Mid Sweden University

This study aims to describe how nurses perceive their professional roles in providing meal support for adult inpatients with anorexia nervosa. A qualitative design and reflexive thematic analysis were used, as well as the SRQR (i.e. Standards for Reporting Qualitative Research) reporting guidelines for accuracy and completeness. Personal interviews were conducted with 11 nursing staff in a general psychiatric inpatient ward. The results revealed an overarching theme: performing meal support – fluent shifting between roles, with two themes: acting as a supervisor, monitoring food intake, and getting into the supportive and helping role. Both themes further consisted of three subthemes each. The results show nurses’ ability to shift between roles and adapt to patients’ needs at the same time as maintaining treatment structure during meal support. Moving between differences in approach is important in fostering a therapeutic relationship and facilitating patient recovery. Balancing this is especially vital in nursing and involves meeting challenging responsibilities at the same time as addressing individual patient requirements.

Introduction:The world needs skilled, well educated, and confident midwives, but there is a lack of instruments to measure confidence in the Swedish context. The aim was to psychometrically test and adapt the COMICE (Confidence Of Midwifery students on selected midwifery Competencies at completion of Education) questionnaire on Swedish midwifery students.

Methods:This is a national cross-sectional study of midwifery students from all 13 universities in Sweden in 2016–2017. The questionnaire comprised antenatal, intrapartum, postpartum and newborn care and underwent a principal component analysis. Analysis of variance was used to study associations with students’ background characteristics.

Results:A total of 238 students (78% response rate) completed the questionnaire. For antenatal care, two components were identified: performing routine midwifery assessments during pregnancy and identifying fetal and maternal risk factors while educating parents (KMO=0.895, p<0.001; Cronbach’s alpha=0.848 and 0.827, respectively). For intrapartum care, three components emerged: managing physiological birth and providing support, managing complicated labor and birth, and identifying and providing lifesaving measures (KMO=0.905, p<0.001; Cronbach’s alpha=0.917, 0.809, and 0.777, respectively). Postnatal and newborn care included managing uncomplicated care while educating parents and managing complications (KMO=0.941, p<0.001; Cronbach’s alpha=0.993 and 0.558, respectively). Younger students (<31 years) reported greater confidence in routine antenatal assessments compared to older students (mean: 27.43 vs 26.01, p=0.004), managing physiological births (mean: 65.41 vs 62.85, p=0.01), and handling complicated labors (mean: 20.37 vs 19.05, p=0.046).

Conclusions:This study supports the Swedish version of the COMICE questionnaire as a tool to measure confidence among midwifery students in a Swedish context.

Background: Previous studies have reported that organizational structures and cultures in primary health care are obstacles to district nurses doing successful work in health promotion practice (HPP). Because organizational structures are not easily changed, Jean Watson’s Attending Nurse Caring Model (ANCM) was introduced and piloted at a primary health care center in Sweden, aiming to transform HPP so as to empower district nurses and increase their work satisfaction. Aim: To investigate patients’ experiences of the caring encounter in HPP after introduction of the ANCM in Swedish primary health care, the aim being to explore the essential components of the caring encounter between patients and district nurses. Methods: A descriptive and qualitative research design was used. Data collection was performed using individual face-to-face interviews with twelve patients at risk for developing CVD. Data analysis consisted of both deductive content analysis, using a categorization matrix based on the ANCM and, subsequently, inductive latent content analysis. Results: The findings were abstracted into three themes: 1.‘Feeling the deepest essence of being cared for’: to be respected and being put at the center of the encounter; 2. ‘Feeling acceptance and worth’: being treated with openness and permissive attitudes, 3. ‘Being in a supportive atmosphere that promotes hope’: to feel trust and being trusted in the encounter, and being empowered by hope. The unifying main theme of the caring encounter was abstracted as ‘Experiencing human dignity’. Conclusion: The present study revealed that the essence of the caring encounter between patients and district nurses in HPP is to be unconditionally accepted in an environment that inspires hope and encouragement. The ANCM seems to be a promising model to use for strengthening the caring encounter and supporting CVD patients in making healthy lifestyle choices. However, further studies of qualitative and quantitative designs are needed to investigate what the ANCM can contribute to HPP in Swedish primary health care.