AimTo describe the variations of family members' conceptions of their supportive care needs (SCN) across the colorectal cancer (CRC) trajectory.DesignA descriptive qualitative study with a phenomenographic approach.MethodIndividual semi-structured interviews were conducted from May 2022 to October 2022 with 23 family members of persons diagnosed with colorectal cancer. The interviews were analysed using phenomenographic analysis following the Consolidated criteria for reporting qualitative research (COREQ) checklist.ResultsThe phenomenographic analysis resulted in five categories. Not of importance describes family members' needs as unimportant due to the good prognosis and the organization of care and in relation to the needs of others. Only satisfiable by professionals describes information possessed by the healthcare professionals as key, as well as the need for professional counselling for the family members to process their emotions. Managed by themselves describes family members preferring to manage their SCN themselves by turning to the appropriate social support and/or by using coping skills. Understood retrospectively describes SCN as only understandable when things have calmed down and as requiring one's own experience to understand. Left unmet describes SCN as unnoticed by the healthcare professionals or not brought to light by the family members, or family members not knowing where to turn for support.ConclusionSupportive care should involve individualized information, proactive and repeated assessments of needs across the trajectory, as well as encouragement of family members to reflect on their needs and to accept support when needed.ImpactThere is a gap in the literature regarding family members' SCN across the CRC trajectory which this study addresses. Findings show five categories of family members' conceptions of their SCN. Those findings could serve as a basis for the development of clinical colorectal supportive care across the cancer trajectory.Implications for the Profession and/or Patient CareFindings show that to offer family members of persons diagnosed with colorectal cancer support only at the time of diagnosis is insufficient. Instead, the healthcare team is recommended to proactively and repeatedly try to identify those in need and the characteristics of their needs. In addition, it is important to offer individualized information and strive to encourage family members to reflect on their situation and to not suppress their own needs if emerging.Reporting MethodReporting adheres to the consolidated criteria for reporting qualitative research (COREQ) checklist.Patient or Public ContributionNo patient or public contribution.

Background: Involving family members in the care process leads to higher-quality patient care. However, this requires collaboration among various healthcare professionals. At interprofessional training wards, healthcare students learn to work together across different disciplines. However, there is limited knowledge about family members’ involvement in the patient care process during interprofessional education in clinical settings. Aim: This study aimed to explore family members’ experience of involvement in the patient care process on an interprofessional training ward. Method: An inductive content analysis was applied on data from individual interviews with 19 family members of patients admitted to an interprofessional training ward.Results: Family members experienced that they had to be involved in the patient care process to bridge knowledge between the patient and the interprofessional student team in order to influence healthcare and have control over the situation. Moreover, they wanted to be acknowledged as family members and needed transparency in the patient care process. Family members’ involvement was governed by the patient’s needs and influenced by the degree of trust in the interprofessional student team. Conclusion: Interprofessional education activities should focus more on family members’ involvement in the interprofessional training ward.

Volt hockey is a team sport developed for persons with physical disabilities. Because family members are important resources to enable sports participation, the purpose of this study was to illuminate experiences of volt hockey from family members’ perspectives. Focus group interviews were conducted, including 20 family members, and the verbatim transcripts were inductively analysed using reflexive thematic analysis. Family members saw the value of enabling participation in volt hockey, being an inclusive team sport that brings enjoyment and strengthens social relationships within, and outside of, the family. Trying to facilitate sport participation, the need for material resources and other actors was emphasised, such as personal assistance, funders, and healthcare professionals informing about the sport and the engagement of the volt hockey clubs. In conclusion, involvement in volt hockey is emotionally and socially rewarding for family members, but there is a need for additional enablers to allow the sport to grow. 

The value of health care delivered via effective interprofessional teams has created an imperative for interprofessional education (IPE) and interprofessional collaborative practice (ICP). To inform IPE strategies, we investigated differences in perceived self-efficacy (SE) for competence in ICP among health professions students. Study data was collected between 2015-2019 from students from 13 different programs (N=3,496) before an annual institutional interprofessional program. Students completed the IPECC-SET, a validated instrument evaluating perceived SE for competence in ICP, and rated their 1) amount of previous contact with, and 2) perceived understanding of the role of different health professions.  Student groups were compared using parametric statistics. Regression analyses explored factors influencing SE for competence in ICP. Findings revealed significant differences in perceived SE for competence in ICP between programs (p<.05). Specifically, health information management/health informatics, dental, medicine, and nursing students expressed relatively higher SE, whereas physical and occupational therapy students expressed relatively lower SE. Perceived understanding of the role of health care professions (p<.01) and gender (p<.01) contributed significantly to predict perceived SE for competence in ICP, while amount of previous contact with other health professions did not (p=.42).  Findings highlight the value of IPE designed with consideration of specific learner needs.

Interprofessional education aims to foster healthcare students’ ability to collaborate in interprofessional teams with the patients at the center of care as active participants. However, little is known about how patients experience this collaboration. Therefore, this study aimed to explore patients’ experiences of being involved in the interprofessional team of healthcare students at a clinical training ward in Sweden. A descriptive design with a qualitative approach was used. Data were collected through semi-structured individual interviews with 22 patients. Braun and Clarke’s reflexive thematic analysis was used. The main finding was that patients were only included as passive participants. Although most patients wanted to be involved, they were hindered due to their health condition or excluded from care planning and decision-making. The patients needed family members’ support to be involved. However, this need was not recognised by the interprofessional team of healthcare students. Patient involvement must be highlighted as an important component of interprofessional education initiatives. Further research is needed to explore family members’ perspectives on involvement in interprofessional training ward settings.

AIM: Identify and describe areas of concern focusing on day-to-day variations during the first month after surgery for patients recovering from colorectal cancer surgery.

DESIGN: A multi-method design was applied using diaries and interviews.

METHOD: Data was collected using semi-structured diaries kept 1 month after surgery by seven patients recovering from colorectal cancer surgery. Also, face-to-face interviews were conducted 1 month after surgery. Data from the diaries constituted a framework for the following directed content analysis of interviews.

FINDINGS: Low levels of pain were experienced but caused reduced mobility and tiredness. Practical matters in daily living were restricted, while social life could be hampered by a frequent need to defecate. Appetite and consequently the ability to eat and drink was the most prominent concern, due to changes in taste and ability to tolerate food. Worries were mainly related to changes in bowel movements. No Patient or Public Contribution.

BACKGROUND: Workplace violence is a global threat to healthcare professionals' occupational health and safety and the situation has worsened during the COVID-19 pandemic. This study aimed to explore workplace violence directed against assistant and registered nurses working on surgical wards in Sweden.

METHODS: This cross-sectional study was conducted in April 2022. Using a convenience sampling procedure, 198 assistant and registered nurses responded to an online questionnaire developed for this specific study. The questionnaire comprised 52 items and included, among other items, subscales from validated and previously used instruments. Data analysis included descriptive statistics, the chi-square test, and independent-samples t-test.

RESULTS: The most frequently reported type of workplace violence was humiliation (28.8%), followed by physical violence (24.2%), threats (17.7%), and unwanted sexual attention (12.1%). Patients and patients' visitors were reported as the main perpetrators of all kinds of exposure. Additionally, one third of the respondents had experienced humiliation from colleagues. Both threats and humiliation showed negative associations with work motivation and health (p < 0.05). Respondents classified as working in a high- or moderate-risk environment were more frequently exposed to threats (p = 0.025) and humiliation (p = 0.003). Meanwhile, half of the respondents were unaware of any action plans or training regarding workplace violence. However, of those who indicated that they had been exposed to workplace violence, the majority had received quite a lot or a lot of support, mainly from colleagues (range 70.8-80.8%).

CONCLUSION: Despite a high prevalence of workplace violence, and especially of humiliating acts, there appeared to be low preparedness within the hospital organizations to prevent and/or handle such incidents. To improve these conditions, hospital organizations should place more emphasis on preventive measures as part of their systematic work environment management. To help inform such initiatives, it is suggested that future research should focus on the identification of suitable measures regarding different types of incidents, perpetrators, and settings.

BACKGROUND: A high level of competence among staff is necessary for providing patient-safe surgical care. Knowledge regarding what factors contribute to the professional development of specialist nurses in surgical care and why they choose to remain in the workplace despite high work requirements is needed. To investigate and describe the organizational and social work environment of specialist nurses in surgical care as part of studying factors that impact on professional development.

METHOD: This was a cross-sectional study with a strategic convenience sampling procedure that recruited 73 specialist nurses in surgical care in Sweden between October to December 2021. The study was guided by STROBE Statement and checklist of cross-sectional studies. The validated Copenhagen Psychosocial Questionnaire was used, and additional demographic data. Descriptive statistics were performed and the comparison to the population benchmarks was presented as the mean with a 95% confidence interval. To study potential differences among the demographic and professional characteristics, pairwise t tests were used with Bonferroni adjustment for multiple comparisons with a significance level of 5%.

RESULTS: Five domains were identified as factors related to success, as they received higher scores in relation to population benchmarks: quality of leadership, variation of work, meaning of work and work engagement as well as job insecurity. There was also a significant association between a having a manager with low nursing education and job insecurity (p = 0.021).

CONCLUSIONS: Quality of leadership is important for the professional development of specialist nurses in surgical care. Strategic work seems to include managers with a higher nursing education level to prevent insecure professional working conditions.

AIM: To further evaluate the postoperative recovery profile regarding its psychometric properties.

BACKGROUND: The postoperative recovery profile is an instrument for the self-assessment of general postoperative recovery that has received increased attention within nursing research. However, psychometric evaluation during development was sparse.

DESIGN: Psychometric evaluation was done using classical test theory.

METHOD: Data quality, targeting, reliability, and scaling assumptions were measured. In addition, confirmatory factor analysis was used to evaluate construct validity. Data collection was made during 2011-2013.

RESULT: Data derived from this study showed acceptable quality; however, item distribution was skewed, with ceiling effects in the majority of items. Cronbach's alpha showed high internal consistency. Item-total correlations indicated unidimensionality, whereas six items demonstrated high correlations pointing at redundancy. The confirmatory factor analysis confirmed problems related to dimensionality as the five proposed dimensions were highly correlated with each other. Furthermore, items were largely uncorrelated with the designated dimensions.

CONCLUSION: This study shows that the postoperative recovery profile needs to be further developed to serve as a robust instrument within nursing as well as medical research. Arguably, values from the instrument should not be calculated at a dimensional level for the time being because of discriminant validity issues.

Background: Colorectal cancer is the third most common cancer diagnosis globally and is increasing in both incidence and prevalence. Despite evidence showing that family members of persons diagnosed with cancer have supportive care needs, no validated questionnaire measuring the needs of family members of persons diagnosed with CRC exists in Swedish. Thus, the objective of the present study was to translate, culturally adapt, and evaluate the psychometric properties the Supportive Care Needs Survey - Partners and Caregivers 45.

Methods: The translation and cultural adaptation followed a systematic yet iterative process. Firstly, the questionnaire was translated using a forward-backward approach. Secondly, face and content validity and comprehensibility were evaluated by two expert panels of colorectal cancer specialist nurses and family members, respectively. Lastly, the psychometric properties, validity, and reliability of the translated questionnaire were evaluated among 45 Swedish family members of persons diagnosed with colorectal cancer.

Results: The face, content, and construct validity of the translated questionnaire were evaluated as satisfying. Moreover, psychometric evaluations showed high data quality and satisfactory internal consistency. However, the results also revealed unsolved issues regarding relevance, targeting, and internal consistency, as well as a probable scaling failure.

Conclusion: The translated and adapted questionnaire can be used to identify family members unmet needs of support throughout the colorectal cancer trajectory. The questionnaire showed promising validity and reliability in the target population. However, it needs to be further evaluated in a larger sample, preferably involving factor analysis and stability over time.

Plain language summary: Colorectal cancer is the third most common cancer diagnose globally. At times of cancer, also the health and wellbeing of the surrounding family members is negatively affected. As a result, family members of persons diagnosed with cancer report that they too need support. Still, no validated questionnaire that enable measurement of family members needs of support throughout the colorectal cancer trajectory existed in Swedish. Thus, the present study undertook the process of translation of a questionnaire from English to Swedish. Thereto, evaluated it among Swedish family members of persons diagnosed with colorectal cancer. The evaluation showed a successful translation and the translated questionnaire appeared reliable and useful for measuring the family members´ needs of support throughout the colorectal cancer trajectory. However, it requires further evaluation.