Logo: to the web site of Uppsala University

Background

Sleep restriction therapy (SRT) is an effective and brief behavioral treatment for insomnia and could serve as a valuable complement to insomnia care. This study explores patients’ experiences of being offered and attending group-SRT at their primary care centers, including experiences of feasibility and mechanisms of impact.

Methods

This qualitative study was undertaken alongside a randomized controlled trial on nurse-led group-SRT in Swedish primary care, involving adults with insomnia disorder. Semi-structured interviews were conducted within three months post-intervention with fourteen patients. Verbatim transcripts were analyzed using qualitative content analysis before trial results were examined. The study was guided by the Medical Research Council framework for process evaluation of complex interventions.

Results

The result is presented in two themes: Increased knowledge, motivation, and flexibility in enhancing adherence to group-SRT and Struggles, solutions, and group dynamics: A path to empowerment. Patients found that understanding sleep reinforced their commitment to group-SRT by providing a rationale for participation. Adherence was influenced by treatment flexibility, personal motivation, and group dynamics. Patients experienced that while group-SRT was challenging, it also offered solutions for better sleep. However, life circumstances and depressive symptoms hindered compliance.

Conclusions

Patients' experience of group-SRT were influenced by the patient-provider relationship, motivation, and comorbid depression, all which impacted engagement. This study provides valuable insights into how patients perceive group-SRT, contributing to the refinement of future insomnia treatments. Further research should explore healthcare providers’ perspectives on both the challenges and opportunities for implementing group-SRT in primary care.

Introduction: Psychiatric inpatient care is often characterized by brief admissions and an orientation toward acute treatments. Persons with dissociative identity disorder have been recognized as a vulnerable group within psychiatric inpatient care and are at risk of not receiving correct support in psychiatric inpatient care. Research within the area is limited and includes no overview of how persons with dissociative identity disorder are cared for in psychiatric inpatient care.

Aim: The aim was to map the area of knowledge on psychiatric inpatient care for persons with dissociative identity disorder.

Method: This scoping review followed the Preferred Reporting Items for Systematic Review and Meta-Analysis for Scoping Reviews. The search strategy included both peer reviewed papers indexed in PubMed, Cinahl and PsycINFO, and grey literature.

Results and conclusions: The review identified eight studies, revealing a small base of knowledge on psychiatric inpatient care for persons with dissociative identity disorder, showing the importance of further research exploring the significance of trauma awareness in this area. Further research should include persons with lived experience, both as participants and as partners in the research process. Nurses are in a position to prevent retraumatisation and promote person-centered approaches to care by valuing the patients' perspectives.

Assessing nursing skills, whether in the first term of a bachelor’s programme or the final term of an APN programme, is, from our experience, a topic frequently discussed among colleagues. This collaborative discussion occurs irrespective of whether the assessment or evaluation targets more solitary theoretical course activities or theoretical knowledge manifested as clinical skills. In all courses – and in broader perspective educational programmes – it is pivotal that teachers and educators, together with students, ensure that learning activities allow students to achieve the expected learning outcomes. All components, from the curriculum to course content and activities, intended outcomes, and evaluation and assessment methods and tools, should be aligned.

Since these are fundamentally based on theoretical knowledge, it is seldom meaningful or purposeful to differentiate between theoretical and clinical nursing skills in clinical skill evaluation and assessments. Hence, assessing clinical skills will also always include theoretical knowledge and reasoning.

This chapter will comprehensively summarise formative and summative evaluation and assessment tools and guidelines relevant to APN education, highlighting best practices for evaluating educational outcomes and competencies which are essential in Advanced Practice Nursing. Numerous methods and tools in this chapter may apply to education at both bachelor’s and master’s level and to other healthcare professions. In this chapter, we emphasise that assessment and evaluation are closely related concepts, where formative methods are related to an evaluation approach, and summative methods are related to an assessment approach. By the end of this chapter, educators and students will feel well-informed and prepared to implement these tools and guidelines in their educational practices.

Severe dissociative states involving the experience of being in parts, typically associated with diagnosis such as dissociative identity disorder and other specified dissociative disorders, continue to be a controversial and rarely studied area of research. However, because persons with severe dissociative states are at risk of being harmed instead of helped within psychiatric care, their experiences of living with such states warrant further examination, while innovative ways to include them in research remain necessary. Against that background, this study aimed to illuminate the meanings of living with severe dissociative states involving the experience of being in parts. This is a phenomenological hermeneutic study with data collected from three social media sources, one personal blog and two Instagram accounts, in February and March 2023. The results were illuminated in light of four themes; Striving to remain in the world, Balancing exposure and trust, Balancing belonging and loneliness and Owning oneselves. The interpretation of the themes suggests that living with severe dissociative states means being a human under inhuman conditions, striving for coherence and meaning in a world that is often unsupportive. This calls for a trauma-informed care to better support recovery for persons with severe dissociative states.

The aim was to explore why registered nurses (RNs) in Sweden choose to quit their jobs in hospitals, also in relation to experienced patient safety. Previous research has shown that nurse turnover, especially in hospital settings, is a serious challenge for society and health care globally. Insufficient staffing of RNs is linked to poorer patient outcomes and a general patient safety at risk. It is, therefore, important to continually explore how nurses describe their reasons for quitting their jobs. The study was conducted using a qualitative descriptive design, based on 11 semistructured interviews with RNs. The analysis generated four categories describing the results: Feeling that the profession is not valued; Psychological and physical symptoms related to work; An insufficient and unsupportive organization; and Unsatisfying leadership and teamwork. Specifically, the RNs participating in this study described a range of reasons for quitting, where the feeling of not being valued and treated as a respected and autonomous profession was a common thread throughout the results. RNs experienced that, overall, the insufficient work conditions, also resulting in lower patient safety, ultimately led to their decision to quit. The findings highlight the crucial need for employers to develop working conditions for RNs, to make sure that the profession is valued according to professional standards and provide the potential for autonomous nursing practice. To reduce nurse turnover, and instead attract and retain nurses, leadership and management in nursing need to be adjusted to meet the demands of a modern academic profession.

ntroduction Psychiatric inpatient care (PIC) is often characterised by high pressure and thresholds for admission, brief periods of care and limited time for caring activities. Dissociative identity disorder (DID) is a contested diagnosis, and persons with DID are at risk of not receiving adequate support when cared for in PIC. Because the limited literature addressing the topic includes no overview on how persons with DID are cared for in psychiatric inpatient settings, the aim of this scoping review is to map the area of knowledge on PIC for persons experiencing DID. This scoping review will provide an overview with the possibility to elucidate gaps in the evidence base and needs for future research on PIC for persons experiencing DID.

Methods and analysis This scoping review will follow Preferred Reporting Items for Systematic Review and Meta-Analysis for Scoping Reviews and steps 1–5 described in the established method for scoping reviews: identifying research question, identifying relevant studies, study selection, charting the data and collating, summarising and reporting results.

Modern learning-centred methods in higher education represent an innovative approach to teaching and learning that aims to actively engage learners and develop practical skills and knowledge. Teaching methods should support and encourage the understanding that learning can occur in many different ways; traditional lectures and seminars may be only one part of the learning process. Active learning must include various learning activities that engage learners in learning beyond listening and memorising. Effective methods support learners’ active participation. Standard active learning methods include problem-based learning, simulation-based learning and integrating technology into learning. These methods promote learner engagement, critical thinking, problem-solving and decision-making, preparing learners for future academic and professional challenges.

Background: Advanced practice nurses (APNs) programs are career-development opportunities significant for nursing workforce retention as well as for the quality of patient care. Inconsistency regarding policy, education, titles, scope of practice, skills and competencies have been identified as major challenges in developing advanced practice nursing in Europe. APN roles and education are under development in the Nordic and Baltic countries. However, there is a lack of information on the current state in this region.Objective: The purpose of this paper is to compare APN programs in the Nordic and Baltic countries to identify their commonalities and differences. Design and methods: This descriptive comparative study reviewed seven master's level APN programs in six Nordic and Baltic countries. Data was extracted from the programme by the expert teachers or leaders of the programmes (N = 9). Competencies recommended in the European Tuning Project (ETP) and the International Council of Nurses (ICN) guidelines on advanced practice nursing, were used to evaluate the programs. The same informants provided additional information on the current state of APN education in the country.Results: The admission requirements were similar in the six countries but in two, clinical work experience is an entry requirement. There are two commonly identified APN roles: clinical nurse specialist (CNS) and nurse practitioner (NP). Most of the programs included all the EPT and ICN competencies. The main differences regarded prescribing competencies. All programmes included clinical training, but the methods on how it is implemented varies.Conclusion: The findings indicate that APN programs in the Nordic and Baltic countries correspond with the recommendations of the European Tuning Project and ICN guidelines. This is an important message for ad-ministrators, policymakers, and politicians, as well as the nursing community, on providing opportunities for APNs to practice to their full potential within each country as well as cross-country.Tweetable abstract: "APN programmes in the Nordic and Baltic countries correspond with international guide-lines. Special attention is needed in future on the clinical training of APNs".