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Nordström, Gun
Publications (10 of 129) Show all publications
Finbråten, H. S., Wilde-Larsson, B., Nordström, G., Pettersen, K. S., Trollvik, A. & Guttersrud, Ö. (2018). Establishing the HLS-Q12 short version of the European Health Literacy Survey Questionnaire: Latent trait analyses using Rasch modelling and confirmatory factor modelling. BMC Health Services Research, 18(506)
Open this publication in new window or tab >>Establishing the HLS-Q12 short version of the European Health Literacy Survey Questionnaire: Latent trait analyses using Rasch modelling and confirmatory factor modelling
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2018 (English)In: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 18, no 506Article in journal (Other academic) Epub ahead of print
Abstract [en]

The European Health Literacy Survey Questionnaire (HLS-EU-Q47) is widely used in assessing health literacy (HL). There has been some controversy whether the comprehensive HLS-EU-Q47 data, reflecting a conceptual model of four cognitive domains across three health domains (i.e. 12 subscales), fit unidimensional Rasch models. Still, the HLS-EU-Q47 raw score is commonly interpreted as a sufficient statistic. Combining Rasch modelling and confirmatory factor analysis, we reduced the 47 item scale to a parsimonious 12 item scale that meets the assumptions and requirements of objective measurement while offering a clinically feasible HL screening tool. This paper aims at (1) evaluating the psychometric properties of the HLS-EU-Q47 and associated short versions in a large Norwegian sample, and (2) establishing a short version (HLS-Q12) with sufficient psychometric properties.MethodsUsing computer-assisted telephone interviews during November 2014, data were collected from 900 randomly sampled individuals aged 16 and over. The data were analysed using the partial credit parameterization of the unidimensional polytomous Rasch model (PRM) and the 'between-item' multidimensional PRM, and by using one-factorial and multi-factorial confirmatory factor analysis (CFA) with categorical variables.ResultsUsing likelihood-ratio tests to compare data-model fit for nested models, we found that the observed HLS-EU-Q47 data were more likely under a 12-dimensional Rasch model than under a three- or a one-dimensional Rasch model. Several of the 12 theoretically defined subscales suffered from low reliability owing to few items. Excluding poorly discriminating items, items displaying differential item functioning and redundant items violating the assumption of local independency, a parsimonious 12-item HLS-Q12 scale is suggested. The HLS-Q12 displayed acceptable fit to the unidimensional Rasch model and achieved acceptable goodness-of-fit indexes using CFA.ConclusionsUnlike the HLS-EU-Q47 data, the parsimonious 12-item version (HLS-Q12) meets the assumptions and the requirements of objective measurement while offering clinically feasible screening without applying advanced psychometric methods on site. To avoid invalid measures of HL using the HLS-EU-Q47, we suggest using the HLS-Q12. Valid measures are particularly important in studies aiming to explain the variance in the latent trait HL, and explore the relation between HL and health outcomes with the purpose of informing policy makers.

Keywords
Confirmatory factor analysis of categorical data; Health literacy; HLS-EU-Q47; HLS-Q12; Rasch modelling; Short version; Validation
National Category
Health Sciences
Research subject
Nursing Science
Identifiers
urn:nbn:se:kau:diva-66962 (URN)10.1186/s12913-018-3275-7 (DOI)
Note

I avhandlingen publicerad med manuskripttiteln: Proposing the HLS-N-Q12 based on a review of the European Health Literacy Survey Questionnaire and associated short versions : Latent trait analyses using Rasch modelling and confirmatory factor modelling

Available from: 2018-04-10 Created: 2018-04-10 Last updated: 2018-06-28Bibliographically approved
Hov, R., Kvigne, K., Aiyub, I., Gillund, M. V., Hermansyah, H., Nordström, G., . . . Höye, S. (2018). Nurses' contributions to health: Perceptionsof first-year nursing students in Scandinaviaand Indonesia. Nordic journal of nursing research
Open this publication in new window or tab >>Nurses' contributions to health: Perceptionsof first-year nursing students in Scandinaviaand Indonesia
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2018 (English)In: Nordic journal of nursing research, ISSN 2057-1585, E-ISSN 2057-1593, p. -9Article in journal (Refereed) Published
Abstract [en]

Nursing students need an understanding of how nurses care for people’s health from a global perspective. The aim of this studywas to explore how nurses can contribute to health from the perspectives of first-year nursing students in Scandinavia (Sweden,Norway) and Indonesia. Data were collected using an open-ended question about nurses’ contribution to health, and analysedusing qualitative content analysis. Three common categories emerged: ‘Promoting health and preventing disease’, ‘Performingcare and treatment’, ‘Establishing a relationship with patients and being compassionate’. ‘Possessing and implementing knowledgeand skills’ was common to Norway and Indonesia. ‘Being a team member’ was emphasised by the Indonesian participants.The Norwegian participants focused on health promotion, whereas those from Indonesia prioritised disease prevention. TheScandinavian participants emphasised individuality, while those from Indonesia focused on the community. The findings indicatethat nursing education should take account of different cultures and include student exchange programmes.

Keywords
health, Indonesia, nurses, nursing students, qualitative research, Scandinavia
National Category
Nursing
Research subject
Nursing Science
Identifiers
urn:nbn:se:kau:diva-65595 (URN)10.1177/2057158517747181 (DOI)
Available from: 2018-01-15 Created: 2018-01-15 Last updated: 2018-01-15Bibliographically approved
Finbråten, H. S., Pettersen, K. S., Wilde Larsson, B., Nordström, G., Trollvik, A. & Guttersrud, Ø. (2017). Validating the European Health Literacy Survey Questionnaire in people with type 2 diabetes. Latent trait analyses applying multidimensional Rasch modelling and confirmatory factor analysis.. Journal of Advanced Nursing, 73(11), 2730-2744
Open this publication in new window or tab >>Validating the European Health Literacy Survey Questionnaire in people with type 2 diabetes. Latent trait analyses applying multidimensional Rasch modelling and confirmatory factor analysis.
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2017 (English)In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 73, no 11, p. 2730-2744Article in journal (Refereed) Published
Abstract [en]

AIM: To validate the European Health Literacy Survey Questionnaire (HLS-EU-Q47) in people with type 2 diabetes mellitus.

BACKGROUND: The HLS-EU-Q47 latent variable is outlined in a framework with four cognitive domains integrated in three health domains, implying 12 theoretically defined subscales. Valid and reliable health literacy measurers are crucial to effectively adapt health communication and education to individuals and groups of patients.

DESIGN: Cross-sectional study applying confirmatory latent trait analyses.

METHODS: Using a paper-and-pencil self-administered approach, 388 adults responded in March 2015. The data were analysed using the Rasch methodology and confirmatory factor analysis.

RESULTS: Response violation and trait violation (multidimensionality) of local independence were identified. Fitting the 'multidimensional random coefficients multinomial logit' model, 1-, 3- and 12-dimensional Rasch models were applied and compared. Poor model fit and differential item functioning were present in some items and several subscales suffered from poor targeting and low reliability. Despite multidimensionality in the data, we did not observe any unordered response categories.

CONCLUSION: Interpreting the domains as distinct but related latent dimensions, the data fit a 12-dimensional Rasch model and a 12-factor confirmatory factor model best. Therefore, the analyses did not support the estimation of one overall 'health literacy score'. To support the plausibility of claims based on the HLS-EU score(s), we suggest: removing the health care aspect to reduce the magnitude of multidimensionality; rejecting redundant items to confine response dependency; adding 'harder' items and applying a six-point rating scale to improve subscale targeting and reliability; and revising items to improve model fit. This article is protected by copyright. All rights reserved.

Place, publisher, year, edition, pages
Oxford: Blackwell Publishing, 2017
Keywords
HLS-EU-Q47, confirmatory factor analysis, health literacy, multidimensional Rasch modelling, nursing research, type 2 diabetes mellitus
National Category
Nursing
Research subject
Nursing Science
Identifiers
urn:nbn:se:kau:diva-55162 (URN)10.1111/jan.13342 (DOI)28543754 (PubMedID)
Available from: 2017-06-19 Created: 2017-06-19 Last updated: 2018-06-12Bibliographically approved
Theander, K., Wilde-Larsson, B., Carlsson, M., Florin, J., Gardulf, A., Johansson, E., . . . Nilsson, J. (2016). Adjusting to future demands in healthcare: Curriculum changes and nursing students' self-reported professional competence. Nurse Education Today, 37, 178-183
Open this publication in new window or tab >>Adjusting to future demands in healthcare: Curriculum changes and nursing students' self-reported professional competence
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2016 (English)In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 37, p. 178-183Article in journal (Refereed) Published
Abstract [en]

Background: Nursing competence is of significant importance for patient care. Newly graduated nursing students rate their competence as high. However, the impact of different designs of nursing curricula on nursing students' self-reported nursing competence areas is seldom reported. Objectives: To compare newly graduated nursing students' self-reported professional competence before and after the implementation of a new nursing curriculum. The study had a descriptive comparative design. Nursing students, who graduated in 2011, having studied according to an older curriculum, were compared with those who graduated in 2014, after a new nursing curriculum with more focus on person-centered nursing had been implemented. Setting: A higher education nursing program at a Swedish university. Participants: In total, 119 (2011 n = 69, 2014 n = 50) nursing students responded. Methods: Nursing students' self-reported professional competencies were assessed with the Nurse Professional Competence (NPC) scale. Results: There were no significant differences between the two groups of nursing students, who graduated in 2011 and 2014, respectively, with regard to age, sex, education, or work experience. Both groups rated their competencies as very high. Competence in value-based nursing was perceived to be significantly higher after the change in curriculum. The lowest competence, both in 2011 and 2014, was reported in education and supervision of staff and students. Conclusions: Our findings indicate that newly graduated nursing students- both those following the old curriculum and the first batch of students following the new one - perceive that their professional competence is high. Competence in value-based nursing, measured with the NPC scale, was reported higher after the implementation of a new curriculum, reflecting curriculum changes with more focus on person-centered nursing. (C) 2015 Elsevier Ltd. All rights reserved.

Keywords
Nurse competence, Professional nursing, Nursing education, Nursing curriculum, Nursing student, NPC scale
National Category
Nursing
Research subject
Nursing Science
Identifiers
urn:nbn:se:kau:diva-41200 (URN)10.1016/j.nedt.2015.11.012 (DOI)000371098300029 ()26703792 (PubMedID)
Available from: 2016-04-01 Created: 2016-04-01 Last updated: 2017-11-30Bibliographically approved
Myhrene Steffenak, A. K., Wilde-Larsson, B., Hartz, I. & Nordström, G. (2015). Experience of psychotropic drug use among young people with mental health problems. Nordic journal of nursing research, 35(4), 241-248
Open this publication in new window or tab >>Experience of psychotropic drug use among young people with mental health problems
2015 (English)In: Nordic journal of nursing research, ISSN 2057-1585, E-ISSN 2057-1593, Vol. 35, no 4, p. 241-248Article in journal (Refereed) Published
Abstract [en]

The aim of the study is to describe the experience of psychotropic drug use among young people with mental health problems. Young people experience mental health problems, and some will need to take psychotropic drugs for either a short or a long time. Psychotropic drugs may be effective in reducing mental distress, but raise questions about increasing use, side effects, long-term treatment and off-label use. Qualitative interviews were accomplished with eight young people who had taken psychotropic drugs. Three categories were identified: ‘Effects of psychotropic drugs’, ‘Access of professional care and follow-up’ and ‘Social life and psychotropic drug use’. The young people experienced both beneficial and undesired effects from the psychotropic drugs. They experienced lack of access to professional support and follow-up. Life with family and friends was influenced negatively by psychotropic drug use and the young people were afraid of being lonely and stigmatized. The results may have implications for those who work with young people. Young people striving with mental health problems and psychotropic drug use have to have access to professional support and follow-up. Knowledge about effects of psychotropic drug use among young people is needed. The work about openness about mental health problems among young people has to continue.

Place, publisher, year, edition, pages
Sage Publications, 2015
Keywords
mental health problems, Psychotropic drug use, adolescence
National Category
Medical and Health Sciences Nursing
Research subject
Nursing Science
Identifiers
urn:nbn:se:kau:diva-30761 (URN)10.1177/0107408315592805 (DOI)
Available from: 2013-12-19 Created: 2013-12-19 Last updated: 2017-09-19Bibliographically approved
From, I., Wilde-Larsson, B., Nordström, G. & Johansson, I. (2015). Formal caregivers' perceptions of quality of care for older people: predicting factors. BMC Research Notes, 8(623)
Open this publication in new window or tab >>Formal caregivers' perceptions of quality of care for older people: predicting factors
2015 (English)In: BMC Research Notes, ISSN 1756-0500, E-ISSN 1756-0500, Vol. 8, no 623Article in journal (Refereed) Published
Abstract [en]

Background

Despite the growing number of studies concerning quality of care for older people, there is a lack of studies depicting factors associated with good quality of care from the formal caregivers’ perspective. The aim was to describe formal caregivers’ perceptions of quality of care for older people in the community and explore factors associated with these perceptions. In total, 70 nursing assistants, 163 enrolled nurses and 198 registered nurses from 14 communities in central Sweden participated in the study. They filled out the following questionnaires: a modified version of Quality from the Patient’s Perspective, Creative Climate Questionnaire, Stress of Conscience Questionnaire, items regarding education and competence, Health Index and Sense of coherence questionnaire. The overall response rate was 57 % (n = 431).

Results

In the perceived reality of quality of care respondents assessed the highest mean value in the dimension medical-technical competence and physical technical conditions and lower values in the dimensions; identity-oriented approach, socio-cultural atmosphere and in the context specific dimension. The caregivers estimated their competence and health rather high, had lower average values in sense of coherence and organizational climate and low values in stress of conscience.

Conclusions

The PR of quality of care were estimated higher among NA/ENs compared to RNs. Occupation, organizational climate and stress of conscience were factors associated with quality of care that explained 42 % of the variance. Competence, general health and sense of coherence were not significantly associated to quality of care. The mentioned factors explaining quality of care might be intertwined and showed that formal caregivers’ working conditions are of great importance for quality of care.

Keywords
Patient’s Perspective, Creative Climate Questionnaire, Stress of Conscience Questionnaire
National Category
Nursing
Research subject
Nursing Science
Identifiers
urn:nbn:se:kau:diva-8957 (URN)10.1186/s13104-015-1597-7 (DOI)
Note

This article was published as manuscript in the thesis.

Available from: 2011-12-15 Created: 2011-12-15 Last updated: 2017-12-08Bibliographically approved
Steffenak, A. K., Nordström, G., Hartz, I. & Wilde-Larsson, B. (2015). Public health nurses' perception of their roles in relation to psychotropic drug use by adolescents: a phenomenographic study. Journal of Clinical Nursing, 24(7-8), 970-979
Open this publication in new window or tab >>Public health nurses' perception of their roles in relation to psychotropic drug use by adolescents: a phenomenographic study
2015 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 24, no 7-8, p. 970-979Article in journal (Refereed) Published
Abstract [en]

Aims and objectivesThe purpose of the paper was to describe the perceptions of public health nurses' roles in relation to psychotropic drug use by adolescents. BackgroundMental health problems among adolescents are documented with studies indicating an increased use of psychotropic drugs. In Norway, care for such adolescents may fall naturally into the remit of public health nurses. DesignA phenomenographic approach was used to analyse the data. MethodA qualitative interview study was made of 20 Norwegian public health nurses, strategically chosen using phenomenographic methodology. ResultsThe public health nurses described three categories: discovering public health nurses who become aware of psychotropic drug use in the health dialogue with adolescents and choose to either act or not act in relation to psychotropic drug use. Those public health nurses who take action are cooperating public health nurses, who cooperate with adolescents, their families, schools and others. If cooperation has been established, supporting public health nurses teach and support the adolescent in relation to psychotropic drug use. ConclusionThe public health nurses who do not act can hinder or delay further treatment. Public health nurses need to acquire knowledge about psychotropic drugs, to fulfil their role in nursing mental health problems among adolescents and the increasing use of psychotropic drugs. Relevance to clinical practiceThe results demonstrated that public health nurses, working in health centres and schools, have the responsibility and the opportunity to identify young people struggling with mental health problems and psychotropic drug use as well as teach and support significant others, e.g. parents and siblings. Intervention studies are needed with regard to health promotion programmes aimed at fortifying young people's mental health.

Keywords
adolescents, mental health, phenomenography, psychotropic drug use, public health nurses
National Category
Nursing
Research subject
Nursing Science
Identifiers
urn:nbn:se:kau:diva-41626 (URN)10.1111/jocn.12716 (DOI)000351633800009 ()25639291 (PubMedID)
Available from: 2016-04-11 Created: 2016-04-11 Last updated: 2017-11-30Bibliographically approved
German Millberg, L., Berg, L., Björk Brämberg, E., Nordström, G. & Öhlén, J. (2014). Academic learning for specialist nurses: a Grounded Theory study. Nurse Education in Practice, 14(6), 714-721
Open this publication in new window or tab >>Academic learning for specialist nurses: a Grounded Theory study
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2014 (English)In: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 14, no 6, p. 714-721Article in journal (Other academic) Published
Abstract [en]

The aim was to explore the major concerns of specialist nurses pertaining to academic learning during their education and initial professional career. Specialist nursing education changed in tandem with the European educational reform in 2007. At the same time, greater demands were made on the healthcare services to provide evidence-based and safe patient-care. These changes have influenced specialist nursing programmes and consequently the profession. Grounded Theory guided the study. Data were collected by means of a questionnaire with open-ended questions distributed at the end of specialist nursing programmes in 2009 and 2010. Five universities were included. Further, individual, pair and group interviews were used to collect data from 12 specialist nurses, 5-14 months after graduation. A major concern for specialist nurses was that academic learning should be "meaningful" for their professional future. The specialist nurses' "meaningful academic learning process" was characterised by an ambivalence of partly believing in and partly being hesitant about the significance of academic learning and partly receiving but also lacking support. Specialist nurses were influenced by factors in two areas: curriculum and healthcare context. They felt that the outcome of contribution to professional confidence was critical in making academic learning meaningful.

Place, publisher, year, edition, pages
Elsevier, 2014
Keywords
Clinical Nurse Specialist, Grounded Theory, Higher Education, The Bologna Process, Nursing Masters, Postgraduate Degree Projects.
National Category
Medical and Health Sciences Educational Sciences
Research subject
Nursing Science
Identifiers
urn:nbn:se:kau:diva-15642 (URN)10.1016/j.nepr.2014.08.008 (DOI)000349568300022 ()25240945 (PubMedID)
Available from: 2012-11-19 Created: 2012-11-18 Last updated: 2017-12-07Bibliographically approved
Nilsson, J., Johansson, E., Egmar, A.-C., Florin, J., Leksell, J., Lepp, M., . . . Wilde-Larsson, B. (2014). Development and validation of a new tool measuring nursesself-reported professional competence—The nurse professionalcompetence (NPC) Scale. Nurse Education Today, 2014(34), 574-580
Open this publication in new window or tab >>Development and validation of a new tool measuring nursesself-reported professional competence—The nurse professionalcompetence (NPC) Scale
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2014 (English)In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 2014, no 34, p. 574-580Article in journal (Refereed) Published
Abstract [en]

Objectives: To develop and validate a new tool intended for measuring self-reported professional competenceamong both nurse students prior to graduation and among practicing nurses. The new tool is based on formalcompetence requirements from the Swedish Board of Health and Welfare, which in turn are based on WHOguidelines.Design: A methodological study including construction of a new scale and evaluation of its psychometricproperties.Participants and settings: 1086 newly graduated nurse students from 11 universities/university colleges.Results: The analyses resulted in a scale named the NPC (Nurse Professional Competence) Scale, consisting of 88items and covering eight factors: “Nursing care”, “Value-based nursing care”, “Medical/technical care”, “Teaching/learning and support”, “Documentation and information technology”, “Legislation in nursing and safetyplanning”, “Leadership in and development of nursing care” and “Education and supervision of staff/students”.All factors achieved Cronbach's alpha values greater than 0.70. A second-order exploratory analysis resulted intwo main themes: “Patient-related nursing” and “Nursing care organisation and development”. In addition,evidence of known-group validity for the NPC Scale was obtained.

Place, publisher, year, edition, pages
Midlothian, Scotland: Churchill Livingstone, 2014
Keywords
Nurses' competence, Professional nursing, Nursing education, Nursing students, Graduate nurses, Quality of care, Safety in healthcare, Scale development, Validation, Psychometric properties
National Category
Nursing
Research subject
Education
Identifiers
urn:nbn:se:kau:diva-33841 (URN)10.1016/j.nedt.2013.07.016 (DOI)000333781600016 ()23938092 (PubMedID)
Available from: 2014-09-26 Created: 2014-09-26 Last updated: 2017-12-07Bibliographically approved
Wilde-Larsson, B., Inde, M., Carlson, A., Nordström, G., Larsson, G. & Rystedt, I. (2014). Implementation of patient-focused care: before-after effects. International Journal of Health Care Quality Assurance, 27(7), 594-604
Open this publication in new window or tab >>Implementation of patient-focused care: before-after effects
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2014 (English)In: International Journal of Health Care Quality Assurance, ISSN 0952-6862, E-ISSN 1758-6542, Vol. 27, no 7, p. 594-604Article in journal (Refereed) Published
Abstract [en]

PurposeThe purpose of this paper is to evaluate an organizationally oriented, patient-focused care (PFC) model's effects on care quality and work climate. Design/methodology/approach The study has a before-after (PFC implementation) design. The sample included 1,474 patients and 458 healthcare providers in six participating wards before and after PFC implementation, plus five additional randomly chosen wards, which only featured in the post-assessment.FindingsNo pre-post differences were found regarding care perceptions or provider work climate evaluations. Statistically significant improvements were noted among provider care evaluations. Using aggregate-level ward data, multiple regression analyses showed that high adherence to PFC principles and a positive work climate contributed significantly to variance among care quality ratings. Research limitations/implications Among healthcare providers, questions related to specific PFC aspects during evenings, nights and weekends had to be dropped owing to a low response rate. Practical implications An important requirement for both practice and research is to tailor PFC to various health and social care contexts. Originality/valueThe study is large-scale before-after PFC model review, where patient and provider data were collected using well-established measurements.

Place, publisher, year, edition, pages
Emerald Group Publishing Limited, 2014
Keywords
Job satisfaction, Organizational development, Patient centredness, Quality assessment
National Category
Medical and Health Sciences
Research subject
Nursing Science
Identifiers
urn:nbn:se:kau:diva-29489 (URN)10.1108/IJHCQA-06-2013-0067 (DOI)
Available from: 2013-10-15 Created: 2013-10-15 Last updated: 2017-12-06Bibliographically approved
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