Nordic Journal of Nursing Research

The aim of this systematic review was to gather, assess and synthesize evidence on educational interventions promoting learning and implementation of evidence-based practice in nursing education and their outcomes. Literature was sought from the Cochrane, CINAHL and PubMed databases. The data (10 articles) were analysed by applying qualitative content analysis. The analysis of the interventions produced five main categories: Theoretical foundations, Teachers and partnerships, Learning contents, Learning/teaching methods, and Learning tools. Outcomes of the evaluations were divided into three categories. A Web-based EBP learning module supplemented by help sessions, a program including the Self-Directed Learning Process for EBP Basics and a Workshop for Critical Appraisal of Literature, and an Evidence-Based Practice Project as a group work were interventions that had gained ‘excellent’ outcomes. When supporting nurse students’ learning of EBP, it is recommended to use a combination of self-directed learning and a consultation by a teacher when needed, different learning tools, as well as partnerships in planning and conducting interventions.

The purpose of this article is to argue for transformational leadership as a relevant theoretical basis for leadership in nursing in meeting with demands of efficiency. Following the introduction of the New Public Management in the health care sector in Norway, efficiency demands in particular give organizational realities that do not coincide with traditional quality in nursing. It is therefore important to study nurses’ experiences in relation to leaders and increased demands on efficiency. Data from a Norwegian empirical study is re-analysed in relation to the main components of the transformational leadership model: idealized influence, inspirational motivation, intellectual stimulation and individualized consideration. Empirical examples are presented within the frame of the main components of the transformational leadership model. More concretely, the examples show that the nursing leader is a person with great influence. It is of importance how the leader inspires and intellectually stimulates the nurses in their daily work and also takes individual care of them. Our conclusion is that nursing leaders who promote nurses’ capacity may, as an effect of that leadership, find that nurses are better able to meet demands on efficiency.

The aim of the present study was to explore health-related quality of life (HRQoL) and associated variables among all community-dwelling older women (≥65 years) (n = 2724) on Åland, a Finnish self-governing island community. A total of 1023 women participated (mean age 72.9 ± 6.8 years). Absence of depression, absence of diagnosed disease(s), having the opportunity to engage in meaningful leisure activities, and never or seldom feeling lonely explained, together with socio-economic control variables (i.e. age, education and economic situation), 34.4% of the variation in physical health. Absence of depression, strong inner strength, and never or seldom feeling lonely explained, together with socio-economic control variables, 27.7% of the variation in mental health. HRQoL was rated as relatively good, although special attention should be paid to women aged 80+years. To promote HRQoL, interventions aimed at preventing, detecting and treating depression should be prioritised. In addition, interventions aimed at reducing feelings of loneliness are also recommended in order to enhance overall HRQoL.

Research that examines nursing staff competence that is necessary in order to provide safe community care is called for. This literature review examines Norwegian policy documents and international research with the aim to assess whether there is a match between expected and actual nursing staff competence in community care. Twelve policy documents and ten research articles were included in the review, of which key themes were identified. The Norwegian government expects a wide range of competence ranging from specific tasks in medical management to adhering to safe practice and care guidelines. Major discrepancies were identified between the advanced competence expected in policy documents and the actual competence as described by the research literature, which was mainly concerned with assistance with activities of daily living, medical knowledge, and personal abilities. There is a general lack of opportunities for competence development in the sector, implying that a general development of nursing staff competence is a pressing need in community care.

The aim of this study was to provide a description and evaluation of birth outcomes for women who started care at Føderiket Midwifery Unit (FMU), a freestanding midwifery unit in Oslo. FMU opened in 2007 as a five-year project. It was closed in 2011 for economic reasons, and the planned evaluations were never performed. Data from 495 women who started care at FMU were prospectively collected. Socio-demographic characteristics, transfers to hospital, maternal and neonatal outcomes were described. The findings showed that 115 (23%) of the women were primiparous and 380 (77%) multiparous. A total of 408 women (82%) had no complications and no need for additional medical treatment during labour and birth. There were 73 (15%) transfers before birth, and 14 (3%) after birth. Nine women (2%) were delivered by caesarean section and 19 (4%) by vacuum extraction. Thirty women (6%) had postpartum haemorrhage >500 ml and five (1%) received blood transfusions. Five babies (1%) were transferred to the Neonatal Intensive Care Unit, all were discharged to their homes within a week. There were no cases of deaths, or serious morbidity. Our conclusions are that the results after four years management were comparable to other freestanding midwifery-led units in Western countries.

Caesarean section (CS) on maternal request is increasing. There is a need to understand why, and find measures to help women give birth vaginally. The purpose of this study was to compare the rate of complications in the first birth of 129 second time mothers wanting caesarean section with the rate of complications in the general population; to determine how many changed their mind and wanted to give birth vaginally when given the opportunity to know their midwife in advance; and to examine whether there were any differences in the prevalence of health problems and labour complications between the known midwife group and those maintaining their wish for a CS. A quantitative study based on data from The Medical Birth Registry and from medical records was carried out. The findings show that 129 women had experienced significantly more complications than the general population during their first birth. Among the 48 women joining the ‘known midwife group’, 81% gave birth vaginally. The 81 women maintaining a demand for CS significantly more often had a health problem and fear of childbirth before their second pregnancy and were delivered by elective CS in their first pregnancy. Our conclusion is that interventions such as the ‘known midwife project’ help some women with a wish for a CS to give birth vaginally.

The ambulance service is often summoned by a significant other. Therefore the ambulance clinician is expected to establish a trusting relationship with her/him and not focus solely on the patient. The aim of this study was to illuminate the meaning of significant others’ encounter with ambulance clinicians in a non-emergency ambulance care context, where patients were triaged to a level of care below that of the Accident and Emergency Department. The design was inductive. We used the phenomenological hermeneutic method developed by Lindseth and Norberg. Eleven significant others were interviewed using an open-ended method. A structural analysis resulted in a total of seven themes, covering the meaning of being de-burdened or the absence of de-burdening. When de-burdened, the significant other was empowered, irrespective of the outcome of the medical assessment and triage process. In the absence of de-burdening, the significant other felt inferior, petty, de-powered and not taken seriously by the ambulance clinicians. The majority of ambulance assignments are considered non-emergency care. The ambulance clinicians are the first to encounter significant others in these situations and therefore have a huge obligation to understand and handle their basic needs.