Background: Nurse practitioners (NPs) play a crucial role in healthcare by providing person-centred and high-quality care. Their contributions encompass enhanced accessibility to healthcare and reduced hospital admissions and cost-effectiveness. They usually hold a master's degree in nursing, incorporating expanded clinical skills to manage patients in different settings and address both nursing and medical needs. Despite the global development of the role, its implementation varies, presenting challenges related to role clarity, regulation and acceptance by other healthcare professionals.

Aim: To explore how nurses who are or have been employed as NPs describe their experiences of transitioning to and working in the NP role in Sweden.

Design: A qualitative interview study.

Method: This study explores the experiences of 15 NPs in Sweden, using a snowball sampling strategy and semi-structured interviews. The data were collected through interviews in April and May 2022 and analysed with inductive content analysis.

Findings: The present study explores the experiences of NPs as they transition from experienced nurses to NPs, emphasising motivations, educational challenges, acceptance and autonomy. Transitioning into the NP role initially brought isolation that evolved into acceptance. They recognised their strength in integrating medical and nursing competencies for holistic care. Leadership was pivotal, with managerial support crucial for the successful implementation of the role. Autonomy-related challenges, such as prescription rights and dependency on physicians, underscored the need for a protected professional title and national guidelines.

Conclusion: This study enriches the evolution of the NP role in Sweden, offering vital insights into the ongoing national-level dialogues on NP role development in Sweden.

Impact: The paper's relevance extends globally by providing valuable perspectives on NPs practicalities and fostering international understanding and advancement.

Reporting method: Standards for reporting qualitative research.

Patient or public contribution: Not applicable.

Background: The nurse practitioner role has become important globally in handlingthe growing healthcare needs of older adults with chronic diseases. Nevertheless,research shows that introducing the role is a complex process, and more studies areneeded to prepare for its introduction into different healthcare contexts, such as municipalhealthcare.Aim: The aim is to investigate what Swedish stakeholders identify as the preparatorywork needed before introducing the nurse practitioner role into municipalhealthcare.Methods: Data were collected through four focus group interviews conducted virtuallyon the TEAMS digital platform, with three to six participants in each groupand 18 participants total. The transcribed interviews were analysed using a six-stepthematic approach: familiarisation with the data, coding the data, generating initialthemes, reviewing themes, defining and naming the themes and producing thereport.Findings: The findings are divided into two main themes, each with two sub-themes.In the first, clarifying why the nurse practitioner role is needed, participants stressedthe importance of having a clear intention for introducing the role. The second, ensurea national framework to bolster the introduction at the local level, demonstratesthe need for collaboration among national actors to clarify the role's mandate andauthority before its introduction.Conclusions: Adding the nurse practitioner role to municipal healthcare can helpincrease the supply of nursing competence and the quality of patient care, but preparationfor introducing the role requires extensive work. The development of thenurse practitioner role requires decision-makers and leaders to take primary responsibilityfor its introduction. This study can support countries in the early phase ofdeveloping the nurse practitioner role by identifying both best practices and pitfalls.

INTRODUCTION: Research suggests that participating in after-school leisure activities has been related to promoting health, well-being and safety among children living in disadvantaged neighbourhoods. The United Nations Child Rights Convention emphasises the inclusion of children in decisions that concern them. However, children seldom are involved in designing implementing and evaluating health promotional environments. The aim of this programme is through a participatory process with children, parents/guardians, and peer-activity leaders explore, measure and evaluate the impact on children's overall well-being related to the social context in an already established health promotion environments in Southern Sweden.

METHODS AND ANALYSIS: The project is based on a previously implemented unique community-based participatory research (CBPR) model for equal health in three socially disadvantaged areas in Malmö. All activity house (AAH) is a meeting place for children established in schools but after school time by the culture department of the Malmö municipality. In AAH migrant children participate in need-driven after school activities that they themselves create and develop. To increase participation of the children and ensure that these environments are based on their needs, 30 children (10-12 years), parents/guardians (30), peer-activity leaders (15), and researchers create CBPR teams in the areas and engage in a participatory process. The children reflect, analyse and write about their well-being; identify and discuss key factors in an iterative process, which also includes a strategic group of stakeholders. The children then develop and validate (with 100 other children from AAH) the Socioculturally Aligned Survey Instrument for Children survey inspired by the KIDSSCREEN V.27. The survey tool so developed will further be used to evaluate AAH and will be distributed to all children participating in their activities.

ETHICS AND DISSEMINATION: This programme has been approved by the Swedish Ethical Review Authority. The results from this programme will be published as reports and scientific publication.

INTRODUCTION: Existential loneliness (EL) is an unavoidable, deeper sense of loneliness. EL has been described as disconnection from life and the universe, experienced even in the presence of family and friends. Meaninglessness, loss of health and significant others seem to trigger older persons EL. Older Arabic-speaking women are a large migrant group in Sweden and there is a lack in knowledge about their experience of EL. Therefore, this study aimed to describe the phenomenon of EL as experienced by older Arabic-speaking female migrants.

METHODS: This study was based on a phenomenological approach known as reflective lifeworld research (RLR). Ten older migrated Arabic-speaking women were included in the study. Lifeworld interviews were conducted to collect data. The data were analysed in accordance with the phenomenological RLR principles of openness, flexibility and bridling.

RESULTS: This study shows that EL is experienced when there is a lack of attachment to place and people. EL is experienced more distinctively in the beginning of the migration process. It was difficult sharing feelings of EL with anyone. Feelings of meaninglessness occurred when entering a new lifeworld and triggered EL. EL was however attenuated when being able to practise their religion.

CONCLUSION: Lack of attachment to place and people as well as feelings of meaninglessness brought existential loneliness to the fore for the older Arabic-speaking female migrants. There was a collision of lifeworlds not at least by the fact moving as a Muslim woman to one of the most secular countries in the world. Practising their religion attenuated their EL. To promote better health for this group of women, it is of importance to be aware of EL and its mode of expression.

IMPLICATIONS FOR PRACTICE: It is crucial to let the voice of older Arabic-speaking female migrants be heard and to be aware of their experience of EL and its mode of expression in order to promote better health. Further, educational training for nursing professionals and nursing students needs to be provided to develop skills how to be aware of and address EL.

Introduction: Social determinants of health impact health, and migrants are exposed to an inequitable distribution of resources that may impact their health negatively, leading to health inequality and social injustice. Migrant women are difficult to engage in health-promotional activities because of language barriers, socioeconomic circumstances, and other social determinants. Based on the framework of Paulo Freire, a community health promotion program was established in a community-academic partnership with a community-based participatory research approach.

Aim: The aim of this study was to describe how a collaborative women's health initiative contributed to migrant women's engagement in health promotion activities.

Materials and methods: This study was part of a larger program, carried out in a disadvantaged city area in Sweden. It had a qualitative design with a participatory approach, following up on actions taken to promote health. Health-promotional activities were developed in collaboration with a women's health group, facilitated by a lay health promoter. The study population was formed by 17 mainly Middle Eastern migrant women. Data was collected using the story-dialog method and the material was analyzed using thematic analysis.

Result: Three important contributors to engagement in health promotion were identified at an early stage of the analysis process, namely, the group forming a social network, the local facilitator from the community, and the use of social places close to home. Later in the analysis process, a connection was made between these contributors and the rationale behind their importance, that is, how they motivated and supported the women and how the dialog was conducted. This therefore became the designated themes and were connected to all contributors, forming three main themes and nine sub-themes.

Conclusion: The key implication was that the women made use of their health knowledge and put it into practice. Thus, a progression from functional health literacy to a level of critical health literacy may be said to have occurred.

Background Citizens with low levels of social capital and social status, and relative poverty, seem to have been disproportionally exposed to COVID-19 and are at greater risk of experiencing poor health. Notably, the incidence of COVID-19 was nearly three times higher among citizens living in socially vulnerable areas. Experiences from the African Ebola epidemic show that in an environment based on trust, community partners can help to improve understanding of disease control without compromising safety. Such an approach is often driven by the civil society and local lay health promoters. However, little is known about the role of lay health promoters during a pandemic with communicable diseases in the European Union. This study had its point of departure in an already established Community Based Participatory Research health promotion programme in a socially disadvantaged area in southern Sweden. The aim of this study was to explore how citizens and local lay health promoters living in vulnerable neighbourhoods responded to the COVID-19 pandemic a year from the start of the pandemic.Method In-depth interviews with the 5 lay health promoters and focus group discussions with 34 citizens from the neighbourhood who were involved in the activities within the programme were conducted in autumn 2020. The interviews and focus group discussions were transcribed verbatim and analysed using qualitative content analysis following an inductive approach.Results Four themes emerged including, 'balancing between different kinds of information', 'balancing between place-based activities and activities on social media', 'bridging between local authorities and the communities and community members', and 'balancing ambivalence through participatory dialogues'.Conclusion The study highlights that a Community Based Participatory Research programme with lay health promoters as community trust builders had a potential to work with communicable diseases during the pandemic. The lay health promoters played a key role in promoting health during the pandemic by deepening the knowledge and understanding of the role that marginalised citizens have in building resilience and sustainability in their community in preparation for future crises. Public health authorities need to take the local context into consideration within their pandemic strategies to reach out to vulnerable groups.

Introduction Worldwide, countries are struggling with strained healthcare systems, especially due to the growing number of frail elderly. Developing the role of nurse practitioner in the care of the frail elderly is therefore of interest to make the care chain more efficient. In Sweden, the role is in an early development phase, but more research is needed. Aim The aim was to investigate how stakeholders at the national level express the challenges and opportunities of the evolving nurse practitioner role in Swedish municipal elderly care. Method A Delphi survey technique with three rounds of electronic questionnaires was used. Twenty-seven experts responded to the first questionnaire, containing two open questions; what opportunities respectively challenges do you see in developing and implementing the nurse practitioner role in municipal elderly care? The following questionnaires consisted of statements to rate using a four-grade Likert scale, and 20 and 17 responded to the second and third, respectively. The first round was analysed using content analysis, and the other two with descriptive statistics. Results Thirty-four statements about challenges and opportunities related to the nurse practitioner role in municipal elderly care were identified and rated as important. Conclusion The findings provide knowledge that can contribute to discussions and decisions to refine the nurse practitioner role in Swedish municipal elderly care. The nurse practitioner role may contribute with much-needed competence to the elderly care. However, it is important to consider the challenges that need to be overcome before the development of the role. To solve this, it is necessary to have clear national guidelines concerning issues of education, title protection and the mandate and authority of the NP role.

Health promotion is thus not only a participatory practice, but a practice forempowerment and social justice. The study describes findings from a community-basedparticipatory and challenge-driven research program. that aimed to improve health through healthpromotion platform in an ethnically diverse low-income neighbourhood of Malmö, Sweden. Localresidents together with lay health promoters living in the area were actively involved in theplanning phase and decided on the structure and content of the program. Academic, public sectorand commercial actors were involved, as well as NGOs and residents. Empowerment was usedas a lens to analyse focus group interviews with participants (n=322) in six co-creative healthpromotinglabs on three occasions in the period 2017-2019. The CBP R interview guide focusedon the dimensions of participation, collaboration and experience of the activities. The CBP Rapproach driven by community member contributed to empowerment processes within the healthpromotion labs: Health promotors building trust in social places for integration, Participantsmotivate each other by social support and Participants acting for community health in widercircle. CBP R Health promotion program should be followed up longitudielly with communityparticipants to be able to see the processes of change and empowerment on the community level.

Background: To achieve the requisites for a child’s healthy development and to reducehealth inequalities, it is important to promote health initiatives at an early stage in a child’slife and to include the parents. Home visits by healthcare professionals have been foundto have positive health effects for both the baby and the parents. From an extended homevisit programme in Sweden, our aim was to illuminate first-time parents’ experience of ahome visit conducted by a midwife and a child health care nurse 1–2 weeks postnatal.Methods: Data was collected by interviews (n = 13) with first-time parents. Thetranscribed texts were analyzed using inductive content analysis.Results: The participants’ experiences could be understood from the two themes, Atrust in the professionals and Feeling safe as a new parent. The participants experiencedthat the midwives and the child health care nurses complemented each other andappreciated to get knowledge and information from both professions. In their own home,they felt secured and relaxed, and the professionals could help them provide a safe homeenvironment for the child.Conclusion: By meeting both professionals at the same time and in their own home,the participants experienced that the needs of the baby and their needs and concernsas new parents were included and supported.