware of YACS’ symptom burden and monitor HRQOL and physical parameters to ascertain holistic cancer survivorship care.

Understanding barriers to implementing the Norwegian national guidelines for healthy school meals: a case study involving three secondary schools

The main goal of the present study was to investigate the barriers to implementing the Norwegian national guidelines for healthy school meals as perceived by principals, project leaders, teachers and students. This study employed a multiple-case design using an explorative approach. Data were collected at three secondary schools in Norway participating in the intervention project Physical activity and healthy school meals. Individual interviews were conducted with school principals and project leaders, and focus group interviews were conducted separately with teachers and students. Four categories of barriers were identified: (1) lack of adaptation of the guidelines to the target group; (2) lack of resources and funding; (3) conflicting values and goals; and (4) access to unhealthy food outside school. The research identified differences in perceived barriers between the staff responsible for implementation and the students as the target group of the measures. All staff groups perceived barriers relating to both resources, and conflicting values and goals. The teachers were more concerned about issues of relevance for adaptation to the target groups than were the principals and project leaders. The students were concerned mostly with issues directly affecting their experience with items offered in the canteen.

Participating in life again: a mixed-method study on a goal-orientated rehabilitation program for young adult cancer survivors.

Background: Young adult cancer survivors (18–35 years old) are at risk of lifelong threats to physical and psychosocial health and decreased life participation. Research indicates lack of information about the late effects and health risks and limited follow-up and rehabilitation. Objective: The objectives of this study were to examine whether a goal-oriented rehabilitation program increased young adult cancer survivors’ participation and explore the participants’ descriptions and experience of the process. Methods: We used a convergent parallel design combining quantitative and qualitative methods. Sixteen young adult cancer survivors (aged 24–35 years), with different cancer diagnoses, were allocated to a 6-month rehabilitation program. Results: The Canadian Occupational Performance Measure showed significant (P < .001) change in both performance and satisfaction from the start (T1) to the end (T4) of the program. Qualitative results indicated that increased participation was depended on building capacity and finding the balance, gaining new insight, and follow-up. Important factors of the rehabilitation program seemed to be physical activity, psychoeducation, peer-to-peer support, and follow-up over time. Conclusions: Results indicate that a goal-oriented rehabilitation program may increase participation by young adult cancer survivors. The goal-oriented process is not straightforward and depends on experience of coping and control, finding a balance between the different areas of life and follow-up over time. Implications for Practice: Health professionals should play an important role in the rehabilitation of young adult cancer survivors by promoting empowerment and follow-up over time. The Canadian Occupational Performance Measure seems to be a valuable instrument for setting goals and thus helps facilitate participation.

The role of physical structures in implementing the Norwegian guidelines for healthy school meals

Drawing on a multiple case design, this study examines the role of physical structures in the implementation of national guidelines for healthy school meals at three Norwegian schools. Findings suggest that the degree of implementation of the guidelines was influenced by types of consumer product, facilities in buildings and regulation of access to neighbourhood facilities. Further, lack of adequate canteen facilities influenced the selection of food on offer, food safety and capacity. Students seeking an alternative to the traditional packed lunch were generally forced to eat their lunch away from the school.

School mental health promotion and intervention: Experiences from four nations

All around the world, partnerships among schools and other youth-serving systems are promoting more comprehensive school-based mental health services. This article describes the development of international networks for school mental health (SMH) including the International Alliance for Child and Adolescent Mental Health and Schools (INTERCAMHS) and the more recent School Mental Health International Leadership Exchange (SMHILE). In conjunction with World Conferences on Mental Health Promotion, SMHILE has held pre-conference and planning meetings and has identified five critical themes for the advancement of global SMH: 1) Cross-sector collaboration in building systems of care; 2) meaningful youth and family engagement; 3) workforce development and mental health literacy; 4) implementation of evidence-based practices; and 5) ongoing monitoring and quality assurance. In this article we provide general background on SMH in four nations, two showing strong progress (the United States and Canada), one showing moderate progress (Norway), and one beginning the work (Liberia). Following general background for each country, actions in relation to the SMHILE themes are reviewed. The article concludes with plans and ideas for future global collaboration towards advancement of the SMH field.

Psychometric properties of the five-item version of the Mindful Awareness Attention Scale (MAAS) in Norwegian adolescents:

Objectives: The aim of the present study was to examine the factor structure, model-based reliability, measurement invariance and concurrent validity of the five-item version of the Mindfulness Attention Awareness Scale (MAAS) in Norwegian adolescents. Methods: An initial pilot study was carried out using a sample of 77 fifteen year olds. For the main analyses, a sample of 2140 Norwegian adolescents was used who participated in the cross-sectional Health Behaviour in School-Aged Children (HBSC) study. All participants were asked to complete a questionnaire. Results: Confirmatory factor analyses found support for the one-factor structure of the five-item version of the MAAS. Acceptable model fit was found in both the pilot sample (χ2=6.48, df=5, p=0.26; root mean square error of approximation [RMSEA]=0.06; comparative fit index [CFI]=0.99; standardised root mean square residual [SRMR]=0.03) and the HBSC sample (χ2=27.1, df=4, p<0.001; RMSEA=0.05; CFI=0.99; SRMR=0.01). The model-based reliability of the scale was good (ω=0.84 and ω=0.81, respectively). Scalar measurement invariance was established for sex, age and material affluence. Finally, the five-item MAAS displayed concurrent validity through moderate negative associations with health complaints (r=−0.44; p<0.001) and school stress (b=−0.44, p<0.001), and a positive moderate correlation with life satisfaction (r=0.26; p<0.001). Conclusions: The five-item version of the MAAS is an adequate measure of mindfulness in Norwegian adolescents. Due to the brief nature of the scale, it can easily be included in epidemiological and clinical studies with an interest for trait mindfulness. The five-item MAAS may therefore have great potential to facilitate more knowledge about the role of mindfulness in adolescent health.