Background: The use of digital health technology in diabetes self-care is increasing, making eHealth literacy an importantfactor to consider among people with type 1 diabetes. There are very few studies investigating eHealth literacy among adultswith type 1 diabetes, highlighting the need to explore this area further.Objective: The aim of this study was to explore associations between eHealth literacy and demographic factors, disease-specific factors, and well-being among adults with type 1 diabetes.Methods: The study used data from a larger cross-sectional survey conducted among adults with type 1 diabetes in Sweden(N=301). Participants were recruited using a convenience sampling method primarily through advertisements on social media.Data were collected between September and November 2022 primarily through a web-based survey, although participantscould opt to answer a paper-based survey. Screening questions at the beginning of the survey determined eligibility toparticipate. In this study, eHealth literacy was assessed using the Swedish version of the eHealth Literacy Scale (Sw-eHEALS).The predictor variables, well-being was assessed using the World Health Organization-5 Well-Being Index and psychosocialself-efficacy using the Swedish version of the Diabetes Empowerment Scale. The survey also included research group–developed questions on demographic and disease-specific variables as well as digital health technology use. Data wereanalyzed using multiple linear regression presented as nested models. A sample size of 270 participants was required in orderto detect an association between the dependent and predictor variables using a regression model based on an F test. The finalsample size included in the nested regression model was 285.Results: The mean Sw-eHEALS score was 33.42 (SD 5.32; range 8‐40). The model involving both demographic anddisease-specific variables explained 31.5% of the total variation in eHealth literacy and was deemed the best-fitting model.Younger age (P=.01; B=–0.07, SE=0.03;95% CI –0.12 to –0.02), lower self-reported glycated hemoglobin levels (P=.04; B=–0.06, SE=0.03; 95% CI –0.12 to 0.00), and higher psychosocial self-efficacy (P<.001; B=3.72, SE=0.53; 95% CI 2.68-4.75)were found associated with higher Sw-eHEALS scores when adjusted for demographic and disease-specific variables in thismodel. Well-being was not associated with eHealth literacy in this study.Conclusions: The demographic and disease-specific factors explained the variation in eHealth literacy in this sample. Furtherstudies in this area using newer eHealth literacy tools are important to validate our findings. The study highlights theimportance of development and testing of interventions to improve eHealth literacy in this population for better glucosecontrol. These eHealth literacy interventions should be tailored to meet the needs of people in varying age groups and withdiffering levels of psychosocial self-efficacy.

Aim: To investigate and compare the self-assessed professional competence of registered nurses, specialist nurses and midwives at a regional teaching hospital in Sweden. Moreover, to explore associations between potential predictive background factors and self-assessed professional competence.

Design: A cross-sectional study.

Methods: Convenience sample of 615 nurses answered a questionnaire; sociodemographic data, 35-item Nurse Professional Competence Scale, Occupational Self-Efficacy Scale. Statistical analyses: Fisher's non-parametric permutation test, Kruskal–Wallis test, Mantel–Haenszel chi-square test, Spearman rank correlation test, calculating sum score. Multiple linear regressions and reliability testing with Cronbach's alpha.

Results: Response rate, 58.7%; mean age, 44.7 years; work experience, 0.2 years to 45 years (mean 16.4 years); 83.4% women. 82.4% bachelor's degree; out of these, 34.3% with an additional master's degree. 17.6% nursing diploma without an academic degree. The highest mean scores for the NPC Scale were in Value-based nursing care, Medical and technical care. The lowest were in Care pedagogics and Development, leadership and organisation of nursing care. Total mean score 84.3, (79.3–90.0). Specialist nurses scored higher in all areas except Care pedagogics. Predictive factors indicated being a woman was positively associated with higher competence scores in all six areas, β coefficients 2.2–5.3 with p < 0.05. Longer nursing experience was positively associated with higher competence in Nursing care (β 0.17 per year, p = 0.01), Medical and technical care (β 0.14 per year, p = 0.01). The occupational self-efficacy scale was strongly positively associated with higher competence in all areas, β per scale step 0.42–0.63 with p < 0.0001. Nurses without academic degree had lower competence scores in several areas compared to bachelor's degree, β ranges from −3.47 to −2.31, p < 0.05.

Conclusion: Utilising competence data, the Swedish Enhanced Competence Development Model (vKUM) can effectively support the planning and management of ongoing professional competence development.

IntroductionFirst-line managers in Swedish communities have responsibility for that care to older people is provided, staffing is sufficient and the budget is balanced in their unit. It is a struggle with limited resources due to a growing population in need of care. This can lead to missed nursing care. The aim was to describe first-line managers<acute accent> perceptions of missed nursing care in community health care for older people.MethodsA qualitative design with a phenomenographic approach, interviewing 24 first-line managers. Ethics approval for the study was received from the Research Ethics Committee at Karlstad University (Dnr HNT 2020/566).ResultsThe results are shown in six descriptive categories containing 15 perceptions. The descriptive categories are 'occurrence of missed nursing care', 'becoming aware of missed nursing care', 'reasons for missed nursing care', 'missed nursing care has consequences for the older persons', 'missed nursing care has consequences for the staff' and 'taking action to decrease missed nursing care'.ConclusionsIt is important for first-line managers to become aware of the existence and reasons for missed nursing, as it has consequences for older people and staff. Managers need to take missed nursing care seriously in order to work with improvements for maintaining good quality of care and patient safety.

Introduction The management of type 1 diabetes, a non-preventable chronic disease, leads to a high physical and psychological burden on the individual. Digital health technology can improve a person's psychosocial self-efficacy and thereby contribute to improved diabetes self-care. The aim of this study was to explore associations between psychosocial self-efficacy and demographic-, disease specific-, well-being as well as digital health technology (DHT) related factors among adults with type 1 diabetes.Methods A primarily web-based cross sectional survey was conducted among adults with type 1 diabetes in Sweden (n = 301). Psychosocial self-efficacy was assessed using the Swedish version of the Diabetes Empowerment Scale, Swe-DES-23. The survey also contained questions related to demographic-, disease specific-, well-being as well as digital health technology related variables.Results Higher well-being scores and lower HbA1c levels were associated with higher psychosocial self-efficacy in multiple linear regression analysis. In multivariate analysis, gender, body mass index, well-being scores, and HbA1c levels showed association with psychosocial self-efficacy. None of the DHT factors were found associated with psychosocial self-efficacy.Conclusions In this study, higher well-being score and lower self-reported HbA1c levels were associated with higher psychosocial self-efficacy in both univariate- and multivariate analysis and accounted for 30% of the variation in psychosocial self-efficacy in the regression model. Thus, measures to improve psychosocial self-efficacy in adults with type 1 diabetes may help maintain their psychological well-being and blood glucose control.

Aim: To describe experiences of work-related stress, stress reactions and coping strategies among registered nurses (RNs) in the ambulance service (AS).Design: A descriptive and qualitative design.Methods: Participants were recruited from eight different ambulance stations from different geographical locations in central Sweden. Data were collected from 14 RNs during the period from January 2022 to May 2022 using a semi-structured interview guide. Qualitative content analysis was used to analyse data using an abductive approach.Results: Three categories describe the RNs' experiences; (1) Situations that cause work-related stress, (2) Reactions and feelings that occur and (3) Management of work-related stress. These three main categories included a total of 12 subcategories. Work-related stress was experienced when participants were a part of traumatic events or experienced insufficient cooperation or a disturbing event in the work environment. The different causes lead to different kinds of reactions with feelings of frustration, fear and loneliness being prominent. To manage the work-related stress, RNs used different kinds of strategies and support from colleagues or lack thereof seemed to have a major impact.Conclusions: Findings revealed the importance of having competent colleagues in the AS. Working with a competent colleague can reduce experiences of stress and prevent feelings of loneliness. It is important for the AS to provide stress-reduction support, to promote cooperation and to maintain and develop RNs' professional competence to ensure quality care and patient safety in the AS.

The aim of this grounded theory study was to explore late-adolescents' process of sexual development along with their information- and support-seeking behaviors in a Swedish context. Data were collected in semi-structured interviews with late-adolescents aged between 18 and 21 years in high schools in central Sweden. The results showed that late-adolescents' sexual development involved seeking for knowledge, discussing norms and attitudes, learning through interactions, and growing through practice and experience. Information- and support-seeking behaviors were observed throughout their developent. This study highlights that, in order to be able to provide adequate help and support, healthcare professionals need to have an awareness of the changing information and support needs of adolescents in our constantly changing and diverse society.

AimThe aim of the study was to translate, adapt and validate the instrument Basel Extent of Rationing of Nursing Care for Nursing Homes and Home Care for use in the Swedish community health care context. DesignA cross-sectional study. Data were collected from October 2019 to January 2020, and the questionnaire was sent to Registered Nurses, Enrolled Nurses and assistant nurses. MethodsThe study was performed in four phases: (1) translation, (2) adaptation of the Basel Extent of Rationing of Nursing Care for Nursing Homes and Home Care to the Swedish context, (3) content validity testing, and (4) evaluation of psychometric properties. The collected data resulted in 611 responses. Explorative factor analysis was performed to explore the interrelationship, and Cronbach's alpha was used to evaluate the internal consistency. ResultsExplorative factor analysis presented six factors/subscales: (1) fundamental care, (2) timely needed-based care, (3) dignity and support, (4) ensuring respectful treatment, (5) social activities, and (6) documentation, planning and reporting. The Cronbach's alpha for the components showed values between 0.7 and 0.9. ConclusionThe analyses indicate an instrument to be usable for Enrolled Nurses and nurse assistants in community health care. Additional tests, can contribute to refining the content of the items and further test reliability and validity of the instrument. No patient or public contributionAs this is a study of translation and validation of the instrument Basel Extent of Rationing of Nursing Care for Nursing Homes and Home Care.

Aim: To examine the extent and nature of missed nursing care in elderly care in community healthcare contexts from the perspective of healthcare staff, and to identify instruments used to measure missed nursing care and the content of these instruments. Design: Scoping review. Methods: Searches were conducted in the CINAHL, PubMed, Scopus and Google Scholar databases in March 2020. The selection process followed the PRISMA flow diagram. Results: Sixteen research papers were found from nine countries. The instruments used in the studies were Basel Extent of Rationing of Nursing Care for nursing homes (BERNCA-NH), modified MISSCARE survey and study-specific instruments or items. The item content differed, as did the number of items, which was between one and 44. The studies reported values for missed nursing care, as well as described reasons for and/or the relation between missed nursing care and organization, working climate and patient outcomes.