Purpose: The purpose of the current study was to explore family members’ experiences of how to support an adult person with type 1 diabetes (T1D).

Methods: A qualitative descriptive study with thematic analysis was conducted in Sweden between 2020 and 2021. Interview transcripts were analyzed from 13 people who are a family member (≥18 years) of an adult with T1D, and inductive coding identified salient themes. Family members were recruited via social media, and their length of time as a family member to an individual with the T1D ranged between 3 and 38 years (median 24).

Results: The analysis and coding identified 4 salient themes: (1) searching for knowledge in unfamiliar situations, (2) applying new knowledge in everyday life, (3) balancing support to fit need and situation, and (4) over time, the support role matures.

Conclusions: Families with members with T1D are complex, with relational and behavioral challenges arising as the members live their lives. Routines, habits, and unexpected events become especially challenging for families with a member with T1D. Because most self-care activities for adults are carried out within the family, directly involving family members in educational interventions is important. These interventions should include providing information about the symptoms and treatment for T1D, developing knowledge about how families can be affected, but also providing strategies for how families optimally implement necessary daily changes.

OBJECTIVE: To examine the self-reported adherence of ambulance nurses to acute chest pain guidelines and analyse how demographic and professional characteristics influence this adherence.

DESIGN: Cross-sectional study.

SETTING: Regional ambulance service in southern Sweden (18 ambulance stations).

PARTICIPANTS: Ambulance nurses (registered and specialist nurses). Of the 397 ambulance nurses invited, 261 responded (65.7%) in 2023.

DATA ANALYSIS: Descriptive statistics; independent-samples t-tests and χ2 tests for group comparisons; Pearson correlation; and stepwise linear regression to identify predictors of adherence.

PRIMARY AND SECONDARY OUTCOME MEASURES: Primary: adherence to the prehospital acute chest pain guideline, measured with the 5-item Self-Reported Adherence scale (5-25). Secondary: medication-specific adherence; guideline-access sources.

METHOD: A cross-sectional study involving 261 ambulance nurses from 18 ambulance stations in southern Sweden. Adherence to acute chest pain guidelines was assessed using a validated instrument. Data collected in autumn 2023 were analysed using descriptive and inferential statistics, including stepwise linear regression analysis.

RESULTS: The study revealed an average self-reported adherence score of 19.2 out of 25 for acute chest pain guidelines. Mobile applications were the most commonly used source for accessing acute chest pain guidelines, while ambulance managers were the least used. Notably, older and more experienced ambulance nurses reported higher adherence scores. Additionally, a positive attitude towards the guidelines was correlated with higher adherence. Prioritisation of guidelines and age were predictors of adherence. In contrast, other demographic variables, such as sex and specialist nursing education, were not found to be associated with adherence.

CONCLUSION: The study indicates that self-reported adherence to acute chest pain guidelines among ambulance nurses is influenced by how highly they prioritise these guidelines and by their attitudes towards them, as well as their age and professional experience. Enhancing educational programmes and digital resources, particularly for younger and less experienced nurses, may improve adherence and patient outcomes in prehospital settings.

Background: Patients with intermittent claudication (IC) need lifelong treatment with secondary prevention, including smoking cessation, physical activity, and best medical treatment. The deficiency in existing support indicates a need for new strategies to improve self-management of the disease. However, knowledge of electronic health (e-health) as support for these patients is lacking. The primary aim was to evaluate the effect on secondary prevention outcomes and the usability of a web-based application for patients with IC. The secondary aim was to describe the patients’ experiences of using a web-based application. Patients and methods: Patients with IC (n=34) were recruited from a vascular outpatient clinic to a randomized controlled pilot trial. The study population had a mean age of 73 years and 52.9% were women. For three months, the intervention group (n=18) reported information through/via the application about physical activity, smoking, medication therapy, blood pressure, pain after activity, and quality of life (QoL). Primary outcome was walking distance, and the secondary outcome included ankle brachial index (ABI), blood pressure measurements, lifestyle factors, health education, and QoL. A linear mixed model was used to determine how the intervention affected the progression of walking distance, ABI, blood pressure measurements and BMI and Wilcoxon signed ranked test for QoL. After completing the study, the intervention group was interviewed in focus groups. Results: The reporting adherence was high (86–93%). QoL were improved in the intervention group (p=.049), and the level of insight into their condition increased in both intervention - (p=.016) and control group (p=.014). No significant differences in variables walking distance, ABI, blood pressure or BMI were observed between the groups. The interviews show an overall positive experience of using the application. Some patients experienced that the application increased their motivation to adhere to lifestyle recommendations. Conclusions: High reporting adherence and improved QoL, together with the participants experiences, indicate that using e-health may support adherence to secondary prevention in patients with IC but needs to be further studied in a full-scale randomized controlled trial.

Introduction: Computational sciences have significantly contributed to characterizing airway disease phenotypes, complementing medical expertise. However, comparing studies that derive phenotypes is challenging due to varying decisions made during phenotyping. We conducted a systematic review to describe studies that utilized unsupervised computational approaches for phenotyping obstructive airway diseases in children and adults. Methods: We searched for relevant papers published between 2010 and 2020 in PubMed, EMBASE, Scopus, Web of Science, and Google Scholar. Additional sources included conference proceedings, reference lists, and expert recommendations. Two reviewers independently screened studies for eligibility, extracted data, and assessed study quality. Disagreements were resolved by a third reviewer. An in-house quality appraisal tool was used. Evidence was synthesized, focusing on populations, variables, and computational approaches used for deriving phenotypes. Results: Of 120 studies included in the review, 60 focused on asthma, 19 on severe asthma, 28 on COPD, 4 on asthma-COPD overlap (ACO), and 9 on rhinitis. Among asthma studies, 31 focused on adults and 9 on children, with phenotypes related to atopy, age at onset, and disease severity. Severe asthma phenotypes were characterized by symptomatology, atopy, and age at onset. COPD phenotypes involved lung function, emphysematous changes, smoking, comorbidities, and daily life impairment. ACO and rhinitis phenotypes were mostly defined by symptoms, lung function, and sensitization, respectively. Most studies used hierarchical clustering, with some employing latent class modeling, mixture models, and factor analysis. The comprehensiveness of variable reporting was the best quality indicator, while reproducibility measures were often lacking. Conclusion: Variations in phenotyping methods, study settings, participant profiles, and variables contribute to significant differences in characterizing asthma, severe asthma, COPD, ACO, and rhinitis phenotypes across studies. Lack of reproducibility measures limits the evaluation of computational phenotyping in airway diseases, underscoring the need for consistent approaches to defining outcomes and selecting variables to ensure reliable phenotyping.

Purpose: Medication non-adherence is a global public health issue influenced by various factors, including the quality and comprehensiveness of medication information provided to patients. Migrants, particularly women, face unique healthcare and societal challenges in their new home countries. This study aims to explore Arabic-speaking migrant women’s experiences and perspectives on medication information and use.

Methods: This study was part of the Equal Health program, a health promotion initiative established in socially vulnerable areas to address health inequities. Arabic-speaking women aged 40–80 years with chronic illnesses participated in multistage focus group sessions exploring their experiences with medication information from healthcare, medication use, and perspectives on necessary improvements in medication information at hospital discharge. The sessions were conducted in Arabic, audio-recorded, transcribed verbatim, and translated into Swedish for analysis. Data were analyzed using Braun and Clark’s six-phase reflexive thematic analysis.

Results: Four multistage focus group sessions with 15 participants were conducted. The analysis generated three themes: receiving or not receiving professional medication information, medication adherence patterns, and needs and suggestions for improved medication information—a call for action. Participants reported inadequate medication information from physicians, particularly at the time of discharge from the hospital, and described instances of intentional and unintentional non-adherence. Suggestions for improvement included providing written medication information at discharge in their native language, using interpreters, and including a current medication list detailing overall medication information and potential drug interactions.

Conclusion: This study highlights inadequate medication information provision to Arabic-speaking migrant women, which may impact medication use and pose patient safety risks. Although the adherence patterns of the study subjects resembled those of the general population, unique barriers require additional healthcare support. This study can inform healthcare practices and establish a foundation for further research on medication information and use in this group, including comparisons with native-born individuals.

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.

Background: Stress of conscience is common in health and social care, being associated with adverse health consequences, staff turnover, and poor care quality. Person-centred care (PCC), an ethical approach to care with potential to reduce stress of conscience, has been little explored across healthcare settings. This study assesses the association between perceived PCC and stress of conscience among health and social care professionals in hospital and municipal care settings.

Methods: A web survey was sent to 11,554 health and social care professionals employed in hospital and municipal care settings in western Sweden. It yielded 2123 responses, and cross-sectional analyses were performed with data from 1671 professionals. The Person-Centred Care Assessment Tool was used to measure PCC, for both the full scale (P-CAT) and its subscales “Extent of Personalising Care” (EPC) and “Organisational and Environmental Support” (OES). The Stress of Conscience Questionnaire (SCQ) was used to measure the outcome stress of conscience. Bivariate correlations and linear regressions were used to analyse the data.

Results: The bivariate correlations were significant and negative for P-CAT ( r s = − 0.399, p <  0.01), EPC ( r s = − 0.239, p <  0.01), and OES ( r s = − 0.482, p <  0.01) with SCQ. When adjusted for covariates, multivariate linear regressions identified negative associations for P-CAT ( B = − 1.16, 95% CI − 1.33, − 0.99, p  < 0.001), EPC ( B = − 0.8, 95% CI − 1.04, − 0.56, p  < 0.001), and OES ( B = − 3.14, 95% CI − 3.52, − 2.78, p  < 0.001) with SCQ, indicating that as the scores of P-CAT and its subscales increase, the SCQ score decreases.

Conclusions: Our findings revealed that hospital and municipal health and social care professionals who perceived higher levels of PCC also perceived lower levels of stress of conscience. Considering the increased focus on PCC internationally, the results are relevant, as PCC might be one possible approach to mitigate stress of conscience. More knowledge of EPC and OES in relation to stress of conscience could be important for improved and better-targeted PCC implementation efforts.

Purpose: The purpose of this study was to illuminate the lived experiences of lifelong learning in self-care from the perspective of adults diagnosed with type 1 diabetes in younger years.

Methods: In 2020 to 2021 a hermeneutic phenomenological study was conducted in Sweden based on individual conversational interviews. Participants in the study were 20 consecutively chosen adults diagnosed with type 1 diabetes, ages 25 to 75 years (median 44.5 years) and with an illness duration of 10 to 61 years (median 26 years), recruited purposively via social media.

Results: The analysis of participants’ lived experiences of lifelong learning in self-care generated the overall theme “making meaning of type 1 diabetes as a lifelong illness”; this process was constantly challenged or triggered by all other ongoing or occurring processes in the participants’ everyday lives. More precisely, the participants likened this to having a ticket for a lifelong journey of personal learning, largely informal, characterized by a continuous reconstruction of one’s understanding of the illness and the necessary self-care while having to acknowledge, understand, manage, and endure diabetes.

Conclusions: Study findings suggest that lifelong learning in diabetes self-care in everyday life means learning how to become and remain a lifelong learner in the trajectory of diabetes. Thus, continuously learning how to manage self-care in different situations throughout life helps those diagnosed with a lifelong illness to construct and reconstruct living with the illness into a meaningful life.

Rationale, Aims and Objectives: Colonoscopy, though common, can be uncomfortable, necessitating routine assessment of patient experience per European guidelines. Positive patient experiences are crucial as they influence willingness for repeat procedures. Patient‐reported experience measures (PREMs) effectively capture patient perspectives through surveys, empowering patients to influence healthcare quality. These surveys identify areas for improvement and inform research, enhancing healthcare and its quality. The Patient Experience Colonoscopy Scale (PECS) is a colonoscopy‐specific PREM that measures adult patient experience after an elective colonoscopy. It consists of items derived from the patient's perspective and has been found to be content valid. The PECS is multidimensional and divided into five constructs: health motivation, discomfort, information, a caring relationship, and understanding. The current study aims to evaluate the measurement properties of the new PREM, called the PECS regarding reliability and construct validity.

Method: The sample comprised 331 adult patients who had undergone an elective colonoscopy at a University Hospital in Sweden. The PECS was evaluated using intraclass correlation coefficients, confirmatory factor analysis, and multi‐ and unidimensional Rasch analyses.

Results: The test−retest reliability was acceptable, with an average intraclass correlation coefficient of 0.72. Construct validity was tested with three different techniques. The confirmatory factor analysis revealed that the theoretical bifactor model containing the five constructs was supported. The multi‐ and unidimensional Rasch analyses showed that approximately 60% of the items had acceptable values. Some violation of local independence and some evidence of differential item functioning with respect to age and gender were identified, but they all made subject matter sense. The PECS is well‐targeted to patients with less positive experiences. The overall evaluation of the construct validity showed the PECS has acceptable measurement properties.

Conclusion: The PECS is a reliable and valid 30‐item colonoscopy‐specific PREM that can play an important role in gathering data for research and quality improvement initiatives that seek to incorporate patient perspectives on colonoscopy experiences. Some potential areas for improvement were found, but the PECS is ready to be utilised in clinical practice for the purpose of collecting patient experiences.

BackgroundIn endoscopic care, favourable patient experiences before, during and after a colonoscopy are essential for the patient's willingness to repeat the procedure. To ensure that significant experiences are measured, patients should be involved in creating the measurement instruments. Thus, the aim of the present study was to develop a colonoscopy-specific PREM by (1) operationalising patient experiences before, during and after a colonoscopy procedure and (2) evaluating its content validity.MethodsThe colonoscopy-specific PREM was developed in two stages: (1) operationalisation with item generation and (2) content validity testing. A previously developed conceptual model, based on a systematic literature review that illustrates patients' (n = 245) experiences of undergoing a colonoscopy, formed the theoretical basis. To assess the degree to which the PREM reflected patients' experiences before, during and after a colonoscopy procedure, content validity was tested-through face validity with healthcare professionals (n = 4) and cognitive interviews with patients (n = 14) having experienced a colonoscopy. Content validity index (CVI) was calculated to investigate the relevance of the items.ResultsThe Patient Experience Colonoscopy Scale (PECS) is a colonoscopy-specific PREM consisting of five different constructs: health motivation, discomfort, information, a caring relationship and understanding. Each construct was defined and generated into a pool of items (n = 77). After face-validity assessment with healthcare professionals, a draft 52-item version of the PECS was ready for content validity testing by the patients. During cognitive interviews the patients contributed valuable insights that led to rewording and removal of items. Results from the CVI suggest that the PECS and its content are relevant (I-CVI range 0.5-1, S-CVI/Ave = 0.86). The final PECS consists of 30 items representing a colonoscopy-specific PREM.ConclusionThe PECS is a new 30-item PREM instrument designed for adult elective colonoscopy patients after they have undergone the procedure. Each item in the PECS derives from a conceptual model based on a systematic literature review. Patients and healthcare professionals were involved in developing the PECS, which measures colonoscopy-specific patient experiences before, during and after the procedure. The content validity testing positively contributed to the development of the PECS. Psychometric properties need to be evaluated further.