Högskolan i Skövde

Background

Sense of Coherence (SOC) relates to an individual’s overall life orientation, and stronger SOC is associated with better health, quality of life, and coping strategies. When our research group used the SOC-13 questionnaire for the first time in Nepal, we identified difficulties in response patterns. The findings necessitated further evaluation of the Nepali version of the SOC-13 questionnaire.

Objective

To qualitatively evaluate the SOC-13 questionnaire in Nepali for cross-cultural adaptation.

Method

Nineteen nurses were interviewed. We used the methodological approach of “think aloud” to obtain a deeper understanding of the interferences of the scales. Transcribed materials were analyzed using a deductive approach through qualitative content analysis. The original translated version of the SOC-13 questionnaire in Nepali was modified by replacing words that were easier to understand.

Result

Participants found the questionnaire content general and non-specific but easy to complete. The nurses experienced that the meanings and sentences in some of the items and response alternatives were difficult to understand. However, the overall comprehensiveness of most items and response alternatives was perceived as good. Nurses’ interpretation of the SOC-items in the translated version of the SOC-13 questionnaire in Nepali matched the original English version. Items that were experienced as difficult in the Nepali language were modified to increase their comprehensiveness. Modified items and response alternatives had the same content as before, but some words and meanings were substituted with easier language.

Conclusion

The current revised version of SOC-13 in Nepali is valid and useful to explore individuals’ overall life orientation and their abilities to deal and cope with various life events in the Nepalese context.

Background

Implementation of digital technology has been suggested as a potential solution to future healthcare challenges. Healthcare personnel’s attitudes are important in the acceptance and implementation of digital technologies.

Aim

The aims of this study were to (1) translate and validate two different questionnaires to Norwegian and Swedish respectively, and then (2) use these to examine nursing students’ attitudes towards digital technology in healthcare, as well as their attitudes towards older adults’ abilities to use digital technology.

Design

Cross-sectional.

Methods

A web-based questionnaire was distributed in first year nursing students in a Norwegian and a Swedish university college, respectively. The questionnaire consisted of the short form of the ‘Information Technology Attitude Scales for Health (ITASH)’ and the ‘Attitudes Towards Older Adults Using Digital technology (ATOAUT-11)’ questionnaire. The questionnaires were translated and validated in both countries. Frequencies, Student’s t-test, and one-way ANOVA were used to analyze the data.

Results

In total 236 students responded to the questionnaire in the period September 2022 to April 2023. Students mainly reported positive attitudes towards digital technology use in general. They most agreed with the items ‘Using digital technology devices makes my communication with other health professionals faster’, ‘The sort of information I can get from the digital technology devices helps me give better care to patient’, and ‘Digital technology skills are becoming more and more necessary for healthcare professionals’. However, they reported more negative attitudes towards older adults using digital technology. They most agreed with the items ‘One needs a lot of patience to explain to an older adult how to use digital technologies’, ‘It’s hard to explain to older adults how to use digital technology’, ‘Using digital technology is harder for most older adults’, and ‘Most older adults fear using digital technology because they fear of being scammed or cheated’.

Conclusion

The ITASH and the ATOAUT-11 is appropriate for use in a Norwegian and Swedish setting. Even if nursing students are positive to digital technology in healthcare in general, they are sceptical to older adults using digital technology. This may impact on their attitudes to using digital technology in the healthcare of older adults. These aspects need emphasis when revising nursing education curricula focusing on developing technological competencies in nursing, and gaining knowledge regarding older adults’ use of digital technology.

Background: The characteristics of women-dominated work differ in Nepal compared to Sweden. Women in Nepal perform household and other low-income work, including nursing, which is a women-dominated occupation in both Nepal and Sweden. Work-related adverse health outcomes, such as burnout, fatigue, depression, sleep disturbances, and long-term sickness absence, are evident in women-dominated work, especially within nursing. These challenges are accompanied by an increasing elderly population and a shortage of nursing personnel. Good health and well-being for all, improvingworking conditions and working environment, and providing adequate health and safety at work are the targets of sustainable development goals. Healthpromotive actions and interventions are needed to maintain and sustain health in women-dominated work.

Aims: The overall aim of this thesis was to identify means for promoting and sustaining health in women-dominated work in Nepal and Sweden through the evaluation and exploration of sense of coherence (SOC), work-related health, job demands, job resources, and health outcomes.

Methods: This thesis includes five individual papers. Paper I is a community-based intervention study with a quantitative design conducted in Nepal. The participants were 857 women before and 1268 women after health educationintervention in Nepal, who responded to a translated version of the SOC-13 questionnaire in Nepali. Papers II and III have a qualitative design and are based on 19 individual interviews with nurses in Nepal. Paper IV is also a qualitative study, based on 13 individual interviews with midwives and nurses in Sweden. Paper V is derived from the Swedish Longitudinal Occupational Survey of Health (SLOSH). Data were collected in 2016–2019 for all papers. The quantitative studies were analyzed through descriptive statistics, chisquared tests, one-way analyses of variance (ANOVAs), multivariable oneway ANOVAs, and logistic regression analyses. The qualitative studies werebased on individual interviews, and the data were analyzed through qualitative content analysis and thematic analysis.

Results: Women in semi-urban Nepal exhibited total SOC mean values between 51.1 and 57.4, which are comparable to India within a similar context. Qualitative validation of the SOC-13 questionnaire in Nepali was found to be general and not specific, and some translations were confusing. The SOC-13 items needed to undergo further editing in translation to increase theircomprehensions. Nurses in Nepal and nurses and midwives in Sweden described their work experience as meaningful, and several experiences were partially similar; their work and health were reported to be strengthened through collegial support, teamwork, and opportunities for skills and competence development. Shift work, lack of rewards and appreciation from managers, low staff-patient ratios, and high workload affected their work-related health negatively. In particular, nurses in Nepal experienced a lack of a safe physical work environment and insufficient managerial support. Results from SLOSH-data showed that the nursing professionals’ job demands were associated with lower self-rated health, higher burnout, and higher sickness absence. Job resources were associated with higher self-rated health and lower burnout.

Conclusion: This thesis shows that the SOC-13 questionnaire is useful and qualitatively validated for future use in the Nepalese context, to explore individuals’ overall life orientation and abilities to cope with various life events. Health education can be useful in strengthening SOC among women. To maintain, promote, and sustain health in women-dominated work, a health-promotive approach should be fostered. Nursing professionals’ health can be strengthened and sustained through the development of a positive work environment through good collegial, organizational, and managerial support, offering skills and competence development opportunities, and creating a safe physical and psychosocial work environment. Increasing job resources and minimizing job demands are important to increase positive health outcomes and decrease adverse health outcomes. Nursing professionals in Nepal and Sweden can also adopt strategies that support recovery and stress-management at work

Background

Work-related health problems, such as work stress, fatigue, and burnout constitute a global challenge within the nursing profession. Work-related health among nurses is not yet a prioritized phenomenon in Nepal. Health-promoting approaches to maintaining and sustaining nurses’ health are therefore essential. The aim of this study was to explore and thereby gain a deeper understanding of how nurses in Nepal’s hospitals experience their everyday work, with a focus on promoting and sustaining their work-related health.

Methods

A qualitative design with semi-structured individual interviews were used. Nineteen registered nurses working at hospitals in Kathmandu Valley, Nepal, were individually interviewed between October 6 and December 5, 2018. Transcribed interviews were analyzed through thematic analysis.

Results

Four main themes with belonging eight subthemes were constructed from the analysis: (1) “Sense of meaningfulness and belongingness in work culture” with subthemes; “Open environment” and “Sharing attitude and cooperating for the entire team” (2) “Support and rewards from the management team” with subthemes; “Lacking managerial support” and “Fair evaluation and job promotion opportunities”(3) “Workload and protection against work-related hazards” with subthemes; “Stressful and multitasking in workload” and “Lacking equipment for own health and caring”, and (4) “Motivation through opportunities and activities” with subthemes; “Employment benefits that motivate work”, and “Activities outside of work needed to recover”. These main themes and subthemes described nurses’ facilitators for and barriers to their work environment and health.

Conclusion

Our study highlighted nurses’ experiences with facilitators and barriers to their work-related health. Nurses’ work-related health was positively affected by support from colleagues, managers, and the organization. Conversely, less support from managers, lack of equipment, and unfair judgment were barriers to nurses’ work-related health. This study adds new knowledge about nurses’ work-related health from the context of Nepal. Hospital organizations and nursing managers in similar cultural and healthcare settings can apply the results of our study to develop strategies to promote and sustain nurses’ health and prevent work-related illness.

Background

Nursing professionals exhibit high prevalence of stress-related health problems. Job demands and job resources are parallel drivers of health and well-being among employees. Better job resources associate with better job satisfaction, job motivation and engagement even when job demands are high. To date, there is limited research which explores the association between job demands, job resources and health outcomes among nursing professionals in the Swedish context. The aim of this study was therefore to investigate Swedish nursing professionals’ job demands and job resources in relation to health outcomes, with comparisons between the private and public healthcare sectors. The specific research questions were as follows: (1) Are there differences between private and public healthcare regarding job demands, job resources, and health outcomes? and (2) Are there prospective associations between job demands and job resources in relation to health outcomes?

Methods

Data were drawn from the Swedish Longitudinal Occupational Survey of Health (SLOSH) 2016 and 2018, including 520 nurses and 544 assistant nurses working in the private and public healthcare sectors from 2016 (baseline). Data were analyzed using binary logistic regression.

Results

Nursing professionals reported higher threats, lower bullying, lower control, lower social support, and lower cohesion in the public healthcare units compared to the private healthcare units. The prospective analyses showed that job resources in terms of social support and rewards were associated with higher self-rated health and lower burnout. Cohesion was associated with higher self-rated health. Job demands in terms of psychological demands and job efforts were associated with lower self-rated health, higher burnout, and higher sickness absence, while emotional demands were associated with higher burnout.

Conclusions

Nursing professionals’ job resources are deficient in public healthcare units. Job resources are associated with positive health outcomes, whereas job demands are associated with negative health outcomes, among nursing professionals. Strengthening job resources among nursing professionals in the private and public healthcare sectors can promote and sustain their work-related health.

Registered nurses and midwives are in short supply and have among the highest rates of sick leave in the global workforce. The aim of this study was therefore to explore and gain a deeper understanding of how nurses and midwives experience their everyday work, with a view toward promoting and sustaining their work-related health. Nine registered nurses and four registered midwives working in hospitals and community healthcare facilities in Sweden were interviewed. The interviews were analyzed using content analysis. This study is reported in accordance with COREQ. One main category emerged: ‘Quality of organizational and collegial support and opportunities to facilitate recovery, health, and patient care’. From this category, four generic categories describing the overall experiences of registered nurses and midwives could be discerned. Based on these results, it is recommended that employers adopt a systematic health-promotive approach to foster and maintain the workplace health of registered nurses and midwives.