vatne

• Måløy, Elfrid; Aasen-Stensvold, Maria Therese; Vatne, Solfrid & Julnes, Signe Gunn (2023). Intellectual disability nurses’ challenges in medication management in primary health care : a qualitative study. Journal of Intellectual Disabilities. ISSN 1744-6295. 28(2024)(3), s. 854–871. doi: 10.1177/17446295231189368. Fulltekst i vitenarkiv Vis sammendrag

  This study examines how intellectual disability nurses employed in residential living services for persons with intellectual disabilities, in Norway, deal with medication management for these individuals. Using a qualitative study, a total of 18 intellectual disability nurses were interviewed as part of four focus groups. The results demonstrate six main challenges: First, Being alone with the responsibility of medication management - a challenge; Second, The need for further competence development; Third, Teaching and supervising unskilled colleagues in safe medication management; Fourth, Interpreting residents with little or only nonverbal communication; Fifth, The need to act as advocates when residents require hospitalization; Sixth, Deficient systems for medication management on several levels. The findings point to several major flaws in the system of medication management, which necessitates the need for highly qualified intellectual disability nurses. Managers must ensure that there is a secure system to mitigate errors and promote patient safety.

• Julnes, Signe Gunn; Reitan, Laila Solli; Myrvang, Tove; Rønning, Gry & Vatne, Solfrid (2022). Use of rapid response system afferent limb to recognize and respond to deteriorating patients: An action research study. The Nordic Journal of Nursing Research (NJNR). ISSN 2057-1585. 43(2023)(1), s. 1–9. doi: 10.1177/20571585221124376. Fulltekst i vitenarkiv Vis sammendrag

  Failure to recognize the deterioration of hospital patients has led to the implementation of a system known as the Rapid Response System. The aim was to explore nurses’ use of the afferent limb of the Rapid Response System to recognize and respond to deteriorating patients. Data were collected via video recordings with observations of 20 registered nurses (RNs) from general wards performing scenarios in a simulation laboratory with focus group interviews. Data were analyzed using systematic text condensation. COREQ were followed. In the first scenario, nurses did not apply ABCDE or ISBAR, and the use of NEWS was insufficient. Completing an education program led to evident improvement in the use of the tools during the second scenario. Nurses initially viewed their new competency as useful, but it was not sustained a year later. Customized education programs and fidelity-scale simulations are suited but not sufficient to change clinical competency without management anchoring.

• Julnes, Signe Gunn; Myrvang, Tove; Reitan, Laila Solli; Rønning, Gry & Vatne, Solfrid (2022). Nurse leaders' experiences of professional responsibility towards developing nursing competence in general wards : a qualitative study. Journal of Nursing Management. ISSN 0966-0429. 30(7), s. 2743–2750. doi: 10.1111/jonm.13745. Fulltekst i vitenarkiv Vis sammendrag

  Aim: To explore nurse leaders' experiences of professional responsibility to facilitate nursing competence in general wards. Background: Nurse leaders are responsible for maintaining high levels of competence among nurses to improve patient safety. Methods: Qualitative analysis was conducted between February and April 2019 using semi-structured interview data from 12 nurse leaders in surgical and medical wards at three Norwegian hospitals. Results: Four main themes were identified: struggle to achieve nursing staff competence; focus on operational and budgetary requirements rather than professional development; demands to organize sick leaves and holiday periods; and challenges in facilitating professional development. Conclusion: Nurse leaders felt that their responsibilities were overwhelming and challenging. They witnessed more support for current administrative tasks than for the implementation of professional development. Additionally, unclear work instructions from the employer provided few opportunities to facilitate professional development. Hospital management failed to ensure quality of care and patient safety in general wards by not supporting the strengthening of nurses' professional competence and preventing turnover. Implications for Nursing Management: Management may integrate formal work instructions that clarify nurse leaders' responsibilities as professional developers, allowing nurse leaders to meet their obligation of maintaining adequate professional competence among nursing staff in general wards.

• Hol, Hege Bente; Vatne, Solfrid; Strømskag, Kjell Erik; Orøy, Aud Jorun & Rokstad, Anne Marie Mork (2022). Norwegian nurses' perceptions of assisted dying requests from terminally ill patients : a qualitative interview study. Nursing Inquiry (NI). ISSN 1320-7881. 30(1), s. 1–9. doi: 10.1111/nin.12517. Fulltekst i vitenarkiv Vis sammendrag

  This study explores the perceptions of Norwegian nurses who have receivedassisted dying requests from terminally ill patients. Assisted dying is illegal inNorway, while in some countries, it is an option. Nurses caring for terminally illpatients may experience ethical challenges by receiving requests for euthanasia andassisted suicide. We applied a qualitative research design with a phenomenologicalhermeneutic approach using open individual interviews. A total of 15 registerednurses employed in pulmonary and oncology wards of three university hospitals andhome care in one municipality were recruited. Four themes emerged from theanalysis: (1) unprepared for the request; (2) meeting direct, indirect, and nonverbalrequests; (3) working in a gray zone, and (4) feeling alone and powerless. The studyfound that nurses were unsure how to handle such requests due to professionaluncertainty about assisted dying. Working in an environment where the topic istaboo made nurses morally uncertain, and some perceived this as moral distress. Thehospital chaplain played a significant role in providing support to these nurses. Keywords: assisted dying requests, ethical challenge, interviews, moral distress, moral uncertainty, nurses'experiences, phenomenological hermeneutic design

• Bachmann, Liv; Vatne, Solfrid & Mundal, Ingunn Pernille (2022). Safeguarding patients while implementing mechanical restraints : a qualitative study of nurses and ward staff’s perceptions and assessment. Journal of Clinical Nursing (JCN). ISSN 0962-1067. 32(3/4), s. 438–451. doi: 10.1111/jocn.16249. Fulltekst i vitenarkiv Vis sammendrag

  Aims and Objectives: To explore nurses’ and ward staff's perceptions and assessments of patient care while implementing mechanical restraints. Background: To prevent the risks associated with the use of restraints in psychiatry and ensure safe mental health care, it is necessary to know more about how the nursing staff experiences, comprehends and intervenes in managing patients subjected to coercive measures. Design: This study employed a qualitative descriptive design, in accordance with the COREQ guidelines. Methods: Semi-structured interviews were conducted with 18 nurses and ward staff aged between 22 and 45 years old, who had experience implementing mechanical restraints. Data were digitally audio-recorded and transcribed verbatim. Inductive thematic analysis was conducted using NVivo 12. Results: The participants believed that mechanical restraints should be used as a last resort and that safeguarding patients during implementation is important; however, their assessments of the patients’ physical and mental conditions varied. A clear difference emerged in how management qualified professionals handled situations prior to and during the implementation of mechanical coercive measures. Conclusions: The findings emphasise the need to focus on the assessment of patients prior to and during restraint, ensure the quality of safe implementation in a risk-of-harm situation, prioritise competence in education, and practice, and improve management. Relevance to clinical practice: The findings highlight the importance of assessing the physical and mental condition of patients while implementing restraints, as well as aiding the management, nurses and ward staff in tailoring safety procedures.

• Hol, Hege Bente; Vatne, Solfrid; Orøy, Aud Jorun; Rokstad, Anne Marie Mork & Opdal, Øivind (2022). Norwegian nurses' attitudes toward assisted dying : a cross-sectional study. Nursing: Research and Reviews. 2022(12), s. 101–109. doi: 10.2147/NRR.S363670. Fulltekst i vitenarkiv Vis sammendrag

  Purpose: The purpose was to investigate: (a) Norwegian nurses’ attitudes toward assisted dying, and (b) how much nurses receive requests from terminally ill patients for help in dying. Participants and Methods: A quantitative explorative study was conducted using a web-based cross-sectional survey to collect data. The survey was sent to a total of 734 eligible participants, and 205 clinical nurses participated by completing the survey. Data were analyzed using bivariate statistics and multivariate ordinal regression. Results: The study revealed that 56% of the participating nurses agreed with the statement that physician-assisted suicide should be allowed, and 48% supported legalization of euthanasia. Nurses in pulmonary wards were more positive about the legalization of physician-assisted suicide (OR = 2.98, CI = 1.34– 6.66, p = 0.008) and euthanasia (OR = 3.51, CI = 1.58– 7.81, p = 0.002) than nurses in oncological wards. Nurses over 30 years old held more negative attitudes about physician-assisted suicide than younger nurses (OR = 0.16, CI = 0.07– 0.39, p

• Sunde, Olivia Sissil; Vatne, Solfrid & Ytrehus, Siri (2021). Professionals' understanding of their responsibilities in the collaboration with family caregivers of older persons with mental health problems in Norway. Health and Social Care in the Community. ISSN 0966-0410. 30(4), s. 1325–1333. doi: 10.1111/hsc.13456. Fulltekst i vitenarkiv Vis sammendrag

  Research has highlighted the importance of health and social care professionals' collaboration with family caregivers. In the field of mental healthcare, involvement of family members is perceived as beneficial to the recovery process of the care recipient. Furthermore, family care-giving is an essential part of elderly care. It is well documented that family members need support to prevent negative consequences of care-giving. Nevertheless, involvement of and support for family caregivers have not developed into a common practice, and research has identified professional barriers to collaboration with family caregivers in several areas. The aim of this study was to explore professionals' experiences of collaboration with family caregivers of older persons with mental health problems, and how they understood their responsibility towards families. We conducted three focus group interviews with 18 health and social care professionals working in community-based services, in three rural municipalities in Western Norway. The thematic analysis by Braun and Clarke guided the analysis. The findings in relation to the professionals' role and responsibility towards family caregivers are presented in three themes: family caregivers – a resource that needs support; a responsibility with unclear boundaries; and balancing different needs. Professionals recognised family caregivers' need for support and acknowledged the importance of family relationships. However, they experienced dilemmas in performing their dual responsibility of caring for the older care recipient as well as the family member, which they described as having unclear guidelines. They also experienced that they had insufficient knowledge to take on this responsibility. We argue that the exercising of discretion is essential for the professionals' responsibility, and that clarification of their responsibility is needed. We recommend a stronger focus in education on developing competence in the family perspective. Furthermore, the apportionment of professionals' responsibility needs to be formalised, especially when several services are involved in providing care.

• Mordal, Elin; Hanssen, Ingrid; Kassa, Andargachew & Vatne, Solfrid (2021). Mothers’ experiences and perceptions of facility-based delivery care in rural Ethiopia. Health Services Insights (HSI Journal). 14, s. 1–7. doi: 10.1177/11786329211017684. Fulltekst i vitenarkiv Vis sammendrag

  In Ethiopia, delivery wards are a part of primary healthcare services. However, although the maternal mortality rate is very high, approximately 50% of mothers use skilled birth attendants. This study focused on how women in a rural southern district of Ethiopia experience maternity care offered at the local delivery wards. In this qualitative, exploratory study, 19 women who had given birth in a healthcare facility were interviewed in 2019. Individual in-depth interviews were supplemented with observations conducted at 2 different delivery wards in the same district in 2020. Two main themes emerged from the thematic content analysis: increased awareness and safety were the primary reasons for giving birth at a healthcare facility, and traditions and norms affected women’s birth experiences in public maternity wards. The main shortcomings were a shortage of medicine, ambulance not arriving in time, and lack of care at night. For some women, being assisted by a male midwife could be challenging, and the inability to afford necessary medicine made adequate treatment inaccessible. Providing continuous information gave the women a certain feeling of control. Strong family involvement indicated that collectivistic expectations were key to rural delivery wards. The healthcare system must be structured to meet women’s needs. Moreover, managers and midwives should ensure that birthing women receive high-quality, safe, timely, and respectful care. Keywords: Women, childbirth, primary healthcare, person-centered care, rural, Ethiopia, interviews, observation

• Mordal, Elin; Hanssen, Ingrid; Biratu, Andargachew Kassa & Vatne, Solfrid (2021). Providing safe maternity care under challenging conditions in rural Ethiopia : a qualitative study. BMC Health Services Research. 21(1), s. 1–10. doi: 10.1186/s12913-021-06324-4. Fulltekst i vitenarkiv Vis sammendrag

  Background: Women’s health and the reduction in the global maternal mortality rate is a research priority worldwide. The aim of this study was to investigate the structural conditions that influence the maternity care provided for women in rural Ethiopia. Methods: A qualitative descriptive study was conducted, composed of 28 individual in-depth interviews with midwives and women who had given birth during the past 8 months, and observations of maternity care at health centres and a primary hospital. A thematic analysis was conducted. Results: The midwives do their utmost to save the lives of mothers and prioritise saving lives over providing compassionate care. Inadequate resources, such as equipment, medicine and water, affect the quality of care they provide for the birthing women. This creates a conflict between the midwives’ ideals and what conditions allow them to do. Families and the women’s network play important roles in providing care and support to the women who give birth in health facilities. Conclusions: Structural conditions make it difficult for Ethiopian midwives in rural areas to provide optimal maternity care. In addition to the availability of professional midwifery care, the expectant mothers’ families and networks also tend to provide important support and care. Further studies on how to improve the quality of maternity care from the women’s perspective are needed. Keywords: Maternity care, Childbirth, Structural conditions, Qualitative method, Rural area, Ethiopia.

• Angel, Sanne; Vatne, Solfrid & Martinsen, Bente (2020). Vulnerability in nurses : a phenomenon that cuts across professional and private spheres. Advances in Nursing Science. ISSN 0161-9268. 43(1), s. E46–E56. doi: 10.1097/ANS.0000000000000293. Fulltekst i vitenarkiv Vis sammendrag

  Patients' vulnerability is a core concern in nursing. However, the nurse's endeavor to succeed may precipitate her vulnerability. Involving master students, 14 nurses' experiences of vulnerability in their professional roles were explored with a descriptive phenomenological approach. Vulnerability among nurses showed to be a latent feeling that manifests via bodily reactions including being overwhelmed by one's feelings and struggling to avoid being hurt. These experiences were evident in situations with patients and relatives, but also coworkers and working conditions, the latter suggests that the exposure of vulnerability may be possible to reduce by organizational awareness.

• Hauvik, Stine & Vatne, Solfrid (2020). Velferdsteknologi – fremtidens helsevesen med eller uten omsorg? Nordisk tidsskrift for helseforskning. ISSN 1504-3614. 16(1), s. 1–14. doi: 10.7557/14.4803. Fulltekst i vitenarkiv Vis sammendrag

  In the future, it will be a challenge to maintain today’s quality of care. Welfare technology may be a solution to reduce the expected care crisis. The public healthcare system is influenced by New Public Management ideals as” what can we afford? rather than “what are the patients` need”. Questions concerning patients’ rights and healthcare providers’ moral obligation seem to be less important. In the discussion Martinsen criticizes that caring has become a secondary term where patients` have less power. To increase the patient’s user involvement, Habermas suggests communicative discourse as a solution to the discrepancy between the public healthcare systems focus on earnings, and the patients’ need for care.

• Måløy, Elfrid; Grønvik, Cecilie K Utheim; Eines, Trude Fløystad & Vatne, Solfrid (2020). Studenters erfaringer med videreutdanning i tjenestedesign for ansatte i helse- og omsorgstjenesten. Nordisk sygeplejeforskning. ISSN 1892-2678. 10(4), s. 292–304. doi: 10.18261/issn.1892-2686-2020-04-07. Fulltekst i vitenarkiv Vis sammendrag

  Helse- og omsorgstjenesten i Norge står overfor nye utfordringer med en økning i andelen eldre med komplekse sykdommer. Helse- og omsorgstjenestene har kontinuerlig fokus på kvalitet, men er blitt kritisert for å ikke ivareta brukermedvirkning på en tilfredsstillende måte. Tjenestedesign er en metodikk som kan bidra til å øke brukermedvirkning. Med det som utgangspunkt, ble det etablert en videreutdanning i tjenestedesign for å øke helsepersonells kompetanse. Hensikten med studien var å belyse studenters erfaringer med videreutdanning i tjenestedesign for ansatte i helse- og omsorgstjenesten. Studien har et beskrivende design med en kvalitativ tilnærming og bruk av fokusgruppeintervju. Data ble analysert med utgangspunkt i Malteruds metode for systematisk tekstkondensering. Funnene viser at studentene ønsket en metodikk som kan bidra til økt brukermedvirkning i helse- og omsorgstjenesten. Studentene erfarte at studentaktive læringsformer bidro til motivasjon og engasjement i læringsprosessen. De erfarte at brukermedvirkning og tverrprofesjonelt samarbeid bidro til mer brukertilpassede løsninger. Studentene ga uttrykk for at verktøyene de lærte, var til god hjelp for å identifisere brukere og pasienters reelle behov. Tjenestedesign kan derfor være en egnet metodikk for å øke brukermedvirkning, noe som kan bidra til forbedret kvalitet i helse- og omsorgstjenesten. Nøkkelord: brukermedvirkning, fokusgruppeintervju, læringsutbytte, studentaktive læringsformer, tverrprofesjonelt samarbeid

• Sundal, Hildegunn & Vatne, Solfrid (2020). Parents’ and nurses’ ideal collaboration in treatment-centered and home-like care of hospitalized preschool children : a qualitative study. BMC Nursing. 19, s. 1–10. doi: 10.1186/s12912-020-00445-7. Fulltekst i vitenarkiv Vis sammendrag

  Background: The hospitalization of children requires collaboration between parents and nurses in partnerships. This study examines parents’ and nurses’ experiences of ideal collaboration in treatment-centered and home-like care of hospitalized preschool children. Methods: This qualitative study is part of a larger study of 12 parents and 17 nurses who were responsible for 11 hospitalized children. Data collection took place at a Norwegian general paediatric unit, and the data were gathered from observations of and qualitative interviews with the parents and nurses. The analysis was conducted in six steps, in alignment with Braun and Clarke. Results: Two essential themes emerged from the analysis. (1) Treatment-centered care focuses on the following tasks in building relationships – gaining trust, securing – gaining voluntariness, distracting and comforting, and securing and gaining voluntariness. The purpose of treatment-centered care is to perform diagnostic procedures and offer treatment. (2) Home-like care, the purpose of which is to manage a child’s everyday situations in an unfamiliar environment, focuses on the following tasks: making familiar meals, maintaining normal sleeping patterns, adjusting to washing and dressing in new situations, and normalizing the time in between. From this pattern, we chose two narratives that capture the essence of ideal collaboration between parents and nurses. Conclusion: The ideal collaboration between nurses and parents is characterized by flexibility and reciprocity, and is based on verbal and action dialogues. In treatment-centered care, parent-nurse collaboration was successful in its flow and dynamic, securing the children’s best interests. Meanwhile, the achievement of the children’s best interest within home-like care varied according to the level of collaboration, which in turn was related to the complexity of the children’s everyday situations. Keywords: children’s hospitalization, preschool, nurse-parent collaboration, qualitative design, field study, interview

• Synnes, Oddgeir; Orøy, Aud Jorun; Råheim, Målfrid; Bachmann, Liv; Ekra, Else Mari Ruberg & Gjengedal, Eva [Vis alle 12 forfattere av denne artikkelen] (2020). Finding ways to carry on : stories of vulnerability in chronic illness. International Journal of Qualitative Studies on Health and Well-being. ISSN 1748-2623. 15(1), s. 1–13. doi: 10.1080/17482631.2020.1819635. Fulltekst i vitenarkiv Vis sammendrag

  Purpose: In this study, we explore the lived experiences of chronic illness in four groups of patients; children with asthma, adolescents with diabetes, young adults with depression, and adult patients with chronic, obstructive pulmonary disease (COPD). Persons living with chronic illness are often designated as vulnerable. This study builds on the assumption that being vulnerable belongs to being human, and that vulnerability also might entail strength and possibilities for growth. Methods: A narrative analysis was undertaken to illuminate how experiences of vulnerability were narrated across the four patient groups, presenting four individual stories, one from each of the patient groups. Results/conclusion: The stories illuminate how living with a chronic illness implies differing capabilities and capacities dependent on the specific condition. At the same time the stories point to how various abilities and challenges in living with chronic illness can be alleviated or seen as resources. Considered together, the stories underscore how ´finding ways to carry on´ in chronic illness requires interpretational work. By calling upon resources among significant others, in the surroundings and in oneself, the narrator can find ways of interpreting living with chronic illness that might open towards a hopeful future. Keywords: chronic illness, vulnerability, narrative analysis, life

• Rokstad, Anne Marie Mork; McCabe, Louise; Robertson, Jane; Strandenæs, Margit Gausdal; Tretteteig, Signe & Vatne, Solfrid (2019). Day Care for People with Dementia: A Qualitative Study Comparing Experiences from Norway and Scotland. Dementia. ISSN 1471-3012. 18(4), s. 1393–1409. doi: 10.1177/1471301217712796. Fulltekst i vitenarkiv Vis sammendrag

  Potential benefits from day care attendance are reported in the literature for both people with dementia and caregivers, although the evidence-base is limited. The study aimed to explore and compare experiences of day care services for people with dementia as described by day care attendees and their caregivers in Norway and Scotland. Whereas day care receives prominence in Norway’s national dementia plan, Scotland does not highlight day care in its national dementia strategy. A qualitative cross-national comparative study was undertaken. Semi-structured interviews were conducted with 17 people with dementia and 17 caregivers in Norway, and 19 people with dementia and 15 caregivers in Scotland. Data were analyzed thematically and comparatively to explore the experiences and outcomes of the participants. Findings indicate positive outcomes from day care for both people with dementia and caregivers. Satisfaction with services related to meaningful activities, getting out of the home, strengthening social connections and careful staff facilitation to create a positive and welcoming atmosphere. There were strong similarities in the content of services and experiences reported in the two countries. Some minor differences were noted, with caregiver support being an area of notable divergence in experiences. Specialist day care for people with dementia seems to provide important support and positive outcomes for people with dementia, and respite and reassurance for their caregivers.

• Bachmann, Liv; Michaelsen, Ragnhild Karen Astad & Vatne, Solfrid (2019). Professional vulnerability in mental healthcare contexts : a focus group study of milieu‐therapists’ experiences. Nursing Open. 6(3), s. 1076–1087. doi: 10.1002/nop2.292. Fulltekst i vitenarkiv Vis sammendrag

  Aims and objectives: To gain insight into how the workplace influences milieu‐therapists’ vulnerability in the mental healthcare context. Background: Mental health services have experienced substantial changes. Reduced institutional treatment capacity is replacing the development of locally based treatment. Changes in external conditions in mental health services have influenced the working conditions of nurses and milieu‐therapists. Design: Qualitative design. The study complied with the COREQ checklist. Methods: Focus group interviews. Results: “Vulnerability due to unpredictable and threatening working context” was the common key theme that emerged in both contexts. Two key themes were different and opposite. In municipal mental health care, “Alone and unprotected” and in institutional care, “Together and protected.” Conclusion: The participants from both specialized and community mental health care, experienced vulnerability at different levels interpreted as a contradictory relationship between the healthcare system and their own ideals of what professional practice ought to be. Relevance to clinical practice: This study contributes to extended knowledge and understanding about the experienced influence of the working environment on professional vulnerability of nurses and milieu‐therapists` in mental health services. The impact of contextual conditions on health professionals’ working conditions has multi‐professional relevance for milieu‐therapists and managers of mental health services, and it is an important topic in health and social higher education. Keywords: focus group study, mental Health care context, milieu‐therapists, professional vulnerability

• Eines, Trude Fløystad; Angelo, Elin & Vatne, Solfrid (2019). Discourse analysis of health providers’ experiences using service design. Nursing Open. 6(1), s. 84–92. doi: 10.1002/nop2.191. Fulltekst i vitenarkiv Vis sammendrag

  Background: Municipal healthcare organizations are facing increasing challenges to developing more cost‐effective organizations and services, particularly in nursing homes. The background for this article is an attempt in this concern; implementing service design in a nursing home. Aim: The aim of the study is to explore nurses and nurse assistants' experiences using service design in a nursing home. Design: A qualitative design was applied. Method: Data were collected through focus group interviews with 17 nurses and nurse assistants in 2015. Thematic discourse analysis was conducted to analyse their discussed experiences. Results: The employees had positive attitudes towards incorporating a service design approach that focused on the patients' needs, which thus encouraged creative solutions and promoted employee involvement. The study shows that involving service designers and employees in the entire process, from planning to implementation of new and innovative solutions, requires closer collaboration between the service designers, managers, and employees to achieve the final goal. We consider that the results of this study will be of relevance to the future development of health care and nursing in nursing homes.

• Vatne, Solfrid (2019). Brukermedvirkning og involverende pedagogikk. I Brataas, Hildfrid V.; Evensen, Aud Emilie & Ingstad, Kari (Red.), Pedagogisk praksis i sykepleie. Gyldendal Norsk Forlag A/S. ISSN 9788205514027. s. 43–53. Fulltekst i vitenarkiv
• Mordal, Elin; Vatne, Solfrid; Agafari, Hirut Gemeda; Tsegaye, Meseret & Ulvund, Ingeborg (2018). Women’s childbearing location preferences in South Ethiopia : a qualitative study. Health Care for Women International. ISSN 0739-9332. 40(2), s. 138–157. doi: 10.1080/07399332.2018.1526287. Fulltekst i vitenarkiv Vis sammendrag

  Maternal mortality is unacceptably high in developing countries, and maternal health care service utilization is associated with improved maternal outcomes. We shed light on conditions that influence women’s preferences for childbirth location. Based on a qualitative descriptive design, 25 interviews were conducted with women of childbearing age in Southern Ethiopia in 2015. Previous experience of complications was the most common reason for using skilled attendants at the next childbirth. In addition, women’s limited decision-making authority and knowledge, as well as the quality of health care services and infrastructure, influenced childbirth location preferences. Home birth is still the norm, but there is growing interest in using health facilities and skilled attendants.

• Unhjem, Jeanette Varpen; Hem, Marit Helene & Vatne, Solfrid (2018). Encountering ambivalence : a qualitative study of mental health nurses' experiences with dual relationships. Issues in Mental Health Nursing. ISSN 0161-2840. 39(6), s. 457–466. doi: 10.1080/01612840.2017.1416507. Fulltekst i vitenarkiv Vis sammendrag

  Nurses are obliged to set professional boundaries in nurse–patient relationships. Relationships with patients that are pursued outside of working hours (dual relationships) are commonly prohibited by legislation and professional codes of ethics, but some nurses still engage in them. A thematic analysis of qualitative interviews revealed that the nurses experienced ambivalence regarding how they see the patients, their assessment of the dual relationships and how people around the nurses react to the relationships. Ambivalence was characterized by contradictory and indeterminate thoughts and attitudes toward patients and dual relationships. Results indicated that dual relationship decisions were complex and highly contextually dependent.

• Eines, Trude Fløystad & Vatne, Solfrid (2018). Nurses and nurse assistants’ experiences with using a design thinking approach to innovation in a nursing home. Journal of Nursing Management. ISSN 0966-0429. 26(4), s. 425–431. doi: 10.1111/jonm.12559. Fulltekst i vitenarkiv Vis sammendrag

  Aim: The aim of this study was to evaluate nurses’ and nurse assistants’ experiences with a design thinking approach to innovation used in a nursing home in Norway. Background: A design thinking approach to innovation that focuses on users’ needs can be employed to address many of the challenges facing health care providers in a field facing a growing ageing population, complex diseases and financial shortfalls. Evaluation: This study is based on a thematic analysis of four focus group interviews with nurses and nurse assistants (n = 23). Key issues: In the initial phase of developing the new service model, which included defining staff roles and responsibilities, participating nurses and nurse assistants felt engaged and motivated by the designers' inclusive and creative methods. However, during the new model's testing phase, they were critical of management's lack of involvement in the model`s implementation and therefore became less motivated about the project. Conclusion: The findings of the study highlight the importance of the designers cooperating with management and staff for the duration of the innovation process. Implications for nursing management Challenging innovation processes require strong managers who engage with designers, patients, staff and volunteers throughout all phases of an innovation process using a design thinking approach.

• Unhjem, Jeanette Varpen; Vatne, Solfrid & Hem, Marit Helene (2018). Transforming nurse-patient relationships : a qualitative study of nurse self-disclosure in mental health care. Journal of Clinical Nursing (JCN). ISSN 0962-1067. 27(5/6), s. e798–e807. doi: 10.1111/jocn.14191. Fulltekst i vitenarkiv Vis sammendrag

  Aims and objectives: To describe what and why nurses self-disclose to patients in mental health care. Background: Self-disclosure is common, but controversial and difficult to delineate. Extant research suggests that self-disclosure might have several potentially beneficial effects on therapeutic alliance and treatment outcome for patients in mental health care, but results are often mixed and limited by definitional inconsistencies. Method: Qualitative descriptive study including data from 16 nurses taking part in participant observation, individual interviews and focus group interviews. Results: Separate analyses resulted in four themes addressing the research question of what nurses self-disclose, and one main theme and four subthemes addressing why nurses self-disclose. The content of self-disclosure was captured in the four themes: Immediate family, Interests and activities, Life experiences, and Identity. In addition, results showed that disclosures were common among the nurses. Self-disclosure's potential to transform the nurse-patient relationship, making it more open, honest, close, reciprocal and equal, was the overarching reason why nurses shared personal information. The nurses also chose to self-disclose to share existential and everyday sentiments, to give real-life advice, because it felt natural and responsive to patients’ question to do so. Conclusion: Nurse self-disclosure is common and covers a variety of personal information. Nurses have several reasons for choosing to self-disclose, most of which are connected to improving the nurse-patient relationship. Relevance to clinical practice: Self-disclosure controversy can make it difficult for nurses to know if they should share personal information or not. Insights into the diversity of and reasons for nurse self-disclosure can help with deliberations on self-disclosure. Keywords: mental health nursing, nurse–patient relationship, professional boundaries, qualitative study, therapeutic relationships

• Vatne, Solfrid (2017). Exposed to an Accumulation of Burdensome Feelings: Mental Health Nurses' Vulnerability in Everyday Encounters with Seriously Ill Inpatients. Advances in Nursing Science. ISSN 0161-9268. 40(2), s. 194–206. doi: 10.1097/ANS.0000000000000149. Fulltekst i vitenarkiv Vis sammendrag

  Seriously mentally ill patients’ unusual behavior is considered challenging in caring relationships, but we know little about how this affects mental health nurses’ vulnerability. This article uses a phenomenological design inspired by Heidegger’s philosophy with the results of fieldwork and reflection groups with 11 nurses on an acute ward. The nurses were exposed to an accumulation of negative emotions, caused by potentially or actually harmful scenarios that were more extreme than those in other nursing contexts. They protected themselves through limit-setting approaches, which conflicted with their standards of building trusting relationships with patients. The feeling of guilt might function as an appeal for authentic practice, but a change in practice requires the use of acknowledgment approaches and the systematic debriefing of accumulated burdensome feelings. Key words: burdensome emotions, field study, Heidegger, limit-setting, mental health nurses, phenomenological design, physically harm, professional integrity, vulnerability

• Ulvund, Ingeborg; Rokstad, Anne Marie Mork & Vatne, Solfrid (2017). Incident reporting – a difficult balancing act. (Translation of "Varsling av avvik – en vanskelig balansekunst"). Sykepleien Forskning. ISSN 1890-2936. doi: 10.4220/sykepleienf.2016.58904en. Fulltekst i vitenarkiv Vis sammendrag

  Background: Although health authorities expect patient safety incidents to be reported, research shows that such incidents are underreported, and the reasons for this are currently being debated. Knowledge is needed on the factors that promote and inhibit incident reporting in the health services. Objectives: To describe factors that influence midwives’ and mental health nurses’ decisions on whether or not to report adverse incidents. Method: The study has a quantitative design. Data were collected using a self-administered written questionnaire. The respondents were midwives and mental health nurses (n = 133). Main results: The majority of informants were familiar with the procedures for reporting adverse incidents, but had more knowledge of the procedures for reporting clinical errors than unethical practice. The main motivation for reporting such incidents was to avoid harm to patients. However, the informants’ own interests or the interests of their work colleagues affected the decision of whether or not to report. Conclusion: The midwives and mental health nurses highly prioritised the patients’ rights. Still, reporting adverse incidents is complicated and is influenced by cultural and organisational factors.

• Tretteteig, Signe; Vatne, Solfrid & Rokstad, Anne Marie Mork (2017). Meaning in family caregiving for people with dementia : a narrative study about relationships, values, and motivation and how day care influences these factors. Journal of Multidisciplinary Healthcare. 10, s. 445–455. doi: 10.2147/JMDH.S151507. Fulltekst i vitenarkiv Vis sammendrag

  Background: In addition to care-related burdens, most caregivers of a person with dementia perceive a variety of positive and satisfying experiences, such as feeling needed and useful in their family caregiving role. “Meaning-focused coping” describes both positive and negative emotions in periods with high levels of stress. Day care service may have the potential to increase caregivers’ positive experiences and meaning-focused coping, and positively influence interpersonal relationships between those giving care and those receiving care. The aim of this study was to gain knowledge about family caregivers’ experiences of meaning in their caring role. Additionally, the influence of day care services on caregivers’ experiences and motivation in their caregiving role is explored. Methods: A qualitative design based on individual interviews was used. The interviews were analyzed using a narrative method and a case study approach. Findings: Family caregivers’ roles and coping strategies were related to their relational ties. Caregivers had to make decisions about whether to enhance, maintain, or let go of emotional ties to find a good balance between meeting their own needs and the needs of the person with dementia. Family caregivers reported that day care positively influenced their “relationshiporiented coping” and experience of meaning. Conclusion: Finding meaning in the role of a family caregiver for persons with dementia is closely connected to the caregivers’ own values and goals. Finding a balance between attending to their own needs and the needs of the person with dementia is crucial. Day care has the potential to increase family caregivers’ motivation to care by supporting their capacity to meet their own needs, cooperate and communicate with the person with dementia, and make competent and autonomous choices, thus increasing their feeling of mastery. Keywords: dementia, family caregivers, day care, meaning, values, relationship-oriented coping

• Tretteteig, Signe; Vatne, Solfrid & Rokstad, Anne Marie Mork (2017). The influence of day care centres designed for people with dementia on family caregivers : a qualitative study. BMC Geriatrics. 17(5), s. 1–11. doi: 10.1186/s12877-016-0403-2. Fulltekst i vitenarkiv Vis sammendrag

  Dementia is one of the most challenging age-related illnesses for family caregivers, whose care-related burden is well known. Research indicates that day care centres (DCCs) can reduce the caregiver burden and help family caregivers to cope with demands; however, the current body of knowledge is still tentative and inconsistent, and more research is recommended. The aim of this study is to provide an extended understanding of the situation of family caregivers and to examine to what extent DCCs can meet their need for support and respite.

• Angel, Sanne & Vatne, Solfrid (2017). Vulnerability in patients and nurses and the mutual vulnerability in the patient–nurse relationship. Journal of Clinical Nursing (JCN). ISSN 0962-1067. 26(9/10), s. 1428–1437. doi: 10.1111/jocn.13583. Fulltekst i vitenarkiv Vis sammendrag

  Aims and objectives. To examine the mutual vulnerability of patients and nurses, anticipating that an enhanced understanding of the phenomenon may help reduce vulnerability. Background. Patient vulnerability is a key issue in nursing, aimed at protecting the patient from harm. In the literature, vulnerability is described both from a risk perspective and a subjective perspective. This implies that the objective dimension of patient vulnerability does not necessarily reflect the patient’s own perception of being vulnerable. However, external judgment may influence inter- nal perception. Adding to this complexity, attention has also been drawn to the vulnerability of the nurse. Design. A definition deduced from central literature on vulnerability captures the complexity of objective versus subjective vulnerability. Based on the perspective of vulnerability in general, vulnerability in healthcare services shows how depen- dency may increase patient vulnerability. Further, despite education, training and supportive settings, patients may increase nurse vulnerability. The core of this mutuality is explored in the light of Martin Heidegger’s philosophy of being. Conclusion. The patient’s need for help from the nurse opens the patient to engage in supportive and/or harmful encounters. Thus, dependency adds to the vulnerability related to health issues. The nurse’s vulnerability lies in her engage- ment in caring for the patient. If failing to provide proper care, the nurse’s exis- tence as ‘a good nurse’ is threatened. This is exacerbated if the patient turns against the nurse. Therefore, the core of vulnerability seems to lie in the fact that the patient and the nurse are both striving to be the persons they want to be, and the persons they have not yet become. Relevance to clinical practice. Recognition of the mutual vulnerability in the patient–nurse relationship calls for collective acknowledgement of the demanding nature of caring relationships, for support and for a strengthening of professional skills. Key words: dependency, Heidegger, nurse–patient relationship, vulnerability.

• Bachmann, Liv; Michaelsen, Ragnhild K A & Vatne, Solfrid (2016). Feeling “overloaded” and “shortcomings” : milieu therapists’ experiences of vulnerability in caring for severely mentally ill patients. Journal of Multidisciplinary Healthcare. 9, s. 285–296. doi: 10.2147/JMDH.S106310. Fulltekst i vitenarkiv Vis sammendrag

  Background: Milieu therapists’ relationships with patients with severe mental illnesses are viewed as challenging. Elucidating vulnerability from their perspective in daily face-to-face encounters with patients might contribute to extending our knowledge about milieu therapists’ vulnerability and the dynamics of the interaction between patients in mental health services and expertise in building caring and therapeutic relationships. The aim of this project was to study educated milieu therapists’ experiences of their own vulnerability in their interactions with patients in mental health services. Materials and methods: The data collection method was focus-group interviews. Thirteen part-time master’s in mental health students (eight nurses, three social workers, two social educators) participated. All participants had experience with community or specialized mental health services (2–8 years). Results: The milieu therapists mainly related their experiences of vulnerability to negative feelings elicited by challenging work conditions, disclosed as two main themes: 1) “overloaded”, by the possibility of being physically and mentally hurt and the burdens of long-lasting close relationships; milieu therapists were extremely vulnerable because of their difficulty in protecting themselves; and 2) “shortcomings”, connected to feelings of despair associated with not acting in concordance with their professional standards and insecurity about their skills to handle challenging situations, which was a threat to their professional integrity. There seemed to be coherence between vulnerability and professional inauthenticity. A misunderstanding that professionalism refers to altruism seems to increase milieu therapist vulnerability. Conclusion: Vulnerability in health care is of interest to multiple disciplines, and is of relevance for knowledge development in higher education. Extended knowledge and understanding about milieu therapists’ vulnerability might strengthen their personal and professional integrity in professional practice in mental health services. Health care managers’ focus on the supervision of individual professionals in practice and practical training is important. Further research on the coherence between vulnerability and professionalism is recommended. Keywords: vulnerability, milieu therapists, mental health services, caring and therapeutic relationships, threat to professional integrity

• Ulvund, Ingeborg; Rokstad, Anne Marie Mork & Vatne, Solfrid (2016). Varsling av avvik – en vanskelig balansekunst. Sykepleien Forskning. ISSN 1890-2936. doi: 10.4220/Sykepleienf.2016.58904. Fulltekst i vitenarkiv Vis sammendrag

  Bakgrunn: Helsemyndighetene forventer at avvik meldes. Likevel viser forskning at avvik underrapporteres, og det diskuteres hvorfor. Det er behov for kunnskap om faktorer som fremmer og hemmer avviksrapportering i helsetjenesten. Hensikt: Studien tar sikte på å beskrive faktorer som påvirker jordmødres og psykiatriske sykepleieres varsling av avvik. Metode: Studien har et kvantitativt design. Vi samlet inn data ved å bruke et egenutfylt spørreskjema. Utvalget består av jordmødre og psykiatriske sykepleiere (n = 133). Resultat: De fleste kjente til prosedyrer for avvikshåndtering på egen arbeidsplass, men flere kjente til prosedyrer for varsling av kliniske feil enn for uetisk praksis. Den viktigste grunnen til å varsle var å hindre at pasienter skades. Før de varslet, vurderte mange også om varslingen kunne bli en belastning for dem selv eller en kollega. Konklusjon: Tendensen var at jordmødre og psykiatriske sykepleiere prioriterte pasientens rettigheter høyt. Varsling av avvik utløste kompliserte vurderinger som ble påvirket av kulturelle og organisatoriske forhold.

• Tretteteig, Signe; Vatne, Solfrid & Rokstad, Anne Marie Mork (2016). The influence of day care centres for people with dementia on family caregivers: an integrative review of the literature. Aging & Mental Health. ISSN 1360-7863. 20(5), s. 450–462. doi: 10.1080/13607863.2015.1023765. Fulltekst i vitenarkiv Vis sammendrag

  Objectives: Day care centres (DCC) for people with dementia (PWD) have received increased attention recently, due to a shift in policy from the use of residential care towards home-based services. The aim of this study is to provide an extended understanding of the influence of DCCs on family caregivers (FCs). Method: An integrative review including 19 studies was used: qualitative (n = 2), quantitative non-randomised (n = 8), quantitative descriptive studies (n = 7), and with mixed-method design (n = 2). The quality of the studies was evaluated by the mixed-methods appraisal tool (MMAT). Results: FC experienced the DCC both as a respite service, and to some extent as a support service, improving their competence in caring for the PWD. The quality of the DCC influenced its use, and the FC's motivation to care for the PWD. FC's gender, role, individual needs, PWD behavioural problems and need for assistance played an important role. Conclusion: As a respite and support service, DCCs have the potential to give FCs a feeling of safety and relief, reduce the caregiver's burden, and increase their motivation towards their role as caregivers. These outcomes depend on the quality of treatment, and how the service meets the FC's needs for flexibility, support, information, and responsibility sharing.

• Olsen, Britt Mari; Vatne, Solfrid & Buus, Niels (2015). Kontinuitets- og samhandlingsutfordringer i psykiske helsetjenester : en fokusgruppestudie. Klinisk Sygepleje. ISSN 0902-2767. 29(4), s. 55–68. Fulltekst i vitenarkiv Vis sammendrag

  Samhandling på tvers av organisatoriske grenser har til hensikt å skape kontinuitet i tjenestetilbudet til personer med alvorlige og sammensatte psykiske lidelser, men det er en internasjonal og nasjonal velkjent utfordring å få dette til å lykkes.

• Gudde, Camilla Buch; Olsø, Turid Møller; Whittington, Richard & Vatne, Solfrid (2015). Service users’ experiences and views of aggressive situations in mental health care: a systematic review and thematic synthesis of qualitative studies. Journal of Multidisciplinary Healthcare. 8, s. 449–462. doi: 10.2147/JMDH.S89486. Fulltekst i vitenarkiv Vis sammendrag

  Background: Aggressive situations occurring within mental health services can harm service users, staff, and the therapeutic environment. There is a consensus that the aggression phenomenon is multidimensional, but the picture is still unclear concerning the complex interplay of causal variables and their respective impact. To date, only a small number of empirical studies include users’ views of relevant factors. The main objective of this review is to identify and synthesize evidence relating to service users’ experiences and views of aggressive situations in mental health settings. Methods: We included qualitative studies of any design reporting on service users’ own experiences of conditions contributing to aggressive situations in mental health care and their views on preventative strategies. Eligible articles were identified through an electronic database search (PsycINFO, PubMed, Ovid Nursing Database, Embase, and CINAHL), hand search, and cross-referencing. Extracted data were combined and interpreted using aspects of thematic synthesis. Results: We reviewed 5,566 records and included 13 studies (ten qualitative and three mixed methods). Service users recognized that both their own mental state and negative aspects of the treatment environment affected the development of aggressive situations. Themes were derived from experiential knowledge and included calls to be involved in questions regarding how to define aggression and relevant triggers, and how to prevent aggressive encounters effectively. The findings suggest that incidents are triggered when users experience staff behavior as custodial rather than caring and when they feel ignored. Conclusion: The findings highlight the importance of staffs’ knowledge and skills in communication for developing relationships based on sensitivity, respect, and collaboration with service users in order to prevent aggressive situations. An important factor is a treatment environment with opportunities for meaningful activities and a preponderance of trained staff who work continuously on the development of conditions and skills for collaborative interaction with users.

• Haugen, Kjetil K. & Vatne, Solfrid (2015). A game of asymmetric information between a therapist and a mentally ill patient. Mathematics for applications. ISSN 1805-3610. 4(1), s. 1–13. doi: 10.13164/ma.2015.01. Fulltekst i vitenarkiv Vis sammendrag

  In this paper, we follow up research of Vatne [23] related to how mentally ill patients could (and perhaps should) be treated. We propose, model, and analyze a simple sequential game of incomplete and asymmetric information where the patient moves first, signaling behavior which is observed by the therapist with lack or limited knowledge of the actual patient type. We assume greatly approximated strategy spaces both for patient and therapist, but will still claim that our results increase knowledge of this important relation. Knowledge that may be critically important in continued improved treatment of patients with mental illness.

• Miconi, Alessia; Nuzzo, Daniele De; Vatne, Solfrid & Pierantognetti, Paola (2015). Riding a roller coaster : narrative typologies of patients with neuroendocrine tumors. Journal of Multidisciplinary Healthcare. 8, s. 535–545. doi: 10.2147/JMDH.S90744. Fulltekst i vitenarkiv Vis sammendrag

  Background and objective: Illness stories have attracted growing attention in health care research in the context of learning from looking at the world through the patients’ eyes. No narrative studies were found about the patients with neuroendocrine tumors (NETs); a rare illness including tumors usually starting in hormone-producing cells. The aim of this article was to develop an extended understanding of these patients’ experiences and struggles, as well as their solutions to a common problem. Methods: The data source was 21 letters written by the patients with NETs treated at an ambulatory treatment center at a large urban hospital in Italy. The letters were analyzed using the Arthur Frank’s narrative method. We paid particular attention to statements of self-experience, which is crucial to get the character of the story. Results: We identified four different typologies: “Not illness stories”, “Living in imbalance”, “Living a new life in balance”, and “Living a normal life”. The main characteristics of these four groups could be linked to Frank’s typologies. However, the patients with this periodically changing disease were continuously in the process of attaining balance in life, and they might move between these various typologies. Conclusion: The NETs are incurable illnesses that challenged the peoples to attaining a new balance in life. We will highlight stories focusing on the patients’ imbalance and chaos because they illuminated the patients’ concrete suffering, which might provide clinicians with specific information about the patients’ emotional, physical, and spiritual state. Through learning from the stories of the patients attaining new balance, it seems possible to move forward to acceptance and to develop a model for a new way of living. However, we are skeptical about labeling these stories as a model for clinical practice because they might contribute to individualistic and heroic prescriptions for life that are impossible for others to achieve. Keywords: living in imbalance, coping and adaption, health care, life-threatening illness, neuroendocrine tumors, narrative inquiry

• Rokstad, Anne Marie Mork; Vatne, Solfrid; Engedal, Knut Arne & Selbæk, Geir (2015). The role of leadership in the implementation of person-centred care using Dementia Care Mapping: a study in three nursing homes. Journal of Nursing Management. ISSN 0966-0429. 23(1), s. 15–26. doi: 10.1111/jonm.12072. Fulltekst i vitenarkiv Vis sammendrag

  Aim: The aim of this study was to investigate the role of leadership in the implementation of person-centred care (PCC) in nursing homes using Dementia Care Mapping (DCM). Background: Leadership is important for the implementation of nursing practice. However, the empirical knowledge of positive leadership in processes enhancing person-centred culture of care in nursing homes is limited. Method: The study has a qualitative descriptive design. The DCM method was used in three nursing homes. Eighteen staff members and seven leaders participated in focus-group interviews centring on the role of leadership in facilitating the development process. Results: The different roles of leadership in the three nursing homes, characterized as ‘highly professional’, ‘market orientated’ or ‘traditional’, seemed to influence to what extent the DCM process led to successful implementation of PCC. Conclusion and Implications for Nursing Management: This study provided useful information about the influence of leadership in the implementation of personcentred care in nursing homes. Leaders should be active role models, expound a clear vision and include and empower all staff in the professional development process. Keywords: dementia, Dementia Care Mapping, focus-group interviews, leadership, nursing homes, person-centred care

• Bjerkan, Jorunn; Vatne, Solfrid & Hollingen, Anne (2014). Web-based collaboration in individual care planning challenges the user and the provider roles – toward a power transition in caring relationships. Journal of Multidisciplinary Healthcare. 7, s. 561–572. doi: 10.2147/JMDH.S70470. Fulltekst i vitenarkiv Vis sammendrag

  Background and objective: The Individual Care Plan (ICP) was introduced in Norway to meet new statutory requirements for user participation in health care planning, incorporating multidisciplinary and cross-sector collaboration. A web-based solution (electronic ICP [e-ICP]) was used to support the planning and documentation. The aim of this study was to investigate how web-based collaboration challenged user and professional roles. Methods: Data were obtained from 15 semistructured interviews with users and eight with care professionals, and from two focus-group interviews with eight care professionals in total. The data were analyzed using systematic text condensation in a stepwise analysis model. Results: Users and care professionals took either a proactive or a reluctant role in e-ICP collaboration. Where both user and care professionals were proactive, the pairing helped to ensure that the planning worked well; so did pairings of proactive care professionals and reluctant users. Proactive users paired with reluctant care professionals also made care planning work, thanks to the availability of information and the users’ own capacity or willingness to conduct the planning. Where both parties were reluctant, no planning activities occurred. Conclusion: Use of the e-ICP challenged the user–professional relationship. In some cases, a power transition took place in the care process, which led to patient empowerment. This knowledge might be used to develop a new understanding of how role function can be challenged when users and care professionals have equal access to health care documentation and planning tools.

• Rokstad, Anne Marie Mork; Halse, Ingeborg; Tretteteig, Signe; Barca, Maria Lage; Kirkevold, Øyvind & McCabe, Louise [Vis alle 13 forfattere av denne artikkelen] (2014). Effects and costs of a day care centre program designed for people with dementia : a 24 month controlled study. Journal of Clinical Trials. 4(4), s. 1–5. doi: 10.4172/2167-0870.1000182. Fulltekst i vitenarkiv Vis sammendrag

  Background: Attending day care centres with programs specifically designed for patients with dementia is believed to postpone admittance to nursing home as well as increase quality of life and well-being for both patients and their family carers. Therefore, the Norwegian Ministry of Health and Care Services is presently offering funding to all municipalities that wish to establish day care centre programs for this group of patients. There is only limited knowledge on the effectiveness of day care centre programs designed for patients with dementia. Our research group aims to investigate to what degree attendance in day care centres with programs designed for people with dementia is effective to postpone admittance to nursing home care, to enhance quality of life for the patients and to relieve burden of care for the family carers. Methods/Design: The study is a quasi-experimental trial with a comparison group and a qualitative inquiry. Four hundred patients with dementia and their family caregivers will be included in the trial. Assessments will be made at baseline, after one and two years. Data collection will be made at three levels; at patient level with measures of cognition, depression, coping, quality of life, functioning in activities of daily living, neuropsychiatric symptoms and time of death; at family carer level with measures of depression, coping and burden; and at societal level with measures of nursing home admittance, hospital stays and use of other health and social care resources. For the qualitative analysis, 20 dyads of patients receiving a day care program and their family carers will be asked to participate. The main focus will be to explore how the day care centre programs affect both the patients and the family carers’ daily life. Five of these dyads will be followed closely throughout two years.

• Gudde, Camilla Buch; Møller, Turid; Antonsen, Dag Øivind; Rø, Marit; Eriksen, Lasse & Vatne, Solfrid (2013). Experiences and preferences of users with major mental disorders regarding helpful care in situations of mental crisis. Scandinavian Journal of Public Health. ISSN 1403-4948. 41(2), s. 185–190. doi: 10.1177/1403494812472265. Fulltekst i vitenarkiv Vis sammendrag

  Aims: To examine the experiences of and preferences for helpful care in situations of mental crisis from the perspective of people with major mental disorders. Methods: Qualitative individual interviews with 19 users with major mental disorder, 13 men and six women, aged 22–60 years. Analysis was conducted with systematic text condensation. Results: The main tendencies among a majority of the users are a clear understanding of their own problems and ways of handling these, and the desire for early help from providers whom they know well and who are open to dialogue and reflection. A clear majority perceived a high threshold for contacting the mental health system due to negative experiences and lack of user involvement in treatment planning and implementation. Conclusion: The findings challenge traditional views of professionalism and describe important implications for mental health services from the user’s perspective. Our study provides a clear indication of the importance of becoming an active participant in one’s own life, and the need for deeper understanding among the professionals in relation to user experiences and preferences for helpful care in periods of mental health crisis in order to optimize the care.

• Gjengedal, Eva; Ekra, Else Mari Ruberg; Hol, Hege Bente; Kjelsvik, Marianne; Lykkeslet, Else & Michaelsen, Ragnhild K A [Vis alle 11 forfattere av denne artikkelen] (2013). Vulnerability in health care – reflections on encounters in every day practice. Nursing Philosophy. ISSN 1466-7681. 14(2), s. 127–138. doi: 10.1111/j.1466-769X.2012.00558.x. Fulltekst i vitenarkiv Vis sammendrag

  Vulnerability is a human condition and as such a constant human experience. However, patients and professional health care providers may be regarded as more vulnerable than people who do not suffer or witness suffering on a regular basis. Acquiring a deeper understanding of vulnerability would thus be of crucial importance for health care providers. This article takes as its point of departure Derek Sellman's and Havi Carel's discussion on vulnerability in this journal. Through different examples from the authors' research focusing on the interaction between health professionals and patients, existential, contextual, and relational dimensions of vulnerability are illuminated and discussed. Two main strategies in the professionals' interactions with patients are described. The strategy that aims at understanding the patients or families from the professional's own personal perspective oftentimes ends in excess attention to the professional's own reactions, thereby impairing the ability to help. The other strategy attempts to understand the patients or families from the patients' or families' own perspective. This latter strategy seems to make vulnerability bearable or even transform it into strength. Being sensitive to the vulnerability of the other may be a key to acting ethically.

• Rokstad, Anne Marie Mork & Vatne, Solfrid (2011). Dementia care mapping - en mulighet for refleksjon og utvikling. Sykepleien Forskning. ISSN 1890-2936. 6(1), s. 28–34. doi: 10.4220/sykepleienf.2011.0043. Fulltekst i vitenarkiv Vis sammendrag

  Studiens bakgrunn: Artikkelen beskriver en studie der Dementia Care Mapping (DCM) ble brukt som verktøy for utvikling av praksis i demensomsorg i en norsk sykehjemsenhet. Hensikt: Målet med studien var å innhente kunnskap om de ansattes erfaringer med refleksjonsprosesser som ble igangsatt på bakgrunn av DCM og hvilken betydning dette hadde for utvikling av praksis. Metode: Fokusgrupper ble brukt for å samle kvalitative data om hvilke refleksjoner som ble initiert i personalgruppen. Resultater: Personalet rapporterte at tilbakemeldingen basert på DCM-kartleggingen satte i gang refleksjoner over egen praksis og bidro til nye måter å møte pasientene på. Tilbakemeldingen bidro til økt bevisstgjøring, selvrefleksjoner og refleksjoner i fellesskap. De la særlig vekt på at de positive eksemplene som ble trukket frem i tilbakemeldingen, ga økt oppmerksomhet mot viktigheten av sensitivitet for pasientenes individuelle behov. Konklusjon: DCM kan være en nyttig metode for utvikling av demensomsorg gjennom økt bevisstgjøring og refleksjoner over egen praksis hos personalet. Dette avhenger imidlertid av at det skapes møtesteder der personalet kan reflektere i fellesskap samt av kartleggerens evne til å gi konstruktiv tilbakemelding.

• Vatne, Solfrid (2011). Brukermedvirkning utfordrer sykepleiernes pedagogiske funksjon i psykisk helsearbeid. I Brataas, Hildfrid V. (Red.), Sykepleiepedagogisk praksis : pasientsentrert sykepleie på ulike arenaer. Gyldendal Akademisk. ISSN 9788205399990. s. 123–134. Fulltekst i vitenarkiv
• Michaelsen, Ragnhild K. A.; Vatne, Solfrid & Hollingen, Anne (2011). Det ble en annerledes plan : brukeres erfaringer med nettbasert individuell plan i psykisk helseabeid. Tidsskrift for psykisk helsearbeid. ISSN 1503-6707. 8(3), s. 217–226. Fulltekst i vitenarkiv Vis sammendrag

  Artikkelen fokuserer på brukermedvirkning i arbeid med nettbasert individuell plan og bygger på et prosjekt med intervju av ni brukere som fi kk samme opplæring og støtte i planprosessen som brukernes koordinatorer. Prosjektet var en oppfølging av en større studie. Funnene viser at disse brukerne opplevde opplæringen som framtidsrettet, og at de utviklet en kyndighet som også skapte myndige brukere. Noen brukere fungerte også som sine egne koordinatorer. Gjennom dette ble planen både lik og annerledes enn det forskriftene for individuell plan tilsier. Forskjellen var at planen inneholdt en type selvrefl eksjon som var relatert til brukernes individualterapi, men også en form for egenterapi knyttet til vanskelige følelser og opplevelser. Dette skapte kontinuitet i terapien, og ble en prosess preget av «self- empowerment». Materialet er lite, og det anbefales oppfølging av disse funnene gjennom en større studie.

• Vatne, Solfrid (2010). Development of Professional Knowledge in Action: Experiences from an Action Science Design Focusing on “Acknowledging Communication” in Mental Health. I Tarozzi, Massimiliano & Mortari, Luigina (Red.), Phenomenology and human science research today. Zeta Books. ISSN 9789731997445. s. 108–134. Fulltekst i vitenarkiv
• Rokstad, Anne Marie Mork & Vatne, Solfrid (2009). Dementia care mapping - en mulig metode for utvikling av demensomsorg i sykehjem. Nordisk tidsskrift for helseforskning. ISSN 1504-3614. 5(2), s. 46–61. Fulltekst i vitenarkiv Vis sammendrag

  Artikkelen omhandler en studie av Dementia Care Mapping (DCM) anvendt i et norsk sykehjem. Hensikten med studien var å undersøke om det skjer et perspektivskifte i personalgruppen ved bruk av DCM-metoden, og om dette får konsekvenser for praksis. I studien inngikk fokusgruppeintervju med personalet i sykehjemsavdelingen. Bakgrunnsopplysningene som sykepleierne reflekterte over, var kartlegging av trivsel og velvære hos pasientene innsamlet gjennom DCM-metoden, og meldt tilbake til personalet. Personalet opplevde at tilbakemeldingene førte til økt bevissthet i samhandling med pasientene. Ifølge deres utsagn medførte prosjektet flere konkrete endringer i måten de møtte pasientene på. Kartleggingen foretatt etter tre måneder viste større grad av trivsel og velvære i pasientgruppen. Dette peker i retning av at DCM kan være en nyttig metode for kvalitetsutvikling av demensomsorgen i sykehjem. Det er imidlertid behov for videre forskning med et strammere design og et større utvalg for å bekrefte funnene.

• Vatne, Solfrid; Bjørnerem, Heidi & Hoem, Elisabeth (2009). Development of professional knowledge in action: experiences from an action science design focusing on acknowledging communication in mental health. Scandinavian Journal of Caring Sciences. ISSN 0283-9318. 23(1), s. 84–92. doi: 10.1111/j.1471-6712.2007.00593.x. Fulltekst i vitenarkiv Vis sammendrag

  This article reports a multi-professional development project that was based on an action science design. The purpose was to develop 'acknowledging communication' in a psychiatric department for young people, and the objective to study the staffs' experiences of participating in the project. The professional part of the project has it's foundation in Schibbye's treatment theory of inter-subjective understanding of relationships, and involves three main approaches from her theory: self-reflection, self-delimitation and emotional presence. The article presents the specific action design used, where reflection processes were developed in three different areas: multidisciplinary Reflection groups, a Leader support group for the group leaders of the Reflection groups and collective Project seminars for all employees. A formal study programme designed to increase professional expertise, 15 European Credit Transfer System (ECTS), was also offered. The research methods included the researcher's process notes taken during the process, field notes from participating in the Leader support group, and qualitative interviews of eight informants participating in the various reflection arenas. The article presents and discusses the experiences evolved from the methods that were developed during the professional action science project: reflection on specific situations of interaction with patients in the form of oral/written narratives and the development of video presentations in combination with 'reflective teams'. The study showed that to facilitate change in the role of staff members, it is important to combine several reflection arenas where theoretical principles can be converted into practical action. By drawing data from only one study site, the study has a limited transferability, but should be of interest for professionals working with clinical change processes.

• Dahl, Kari; Julnes, Signe Gunn & Vatne, Solfrid (2008). Den glemte anamnesen ... er det samsvar mellom pasientens opplevelse av egen helse og sykepleierens dokumentsjon i den elektroniske pasientjournalen? Norsk tidsskrift for sykepleieforskning. ISSN 1501-4754. 10(4), s. 16–27. Fulltekst i vitenarkiv Vis sammendrag

  Are patients' perspectives of their own health present in the nursing documentation in the electronic patient records? Holistic health care underpins nursing science today. To provide such care, the patient's perspective must be included. In this project we investigated how patients' perspectives of their health are documented in the hospital electronic patient records. In-depth interviews with 12 patients were conducted. The electronic health records were analysed using the concepts, themes, and categories presented in the VIPS model of patient documentation currently used in many Norwegian hospitals. The software program QRS-NS6 (NUD*IST) was used to manage the data. Results indicated that the patients' perceptions of their own health were absent from their electronic health records. Nurses using the VIPS model completed the categories that focused on physical symptoms, diagnoses and treatment. We conclude that the documentation in patients' records may not support a holistic model of health care. To remedy this, nurses need to consider all aspects of health including the patients' own perspectives. Undergraduate nurse training programs have a role in developing student nurses' understanding of how acknowledgement and documentation of patients' perpectives contributes to optimal health care.

• Vatne, Solfrid & Bjørkly, Stål (2008). Empirical evidence for using subjective quality of life as an outcome variable in clinical studies - A meta-analysis of correlates and predictors in persons with a major mental disorder living in the community. Clinical Psychology Review. ISSN 0272-7358. 28(5), s. 869–889. doi: 10.1016/j.cpr.2008.01.001. Fulltekst i vitenarkiv Vis sammendrag

  This paper presents data from a systematic review and meta-analysis of published quality of life (QOL) studies on the subjective general well-being (GWB) of persons with major mental disorder (MMD) who live in the community. Four research questions were addressed: (1) What is the subjective QOL in persons with MMD who live in the community? (2) Are any specific subjective subdomains of QOL superior predictors of subjective GWB? (3) Is there an association between measures of psychopathology and subjective GWB? (4) Is there an association between sociodemographic variables and subjective GWB? We initially considered 134 potentially relevant articles, but only 42 studies reporting on 49 study units (N=6774 persons with MMD) met criteria of acceptable quality or relevance to be included in the meta-analysis. First, we found that measures of subjective GWB were relatively high. Second, certain subdomains such as Leisure and Social relations were strong predictors of subjective GWB, while the links between both Personal safety and Work, and GWB were weak. Third, we found that the empirical basis for using subjective QOL as an outcome variable in clinical research is scant. In particular, the relationship between changes in measures of psychopathology and subjective QOL appears to be obscure. Finally, the present study failed to confirm any stable relationship between sociodemographic factors and subjective GWB in persons with MMD who live in the community. Consequences of the findings for clinical practice and research are discussed. Limitations inherent in the meta-analytic approach in general, and the lack of homogeneity in the reviewed studies, need to be considered when interpreting the results of this meta-analysis.

• Vatne, Solfrid & Fagermoen, May Solveig (2008). Event Oriented Data Integration: A Qualitative Strategy in Studying Professional Practice. Research and Theory for Nursing Practice. ISSN 1541-6577. 22(1), s. 38–55. Fulltekst i vitenarkiv
• Vatne, Solfrid & Hoem, Elisabeth (2008). Acknowledging communication : a milieu-therapeutic approach in mental health care. Journal of Advanced Nursing. ISSN 0309-2402. 61(6), s. 690–698. doi: 10.1111/j.1365-2648.2007.04565.x. Fulltekst i vitenarkiv Vis sammendrag

  Aim: This paper is a report of a study to develop milieu therapists' acknowledging communication in their relationships with patients. Background: Gunderson's therapeutic processes in milieu therapy have come into use in a broad range of mental health contexts in many countries. Research in nursing indicates that validation needs a more concrete development for use in clinical work. Methods: Schibbye's theory, 'Intersubjective relational understanding', formed the theoretical foundation for a participatory action research project in 2004-2005. The data comprised the researcher's process notes written during participation in the group of group leaders every second week over a period of 18 months, clinical narratives presented by participants in the same group, and eight qualitative interviews of members of the reflection group. Findings: The core concept in acknowledging communication, mutuality, was described as inter-subjective sharing of feelings and beliefs in a respectful way. Participants presented their process of development as a movement from knowing what was best for the patient (acknowledging patients as competent persons, a milieu-therapy culture based on conformity), to appreciating diversity and stubborn talk, to reflective wondering questions. Misunderstanding of acknowledgement occurred, for instance, in the form of always being supportive and affirmative towards patients. Conclusion: The concrete approaches in acknowledging communication presented in this article could be a fruitful basis for educating in and developing milieu therapy, both for nursing and in a multi-professional approach in clinical practice and educational institutions. Future research should focus on broader development of various areas of acknowledging communication in practice, and should also include patients' experiences of such approaches.

• Vatne, Solfrid (2008). Anerkjennende tilnærming : et grunnleggende terapeutisk prinsipp i psykiatrisk sykepleie. I Karlsson, Bengt (Red.), Se mennesket - om forskning og klinisk arbeid i psykiatrisk sykepleie. Gyldendal Akademisk. ISSN 9788205380356. s. 40–63. Fulltekst i vitenarkiv
• Vatne, Solfrid & Fagermoen, May Solveig (2007). To correct and to acknowledge: two simultaneous and conflicting perspectives of limit-setting in mental health nursing. Journal of Psychiatric and Mental Health Nursing. ISSN 1351-0126. 14(1), s. 41-48–41-48. Fulltekst i vitenarkiv Vis sammendrag

  The nurses' work was based on a rationality of coping, because of a balancing act between the two perspectives and conflicting intrapersonal feelings aroused in challenging encounters with patients and colleagues. In reflection groups, relational interventions were developed, grounded in wondering reflection. Patients were regarded as participants in an open dialogue with the aim of securing collaboration.

• Michaelsen, Ragnhild Astad; Vatne, Solfrid & Hollingen, Anne (2007). Koordinatorrollen ved individuell plan i psykisk helsearbeid : fokus på brukermedvirkning og samarbeid. Norsk tidsskrift for sykepleieforskning. ISSN 1501-4754. 9(4), s. 15–28. Fulltekst i vitenarkiv Vis sammendrag

  This article presents findings from a study that focused on challenges professional coordinators met in collaboration with users of the health care and professionals from community mental health services. The aim was to facilitate user participation in the development and use of individual plans. Thirty-seven users with severe mental disorders and 19 coordinators (mental health nurses) in three small municipalities in the western part of Norway participated. The study was conducted within a participatory action research design, involving close collaboration between the researchers and the participants of the study. A subgroup of nine users together with their coordinators was educated to use internet-based individual plan software. Twelve of the coordinators, devided into three groups, were councelled by two of the researchers in monthly sessions. Data from these meetings were analysed using Kvale's content analysing method for qualitative data. Data from the users were collected through a survey. The coordinators expressed the presence of both qualitative and quantitative flaws concerning collaboration within the actual community service and between their psychiatric community services and the psychiatric institutions. The coordinators experienced obstacles to collaboration in terms of a conflict between their role as a mental health nurse and their role as a coordinator for the individual plan. They reported difficulties in motivating the users and in changing to a "non-expert" role as a mental health nurse. They also failed to fully acknowledge the rationale for using individual plans. Educating users in the data program and giving them support during the plan process, appeared to improve their participation and involvement

• Michaelsen, Ragnhild Astad & Vatne, Solfrid (2007). Det er enklere å være fri. I Gjengedal, Eva & Hanestad, Berit Rokne (Red.), Å leve med kronisk sykdom : en varig kursendring. Cappelen Damm Akademisk. ISSN 9788202246594. s. 261–272. Fulltekst i vitenarkiv

Se alle arbeider i NVA

• Ytrehus, Siri & Vatne, Solfrid (2022). Helsepersonell sine erfaringar med samarbeid med pårørande til eldre med psykiske helseproblem. Fulltekst i vitenarkiv
• Vatne, Solfrid & Ytrehus, Siri (2022). Helsepersonell sine erfaringar med samarbeid med pårørande til eldre med psykiske helseproblem. Fulltekst i vitenarkiv
• Mordal, Elin; Vatne, Solfrid; Agafari, Hirut Gemeda; Tsegaye, Meseret & Ulvund, Ingeborg (2019). Women’s childbearing location preferences in Southern Ethiopia : a qualitative study. Fulltekst i vitenarkiv
• Bachmann, Liv; Michaelsen, Ragnhild Karen Astad & Vatne, Solfrid (2017). "Would it be different if I was not there anymore?" Vulnerability described by a young person afflicted of anxiety and depression. Fulltekst i vitenarkiv
• Gjengedal, Eva; Bachmann, Liv; Ekra, Else Mari Ruberg; Høye, Magnhild Mjåvatn; Jørgensen, Else & Lykkeslet, Else [Vis alle 12 forfattere av denne artikkelen] (2017). Vulnerability as an existential challenge in chronic illness : a balance between self and others. Fulltekst i vitenarkiv
• Bachmann, Liv; Michaelsen, Ragnhild K A & Vatne, Solfrid (2016). Ensnared in the talk of the They. Milieu-therapists experiences of vulnerability in everyday practice in a mental health care context. Fulltekst i vitenarkiv
• Bachmann, Liv; Michaelsen, Ragnhild K A & Vatne, Solfrid (2016). Ensnared in the talk of the "They". Health professionals experiences of vulnerability in mental health services. Fulltekst i vitenarkiv
• Tretteteig, Signe; Vatne, Solfrid & Rokstad, Anne Marie Mork (2016). THE INFLUENCE OF DAY CARE CENTRES FOR FAMILY CAREGIVERS. Fulltekst i vitenarkiv
• Tretteteig, Signe; Rokstad, Anne Marie Mork & Vatne, Solfrid (2016). Hvordan dagaktivitetstilbud for personer med demens virker inn på pårørendes situasjon. Tidsskriftet aldring og helse. ISSN 1890-4130. 20(4). Fulltekst i vitenarkiv Vis sammendrag

  De siste årene har det vært en internasjonal og nasjonal satsing på dagaktivitetstilbud til personer med demens (1-4). Å prøve ut gode modeller for slike dagaktivitetstilbud og øke antall plasser var et satsingsområde i Demensplan 2015 gjennom arbeidet med «Utviklingsprogram om dagaktivitetstilbud og avlastningsordninger for personer med demens». Dette arbeidet har gitt betydelig økning av antall plasser.

• Tretteteig, Signe; Rokstad, Anne Marie Mork & Vatne, Solfrid (2015). The influence of day care centres for people with dementia on family caregivers. An integrative review of the literature. Poster. Fulltekst i vitenarkiv
• Bachmann, Liv; Michaelsen, Ragnhild K A & Vatne, Solfrid (2015). Health Care Professionals Vulnerability in Mental Health Care. Fulltekst i vitenarkiv
• Bachmann, Liv; Michaelsen, Ragnhild K A & Vatne, Solfrid (2015). Health Care Professionals Vulnerability in Mental Health Care. Fulltekst i vitenarkiv
• Vatne, Solfrid (2015). Sykepleierutdanningen ved Høgskolen i Molde hevder seg godt. 173(88), s. 44–45. Fulltekst i vitenarkiv
• Vatne, Solfrid & Skuseth, Torill (2015). Litt fandenivoldsk. [Journal]. Romsdals budstikke. Fulltekst i vitenarkiv
• Rokstad, Anne Marie Mork; Vatne, Solfrid; Engedal, Knut Arne & Selbæk, Geir (2014). The role of leadership in the implementation of person-centred dementia care in nursing homes. Fulltekst i vitenarkiv Vis sammendrag

  Objectives: Leadership is important for the implementation of nursing practice. However, the empirical knowledge of positive leadership in processes enhancing the person-centred culture of care in nursing homes is limited. The aim of this study was to investigate the role of leadership in the implementation of person-centred care (PCC) in nursing homes using Dementia Care Mapping (DCM). Methods: The study has a qualitative descriptive design. The DCM method was used in three nursing homes. Eighteen staff members and seven leaders participated in focus-group interviews centring on the role of leadership in facilitating the development process. A qualitative content analysis with a conventional approach was used to analyse the interviews. Results: The different roles of leadership in the three nursing homes, characterised as ‘highly professional’, ‘market-orientated’ or ‘traditional’ based on the analysis of the context, seemed to influence to what extent the DCM process led to successful implementation of PCC. Professional supportive leadership through participation in practice care seemed to enhance personcenteredness in care practice in the ‘highly professional’ nursing home. In the ‘traditional’ nursing home with leaders being supportive on request from the staff and the ‘marked orientated’ nursing homes, where the leaders gave no direct support to the DCM process, awareness on PCC was raised. However, this raised awareness did not seem to result in more person-centeredness in the care practise. Conclusion: This study gave useful information about the influence of leadership in the implementation of PCC in nursing homes. Leaders should be active role models, expound a clear vision and include and empower all staff in the professional development process.

• Vatne, Solfrid & Michaelsen, Ragnhild (2011). Individual plans in mental health – a self-empowering process? I Langdridge, Darren (Red.), 30th International Human Science Research Conference Intertwining body-self-world, 27-30 July 2011 : Programme and abstracts. Department of Psychology, The Open University. s. 66–66. Fulltekst i vitenarkiv Vis sammendrag

  Empowerment refers generally to the increase of strengths of marginalized people, involving development of confidence in their own capacities. Empowerment as a methodology is associated with consciousness-raising by participating in processes of sharing something in common with others, and in activities that increases people’s ability to make choices for themselves, including ability to learn. These are self-empowering processes, which can increase positive self-confidence and overcome stigma. This project is about implementation of computer-based individual plan in community mental health in Norway. The research question addressed was: Will a computer-based individual plan foster patient involvement? The study was designed as a follow-up, with an intervention focusing on the intentions and content of the individual plan, and an education program with exercises used from the computer-based tool. Nine of 37 patients participated in the education program, and got continuous support, based on dialogues about concrete issues in the plan, from a nurse researcher. The results showed that eight of the patients worked on their plan with great engagement, and placed themselves in a leader role of the plan. The plan contained descriptions of small steps in getting a better life, how their worked with emotional challenges - confronting themselves, and preparations for and after individual therapy. By this, the plan became different from the descriptions in the brochure from the Norwegian Health Department, but it led to mark able changes in the individual patient’s lives, which falls along with definitions of self-empowerment. The 28 non-educated patients showed no involvement in the plan.

• Gjengedal, Eva; Lykkeslet, Else; Orøy, Aud Jorun; Michaelsen, Ragnhild Karen Astad; Sundal, Hildegunn & Skrondal, Torill Helene [Vis alle 8 forfattere av denne artikkelen] (2010). Vulnerable groups’ experiences as basis for health care interaction. Fulltekst i vitenarkiv
• Gjengedal, Eva; Lykkeslet, Else; Orøy, Aud Jorunn; Michaelsen, Ragnhild K A; Sundal, Hildegunn & Skrondal, Torill Helene [Vis alle 8 forfattere av denne artikkelen] (2010). Vulnerable groups’ experiences as basis for health care interaction. I Krycka, Kevin C (Red.), 29th International Human Science Research Conference : Giving Voice to Experience. Seattle University, August 4-8, 2010. Seattle University College of Arts and Sciences. s. 17–17. Fulltekst i vitenarkiv Vis sammendrag

  Vulnerability is a characteristic of human existence. Therefore, it plays an important part in almost all human interaction, in particular with "significant others", like family members and health care workers. In the context of the health care system some patient groups are regarded as particularly vulnerable, and therefore represent a challenge for health care providers. For example, major mentally ill patients are regarded as a particularly vulnerable group. Research in mental health care has indicated that the professionals try to avoid conflicting situations with these patients, using various subtle or covert coercion strategies. Such strategies may be regarded as indistinct and non-therapeutic. An alternative approach would be to rely on empathy, self-reflection and self-limitation. Similar strategies may be found in other situations with other groups. The aim of the panel presentation is to give voice to the experiences of different groups who are considered as vulnerable and to professionals who are interacting with such groups. Potential patterns in the experiences across the groups will be elaborated. Finally, the aim is to discuss how knowledge about these experiences can contribute to improved interaction. There will be given a short presentation of four phenomenological qualitative studies of interactions with vulnerable groups along the lifespan. These groups are hospitalized children and their parents, persons with dementia, hospitalized mentally ill persons, and intensive care providers’ interaction with families to donor patients. Some findings from these studies will be presented as condensed descriptions illustrating experience of vulnerability and fragility as well as challenges related to interaction. Further, experiences with interactions across the different groups that seem to both fail and succeed will be visualized. Preliminary results indicate that taking vulnerable patients’ experiences into consideration may ease their situation and improve quality of health care. These preliminary findings will be further elaborated in the presentation.

• Vatne, Solfrid (2009). Nordmøre - et eldorado for for høgskolene? Fulltekst i vitenarkiv
• Vatne, Solfrid (2009). Hva høgskolesektoren kan bidra med i kystregionsamarbeidet med næring og offentlig forvaltning. Fulltekst i vitenarkiv
• Vatne, Solfrid (2009). Nettbasert individuell plan - en forløser av brukermedvirkning? Fulltekst i vitenarkiv
• Vatne, Solfrid (2009). HiMolde får universitetsstatus på logistikk. [Journal]. Logistikk & Ledelse. Fulltekst i vitenarkiv
• Amdam, Jørgen; Oltedal, Geirmund & Vatne, Solfrid (2009). Treng ein forskning i distrikta? s. 34–34. Fulltekst i vitenarkiv
• Vatne, Solfrid (2009). Behov for utdannings- og distriktspolitisk engasjement. 167(16.09.2009), s. 34–34. Fulltekst i vitenarkiv
• Rokstad, Anne Marie Mork & Vatne, Solfrid (2009). Dementia Care Mapping : a possible method for development of dementia care? Fulltekst i vitenarkiv
• Sjømæling, Berit Wiik & Vatne, Solfrid (2009). Hvordan planlegge nettverksmøter fra en akuttpsykiatrisk enhet? Tidsskrift for psykisk helsearbeid. ISSN 1503-6707. 6(1), s. 16–25. Fulltekst i vitenarkiv Vis sammendrag

  Denne artikkelen fokuserer på prosessen med planlegging av et nettverksmøte ved en akuttpsykiatrisk enhet, og er basert på erfaringer fra en studie kalt «samarbeid over grenser». Artikkelen beskriver prosjektet og den teoretiske rammen det bygger på. Presentasjon og diskusjon av planleggingsprosessen er relatert til et strukturert case fra den første fasen i prosjektet. Den illustrerer våre erfaringer med å informere og motivere til møtet, nettverkskartlegging og invitasjon til møtet. Følgende spørsmål som omhandler tro og tvil blir diskutert; er pasienten for «syk», hvem kan delta, vil nettverket møte opp, hvordan ivareta uforutsigbarhet. I slutten av artikkelen presenterer vi sentrale faktorer i planlegging av møtet.

• Vatne, Solfrid (2008). Anerkjennende tilnærming : et grunnprinsipp i brukermedvirkning. Fulltekst i vitenarkiv
• Vatne, Solfrid (2008). Vil ha damer over 30. [Journal]. Romsdals Budstikke. Fulltekst i vitenarkiv
• Vatne, Solfrid (2008). Grensesetting i miljøterapi. Fulltekst i vitenarkiv
• Vatne, Solfrid (2008). Brukermedvirkning i praksis. Fulltekst i vitenarkiv
• Vatne, Solfrid (2008). Miljøterapeutiske utfordringer ved psykosebehandling. I. Fulltekst i vitenarkiv
• Vatne, Solfrid (2008). Rammet av Nokut-rot : krever rolleavklaring. [Journal]. Forskerforum : tidsskrift for Forskerforbundet. Fulltekst i vitenarkiv
• Vatne, Solfrid (2008). Miljøterapeutiske utfordringer ved psykosebehandling. II. Fulltekst i vitenarkiv
• Vatne, Solfrid (2008). Development of professional knowledge in action : experiences from an action science design focusing on "Acknowledging Communication" in mental health. Encyclopaideia. Journal of phenomenology and education. ISSN 1590-492X. 24(12), s. 9–29. doi: 10.1400/118457. Fulltekst i vitenarkiv
• Hervik, Arild & Vatne, Solfrid (2008). En ny gjøkunge. [Journal]. Romsdals Budstikke. Fulltekst i vitenarkiv
• Vatne, Solfrid (2008). Fikk ja i fjor, nei i år : Høgskolen i Molde fortvilt over Helsedirektoratets studiepolitikk. [Journal]. Romsdals Budstikke. Fulltekst i vitenarkiv
• Vatne, Solfrid (2008). Korrigere og anerkjenne - en utfordring i samhandling med pasienter med utfordrende atferd : fokus på miljøterapi. Fulltekst i vitenarkiv
• Vatne, Solfrid (2007). Development of professional knowledge in action : experiences from an action science design focusing on acknowledging communication in mental health. Fulltekst i vitenarkiv Vis sammendrag

  This article reports a multi-professional development project that was based on an action science design. The purpose was to develop ¿acknowledging communication¿ in a psychiatric department for young people, and the objective to study the staffs¿ experiences of participating in the project. The professional part of the project has its foundation in Schibbye¿s treatment theory of intersubjective understanding of relationships, and involves three main approaches from her theory: Self-reflection, Self-delimitation and Emotional presence. The article presents the specific action design used, where reflection processes were developed in three different arenas: multidisciplinary Reflection groups, a Leader support group for the group leaders of the Reflection groups and collective project seminars for all employees. A formal study program designed to increase professional expertise, 15 credits, was also offered. The research methods included the researcher¿s process notes taken during the process, field notes from participating in the leader support group, and qualitative interviews of eight informants participating in the Reflection groups. The article presents and discusses the findings evolved from the methods that were developed during the professional action science project: reflection on specific situations of interaction with patients in the form of oral/written narratives and the development of video presentations in combination with ¿reflective teams¿. The study showed that in order to facilitate change in the role of staff members, it is important to combine several reflection arenas where theoretical principles can be converted into practical action. By drawing data from only one study site, the study has a limited transferability, but should be of interest for professionals working with clinical change processes.

• Vatne, Solfrid (2007). Relasjonens betydning i miljøterapi. Fulltekst i vitenarkiv
• Vatne, Solfrid (2007). Aksjonsforskning i helsesektoren. Fulltekst i vitenarkiv
• Dahl, Kari & Vatne, Solfrid (2007). Mangel på pasientperspektiv. Tidsskriftet sykepleien. ISSN 0806-7511. 95(18), s. 70–72. Fulltekst i vitenarkiv
• Vatne, Solfrid (2007). Organisering av FoU i helseforetakene : relasjonen høgskole - helseforetak. Fulltekst i vitenarkiv
• Vatne, Solfrid (2007). Relasjonens betydning i miljøterapi. Fulltekst i vitenarkiv
• Vatne, Solfrid (2007). Grensesetting. Fulltekst i vitenarkiv
• Tretteteig, Signe; Rokstad, Anne Marie Mork; Vatne, Solfrid & Kirkevold, Øyvind (2017). The impact of day care designed for persons with dementia on their family caregivers. Universitetet i Oslo. Fulltekst i vitenarkiv Vis sammendrag

  Providing family caregivers with information, support and respite is an important fundamental objective of dementia care. Day care is one of several support and respite services for family caregivers, but there was a need for more knowledge about how day care meets family caregivers’ needs. A multi-method study was designed to investigate various aspects of how day care impacts on the situation and needs of family caregivers. The study shows that day care can help family caregivers to master a complex care role through a sense of security, support and respite. Day care can reduces the time a family caregiver spends on care, and helps them to find a balance between attending to their own needs and meeting the needs of the person with dementia. Additionally, day care can have a positive impact on the relationship and can help increase the family caregiver’s motivation to provide care. Day-care services have room for improvement with regard to offering more flexible opening hours, as well as offering content and family caregivers support that is more individually tailored and adapted to their situation.

• Ulvund, Ingeborg & Vatne, Solfrid (2016). Varsling og unnlatt varsling av avvik i helsetjenesten : en studie blant jordmødre og psykiatriske sykepleiere i Australia og Norge. Møreforsking. Fulltekst i vitenarkiv Vis sammendrag

  Helsetjenesten skal tilby en sikker tjeneste av god kvalitet, likevel skades pasienter som følge av helsetjenestens ytelser eller mangel på det samme. Internasjonalt er det anslått at avvik forekommer ved ti prosent av sykehusinnleggelsene og at halvparten av hendelsene kunne vært unngått. Et av virkemidlene i pasientsikkerhetsarbeidet er avviksrapportering med påfølgende læring av feil. På den andre siden har det vært påpekt at avvik underrapporteres og at det i helsetjenesten mangles kunnskap om hvorfor helsepersonell unnlater å varsle avvik. Hensikten med dette prosjektet var å belyse et utvalg australske og norske jordmødre og psykiatriske sykepleieres erfaringer med og overveielser i tilknytting til varsling av avvik.   Studien hadde både et kvantitativt og kvalitativt forskningsdesign. Tilsammen 528 jordmødre og psykiatriske sykepleiere i Australia og Norge besvarte et spørreskjema. Flere jordmødre enn psykiatriske sykepleiere, og flere kvinner enn menn deltok i studien. I den norske kvalitative studien ble 25 informanter intervjuet, 8 psykiatriske sykepleiere og syv jordmødre. De fleste kjente til prosedyrer for avvikshåndtering på egen arbeidsplass, men flere kjente til prosedyrer for varsling av kliniske feil enn for uetisk praksis. Den viktigste grunnen til å varsle var å hindre at pasienter skades. I den kvalitative delen av studien kom det fram at informantene oppfattet det som en del av sin yrkesfunksjon å være pasienters talsperson og å varsle avvik. Både i det kvantitative og kvalitative datamaterialet kommer det imidlertid også fram at både det å forårsake et avvik, og å varsle det, forbindes med personlig og profesjonell risiko, noe som igjen kunne forhindre varsling. Tendensen var at selv om jordmødre og psykiatriske sykepleiere prioriterte pasientens rettigheter høyt utløste avvik kompliserte vurderinger der avgjørelsen om å varsle eller ikke ble påvirket av personlige, kulturelle og organisatoriske forhold. Det er viktig med en kultur for åpenhet om avvik og varsling samt støtte til de involverte uten tildeling av skyld eller fare for sanksjoner.

• Måløy, Elfrid; Eines, Trude Fløystad & Vatne, Solfrid (2016). Opplevelse av lav kompetanse og pulverisert ansvar ved legemiddelhåndtering i kommunehelsetjenesten. Møreforsking Molde AS. Fulltekst i vitenarkiv Vis sammendrag

  Bakgrunn: I kommunehelsetjenesten har pasientenes sykdomsbilde blitt mer sammensatt, og de skrives tidligere ut fra sykehus enn før. Dette medfører større ansvarsutfordringer for sykepleierne, også når det gjelder legemidelhåndtering. Mangelfull kompetanse på dette området og sviktende ansvarsfordeling kan få alvorlige konsekvenser for pasientsikkerheten. Hensikt: Å presentere sykepleiernes og ledernes erfaringer med legemiddelhåndtering i praksis i kommunehelsetjenesten samt forventninger til læringsutbytte ved videreutdanning i legemiddelhåndtering. Metode: Kvalitativ studie basert på fokusgruppeintervju som datainnsamlingsmetode. 10 studenter ved videreutdanning i legemiddelhåndtering og fire av deres ledere, fordelt på tre ulike fokusgrupper, ble intervjuet. Analysen tok utgangspunkt i Malteruds metode for systematisk tekstkondensering. Resultat: Tre hovedtema framkom i analyseprosessen: 1) uklare roller og uklart ansvar fører til ansvarspulverisering, 2) informantene etterlyser bedre system for ansvarsfordeling, og 3) legemiddelhåndtering er et komplekst fagområde med behov for kompetanseheving. Konklusjon: Studien tyder på at uklare roller og uklart ansvar innen legemiddelhåndtering i kommunehelsetjenesten fører til en ansvarspulverisering. For å bedre pasientsikkerheten bør sykepleiernes kompetanse i legemiddelhåndtering styrkes. Et sikrere ansvarssystem bør også utvikles.    Nøkkelord: legemiddelhåndtering, kommunehelsetjenesten, sykepleie, kompetanse, videreutdanning, fokusgruppeintervju

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