IntroductionDespite the lack of knowledge about the SARS-CoV2 virus, the lack of personal protect... more IntroductionDespite the lack of knowledge about the SARS-CoV2 virus, the lack of personal protection gear among frontline healthcare workers, and lack of vaccines in the beginning of the pandemic, paramedic students in Norway contributed to the National response against the COVID-19 pandemic by working in test-stations, ambulance services, ambulance decontamination stations etc. Despite fear of contracting the COVID-19 reported by healthcare workers worldwide, paramedic students in Norway reported higher-than-average quality of life after four months of the COVID-19 pandemic (first pandemic wave). In this study we aimed to investigate how students reported their quality of life, study motivation and job satisfaction after one year of living with the COVID-19 pandemic. MethodAt each data collection point, all paramedic students enrolled at Oslo Metropolitan University were invited to participate in a digital, online, self-administered survey. The first data collection was in June 202...
Avdeling for paramedisin Institu for sykepleie og helsefremmende arbeid OsloMet Forfa erbidrag: i... more Avdeling for paramedisin Institu for sykepleie og helsefremmende arbeid OsloMet Forfa erbidrag: idé, utforming/design, datainnsamling, li eratursøk, utarbeiding og revisjon av manus samt godkjenning av innsendte manusversjon. Nina Øye Thorvaldsen er universitetslektor. Hun er sykepleier med mange års erfaring fra paramedicarbeid, hovedsakelig fra ambulanseavdelingen, Oslo universitetssykehus. Forfa eren har fylt ut ICMJE-skjemaet og oppgir ingen interessekonflikter. Avdeling for paramedisin Institu for sykepleie og helsefremmende arbeid OsloMet Forfa erbidrag: idé, utarbeiding og revisjon av manus samt godkjenning av innsendte manusversjon. Anne Kristine Bergem er spesialist i psykiatri og førstelektor II. Hun er spesialrådgiver i Norsk psykiatrisk forening og har videreutdanning i voldsrisikovurdering og-håndtering. Forfa eren har fylt ut ICMJE-skjemaet og oppgir ingen interessekonflikter.
Background: Care policies worldwide aim to control care expenses and provide more care in peoples... more Background: Care policies worldwide aim to control care expenses and provide more care in peoples’ homes, increasing the importance of informal care and the role of family carers’. This Ph.D. project aims to better our understanding of family carers’ perspectives on care provision to older people living with dementia, and how the interplay between health services and informal carers may be enhanced to improve care provision. Method: The study followed an exploratory sequential mixed method design: Substudy 1 was based on in-depth, semi-structured interviews of 23 family carers for older people living with dementia, to explore experiences with care provision. Transcribed interviews were coded and analyzed in four steps, informed by hermeneutics, phenomenology, and thematic analysis. Building on findings from Substudy 1, Substudy 2 comprised a quantitative survey in a larger sample of 188 family carers. Results were analyzed using descriptive statistics, and multiple linear regression models were used to test assumptions that health literacy could predict carer burden, health-related quality of life, and time spent on informal care. Results: Analysis of the interviews highlight how family carers may identify care needs unmet by health services, and indicate four preventive practices employed in their care, aiming to prevent physical, emotional, economic, and relational harm. In interactions with health services, family caregivers resort to two broad involvement strategies: (1) being “the hub in the wheel”, through conciliatory co-ordination; and (2) “getting the wheel rolling”, using purposeful and assertive acts to improve leverage. Both strategies have costs and benefits, and use depends on available personal resources. The survey participants displayed high levels of health literacy, a partially trainable personal resource. Regression analyses indicate that higher health literacy was associated with lower carer burden, higher healthrelated quality of life, and less time spent on informal care. Conclusion: Family cares can be valuable resources in care provision for older people living with dementia, adding important perspectives on safety and quality of care, and facilitating co-ordination and utilization of resources. Strong partnerships between formal and informal care may benefit from awareness of interaction challenges, including involvement strategies; differences in perspectives and motivations, including preventive practices; and differences in personal resources, such as different levels of health literacy
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 2021
Background Healthcare workers have reported increased anxiety while working in hospitals during t... more Background Healthcare workers have reported increased anxiety while working in hospitals during the COVID-19 pandemic, and the role of healthcare students in a health crisis has been discussed among clinicians and researchers. The simultaneous international shortage of personal protection equipment (PPE) during the first wave of the pandemic potentially exposed healthcare workers and students to the virus during their work and clinical training. Our aim was therefore to evaluate the extent to which paramedic students in Oslo, Norway, were exposed to the SARS-CoV-2 virus and were involved in voluntary and/or paid healthcare-related work. An evaluation was also made of the students’ COVID-19-related symptoms and of their health-related quality of life (HRQoL) during the first wave of the pandemic. Methods Paramedic students (n = 155) at Oslo Metropolitan University, Norway, were invited to complete an online survey five months after the first cases of COVID-19 were detected. The unive...
Introduction Family carers are cornerstones in the care of older people living with dementia. Fam... more Introduction Family carers are cornerstones in the care of older people living with dementia. Family carers report extensive carer burden, reduced health-related quality of life (HRQoL), and extensive time spent on informal care (Time). Health literacy (HL) is a concept associated with people’s ability to access health services, and navigate the healthcare system. This study’s aim was to investigate HL among family carers, and investigate the associations between HL and carer burden, HRQoL, and Time spent on informal care. Method We designed a self-administered survey comprising validated instruments, including the Health Literacy Scale (HLS-N-Q12) to measure HL, Relative Stress Scale (RSS) to measure carer burden, the EQ-5D-5L instrument to measure HRQoL, and some modified questions from the Resource Utilization in Dementia (RUD) questionnaire to measure time spent on informal care (Time). Descriptive analysis in addition to bivariate and multiple linear regressions were undertaken...
Background While dementia policy strategies emphasize the importance of partnerships between fami... more Background While dementia policy strategies emphasize the importance of partnerships between families and formal carers to provide tailored care and effectively allocate community resources, family carers often feel left out or excluded. Poor communication has been identified as one reason for the lack of good partnerships. Few studies have investigated how family carers seek to involve themselves when they experience sub-optimal services, and how their strategies may depend on different considerations and personal abilities. Methods Qualitative in-depth interviews were conducted with 23 family carers to explore their experiences with, perspectives on, contributions to, and interactions with healthcare services provided to older adults living with dementia. To capture nuances and variations, a semi-structured interview guide was used. Interviews were audio-recorded and transcribed verbatim. A four-step analysis of the transcripts was conducted, informed by hermeneutic and phenomenol...
Background: Dementia is a cause of disability and dependency associated with high demands for hea... more Background: Dementia is a cause of disability and dependency associated with high demands for health services and expected to have a significant impact on resources. Care policies worldwide increasingly rely on family caregivers to contribute to service delivery for older people, and the general direction of health care policy internationally is to provide care in the community, meaning most people will receive services there. Patient safety in primary care is therefore important for future care, but not yet investigated sufficiently when services are carried out in patients' homes. In particular, we know little about how family carers experience patient safety of older people with dementia in the community. Methods: This was an explorative study, with qualitative in-depth interviews of 23 family carers of older people with suspected or diagnosed dementia. Family carers participated after receiving information primarily through health professionals working in dementia care. A semi-structured topic guide was used in a flexible way to capture participants' experiences. A four-step inductive analysis of the transcripts was informed by hermeneutic-phenomenological analysis. Results: The ways our participants sought to address risk and safety issues can be understood to constitute protective practices that aimed to prevent or reduce the risk of harm and/or alleviate damage from harm that occurs. The protective practices relate to four areas: physical harm, economic harm, emotional harm, and relational harm. The protective practices are interlinked, and family carers sometimes prioritize one over another, and as they form part of family practice, they are not always visible to service providers. As a result, the practices may complicate interactions with health professionals and even inadvertently conceal symptoms or care needs. Conclusions: When family caregivers prevent harm and meet needs, some needs may be concealed or invisible to health professionals. To recognize all needs and provide effective, safe and person-centered care, health professionals need to recognize these preventive practices and seek to build a solid partnership with family carers.
IntroductionDespite the lack of knowledge about the SARS-CoV2 virus, the lack of personal protect... more IntroductionDespite the lack of knowledge about the SARS-CoV2 virus, the lack of personal protection gear among frontline healthcare workers, and lack of vaccines in the beginning of the pandemic, paramedic students in Norway contributed to the National response against the COVID-19 pandemic by working in test-stations, ambulance services, ambulance decontamination stations etc. Despite fear of contracting the COVID-19 reported by healthcare workers worldwide, paramedic students in Norway reported higher-than-average quality of life after four months of the COVID-19 pandemic (first pandemic wave). In this study we aimed to investigate how students reported their quality of life, study motivation and job satisfaction after one year of living with the COVID-19 pandemic. MethodAt each data collection point, all paramedic students enrolled at Oslo Metropolitan University were invited to participate in a digital, online, self-administered survey. The first data collection was in June 202...
Avdeling for paramedisin Institu for sykepleie og helsefremmende arbeid OsloMet Forfa erbidrag: i... more Avdeling for paramedisin Institu for sykepleie og helsefremmende arbeid OsloMet Forfa erbidrag: idé, utforming/design, datainnsamling, li eratursøk, utarbeiding og revisjon av manus samt godkjenning av innsendte manusversjon. Nina Øye Thorvaldsen er universitetslektor. Hun er sykepleier med mange års erfaring fra paramedicarbeid, hovedsakelig fra ambulanseavdelingen, Oslo universitetssykehus. Forfa eren har fylt ut ICMJE-skjemaet og oppgir ingen interessekonflikter. Avdeling for paramedisin Institu for sykepleie og helsefremmende arbeid OsloMet Forfa erbidrag: idé, utarbeiding og revisjon av manus samt godkjenning av innsendte manusversjon. Anne Kristine Bergem er spesialist i psykiatri og førstelektor II. Hun er spesialrådgiver i Norsk psykiatrisk forening og har videreutdanning i voldsrisikovurdering og-håndtering. Forfa eren har fylt ut ICMJE-skjemaet og oppgir ingen interessekonflikter.
Background: Care policies worldwide aim to control care expenses and provide more care in peoples... more Background: Care policies worldwide aim to control care expenses and provide more care in peoples’ homes, increasing the importance of informal care and the role of family carers’. This Ph.D. project aims to better our understanding of family carers’ perspectives on care provision to older people living with dementia, and how the interplay between health services and informal carers may be enhanced to improve care provision. Method: The study followed an exploratory sequential mixed method design: Substudy 1 was based on in-depth, semi-structured interviews of 23 family carers for older people living with dementia, to explore experiences with care provision. Transcribed interviews were coded and analyzed in four steps, informed by hermeneutics, phenomenology, and thematic analysis. Building on findings from Substudy 1, Substudy 2 comprised a quantitative survey in a larger sample of 188 family carers. Results were analyzed using descriptive statistics, and multiple linear regression models were used to test assumptions that health literacy could predict carer burden, health-related quality of life, and time spent on informal care. Results: Analysis of the interviews highlight how family carers may identify care needs unmet by health services, and indicate four preventive practices employed in their care, aiming to prevent physical, emotional, economic, and relational harm. In interactions with health services, family caregivers resort to two broad involvement strategies: (1) being “the hub in the wheel”, through conciliatory co-ordination; and (2) “getting the wheel rolling”, using purposeful and assertive acts to improve leverage. Both strategies have costs and benefits, and use depends on available personal resources. The survey participants displayed high levels of health literacy, a partially trainable personal resource. Regression analyses indicate that higher health literacy was associated with lower carer burden, higher healthrelated quality of life, and less time spent on informal care. Conclusion: Family cares can be valuable resources in care provision for older people living with dementia, adding important perspectives on safety and quality of care, and facilitating co-ordination and utilization of resources. Strong partnerships between formal and informal care may benefit from awareness of interaction challenges, including involvement strategies; differences in perspectives and motivations, including preventive practices; and differences in personal resources, such as different levels of health literacy
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 2021
Background Healthcare workers have reported increased anxiety while working in hospitals during t... more Background Healthcare workers have reported increased anxiety while working in hospitals during the COVID-19 pandemic, and the role of healthcare students in a health crisis has been discussed among clinicians and researchers. The simultaneous international shortage of personal protection equipment (PPE) during the first wave of the pandemic potentially exposed healthcare workers and students to the virus during their work and clinical training. Our aim was therefore to evaluate the extent to which paramedic students in Oslo, Norway, were exposed to the SARS-CoV-2 virus and were involved in voluntary and/or paid healthcare-related work. An evaluation was also made of the students’ COVID-19-related symptoms and of their health-related quality of life (HRQoL) during the first wave of the pandemic. Methods Paramedic students (n = 155) at Oslo Metropolitan University, Norway, were invited to complete an online survey five months after the first cases of COVID-19 were detected. The unive...
Introduction Family carers are cornerstones in the care of older people living with dementia. Fam... more Introduction Family carers are cornerstones in the care of older people living with dementia. Family carers report extensive carer burden, reduced health-related quality of life (HRQoL), and extensive time spent on informal care (Time). Health literacy (HL) is a concept associated with people’s ability to access health services, and navigate the healthcare system. This study’s aim was to investigate HL among family carers, and investigate the associations between HL and carer burden, HRQoL, and Time spent on informal care. Method We designed a self-administered survey comprising validated instruments, including the Health Literacy Scale (HLS-N-Q12) to measure HL, Relative Stress Scale (RSS) to measure carer burden, the EQ-5D-5L instrument to measure HRQoL, and some modified questions from the Resource Utilization in Dementia (RUD) questionnaire to measure time spent on informal care (Time). Descriptive analysis in addition to bivariate and multiple linear regressions were undertaken...
Background While dementia policy strategies emphasize the importance of partnerships between fami... more Background While dementia policy strategies emphasize the importance of partnerships between families and formal carers to provide tailored care and effectively allocate community resources, family carers often feel left out or excluded. Poor communication has been identified as one reason for the lack of good partnerships. Few studies have investigated how family carers seek to involve themselves when they experience sub-optimal services, and how their strategies may depend on different considerations and personal abilities. Methods Qualitative in-depth interviews were conducted with 23 family carers to explore their experiences with, perspectives on, contributions to, and interactions with healthcare services provided to older adults living with dementia. To capture nuances and variations, a semi-structured interview guide was used. Interviews were audio-recorded and transcribed verbatim. A four-step analysis of the transcripts was conducted, informed by hermeneutic and phenomenol...
Background: Dementia is a cause of disability and dependency associated with high demands for hea... more Background: Dementia is a cause of disability and dependency associated with high demands for health services and expected to have a significant impact on resources. Care policies worldwide increasingly rely on family caregivers to contribute to service delivery for older people, and the general direction of health care policy internationally is to provide care in the community, meaning most people will receive services there. Patient safety in primary care is therefore important for future care, but not yet investigated sufficiently when services are carried out in patients' homes. In particular, we know little about how family carers experience patient safety of older people with dementia in the community. Methods: This was an explorative study, with qualitative in-depth interviews of 23 family carers of older people with suspected or diagnosed dementia. Family carers participated after receiving information primarily through health professionals working in dementia care. A semi-structured topic guide was used in a flexible way to capture participants' experiences. A four-step inductive analysis of the transcripts was informed by hermeneutic-phenomenological analysis. Results: The ways our participants sought to address risk and safety issues can be understood to constitute protective practices that aimed to prevent or reduce the risk of harm and/or alleviate damage from harm that occurs. The protective practices relate to four areas: physical harm, economic harm, emotional harm, and relational harm. The protective practices are interlinked, and family carers sometimes prioritize one over another, and as they form part of family practice, they are not always visible to service providers. As a result, the practices may complicate interactions with health professionals and even inadvertently conceal symptoms or care needs. Conclusions: When family caregivers prevent harm and meet needs, some needs may be concealed or invisible to health professionals. To recognize all needs and provide effective, safe and person-centered care, health professionals need to recognize these preventive practices and seek to build a solid partnership with family carers.
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