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Purpose: Advances in paediatric oncology have improved survival rates, but intensive treatments and frequent hospitalisations disrupt family life. Hospital-to-home transitions are critical yet underexplored in the cancer trajectory. Existing models of discharge planning primarily address parental readiness, with limited attention to how children themselves experience these transitions.

Methods: This qualitative study used a phenomenological-hermeneutic approach to explore the experiences of children and adolescents during transitions from hospital to home. Fieldwork, using go-along and photoelicitation interviews, was conducted with ten children aged 6 to 17. Paul Ricoeur's theory of interpretation inspired the data analysis.

Results: Findings revealed that children experienced homecoming as both a relief and a source of uncertainty. The transition to home was often abrupt and marked by limited child-centred preparation. Participants described being in a liminal position -no longer hospitalised but not fully secure at home-while continuing to manage illness-related risks. Feelings of alertness, bodily awareness, and disconnection from time and identity were prominent.

Conclusions: Hospital-to-home transitions are more than clinical endpoints; they represent an existential and emotional shift for children and adolescents with cancer. Discharge practices should consider the child's emotional readiness, involve them in the preparation, and consider the broader family context. Recognising the transition as a liminal phase may lead to more supportive and inclusive care models for families navigating these complex transitions. (c) 2026 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY license (http:// creativecommons.org/licenses/by/4.0/).

Venipuncture procedures can be highly distressing for paediatric patients, potentially leading to short-term and long-term negative effects on their well-being and future medical experiences. This study aimed to provide a rich description of children's psychological experiences during venipuncture procedures within a specific cultural context. A qualitative descriptive design was employed. Fourteen paediatric patients aged 6-12 years admitted to Heevi Pediatric Hospital's departments in the Duhok province of the Kurdistan Region of Iraq participated in the study. Data were collected using the Drawing and Storytelling (DS) technique and analyzed through thematic analysis. Thematic analysis revealed three primary themes: (1) pain and fear during venipuncture, (2) parental support as a psychological buffer, and (3) ease and comfort strategies. Findings highlight the importance of child-centered, family-inclusive approaches to improve psychological well-being during medical procedures.

Conclusion: Paediatric patients experience pain and fear during venipuncture, but also feel pride and relief. Parental support and strategies like preparation and distraction help reduce anxiety. Implementing child-centered and family-inclusive care, informed by understanding children's unique perspective and family dynamic, is crucial for improving psychological well-being during invasive medical procedures.

Needle-related procedures are painful for infants, highlighting the need to enhance the use and understanding of non-pharmacological strategies to alleviate pain and anxiety during such procedures. This study aims to explore how needle-related routine care procedures, such as vaccinations and blood samples, are designed and described by parents and healthcare professionals to minimize pain and anxiety in newborns and infants aged 3 and 5 months, in the framework of Kolcaba's Comfort Theory. Using a convergent mixed-method approach, which combines qualitative and quantitative data collection and analysis, the results are presented according to the three pillars of Comfort Theory: relief, ease, and transcendence. In total, 16 healthcare professionals, 40 parents, and 27 infants aged 0-5 months were included in the study. The findings describe how needle-related procedures were carried out and perceived by healthcare professionals and parents. Several key aspects were identified as important for alleviating pain, including support for parents, pain relief, preparation for parents, support and comfort for the infant, ensuring safety for the infant and experiences of well-being. The study suggests several practices to decrease pain and anxiety for infants undergoing needle-related procedures in routine care. These include supporting and preparing parents with information about the procedure and possible pain relief methods for the infant, fostering a calm environment, and ensuring the safety of the infant throughout the process.Trial registration ISRCTN 12280133. Registration date: 24/04/2023.

The goal of Swedish public health policy is to create conditions that enable good and equitable health and eliminate avoidable health inequities. Although previous research emphasizes the importance of considering inequities in mental health promotion and policy, and although researchers and policy makers emphasize the importance of a system-approach to mental health, there seems to be an ambiguity in how the concept of equity is understood. Therefore, the aim of this study was to critically examine equity and inequity discourses in Swedish regional action plans for mental health. A critical discourse analysis based on Foucault's discourse theory was used to reveal discursive practices of inequity. Twenty-two regional action plans for mental health were analyzed. The analysis identified three discourse strands: the vague language of equity, the inequitable people, and education as a pathway to equity, all of which are entangled through the individualization of equity. Overall, the equity discourse was interpreted as representing a naturalistic and liberal view on equity. This could be understood as contributing to upholding the system of inequities rather than dismantling it. There is a need for clarification about the considered causes of mental health inequities as well as possible solutions.

BACKGROUND: Step three of the Ten Steps to Successful Breastfeeding encourages midwives in antenatal care to discuss the importance and management of breastfeeding with expectant and new parents. However, there is a gap in the literature regarding mothers' experiences of individual antenatal breastfeeding education. This study aims to explain and understand the meaning of the research phenomenon: support from midwives and partners during a structured breastfeeding support programme in antenatal care. The lived experiences of this phenomenon are interpreted from the perspectives of expectant mothers (during pregnancy) and new mothers (two months postpartum).

METHODS: The analysis employed a lifeworld hermeneutic approach, based on diaries and interviews with 20 mothers conducted during pregnancy and two months after birth. Participants received structured breastfeeding support based on the Ten Steps to Successful Breastfeeding. A purposive sample was recruited in 2021 in Sweden.

RESULTS: The research phenomenon, support from midwives and partners during a structured breastfeeding support programme in antenatal care, is understood through the following themes: Feeling safe through responsive, individualised dialogue; Grounding confidence through tailored and accessible breastfeeding knowledge; Breastfeeding as an existential anchor for emotional closeness and maternal identity; Co‑creating space for breastfeeding, with partner support as negotiated meaning; Weighing breastfeeding as a lived balance of perceived gains and everyday constraints; Trust as a foundation for perseverance and acceptance; and Feeling left behind when dialogue and continuity are missing. The main interpretation can be understood as being prepared to make independent decisions about breastfeeding.

CONCLUSIONS: Being prepared to make independent decisions about breastfeeding extends beyond receiving information and is shaped through responsive, meaningful encounters. Individual dialogue grounded in each mother's lived experiences, needs, and circumstances fostered a sense of safety, reflection, and growing confidence throughout pregnancy and early motherhood. Mothers valued support that recognised their perspectives and strengthened their ownership of breastfeeding decisions, while negotiated partner involvement deepened shared understanding without compromising maternal autonomy. The findings highlight that continuity‑based, individual antenatal breastfeeding education can complement group sessions, enhance maternal satisfaction, and enable midwives to provide more equitable and accessible care for all families.

TRIAL REGISTRATION: ACTRN12623000648628. Date registered 15th June 2023. Retrospectively registered.

Background

Hospitalization for children often involves stress induced by fear and pain. Complementary therapies, such as Animal Assisted Activities (AAA) with dogs, can alleviate the hospital experience.

Purpose

The first aim of this study was to initiate the development of an instrument that measures healthcare professionals’ attitudes toward complementary therapy, specifically dogs in AAA. The second aim was to elucidate the emerging effects of introducing dogs to children in healthcare settings, as reported by healthcare professionals.

Materials and methods

A questionnaire covering demographics, rating attitudes, and allergy and hygiene risks, followed by open-ended questions, was completed by 61 healthcare professionals (HCPs). Quantitative data were analysed statistically, while qualitative data underwent content analysis.

Results

The Attitude Instrument of Complementary Therapy (AICT) included 7 items and was evaluated using exploratory factor analysis. Healthcare professionals had a median score of 25 (range 18–28), high scores indicating a more positive attitude. However, 36 % of the HCPs perceived a risk of allergies, and this group had a significantly lower median score, 22 versus 26. Open-ended answers were analysed into four categories: “Dogs could positively affect children in hospital”, “Dogs may pose a risk of allergies in children”, “Dogs might be frightening for children” and “Dogs can affect healthcare professionals’ working situation”.

Conclusion

The AICT can serve as a valuable tool for investigating HCPs’ attitudes to dogs in AAA as complementary therapies. Professionals view dogs as beneficial for hospitalized children, but attitudes toward dogs working in paediatric care can be influenced by concerns about risks such as allergies.

This study investigated Swedish school nurses experiences, self-perceived knowledge, and attitudes towards HPV vaccination. A cross-sectional repeated questionnaire study was conducted. The results were compared to a previous study conducted in 2016. Additionally, open-ended responses were thematically analysed. A total of 344 nurses participated. Overall, more participants reported good self-perceived knowledge and favourable attitudes towards HPV vaccination compared to 2016. Still, nearly half expressed a need for further education. The thematic analysis revealed barriers including lack of training, inconsistent guidelines for addressing vaccine hesitancy and ensuring children's participation in decision-making, limited access to diverse information materials, and time constraints related to vaccination tasks. Since school nurses in Sweden are responsible for all aspects of school-aged vaccinations within the national immunization program, it is essential that they receive support to feel motivated and confident in addressing vaccine hesitancy. Continued education and the implementation of uniform guidelines are therefore necessary.

Purpose: To improve patient care by describing teachers' and school leaders' experiences in teaching children diagnosed with cancer, to better understand which information would be beneficial for schools to receive from the healthcare system.

Methods: This qualitative study was based on semi-structured interviews with 15 teachers and six school leaders in primary, secondary, and high schools in Sweden (student ages 6-18). The data was analyzed with thematic analysis.

Results: Three main themes were revealed: a different diagnosis from other diagnoses, meaning that the respondents in this study perceived the information about a cancer diagnosis differently compared to other diagnoses due to the uncertain outcome of the child's condition and survival; a balancing act, including a need to balance schools' educational demands with the child's needs; and a desire for more information, especially pedagogical and schoolrelated information.

Conclusions: The emotional impact on teachers of teaching a child with cancer is significant, and the medical information provided by consultant nurses from the hospitals was very appreciated and helpful. However, educators also highlighted their need for pedagogical information. This information would preferably come from a person specialized in special educational needs for children with cancer, for example, a teacher or a special education teacher from the hospital school or the oncological team.

Purpose:

Childhood cancer profoundly affects the entire family, with siblings experiencing significant changes. Transitions between paediatric oncology treatment centres and homes pose particular challenges, fragmenting family life and heightening uncertainty. This study aims to explore how siblings of children with cancer experience transitions between a paediatric oncology centre and home.

Method:

A phenomenological-hermeneutic approach was employed to capture the lived experiences of eight siblings of children with cancer. Semi-structured interviews, supported by photo-elicitation methods, were conducted in the siblings' homes. The analysis was guided by PaulRicoeur's theory of interpretation, which provided a philosophical framework for understanding the deeper meanings of siblings' narratives.

Results:

Three overarching themes on hospital and home transitions emerged: Grappling to find a new family position situated in the periphery, The risk of sudden family separation left with uncertainty and Adapting to a changing siblingship shaped by the illness. These findings highlight that siblings faced considerable demands to adjust and adapt to unpredictable family separations, representing particularly vulnerable periods, amplifying feelings of uncertainty, fear, and loneliness.

Conclusion:

This study provides insights into how siblings adjust to the frequent family disruptions caused by cancer treatment. While siblings strive for family closeness, they often feel distanced and placed in a peripheral role. Siblings' needs during transitions must be prioritized and addressed adequately to ensure their overall adjustment during a cancer course.

Background

Everyday challenges and stress negatively affect young people's mental health. Socioeconomic status (SES) is associated with different stressors and different stress-coping mechanisms. Many interventions target youth mental health, but few consider socioeconomic differences in the planning, implementation, or evaluation. In a Swedish context socioeconomic status is related with migration experience. The aim of the study was to explore proposals for tackling everyday challenges among young people from different socioeconomic neighborhoods.

Methods

Eight focus groups, with participants between 13 and 15 years old from eight schools, were conducted in the south of Sweden. The participants discussed proposals for tackling everyday challenges. Using comparative thematic analysis, the focus group transcripts were divided into two groups, based on the socioeconomic status of the school's neighborhood, and analyzed comparatively. Most of the participants in low SES neighborhoods had foreign background and most of the participants in high SES neighborhoods were Swedish born.

Results

The analysis resulted in four shared themes between the two SES groups: society is responsible, school is responsible, parents are responsible, and I am responsible. The differences and similarities between the two groups are presented in sub-themes. Many of the proposals were similar between the two SES groups, but with different underlying issues and examples.

Conclusion

Both groups proposed that adults must listen more to young people in order to improve the everyday challenges young people face. However, the low SES group in general expressed both more frustration and more agency, compared to the high SES group. This could be important to consider when planning school-based mental health promotion in different socioeconomic neighborhoods.