To Örebro University

BACKGROUND: Writing a bachelor thesis has a central role in nursing education. Nursing students require both information and academic literacy in order to write their theses, and there is an expectation that these skills will contribute to putting their knowledge into practice.

OBJECTIVES: To describe students' perceptions of the student and supervisor roles and to investigate students' experienced self-efficacy during the supervision of their bachelor thesis.

DESIGN: A cross-sectional pre-post design.

SETTINGS: Four universities were included. All four had bachelor thesis courses organized as a group supervision process, with a student active approach. Nursing students met together one hour prior to meeting with their supervisor, in order to discuss concerns, try to solve upcoming problems, and plan the agenda for the upcoming supervision session.

PARTICIPANTS: A total of 472 undergraduate nursing students were invited to participate.

METHODS: A web-based questionnaire was used, incorporating the Supervision of Thesis Questionnaire and the General Self-Efficacy Scale. Data were collected at two points: before and after the thesis course. Descriptive statistics and frequencies were calculated, and the independent t-test and Mann-Whitney U test were used for analytic analysis.

RESULTS: The response rate was 39 % (160/472) pre-course and 28 % (130/472) post-course. Nursing students had high expectations of supervision at both time points. Students reporting high self-efficacy had higher expectations of the supervisor's knowledge of the subject and the methods, compared to those reporting lower self-efficacy.

CONCLUSIONS: Nursing students reported high expectations for the supervision process, the supervisor, and themselves, both when entering and when ending the bachelor thesis course. Self-efficacy may contribute to these expectations. Active learning in a group (i.e., collaborative learning) may contribute to nursing students' commitment during the group supervision process in a bachelor thesis course. Further studies are warranted on the optimal group composition to support learning during bachelor thesis courses.

Purpose: Under-diagnosed and uncontrolled symptoms in patients with prostate cancer during radiotherapy can have a negative impact on the individual's quality of life. An opportunity for patients to report their symptoms systematically, communicate these symptoms to cancer nurses and to receive self-care advice via an application in an Information and Communication Technology-platform could overcome this risk. The content in the application must precisely capture symptoms that are significant to both patients and health care professionals. Therefore, the aim of the study was to map and describe symptoms and self-care strategies identified by patients with prostate cancer undergoing radiotherapy, by health care professionals caring for these patients, and in the literature.

Methods: The study combines data from interviews with patients (n ¼ 8) and health care professionals (n ¼ 10) and a scoping review of the literature (n ¼ 26) focusing on the period during and up to 6 months after radiotherapy.

Results: There was a concordance between the patients, health care professionals, and the literature on symptoms during and after radiotherapy. Urinary symptoms, bowel problems, pain, sexual problems, fatigue, anxiety, depression, cognitive impairment and irregular symptoms were commonly described during the initial treatment period. Self-care strategies were rarely described in all three of the sources.

Conclusions: The results show which symptoms to regularly assess using an Information and Communication Technology-platform for patients with newly-diagnosed prostate cancer during radiotherapy. The next step is to evaluate the efficacy of using the platform and the accuracy of the selected symptoms and self-care advice included in a smartphone application.

Aim: The aim was to investigate occupational stress among newly graduated nurses in relation to the workplace and clinical group supervision.

Background: Being a newly graduated nurse is particularly stressful. What remains unclear is whether the workplace and clinical group supervision affect the stress.

Method: A cross-sectional comparative study was performed in 2012. Data were collected by means of a numerical scale measuring occupational stress, questions about workplace and clinical group supervision. One hundred and thirteen nurses who had recently graduated from three Swedish universities were included in the study.

Results: The stress was high among the newly graduated nurses but it differed significantly between workplaces, surgical departments generating the most stress. Nurses who had received clinical group supervision reported significantly less stress. The stress between workplaces remained significant also when participation in clinical group supervision was taken into account.

Conclusions: Newly graduated nurses experience great stress and need support, especially those in surgical departments. Nurses participating in clinical group supervision reported significantly less stress.

Implications for nursing management: It is important to develop strategies that help to adapt the work situation so as to give nurses the necessary support. Clinical group supervision should be considered as an option for reducing stress.

Purpose: The aim of this study was to test the feasibility and acceptability of an Information and Communication Technology platform for assessing and managing patient reported symptoms during radiotherapy for prostate cancer.

Methods: In cooperation with a health management company, using a patient experience co-design, we developed the platform operated by an interactive application for reporting and managing symptoms in real time. Nine patients diagnosed with prostate cancer and receiving radiotherapy were recruited from two university hospitals in Sweden. Evidence-based symptoms and related self-care advice specific to prostate cancer were implemented in the application based on a literature review and interviews with patients and health care professionals. In the test of the platform the patients reported symptoms, via a mobile phone, daily for two weeks and were afterwards interviewed about their experiences.

Results: Overall, the patients found the symptom questionnaire and the self-care advice relevant and the application user friendly. The alert system was activated on several occasions when the symptoms were severe leading to a nurse contact and support so the patients felt safe and well cared for.

Conclusions: The platform enabled increased patient involvement and facilitated symptom assessment and communication between the patient and the health care provider. The study's results support further development of the platform, as well as tests in full-scale studies and in other populations.

Background: Some patients having multiple sclerosis (MS) still report gains from the adversity o f suffering from a chronic and debilitating illness.

Aim: To explore the subjective experiences o f quality o f life in patients with MS, focusing on possible positive aspects o f having to come to terms with MS.

Method: An inductive approach in the form o f latent content analysis was used to analyze the data from 61 MS-patient interviews.

Findings: Fighting a losing battle but also gradually conquering oneself was the underlying theme that emerged from the following four main categories: Experience o f ill-health, Experience o f health in spite o f illness, Psychosocial consequences o f having MS, and Different ways o f managing MS. Patients with MS were forced to re-evaluate their life during the course o f illness, gaining hard-earned knowledge that became the basis for continually managing their illness.

Conclusion: Nurses and other health care personnel need to be aware o f the impact living with MS has on patients as revealed by the present study in order to be able to help these patients come to terms with and adapt to the deleterious effects o f this illness.

The experience of their life situation of next of kin in informal caregiving needs to be followed as they may need support to maintain their own health and cope with continuing in their caregiving role. Many of these individuals, often the older person’s spouse, are elderly themselves. The aim of this study was to increase the understanding of the next of kin’s experience of their life situation in connection with their informal caregiving of older persons. The study had a qualitative approach, with an inductive explorative design. Informal conversational interviews were conducted. Twelve next of kin were interviewed, nine of them twice. In all, 21 interviews were performed, and subsequently subjected to latent content analysis. The theme that emerged from the data was “A balance or imbalance in next of kin’s daily life.” The three subthemes were: (1) Balance and imbalance in the relationship with the older person, other family members, and friends; (2) Balance and imbalance in the relationship with the staff from municipal care; and (3) Balance and imbalance in demands, affecting the caregiver’s own health. Communication with mutual respect was described as a tool for creating good relations. The results of this study highlight the strained life experiences of next of kin while caring for older persons. There is a need to give more attention to the next of kin’s life situation and to find the means to support them. To reduce worry and stress, health care staff need to understand the next of kin’s experience of their life situation, and good relations need to be created among all involved in the care.

Introduction: For immediate and continuous dialogue between patients and caregivers new approaches in modern technology are encouraged today. In cooperation with a Swedish health management company, we developed an interactive mobile phone application for the assessment of symptom distress, evidence-based self-care advice and an alerting function of severe symptoms with instant access to professionals in real time. By using this technique patients can communicate symptoms with instant support while cared for out-side hospital but at the same time reassured that their condition is monitored by the professionals. The objective of this study was to evaluate the feasibility and acceptability of the application for patients with prostate cancer during radiotherapy and for the involved health care staff.

Material and Methods: Evidence-based symptoms and related selfcareadvices were implemented in the application after literature review and interviews with patients and health care professionals. Nine patients diagnosed with prostate cancer undergoing radiotherapy treatment were recruited to test the application for two weeks. The patients reported in the electronic symptom questionnaire daily. After the two weeks they were interviewed about their experience. Nurses directly involved in the care and treatment of the participating patients were interviewed at the end of study.

Results: Overall, patients and nurses reported positive experiences of using the mobile phone system. The patients considered the application helpful and easy to use although there were some suggestions for further development of the electronic questionnaire. Most of the patients had read the self-care advice and found them useful. The alerting system was activated in several cases; the nurses found it useful to identify and manage problematic symptoms early and the patients felt safe and well cared for. Some of the nurses considered the monitoring system time-consuming and made suggestions for improvement.

Conclusions: Both patients and nurses could see the potential for using the mobile application in clinical practice. The system enables the involvement of the patients and the alerts showed problematic symptoms promoting timely interventions. The results support further development and testing of the system in full-scale.

Aim: To describe patients' experiences of bladder emptying and urinary catheterization in connection with hip surgery.

Background: The capacity of bladder emptying in connection with hip surgery is affected by pain, medication and confinement to bed. In connection with such surgery urinary catheterization is often performed, either intermittent or indwelling. Hip surgery patients' experiences of urinary catheterization and urination have not been studied before.

Design: A qualitative study with descriptive design was conducted among hip surgery patients.

Methods: Thirty face-to-face interviews were conducted from October 2009-March 2010 and analysed with inductive qualitative content analysis.

Results: The main category An issue but of varying impact' illustrated the patients' experiences of bladder emptying and urinary catheterization. Five generic categories were identified: ability to urinate, catheter is convenient, bothersome bladder emptying, intrusion on dignity and concern about complications. Irrespectively of whether the patients were able to urinate or were catheterized, the bladder emptying situation was not as usual. It was described as uncomplicated and experienced as being positive if the patients were able to urinate by themselves or when catheterization was experienced as convenient. Some patients did not want to be catheterized, approving it only reluctantly. Independently of the method for bladder emptying, the patients in our study would choose the same method next time.

Conclusions: The patients undergoing hip surgery seem to experience bladder emptying as an issue but of varying impact. Both bladder emptying through micturition and bladder emptying through catheterization are described in positive and negative terms.