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This paper focuses on how immigrant women experience and negotiate their everyday life with children prior to and after leaving a violent partner. Twenty‐three women staying at domestic violence and abuse shelters with their children were interviewed about their experiences with assistance services and their everyday life with their children. At the time of the interviews, most of the women were legally separated or divorced and were either living in or in touch daily with shelters. In this paper, we look at some of the challenges that women face when exposed to violence in a relationship that involves children. Being exposed to violence from a partner raises a number of economic, practical, and emotional concerns, both prior to and after leaving. For the mothers in our study, maintaining a regular routine is key to making the children feel safe in an unpredictable setting. For many, economic dependence on the partner is replaced with economic dependence on assistance services after leaving the partner. Services must recognize that providing help to mothers who have left a violent partner constitutes more than just practical support but is crucial for mothers' ability to re‐establish a predictable everyday life with their children. [ABSTRACT FROM AUTHOR]

The paper builds on ethnographic, qualitative research that explores the 'No Kids in the Middle' program for high‐conflict divorce families, as practiced in the Agder region of South Norway. Parent education programs targeting parents in divorce are generally found to be 'effective' in the sense that parents learn about the pitfalls of conflict and become socialised into less negative patterns of co‐parenting. However, a narrow understanding of the potential of such programs as vehicles for the transfer of knowledge fails to attend to the relational sides of both education and therapy, and the existential sides of parenthood. Drawing on Gert Biesta's articulation of education as a process working along three dimensions of purpose, the paper approaches the 'No Kids in the Middle' program as an educational practice. It aims to explore whether the educational ambitions of the 'No Kids in the Middle' program should be understood primarily in the general terms of qualification (i.e., parents acquiring knowledge and skills) and socialisation (i.e., parents gaining a specific orientation toward a set of norms and values), or if there were practices or elements that seemed directed at subjectification or bringing the 'I' of each parent into play. Analysing field notes from participant observation in a 'No Kids in the Middle' multi‐family group and interviews with parents, therapists, judges, and child welfare caseworkers, the paper concludes that programs like 'No Kids in the Middle' provide a broad spectrum of educational opportunities. While some of these might be intended to instruct along pre‐defined normative paths toward understanding and behaviour, such practices can also be seen as addressing parents in a different, more existential, way. In the particular local practice studied, the dimension of subjectification was perhaps most clearly in play in the informal settings surrounding the program itself. [ABSTRACT FROM AUTHOR]

Multimodal data have the potential to explore emerging learning practices that extend human cognitive capacities. A critical issue stretching in many multimodal learning analytics (MLA) systems and studies is the current focus aimed at supporting researchers to model learner behaviours, rather than directly supporting learners. Moreover, many MLA systems are designed and deployed without learners' involvement. We argue that in order to create MLA interfaces that directly support learning, we need to gain an expanded understanding of how multimodal data can support learners' authentic needs. We present a qualitative study in which 40 computer science students were tracked in an authentic learning activity using wearable and static sensors. Our findings outline learners' curated representations about multimodal data and the non‐technical challenges in using these data in their learning practice. The paper discusses 10 dimensions that can serve as guidelines for researchers and designers to create effective and ethically aware student‐facing MLA innovations. Lay Description: What is already known about this topic: Many MLA systems are designed without learners' involvement.Understanding of how multimodal data can support learners' authentic needs is needed.MLA have the potential to enable the automated generation of models to provide real‐time feedback. What this paper adds: Understanding how learners perceive multimodal data and the learning context.The findings outline the soft challenges in using multimodal data in the learning practice.Ten dimensions were identified to serve as guidelines for researchers and designers.The paper reports learners' perspectives describing new, intriguing, and under‐developed ideas about potential uses of multimodal data in educational context.The discussion on the need for human‐centred design approaches for educational technologies has been presented. Implications for practice and/or policy: Relevant pointers for what is appropriate and ethically necessary when designing learning technologies.Change in perspective among educators, on how they address progress and engagement in learning. [ABSTRACT FROM AUTHOR]

Background: Globally, digital skills are a crucial aspect of education that schools should develop systematically. Research on digital skills tends to be measured using self‐reports, performance tests or interventions. There is less knowledge about student and teacher uptake of technology in school, making it important to investigate the actual use of technology and digital skills in authentic classroom settings. Objectives: This study contributes unique baseline data concerning students' use of technology and digital skills across mandatory English courses in real classroom settings in secondary schools in Norway over time. Methods: The study adapted a national framework for digital skills into an observation protocol. With it, this study analysed videos from 60 naturally occurring English lessons in 13 English classes at seven lower secondary schools over two school years (grades 9 and 10), following 186 students (aged 13–15) and 10 teachers. Results and Conclusions: Students used digital skills critical for education in half of the video‐recorded English lessons, with more digital skill use at some schools over time. The main finding across classrooms and school years regards students' use of basic, not advanced, digital skills. Takeaways: Although teachers provide opportunities for students to use digital skills in school, more advanced skills are needed. This work calls for continued use of video recordings to provide systematic comparisons of potential shifts in students' digital skills in real English secondary classroom settings over time. Lay Description: What is currently known: Digital skills is a crucial aspect of education globallyStudent and teacher uptake of technology varies extensivelyMost studies on the use of digital technology concern self‐reports and interventionsFew studies exist concerning the actual use of digital skills in the classroom What this paper adds: Video recordings from seven English classrooms across two school years are analysed.A framework for digital skills is adopted and used as observation protocolAttention is given to the difference between basic and advanced digital skillsHow technology is actually used matters more than how much technology is available Implications of study findings for practitioners: Teachers should offer opportunities for students' use of digital skills in the classroomSubject‐specific use of digital skills should be prioritizedThere is a need for more emphasis on reflection and digital judgementWe need to encourage the use of advanced digital skills and not only basic skills [ABSTRACT FROM AUTHOR]

Background: Huntington's disease (HD) is a neurodegenerative disease characterized by a triad of motor, cognitive and psychological symptoms, leading to a gradual breakdown of communication skills. Few studies have investigated how people affected by HD and their professional caregivers, for example, medical doctors, physiotherapists and nurses, experience the patients' gradual loss of speech and language. Aims: To examine communication‐related experiences of patients and professional caregivers. Experiences with speech therapy and the use of augmentative and alternative communication aids (AAC) were also investigated. Methods & Procedures: Seven individuals with HD and seven professional caregivers were interviewed individually, using a semi‐structured interview guide. Transcripts were analysed using a conventional content analysis, and the results presented in three main categories. Outcomes & Results: Most individuals with HD were aware of having communication difficulties, struggling with understanding others as well as being understood. This was confirmed by professional caregivers, who also raised ethical issues encountered when patients struggled with communication. Both groups talked about external factors (such as noise or crowded social settings) as disrupting communication, and shared recommendations on how people in general, and speech and language therapists (SLTs) in particular, could optimize communication. Very few patients had received information about communication aids, and none was using AACs. Professional caregivers underlined the importance of interdisciplinary collaborations, including SLTs, in order to optimize care. Conclusions & Implications: Findings shed a light on everyday communication challenges faced by people with HD and their professional caregivers, and the lack of implementation of communication aids in this group. The dramatic impact of HD on patients' communication skills underscores the need to include SLTs in the follow‐up of this patient group, ideally from the early stages of the disease, while the patient is still capable of voicing his/her own wishes and thoughts. Future research that explores how to optimize communication and implement the use of AACs for individuals with HD is needed. What this paper addsWhat is already known on this subjectAlthough the ability to communicate gradually deteriorates in individuals affected by Huntington's disease (HD), there is little knowledge about how affected individuals experience the loss of speech and language skills. Interdisciplinary care is recognised as essential for this patient group. However, professional caregivers' thoughts and experiences of communicating with their patients have not been fully explored. Recent years have seen a rapid growth of available communication supporting technologies that could potentially be helpful for individuals with HD, but limited attention has been given to this subject.What this paper adds to existing knowledgeWhat do we now know as a result of this study that we did not know before the results highlight that patients are aware of problems with speech and language even in early phases of the disease, and include patients' personal outlook on problems with communication. Professional caregivers raised ethical issues encountered when patients struggled with communication. Both groups described specific strategies that could facilitate communication. There was a significant lack of experience and knowledge about augmentative and alternative communication aids (AACs).What are the potential or actual clinical implications of this work?Clinical implications of this study. The introduction of communication aids in the follow‐up of patients with HD needs to be discussed with the patients in the early phases of the disease, and implemented while the individual still has the capacity to learn and take advantage of alternative communication support. Results underline the importance of including speech and language therapists (SLTs) into multidisciplinary care of patients with HD. SLTs should be available also for professional caregivers who need advice on how to facilitate conversations and social interactions, in order to optimise care of patients with HD. [ABSTRACT FROM AUTHOR]

Background: The scope of this priority‐setting process is communication and collaboration in transitional care for patients with acute stroke. Actively involving persons with stroke and their family caregivers is important both in transitional care and when setting priorities for research. Established priority‐setting methods are time‐consuming and require extensive resources. They are therefore not feasible in small‐scale research. This article describes a pragmatic priority‐setting process to identify a prioritized top 10 list of research needs regarding transitional care for patients with acute stroke. Methods: A pragmatic priority‐setting approach inspired by the James Lind Alliance was developed. It involves establishing a user group, identifying the research needs through an online survey, analysing and checking the research needs against systematic reviews, culminating in an online prioritization of the top 10 list. Results: The process was completed in 7 months. A total of 122 patients, family caregivers, health personnel and caseworkers submitted 484 research needs, and 19 users prioritized the top 10 list. The list includes the categories 'patients and caregivers' needs and health literacy', 'health personnel's common understanding', 'information flow between health personnel and patients and caregivers', 'available interventions and follow‐up of patients and caregivers', 'interaction and collaboration between health personnel and caseworkers across hospital and primary healthcare' and 'disabilities after stroke'. Conclusion: This paper outlines a pragmatic approach to identifying and prioritizing users' research needs that was completed in 7 months. The top 10 list resulting from this priority setting process can guide future research relating to communication and collaboration during the transition from hospital to the community for patients with stroke. Patient and Public Contribution: Members of three stroke organizations participated in the advisory group. They gave feedback on the scope and the process, distributed the surveys and prioritized the top 10 list. Persons with stroke and their caregivers submitted research needs in the survey. [ABSTRACT FROM AUTHOR]

This paper examines the relationship between professional work and standardization. There has been an increase in the use of standardized programmes in child welfare services (CWS) in Western society. Some researchers have criticized standardized programmes suggesting that they undermine professionals expertise and threaten their position, whereas others argue that such programmes strengthen professional practice. In this paper, we examine how standardized tools, in this case, a standardized parenting programme and a standardized Norwegian assessment tool, influence professional roles as experienced by child welfare workers (CWS professionals) in Norway. Semistructured individual and group interviews were conducted with 31 frontline workers in two CWS agencies. Our findings suggest that standardized tools increase the social workers experienced professional competence but challenge their professional knowledge base, reflective practice, and professional accountability. Professional and practical implications for CWS work are discussed in the light of these findings. [ABSTRACT FROM AUTHOR]

This paper focuses on two cohorts of Norwegian young men whose behaviour in childhood and adolescence caused serious concern to their parents, teachers, social workers and, in some cases, the police, Despite having been identified as 'at risk', they made transitions to positive adult masculine identities in two different historical contexts; the 1980s and 2000s. The paper analyses the difference that historical context makes to these young men's lives, their gendered identity work and their perspectives on their past, present and future. In particular, it identifies the ways in which supportive intergenerational relationships and significant others serve to produce positive turning points and, over time, help the young men to develop resilience and potentially happy and successful futures. [ABSTRACT FROM AUTHOR]

Sibling relationships are potentially central in children's and young people's lives. Research has shown that the quality of sibling relationships changes in a variety of ways when a sibling(s) moves into care. There is limited understanding of the mechanisms that cause these changes. This study addresses this gap by reanalysing a dataset of 25 semistructured interviews with young people (16 to 23 years) drawn from a municipality in Southern Norway. The original study explored the changes in sibling relationships when the young person moved into care. This reanalysis of the data set explores specifically, using a template analysis, the mechanisms that children describe when exploring why these changes occur. Findings show the intricacies of the young person's social identification with the biological and/or foster family and how sharing a common identity may be key to the development of the sibling relationship when the young person(s) is taken into care. Our findings also show how key adults, such as foster parents and social workers, influence the relationship. The paper concludes with recommendations for social workers on how they may strengthen sibling relationships in families where children have been taken into care. [ABSTRACT FROM AUTHOR]

Growing numbers of lesbian, gay, bisexual, transgender, questioning (LGBTQ) people are becoming foster parents in several western countries. The LGBTQ perspective on the child welfare system has received little attention in practice, research and policy. Despite their increased rights, LGBTQ foster parents continue to face challenges related to fostering. Knowledge is needed on LGBTQ individual perceptions of the process of becoming foster parents, including barriers and facilitating factors. This paper reports on the experiences of 13 gay or lesbian foster parents in Norway. The study shows a lack of knowledge about the possibility of becoming foster parents due to lack of information directed at them as a minority group. Participants felt vulnerable and experienced "minority stress" before encountering the child welfare system, while mainly experienced the encounter with the staff as good and respectful. Although several valued being treated "like everyone else" by the system, others questioned why LGBTQ‐specific parenting issues were not raised and discussed. Apart from lack of information, the process towards foster parenting seemed mostly hampered by participants' own assumptions that sexual identity would be a barrier and to some extent biological parents' refusal. The study suggests that foster care and child welfare services would benefit from information in recruitment of foster parents, aiming at being more inclusive. Furthermore, we address gender and sexuality diversity related to foster care work and highlight the strengths and challenges it may offer. [ABSTRACT FROM AUTHOR]

The aim of this paper is to address risks young people in the late 20th and 21st century are exposed to with regard to political participation. Based on qualitative data and ordinary language interviews with 27 Norwegian pupils in upper secondary school, we address how the construction of the political space is understood by young people themselves. By analysing how young people define political interest and engagement, the findings indicate that a gap exists in the perception of 'own' and 'institutionalised' political participation. This paper concludes that exploring the understanding of politics among the young may reduce vulnerability of this particular group in their democratic participation as well as facilitate their political empowerment. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to explore the reasons for unintended placement disruptions in foster care. Based on a semistructured survey, the paper presents the views of 132 Norwegian foster parents who have experienced placement disruption between 2013 and 2015. Foster parents rated several relevant causes of placement disruption: the child's behaviour, the need for care, concern for the well‐being of their biological children, and lack of support from the Child Welfare Service (CWS). Although the child's behaviour was the cause most frequently reported in the quantitative data, CWS‐related factors such as poor collaboration, not being valued and listened to, insufficient support and follow‐up, and a mismatch between the child's needs and the foster carers' capacity were reported most frequently in the qualitative data. Placement disruption appears to be caused by the sum and interaction of several coexisting causes. It may not be the child's behaviour per se but rather the combination of challenging behaviour, concern for one's biological children, and insufficient support from CWS that lead to disruption. Good collaboration with the CWS in the form of respect, recognition, support, and follow‐up appears to be of the utmost importance in reducing the risk of placement disruption. [ABSTRACT FROM AUTHOR]

Services providing support for children and families are often described as fragmented and more concerned with the boundaries of their fields of responsibility than collaborating with other sectors. To meet the need for greater collaboration, there is increased impetus for establishing interdisciplinary services, such as family centres. This paper presents the results of a qualitative study based on in‐depth interviews and participant observation in 3 Norwegian family centres. The findings provide insight into central challenges in developing new practices within the field of family support; we discuss how intersectorial collaboration is constructed in relation to the core objectives of the family centre, professional competence, and service stability. This study demonstrates that both managers and professionals struggle with prioritizing intersectorial work, which mainly focuses on prevention and health promotion, over and above their traditional sectoral responsibilities. It also illustrates the necessity of articulating intersectorial collaboration as an explicit aim and exploring its implications and examining how this contributes to family centres building supportive communities. Building integrated services is not the ultimate goal of this particular form of service provision but rather the first step towards building interconnected support systems for all children in the community. [ABSTRACT FROM AUTHOR]

Siblings are key actors in the social network of young people in care. This paper explores young people's perceptions of changes in the quality of sibling relationships and the pathways relationships follow during the transition from the biological family into care. A thematic analysis of interviews with young Norwegian people (n = 25) in care showed that, in the biological family, sibling relationships are characterized by alliances, parentification, conflicts or nonexistence. After admission to child welfare services care, sibling relationships developed along multiple pathways. Their sibling relationships reshaped into either close and supportive, conflictual or completely broken relationships. Sibling relationships were dynamic, complex, with the pathway, and its impact on well‐being, being unique to each young person. Sibling relationship quality in the biological home did not predict relationship quality after admission to child welfare services. The implications for social worker practice are discussed. [ABSTRACT FROM AUTHOR]

Objective: The aim of this paper was to explore child sexually abused survivors' experiences of dental treatment in order to obtain a deeper understanding of them as dental patients. Methods: Data were drawn from qualitative semi‐structured interviews with 16 adult informants recruited from four different Centres against Sexual Abuse in Norway. Data analysis was developed according to the principles of grounded theory suggested by Charmaz. Results: A conceptual framework was generated, and a core concept was constructed from the informants' reports of their experiences of dental treatment: Preparing for attack and recovering from battle based on four main categories: (a) Expecting danger, (b) Battling anxiety, (c) Reliving abuse and (d) Struggling with the aftermath. Conclusions: The analyses increase the understanding of how child sexual abuse survivors prepare before—battle during—and recover after dental treatment. This study revealed child sexual abuse survivors' experiences of extensive anxiety, triggered by sensory stimuli such as sensations, movement, muscles, touch, sight, sound, smell and taste, associated with dental procedures per se, but also sensory stimuli similar to previous traumatic experiences. The findings suggest that child sexual abuse survivors' dental anxiety is primarily trauma‐driven and possibly being one of the long‐term effects of child sexual abuse. This may be an important contribution to the understanding of CSA survivors and should affect the approach of clinicians treating dental patients with such a history. [ABSTRACT FROM AUTHOR]

Background: Collaboration with care partners is a political aim in recent white papers in Norway and internationally. Home care services regularly work closely with care partners, but there are many indications that the collaboration does not work satisfactorily. Aim: To explore home care staff and leaders' experiences of collaborating with care partners of older people with mental health problems through a personhood perspective. Methods: The study had a qualitative design and comprised eight health professionals in two focus groups and in‐depth interviews with three leaders in one home care district. The data were analysed using a thematic framework analysis building on previous research on personhood. criteria for reporting qualitative reporting guidelines were used to ensure comprehensive reporting. Results: Four themes were identified in the analysis: 'non‐negotiated relationships', 'contradictory agendas', 'weak paternalism' and 'moral compromise'. Conclusion: There seems to be a lack of facilitation of collaborative relationships through all levels of the home care organisation. The interactions between care partners and home care staff sometimes appear to produce low or negative levels of emotional energy, and situations where the personhood of neither of them is respected occurs. Paying attention to the four modes of being as a framework for understanding personhood creates the foundation for a person‐centred approach that enhances the potential of creating stronger partnership in care relationships. [ABSTRACT FROM AUTHOR]

Across stages of acquisition, second language (L2) competencies are contingent on the variation among individuals learning the language, in both informal and formal learning contexts. This study investigates a group of outliers whose extreme test scores serve as a foundation to examine them as individuals. The study addresses the outliers' characteristics as good L2 readers but poor first language (L1) readers. Combining quantitative (test results, survey, and language logs) and qualitative (focus groups and interviews) data among 21 adolescents in Norway (aged 16–17 years), the study identifies dimensions of individual language use in L1 Norwegian and L2 English. Findings revealed that they explained their English proficiency by the role of interest and their extensive use of English technology and tools outside school. In‐depth analysis identified three profiles: the Gamer, who spends up to 8 hr daily playing online games while using English mainly; the Surfer, who spends hours on the Internet, searching for authentic language situations, commonly involving English; and the Social Media User, who produces and consumes information in English through social media. Additionally, the Gamers read printed novels voluntarily outside the classroom. This study offers unique perspectives and new directions for future L2 research. Lay Description: What is currently known: Most young people read better in their first language (L1) than in a second language (L2).Young people with an outlier profile read significantly better in L2 English than L1 Norwegian.Internet access facilitates opportunities to improve English skills outside formal schooling. What this paper adds: Outliers develop L2 English reading proficiency due to informal digital technology use.Three different outlier profiles are identified: Gamers, Surfers, and Social Media Users.Most online Gamers also read printed novels voluntarily outside the classroom. Implications of study findings for practitioners: Teachers should bridge English use in the classroom with young people's voluntary use of digital technology.Young people might profit from experiencing a bridging of virtual and physical realities.Their use of digital texts might extend to texts in school, which could help develop L2 reading proficiency. [ABSTRACT FROM AUTHOR]

Aim: The aim of the study was to understand the experiences of nurses who were newly appointed to a position of leadership including facilitators and barriers to success and what they considered important for the development of their role. Methods: We used a qualitative descriptive research design. The study was conducted in Norway with 10 nurses who had been appointed to a leadership position within the last 2 years. Participants were interviewed with individual qualitative interviews which were transcribed and subsequently analysed using thematic analysis. Results: The following four main themes were identified from the data: I feel lonely in the leadership position, I am not confident as a leader, I am unsure of the requirements and expectations of me, and I need support and supervision. Conclusion: The results underscore the challenges reported by new leaders in nursing and their advocacy for mentorship as a facilitator for success. The qualifications of mentors were emphasised with a need for a comprehensive leadership skill set to address the multifaceted aspects of leadership development. [ABSTRACT FROM AUTHOR]

Domestic violence continues to be a serious social problem and represents a challenge for those who are exposed to it and those in public services. In Norway, a variety of services are provided to help victims of domestic violence and improve knowledge among professionals who meet with adults and children exposed to domestic violence. Studies in Norway show that families with immigrant backgrounds are overrepresented among social service users as a result of domestic violence. However, contextualized knowledge to provide background information about this overrepresentation is limited. This paper explores women's need for support and their experience with service providers when faced with difficult and unpredictable situations, namely, escaping from violence and leaving home with no financial resources or limited supportive network and turning to service providers for support. Qualitative interviews were conducted with 18 women who were staying in or were in touch with shelters with their children or alone. Five central themes emerged in the analysis of these interviews: (a) help becoming a burden; (b) timely economic measures; (c) economic support and domestic violence; (d) displaced focus; and (e) flexibility and the victim's background. [ABSTRACT FROM AUTHOR]

ABSTRACT This paper analyses the narratives of adolescents who have experienced domestic violence. It focuses on what we can learn about being an adolescent who experiences domestic violence, using a narrative approach. Attentive to both form and content, the paper sheds light on why the narrative is being told, who the actors in the narratives are, who are positioned in the forefront/background and what the point of the narrative is. The analysis shows that through the storytelling, the father's position as the reluctant/dangerous/weak aggressor is negotiated, the mother is positioned both in the background as a victim and in the forefront as an actor resisting his violent behaviour. The children position themselves as actors with power to alter the progress, to protect and stop the violence. The point of the narratives is to describe the father as the aggressor, and to describe the important role of the children. This picture of the father, mother and child questions the traditional understanding of the father as the aggressor, the mother as the victim and the child as a powerless bystander being exposed to the violence, and underlines the complexities of the dynamics in families living with domestic violence. [ABSTRACT FROM AUTHOR]

Abstract: Background: Due to civil war, Somalis immigrants have settled in Norway and the United States. Large families are valued among Somalis and Somali women continue to give birth in their new countries. Research studies have been conducted with Somali immigrant new mothers in Norway and Minnesota, United States to understand perceptions of their childbirth experience. Purpose: The purpose of this qualitative study was to compare the childbirth experiences of Somali immigrant mothers in the United States and Norway to make recommendations to improve health care practice. Design: This paper presents a comparison of two research studies in order to identify and explain similarities and differences between cross‐cultural immigrant populations. Results: Both studies identified themes related to the importance of family support in the postpartum period, fear of Cesarean delivery, and relationships with nurses. These studies give recommendations for nurses on how to provide culturally sensitive care for Somali new mothers. Conclusions: Implications for practice are that nurses should develop trusting relationships with Somali mothers and facilitate cultural and religious practices. Information regarding support resources in the community should be provided to Somali mothers throughout the perinatal period. [ABSTRACT FROM AUTHOR]

ABSTRACT This paper presents the findings of an exploratory study on parenting in the midst of suspicion of child sexual abuse (CSA). Data were drawn from in-depth interviews with 19 parents. Five of these had been accused of CSA. Study methods followed guidelines of grounded theory approaches. Specific parenting conditions during CSA suspicion were identified. Six analytic categories were developed: uncertainty concerning abuse, dilemmas on protection, changes in parent-child relationships, changes in the natural support network, dependency upon professional competence and severe emotional strain. The results are suggested as a tool for identifying themes in order to support and strengthen parenting in ensuring the safety and well-being of children in these kinds of situations. The current paper contributes to the field by exploring the perspectives of both suspected and non-suspected parents. [ABSTRACT FROM AUTHOR]

Introduction: People should have access to healthcare services that are effective, safe and secure, patient‐centred, and coordinated and continuous. One group that has consistently reported negative experiences and feels dissatisfied with services are patients with Myalgic Encephalomyelitis (ME)/Chronic Fatigue Syndrome (CFS). The objective of this study was to develop a deeper understanding of the experiences of dissatisfaction among ME/CFS patients and explore the reasons for such dissatisfaction. Methods: We conducted in‐depth interviews with 48 people from 24 households (comprising patients and family members), providing insight into the experiences of 37 ME/CFS sufferers in Norway. The participants were purposively sampled and included persons of different ages, genders, time since having the condition (3–30 years), and severity. Results: Four main themes were developed: (1) 'Nonexistent services' cover patients' experience that healthcare services had nothing to offer them after receiving their ME/CFS‐diagnosis. (2) 'Nonpersonalised services' documents experiences where patients did receive services, which in theory was appropriate for relieving a specific health problem, but in practice were experienced as inappropriate because they were not adapted to the patient's need. (3) 'Slow services' address patients' experience of getting services too late (or too little) to be useful. (4) 'Wrong services' comprise patients' experiences of being offered and/or 'forced' to accept services that they felt were inappropriate for their health problems. Conclusions: Providers' lacking knowledge of the condition and lack of precise recommendations for follow up may partly explain unsatisfactory experiences. Providers' belief (or disbelief) in the condition could furthermore influence caregiving. Also, systemic issues in the healthcare sector, like high workloads and bureaucracy, can negatively affect care provision. Finally, users' unsatisfactory experiences may also be due to a lack of patient involvement in the design of such services. Further research should investigate how patients can be involved in service design, and also providers' perspectives on caregiving and the barriers they experience for providing high‐quality care. Patient or Public Contribution: The ME‐patient organisation suggested research topics to the call from which this study got funding. Patients and caregivers provided feedback during analysis and interpretation of data. [ABSTRACT FROM AUTHOR]

Aim: The aim of the study was to explore the experiences of nurse anaesthetists being relocated during the COVID‐19 pandemic. Design: The study has a qualitative design. Methods: A total of 12 nurse anaesthetists from four different hospitals were included. Data were collected using individual semi‐structured interviews and then analysed using content analysis. The Consolidated Criteria for Reporting Qualitative Research checklist was used. Results: The 12 respondents, of whom three were men, were between 46 and 64 years old and had 7 to 30 years of experience as NAs. Two themes emerged in the analysis: (1) 'Diverse experiences' with the sub‐themes 'Preparedness' and 'Insecurity' and (2) 'Both assistant and specialist' with the sub‐themes 'Exhausting' and 'Meaningful'. Conclusion: This study shows that the NAs competencies made them prepared to handle many of the situations. They also experienced situations where they were uncomfortable being pressured to take responsibility. They were regarded as a uniform group without considering their prior experiences. Mapping the personnel's former experiences is required to utilize best possible matching of personnel to assignments and create less stress and insecurity among them. [ABSTRACT FROM AUTHOR]

Chronic obstructive pulmonary disease ( COPD) is a progressive illness that changes the lives of patients and their spouses dramatically. The aim of this paper is to show how spouses of COPD patients integrate their tasks as informal carers with their role as spouses and the tensions and challenges involved in this. The study draws on qualitative interviews with spouses of COPD patients, recruited from the patient pool of ambulatory pulmonary services of two hospitals in Oslo, Norway. The spouses described their great efforts to re-establish normality and continuity in their everyday lives. Accomplishing this was a delicate process because they faced several dilemmas in this work. They balanced the need to sustain the independence and integrity of both parties against the need to ensure safety and deal with the progression of the illness. We propose 'biographical we' as a concept that can highlight the great effort spouses put into establishing a sense of continuity in their lives. In times when healthcare policy involves mobilising informal caregiving resources, an awareness of the complexity of caregiving relationships is crucial when developing appropriate support for informal carers. [ABSTRACT FROM AUTHOR]

Aim: To explore midwives' experiences with providing home‐based postpartum care during the COVID‐19 pandemic in Norway. Design: A descriptive and explorative qualitative study. Methods: The study is based on semi‐structured individual interviews with 11 midwives experienced in offering home‐based postpartum care. We explored their experiences of such care during the first wave of the COVID‐19 pandemic. Data collection occurred from October through November 2020. An inductive thematic analysis was performed using Systematic Text Condensation (STC) by Malterud (2012). Results: The following two main results emerged from the analyses: (1) the midwives adapted quickly to changes in postpartum care during the pandemic and (2) midwives saw the experience as an opportunity to re‐evaluate their practices. Conclusion: This study highlights midwives' resilience and adaptability during the first wave of COVID‐19 pandemic. It emphasises the crucial role of face‐to‐face interactions in postpartum care, while recognising the value of technology when direct access is limited. By shedding light on midwives' experiences, this research contributes to improving postpartum care in unforeseen circumstances. It underscores the significance of interdisciplinary integration in planning postpartum care services and the lasting influence of lessons learned on addressing future challenges. Implications for Practice: The valuable insights gained from lessons learned during the COVID‐19 pandemic may have a lasting influence on the postpartum care system, empowering it to tackle unforeseen challenges both today and in the future. Impact: The current study addressed midwives' experience with providing home‐based postpartum care during the COVID‐19 pandemic in Norway. Midwives received an opportunity to re‐evaluate their own practices and valued being included when changes were implemented. The current findings should alert policy makers, leaders and clinicians in postpartum care services when planning future practice. [ABSTRACT FROM AUTHOR]

Background: During the COVID‐19 pandemic, nursing home leaders implemented infection control to protect residents and staff. Aim: To understand the barriers and facilitators for leading nursing homes through the COVID‐19 pandemic. Methods: We invited 34 nursing homes to participate, and 20 leaders (59%) attended focus group interviews. The COM‐B model and the theoretical domains framework were used in design and analysis of the study. Results: The barriers for infection control were organisational unpreparedness, high volumes of information, lack of clinical skills, protective equipment, and testing capacity, the nursing home's architectural design, health authorities' low priority of nursing homes, staff's fear, and mental pressure on the leaders over time. The facilitators were having a customised corona plan, change of routines, certification of new skills, access to the municipal quality system, the ability for crisis leadership, loyalty to the nursing home, and support from the environment. The number of part‐time positions and the opportunity to outsource parts of the services were also important determinants for infection control. Conclusions: The results identify several barriers and facilitators for nursing home leaders' behaviour for infection control. The results confirm the importance of supporting the leaders' resilience and crisis leadership while working in the pressurised environment of a pandemic. Relevance to Clinical Practice: The study provides important insights into barriers and facilitators for leading nursing homes through the COVID‐19 pandemic, which could help to inform future strategies for infection control. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

ABSTRACT This paper analyses child welfare workers' perceptions of ethnic minority children in England and Norway based on in-depth interviews with 52 child welfare workers in 2008. We employ a child-centric theoretical framework to explore up to what extent workers focus on minority children in their perceptions. We found that about half of our study participants ( n= 27) did so, and many more in Norway than England. They perceived many risks and problems for minority children related to their ethnicity, including children's biculturalism and language skills, parenting methods, unequal treatment and racism, lack of social inclusion, and problems in school. Norwegian workers displayed a broad needs perception and embraced a change-orientated perspective and held parents accountable for their children's educational success and social inclusion. English workers had a narrower approach, focusing on protecting children. We discuss how the cross-country differences may be related to different welfare state and child welfare paradigms. [ABSTRACT FROM AUTHOR]

Aims and objectives. The aim of this paper was to explore carers’ and nurses’ appraisals concerning if and when nursing home placement for frail older people awaiting placement was needed and to illuminate ethical issues involved in decisions regarding nursing home placement. Background. Requesting nursing home placement can be a complicated decision for carers, causing feelings of failure, anxiety and guilt. After the necessity of nursing home care is determined, the names of the older people are put on waiting lists. While waiting, home health care provides support services. Even with this care, many of the older people and their carers face difficult life situations. Design. This is a descriptive and comparative cross-sectional study using qualitative methods. Methods. The convenience sample ( n = 36) comprised 11 carers of older people on a nursing home placement waiting list in Norway and 11 nurses caring for these older people. Every one willingly participated in interviews that were transcribed and analysed by qualitative content analysis. Results. Various similarities and differences between nurses’ and carers’ appraisals were found. Complex ethical issues of justice, equality, autonomy, beneficence and justifiability in nursing were involved in decision making concerning nursing home placement. Four categories constructed were: ‘appraising nursing home to be the level of care needed’, ‘appraising the older people as able to continue living at home’, ‘being ambivalent about nursing home placement’ and ‘being sceptical about use of coercion regarding nursing home placement’. Conclusions. Not all of the older people awaiting nursing home placements could be placed in nursing homes when beds became available. The situations were complex and involved ethical issues. Relevance to clinical practice. Despite insufficient resources in home health care, providing appropriate support for older people and their carers means that nurses have to consider individual concerns in each situation, cooperate with carers, respect their appraisals of needs and argue for the timely nursing home placement of older people. [ABSTRACT FROM AUTHOR]

Clinical ethics committees have recently been established in nearly all Norwegian hospital trusts. One important task for these committees is clinical ethics consultations. This qualitative study explores significant barriers confronting the ethics committees in providing such consultation services. The interviews with the committees indicate that there is a substantial need for clinical ethics support services and, in general, the committee members expressed a great deal of enthusiasm for the committee work. They also reported, however, that tendencies to evade moral disagreement, conflict, and ‘outsiders’ are common in the hospitals. Sometimes even the committees comply with some of these tendencies. The committees agree that there is a need to improve their routines and procedures, clarify the committees' profile and field of responsibility, to make the committees well-known, to secure adequate operating conditions, and to develop organizational integration and support. Various strategies to meet these challenges on a local, regional or national level are also explored in this paper. [ABSTRACT FROM AUTHOR]

Old age is the leading cause of impaired bodily function, which gradually increases healthcare service needs. To offer the best possible care in the home and to be able to detect health‐related functional impairment at an early stage, it is necessary to carry out systematic and structured observations. The assessment tool Subacute and Acute Dysfunction in the Elderly (SAFE) has been developed explicitly for these structured observations. This study aims to explore the experiences and challenges of home‐based care work team coordinators (WTCs) regarding the introduction and use of SAFE. Method: The present qualitative study was performed following Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines. The data were collected through individual interviews (n = 3) and focus group (FG) interviews (n = 7). The interview transcripts were analysed using the Gioia method. Results: Five aggregated dimensions were identified: Varying acceptance of SAFE, Structuring and quality‐assurance of home‐based nursing practice, Obstacles for the integration of SAFE in daily practice, Acceptance and use of SAFE require continuous supervision and SAFE contributes to increased quality of nursing care. Conclusion: The introduction of SAFE contributes to a structured follow‐up of functional status in patients receiving home care. In order to incorporate the tool into home care practice, it is essential to set aside time to introduce the tool and to support nurses' use of it by offering continuous supervision. [ABSTRACT FROM AUTHOR]

Introduction: Scarce health resources and differing views between persons with hand osteoarthritis (OA) and health professionals concerning care preferences contribute to sustaining a gap between actual needs and existing clinical guidelines for hand OA. The aim of this study is to explore the experiences of persons diagnosed with hand OA in their encounters with health services and how those experiences influence negotiations and decision‐making in hand OA care. Methods: Data from 21 qualitative interviews with persons diagnosed with hand OA were collected, transcribed verbatim and analysed using reflexive thematic analysis. Results: Three main themes were developed: symptoms are perceived as ordinary ageing in everyday life, consultations are shaped by trust in healthcare and the responsibilities of prioritisation and self‐care govern interactions. Conclusion: Ideas of ageing, professional knowledge and self‐management dominate hand OA health encounters and contribute to shaping illness perceptions, preferences and opportunities to negotiate decisions in consultations. Patient or Public Contribution: Two patient research partners with hand OA are members of the study project group. One of them is also a co‐author of this manuscript. [ABSTRACT FROM AUTHOR]

Disabled young people leaving care often experience a more complex transition to adulthood than other youths. Still, policy and services can fail to recognize the intersection between a young person's care experiences and disability. Drawing on data from a qualitative interview study with 14 social workers who work with aftercare in the Norwegian child welfare services, we investigate social workers' professional judgements about support for this subgroup of the leaving care population. Our analysis uses the theoretical construct of institutional logics and shows that social workers did not include concepts of disability in their judgements about support for these young people. Instead, the social workers' considerations were guided by three other organizing principles: a 'medical logic', an 'activation logic' and an 'aftercare logic'. We discuss these findings in light of critical disability studies and argue for a more nuanced understanding of disability in social work practice with care leavers. Highlighting disability rights and going beyond diagnosis and categorisations of disabled people can challenge a medical model approach to service provision. [ABSTRACT FROM AUTHOR]

Patient or Public Contribution: Patients, relatives and nurses were involved in this study. Aim: The aim was to explore patients', relatives' and nurses' experiences of palliative care on an advanced care ward in a nursing home setting after implementation of the Coordination Reform in Norway. Design: Secondary analysis of qualitative interviews. Methods: Data from interviews with 19 participants in a nursing home setting: severely ill older patients in palliative care, relatives and nurses. Data triangulation influenced by Miles and Huberman was used. Results: The overall theme was "Being in an unfamiliar and uncaring culture leaves end‐of‐life patients in desperate need of holistic, person‐centred and co‐creative care". The main themes were: "Desire for engaging palliative care in a hopeless and lonely situation", "Patients seeking understanding of end‐of‐life care in an unfamiliar setting" and "Absence of sufficient palliative care and competence creates insecurity". The patients and relatives included in this study experienced an uncaring culture, limited resources and a lack of palliative care competence, which is in direct contrast to that which is delineated in directives, guidelines and recommendations. Our findings reveal the need for policymakers to be more aware of the challenges that may arise when healthcare reforms are implemented. Future research on palliative care should include patients', relatives' and nurses' perspectives. [ABSTRACT FROM AUTHOR]

Background: Health and social care systems face difficulties in managing multimorbidity, disease burden and complex needs in long‐term conditions such as Parkinson's disease. Objective: This study aimed to develop a European understanding of how health and social care professionals can collaborate with stakeholders from different organizations and sectors to enhance the management of Parkinson's disease in a community setting by identifying the existing gaps in this process and how people with Parkinson's disease and their family carers could benefit from these partnerships. Methods: A mixed‐methods sequential study was conducted in Denmark, Norway, Spain and the United Kingdom. The findings from the qualitative phase are presented. Individual semistructured interviews were analysed using Braun's and Clarke's thematic analysis. A meta‐ethnography approach was used to analyse and synthesize cross‐national findings. Results: A total of 41 healthcare professionals and 39 stakeholders from different disciplines and sectors were interviewed in the four countries. The participants acknowledged a lack of awareness of available resources and poor communication between the different support systems in the management of Parkinson's disease. To promote multiagency collaborations, the participants highlighted the need to organize services along the Parkinson's disease journey, patient involvement and strategic involvement of carers in organizing resources and Parkinson's disease care pathways. According to the participants, the benefits from multiagency partnerships could lead to an enhanced continuity of care and specialized knowledge, mobilization of resources in the community, personalized support and improved access to services. Conclusions: Policymakers are called upon to create formal structures that facilitate multisectoral collaborations to promote an integrated system of care for the management of Parkinson's disease in the community. To address this challenge, we propose five strategies showing how organizations can work together to optimize the use of resources and enhance the management of Parkinson's disease throughout the illness trajectory. Patient or Public Contribution: Patient and Public Involvement groups made up of stakeholders, healthcare professionals, patients with Parkinson's disease and family carers participated in the design of the study, the development of the interview guides and the validation of the findings. [ABSTRACT FROM AUTHOR]

Background: Nurses encounter many ethical dilemmas in their practice. The ability to make good ethical decisions is a necessary competence in healthcare professions. International studies call for development and research on various methods to teach healthcare professionals ethics. This article describes an approach for learning how to be aware of and discover ethical dilemmas. By applying experienced narratives from healthcare practice and using question guidelines from a structured ethical model, nursing students learn to discover and find possible solutions for ethical problem in their practice. Aim: The aim of this study was to describe second‐ and third‐year nursing students' experiences by using structured ethical reflection as an approach to increase ethical awareness and deal with ethical decisions. Design: This study has a descriptive exploratory design. A three‐day ethics seminar was carried out to help students learn how to recognize and explore ethical dilemmas in their practice. Materials and Methods: The data are collected from questionnaires used to evaluate the ethics seminar where 52 nursing students participated. The questionnaire contained open‐ended and closed questions and was analysed using Braun and Clarke's reflexive thematic analysis. The empirical data were collected by 52 nursing students answering an evaluation questionnaire after the ethics seminar. Findings Four themes were developed: Becoming aware of ethical dilemmas, Learning ethics by discussing knowledge and experiences with other students, Increased curiosity about ethics as a subject and Understanding the importance of critical ethical reflection work in clinical practice. Discussion The process of learning how to understand the ethical principles in real‐life nursing context continues progressing through the bachelor's program. Using group discussions and discussing examples of ethical dilemmas from practice help the students to a more comprehensive reflection process. Conclusion: The nursing students experienced video lessons, group discussions and the use of a structured reflection model as a valuable approach in learning to recognize ethical dilemmas and how to deal with real‐life ethical dilemmas. [ABSTRACT FROM AUTHOR]

This qualitative case study aimed to explore environmental circumstances and interactional processes that appeared to be relevant for the dynamics of resilience in adolescents exposed to child abuse. Fieldwork at a learning and coping centre for children and their families was combined with semi‐structured interviews with adolescent participants aged 12 to 18 years. A critical realist approach was used to unpack what has been called the 'ordinary magic' of resilience. We found that intensively validating qualities of both the environment and relationships seemed to be driving components for resilience. Borrowing ideas from the sociometer theory, we propose that particularly the consistent intensiveness may offer a recalibration of the adolescents' immediate life‐worlds, in terms of how they perceive the people they meet and the environments they step into. In keeping with the transactional‐ecological model of resilience, we suggest that such a recalibration leads to altered social agency that becomes visible through their immediate social participation. [ABSTRACT FROM AUTHOR]

Objectives: Reablement is a relatively new service targeting people with or at risk of functional decline. The approach is team based, and physiotherapists (PTs), occupational therapists, and nurses have the responsibility to guide and supervise the support personnel, referred to as home trainers (HTs). The aim of this study was to explore how the HTs follow up instructions and supervision by PTs in reablement. Methods: This qualitative study included video recordings of practice and individual interviews in seven Norwegian reablement teams. The analysis involved a triangulation of all data. Results: The results identified that HTs had the main responsibility to carry out interventions in reablement and were also expected to report back to the therapists if they recognized further need for assessment or adjustments. The content of the practices varied considerably along a continuum from rigidly standardized practices to individually tailored approaches emphasizing quality of movement. This paper presents analyses of two examples representing the two widely different approaches. Conclusion: Practitioners and health authorities should be aware of the broad variation in reablement services in Norwegian municipalities. The results indicate that a standardized approach may be more efficient in the short term, targeting a large population, whereas a tailored approach, valuing quality of movement, is essential to provide high‐quality movement training for users with complex rehabilitation needs. The target groups receiving the different reablement methods should be clearly identified. [ABSTRACT FROM AUTHOR]

Background: Parents are a resource that can be of considerable importance in supporting their adolescents' recovery and shared decision‐making processes. However, involving both adolescents and their parents in treatment creates challenges. Understanding the roles of all decision stakeholders is vital to the implementation of shared decision‐making and delivery of high‐quality healthcare services. Objective: The aim of this study is to explore parents' experiences with adolescents' participation in mental health treatment and how parents perceive being involved in decision‐making processes. Design: This was a qualitative study with a phenomenological, inductive design. Content analysis of data from qualitative interviews was performed. Setting and Participants: This study took place in a Norwegian public healthcare setting. Twelve parents of adolescents who received treatment for severe mental illness participated. Results: Four themes were identified: (1) self‐determined treatment, but within limits; (2) the essential roles of parents; (3) the need for information and support; and (4) the fight for individualized treatment and service coordination. Conclusion: User participation is vital in adolescent mental healthcare and parents play essential roles regarding the shared decision‐making process. However, user participation and shared decision‐making pose several dilemmas. Parental involvement in treatment decisions may be necessary when adolescents are mentally ill, but could simultaneously hinder those adolescents' empowerment and recovery. Cooperation among parents, adolescents and healthcare professionals can improve treatment engagement and adherence, but may be challenged by divergent interests. Health services should provide family‐oriented services to utilize the potential of parents as a resource and minimize conflicting interests. Patient or Public Contribution: Two adolescent user representatives participated in designing the study. [ABSTRACT FROM AUTHOR]

Aims and objectives: The study describes experiences of registered nurses and general practitioners when using the Modified Early Warning Score (MEWS) to assess acute functional decline in older home nursing care patients. Background: Acute functional decline is common among older home nursing care patients; typically characterised by nonspecific symptoms and a mix of manifestations. Early warning score systems for detecting clinical deterioration have been thoroughly evaluated in hospital settings, but few studies have evaluated these systems used with older people in a community care setting. Methods: A descriptive exploratory research design and a qualitative approach. 36 nurses and eight general practitioners were purposively sampled. Data were collected in seven mixed focus groups and analysed using an inductive thematic content analysis in an iterative process that moved between text, codes, categories and themes. The COREQ checklist was used. Results: Two main themes were developed in the analysis. The first theme derived, was that the MEWS along with medical‐technical equipment and clinical judgement, was used to support nurses' and general practitioners' clinical decisions in assessing older deteriorating patients. The second theme referred to nurses' and general practitioners' experiences with several adjustments when using the MEWS with the older patient group and in complying with its trigger recommendations. Conclusion: The use of the MEWS when assessing older patients in home nursing care is potentially useful in supporting clinical reasoning. However, the tool's usefulness is limited because it is not experienced as sufficiently adapted to neither the home nursing care services nor to older patients. Implications for practice: This study increases our knowledge of how the MEWS tool is used in a community care setting and highlights the importance of adjustment of assessment procedures for older persons with acute functional decline. [ABSTRACT FROM AUTHOR]

Background: Approximately 30% of patients admitted to an intensive care unit experience respiratory distress. The COVID‐19 pandemic has led to an enormous increase in patients with respiratory symptoms. Nurse competence is essential for ensuring quality treatment and care for these patients; however, research on nursing strategies for patients with respiratory insufficiency is limited. Aim: This study explored nurses' perspectives on and nursing strategies in patients with respiratory insufficiency when admitted to three different intensive care units. Design: The study had an exploratory, descriptive, qualitative design. Methods: Four focus group interviews with a total of 20 nurses, critical care nurses, and critical care nursing students were conducted. Data were analysed using content analysis. Results: Participants' perspectives fell into two main themes: "nurse competence" and "the art of balancing." "Nurse competence" incorporated the sub‐themes "observations and assessments," "to make decisions," and "collaboration." The theme 'the art of balancing' incorporated the sub‐themes "nursing interventions," "patients feeling safe," and "patient participation." Conclusion: This study contributes new knowledge about nurses' perspectives on patients with respiratory insufficiency. Nurse competence was assumed essential to observe, assess, and treat patients with respiratory insufficiency. Nursing strategies included balancing nursing interventions, conducting medical treatment, and taking a whole‐person approach to patients' needs. Relevance to clinical practice: The COVID‐19 pandemic has shown the need for nurse competence in caring for patients with respiratory insufficiency. This study adds to existing literature emphasizing the need for competence in health care services. Caring for patients with respiratory insufficiency requires nurses with experience; competence in observation, assessment, and medical treatment; and a whole‐person approach to patients' needs. [ABSTRACT FROM AUTHOR]

Background: Cancer patient pathways (CPPs) were implemented in Norway in 2015–2017 to advance cancer diagnostics and treatment initiation. The aim of CPPs is to ensure standardized waiting times, but also to strengthen patient participation and shared decision‐making. This study investigates how patients enrolled in a CPP experienced shared decision‐making. Methods: This study comprised of 19 individual semistructured interviews with patients who had been enrolled in a CPP at three hospitals in Norway. Twelve patients had breast cancer, four patients had prostate cancer and three patients had malignant melanoma. We analyzed their experiences using a narrative approach. Findings: This study showed how participating in a standardized CPP provided different possibilities for shared decision‐making. The patients' narratives of shared decision‐making in CPPs included stories from the three cancer diagnoses through the following themes: (1) The predictable safeness of standardizations, (2) the ambivalence of making decisions and (3) opposing standardizations and pushing for action. Conclusion: Standardized CPPs provided patients with predictability and safety. Shared decision‐making was possible when the cancer diagnoses supported preference‐sensitive treatment options. Balancing standardizations with individualized care is necessary to facilitate patient participation in CPPs, and the possibility of shared decision‐making needs to be discussed for each specific CPP. Patient or Public Contribution: A service user representative from the Norwegian Cancer Society participated in designing this study. [ABSTRACT FROM AUTHOR]

Background: Numerous studies of user involvement in research have been conducted. However, there is a lack of studies applying observational methods and addressing the concrete practice of involvement. Objective: To determine what knowledge types and competences users apply when involved in the research process through user panel meetings. Design: User panel meetings in a qualitative project in rehabilitation were sound‐recorded and transcribed verbatim. Data analysis applied an abductive approach framed by positioning theory. Setting and participants: Six rehabilitation service users and a similar number of researchers met 20 times during a six‐year project period. They discussed various issues in the research process such as interview guides, analysis and dissemination of results. Findings: The service users combined their respective knowledge and competence into six positions enacted in the panel interactions. They engaged as co‐researchers, based their contributions on their respective personal histories, represented an NGO and peers, applied their respective professional and educational backgrounds and, finally, engaged as concerned citizens. Discussion and conclusion: The findings add to the discussion of professionalization of user involvement by introducing a wider array of positions enacted than do the findings of previous studies. Researchers recruiting user panel members, as well as NGOs appointing candidates for user panels, are advised to consider a wide competence profile for possible candidates. A panel is also considered as a resource in confirming and elaborating on a study's findings. Patient and public contribution: A service user panel contributed to the study. [ABSTRACT FROM AUTHOR]

Aim: To explore aspects of professional identity in nurses' written narratives of what is significant to their choice to remain in the profession. Design: This study used a qualitative design and was underpinned by a hermeneutical approach. Methods: The participants were recruited via purposive sampling procedures and included 13 nurses aged 26 to 62 years. The data were collected in the form of written narratives to initiate the nurses' reflections on the decision to remain in the profession. A thematic analysis was conducted. Results: The analysis revealed two themes: acting as a professional contributor and realigning to maintain professional belongingness. In the nurses' written narratives, these aspects of professional identity were clearly significant to their choice to remain in the profession. In a complexly interwoven way, the aspects constructed who the nurses were as professionals, and thus, professional identity seems to play a critical role in the choice to remain. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to explore how operating room nurses (ORNs) experience operating room (OR) team communication concerning non‐technical skills. Design: Based on the Scrub Practitioners List of Intraoperative Non‐Technical Skill (SPLINTS), qualitative individual in‐depth semi‐structured interviews were conducted with 11 ORNs in a Norwegian university hospital. Braun and Clarke's six analytic phases for thematic data analysis were used. Results: Surgeons being unprepared or demanding different instruments than the preoperative information indicates, cause stress and frustration. So does noise and brusquely or poor communication. Ensuring good information flow within the entire team is important. When silence is required, the ORNs communicate with gestures, looks and nods. Creating a positive and secure team culture facilitates discussions, questions and information sharing. Conclusion: Inappropriate dynamics, inaccurate and/or disrespectful communication and noise may reduce patient safety. Interdisciplinary team training may bring attention to the value of communication as a non‐technical skill. [ABSTRACT FROM AUTHOR]

Aim: To examine and increase understanding of diverse aspects of hope as experienced by the next of kin when someone close to them is critically ill in intensive care unit (ICU). Design: A qualitative study with a phenomenological approach. Method: The data were collected through five in‐depth interviews with next of kin at the ICU in Central Norway. Data were interpreted to gain a deeper understanding on hope in an acute and critical context. Results: The analysis presents five main themes: (i) hope for survival, (ii) hope is fostered by signs of improvement, (iii) hope keeps fear for the worst at bay, (iv) hope that things will turn out well and (v) hope for the return to a normal life. Hope kept next of kin going during a difficult time and was strengthened when they saw their close family member responding positively to treatment provided by the ICU. [ABSTRACT FROM AUTHOR]

Background: Patients are expected to participate in the hospital discharge process, assume self‐management after discharge and communicate relevant information to their general practitioner; however, patients report that they are not being sufficiently empowered to take on these responsibilities. The aim of this study was to explore and understand the discharge process with a focus on medicines communication, from the patient perspective. Methods: Patients were included at a hospital ward, observed during health‐care personnel encounters on the day of discharge and interviewed 1‐2 weeks after discharge. A process analysis was performed, and a content analysis combined data from observations and data from patient interviews focusing on medicines communication in the discharge process. Results: A total of 9 patients were observed on the day of discharge, equalling 67.5 hours of observations. The analysis resulted in the following themes: (a) the observed discharge process; (b) patient initiatives; and (c) the patient role. The medicines communication in the discharge process appeared unstructured. Various patient preferences and needs were revealed. The elements of the best practice structured discharge conversation were observed; however, some patients did not have a discharge conversation at all. Conclusions: The study contributes to a broader understanding of the discharge process, how patients experience it, including their role. It is evident that the discharge process is not always tailored to meet the patients' needs. More focus on early patient involvement and communication, in order to better prepare patients for self‐management of their medications, is important for their health outcomes. [ABSTRACT FROM AUTHOR]

Aim: The aim was to explore how nurse mentors experience the assessment of nursing students in clinical placements at hospitals and in municipal health care. Design: The study is qualitative with an explorative and descriptive design. Methods: Based on an interview guide, we conducted 19 individual qualitative interviews and four focus group interviews with nurse mentors from various levels and fields of nursing education at a Norwegian university. Results: Feedback in and on action was an integrated part of the formative assessment. In the summative assessment, where the university lecturer also participates, the nurse mentors perceived their role as passive. A disturbing finding was that divergent views on the student's competence sometimes occurred in these situations, thus challenging the credibility of the student assessment. Perceptions of nursing values and concerns embedded in nursing practice as collective criteria appear to have an impact on the mentors' assessment of the nursing students. [ABSTRACT FROM AUTHOR]

Alongside other Nordic countries, the Norwegian government has introduced Cancer Patient Pathways (CPPs) for faster diagnostic assessment and timely treatment to improve the quality of cancer care. A key aspect of CPPs is the introduction of time limits for each phase of the diagnostic investigation. Occurring simultaneously are ongoing advances in medical technology, complicating the process of diagnosing and treating cancer. In this article, using institutional ethnography, we examine: how does the CPP policy influence physicians' experiences of diagnostic work? Data were collected from May 2018 to May 2019, through semi‐structured interviews with physicians across five hospitals in Norway (N = 27). Our findings indicate that the implementation of various strategies aimed at enhancing quality in cancer care collide, compelling physicians to negotiate between diagnostic precision and rapid decision‐making. We conclude that attention to interfaces between multiple guidelines and their implications for practice is crucial for understanding and developing quality of care. [ABSTRACT FROM AUTHOR]

Background: One of the core ethical principles in the Norwegian welfare state is the principle of justice; all citizens should have equal access to healthcare services, including nursing homes, independent of where they live, socioeconomic status or age. Patients who apply for a permanent place in a nursing home are among society's most vulnerable. Hence, it is of great importance that the process of nursing home placement is just. The purpose of this study was to explore which criteria and values allocation of nursing home placements are built on, and whether the process is just. Methods: The study has a qualitative design. Data were collected through individual interviews and observation. Executive officers in different municipalities who have the formal responsibility for the placements, and GPs and nurses on short‐term wards in nursing homes were interviewed. In addition, one of the researchers observed meetings where allocation of municipal healthcare services was discussed. Results: Healthcare personnel in primary health care mainly agree on which criteria are the most important in order to safeguard the principle of justice. However, some unintended and less highlighted factors could jeopardise the ideal of fair and just allocation. Some of these were organizational variations, variations in the municipalities' economy, variations in individual judgments and resourceful and strong‐willed relatives. Conclusions: Our study indicates that some of the weakest and most vulnerable patients in the Norwegian society are not treated equally. In order to safeguard the principle of justice, specific national criteria should be used in allocation of nursing home placements. However, national criteria are not enough. We suggest that in addition to guiding criteria, the unintended factors should be given more attention and focus on how to control them in a better way. [ABSTRACT FROM AUTHOR]