Background Nurse migration impacts global healthcare, which has a shortage of nurses, as many nurses move from lower-income to higher-income countries for better opportunities, working conditions, and salaries. Internationally educated nurses (IENs) have often been seen as a crucial solution to this issue. However, policies and regulations have been set in place to protect the public, including the recertification process and training to ensure educational comparability and competence. IENs' contributions to the nursing workforce are significant, underscoring the importance of these policies and regulations. Aim The aim was to describe the demographic and social characteristics of IENs who had completed recertification for nurses' licenses in Sweden and to compare these characteristics among those who completed recertification through the National Board of Health and Welfare (NBHW) or bridging programs. Methods A cross-sectional design using a survey and 818 questionnaires was sent to IENs with an identified postal address who had undergone the recertification process in Sweden. Of them, 296 (38%) were completed. Data were analyzed with descriptive statistics, chi-square tests, Fischer's exact tests, and independent sample t-tests. Results Most IENs who had participated in a bridging program were women, commonly aged between 31 and 40 years of age who had immigrated mainly from Asian or Middle Eastern countries for family-related reasons. The average time to obtain a nursing license was 5.9 years, starting from the year they immigrated until recertification. IENs who received recertification by the NBHW were significantly younger (p < .001), had been in Sweden for a shorter time (p < .001), and the time to license was shorter (p < .001). Significant differences were also shown for origin (p < .001) and reason for immigration (p < .001). Conclusions The findings can be used by decision-makers and authorities when developing higher education strategies for legalization and immigration policy to contribute to IENs' career advancement opportunities.

BackgroundThe global incidence of type 2 diabetes is rapidly rising, particularly among migrants in developed countries. Migrants bear a significant burden of diabetes. However, this study is the only to evaluate the effects of a culturally appropriate diabetes intervention for these migrants on diabetes knowledge and health outcomes, adding a novel perspective to the existing literature.The aim of the study was to evaluate the effects on diabetes knowledge, HbA1c, and self-rated health of a previously developed, culturally appropriate diabetes education model, based on individual beliefs about health and illness, underpinned by knowledge, and conducted through focus group discussions.BackgroundThe global incidence of type 2 diabetes is rapidly rising, particularly among migrants in developed countries. Migrants bear a significant burden of diabetes. However, this study is the only to evaluate the effects of a culturally appropriate diabetes intervention for these migrants on diabetes knowledge and health outcomes, adding a novel perspective to the existing literature.The aim of the study was to evaluate the effects on diabetes knowledge, HbA1c, and self-rated health of a previously developed, culturally appropriate diabetes education model, based on individual beliefs about health and illness, underpinned by knowledge, and conducted through focus group discussions.MethodsObservational study evaluating the intervention using a pre-test-post-test design. It involved structured interviews and HbA1c measurements before, immediately after, and three months post-participation in the group-based intervention. The study included 22 migrants from the Middle East and Africa, divided into eight focus groups. The group education was conducted by a multi-professional team, led by a diabetes specialist nurse, in primary healthcare settings. Descriptive and analytical statistics applied in analysing data.ResultsThe findings showed that participation in the diabetes education significantly improved the knowledge levels, led to an initial change and possible short-term improvement in HbA1c (better immediate post-intervention), albeit statistically insignificant, but no change in glycaemic control over time and in self-rated health (SRH).ConclusionsThe findings supported the hypothesis of improved knowledge. Moreover, the findings showed a possible initial change in glycaemic control, but no overall effect. The study showed no change in self-rated (perceived) health. Further studies involving other populations and long-term follow-ups are needed. This study highlights the importance of culturally tailored diabetes educational programmes in our multicultural society. By recognising individual beliefs about health and illness, this education programme can significantly increase knowledge and thereby contribute to improved self-care and thus, overall health. Furthermore, it is recommended for daily practice in primary healthcare, supporting healthcare professionals with a proven strategy to increase knowledge.

BackgroundSweden has a large population of migrant women, which contributes to communication challenges and, consequently, suboptimal maternity care. Compared with native-born women, migrant women have an increased prevalence of adverse pregnancy outcomes. Miscommunication and language barriers are among the reasons for these results. Thus, language barriers can also lead to providing less information to migrant women. A digital Swedish-Arabic dialog support tool was developed and tested at antenatal care, to facilitate communication between midwives and Arabic-speaking women. This study aimed to describe midwives' perceptions of communication via Swedish-Arabic dialog support (Sadima) in antenatal care.MethodsA qualitative study was conducted with 14 midwives in antenatal care with experience communicating using a Swedish-Arabic dialog support tool. The data were collected via semi structured individual interviews and were analyzed via phenomenographic analysis.ResultsThe analysis resulted in three categories: (1) Dialog support - the skill of constructing bridges, comprised the main finding that dialog support facilitated communication by providing a multimodal way of communication including intercultural evidence-based content;(2) Dialog support - challengingly implementing adaptive efficiency, represented the implementation of dialog support to be time-consuming and, eventually, time-efficient when midwives gained digital skills; and (3) Women and their partners - the ability to be empowered, included the main finding of increased women's empowerment and control over their lives by being less dependent on interpreters.ConclusionsThe findings contribute to the understanding of communication via dialog support based on midwives' experiences. This study highlights that communication via dialog support facilitates communication between midwives and Arabic-speaking women and enhances midwives' working conditions. Within our increasingly heterogeneous societies, health care could provide support for communication via digital dialog support that is women-centered and culturally sensitive to avoid misunderstandings and delayed or incorrect treatment of migrant women.

Background: Previous research found that healthcare professionals had low preparedness for palliative care. Thus, it is necessary to explore healthcare professionals' self-efficacy. The Swedish Self-Efficacy in Palliative Care Scale (SEPC-SE) evaluates readiness in communication, patient management and multidisciplinary teamwork; however, it should be tested on a larger population. Furthermore, the constructs of the SEPC-SE should be compared to that of the original SEPC.

Aim: This study aimed to evaluate the consensus between the construct validity and reliability of the SEPC and the translated and adapted SEPC-SE. Furthermore, it aimed to describe and compare the self-efficacy of nurses and physicians in hospitals and explore the associated factors.

Methods: The nurses (n = 288) and physicians (n = 104) completed the SEPC-SE. Factor analysis with Cronbach's alpha evaluated validity and reliability, and an analysis using the Mann-Whitney U test compared self-efficacy and multiple linear regression-associated factors.

Results: The SEPC-SE revealed three factors with high reliability. Education or experience in specialised palliative care was minor, especially for nurses. Self-efficacy was highest in patient management (nurses, median [md] = 74.57, physicians md = 81.71, p = 0.010) and communication (nurses md = 69.88, physicians md = 77.00, p = 0.141) and lowest in multidisciplinary teamwork (nurses md = 52.44, physicians md = 62.88, p = 0.001). The strongest associations with self-efficacy were education at work and advanced homecare experiences. In addition, there were significant associations between years in the profession, male sex, physicians and university education.

Conclusion: The SEPC-SE is valid and reliable for measuring self-efficacy. Nurses had lower self-efficacy than physicians. Physicians were associated with higher self-efficacy and had more education and experience in palliative care settings, which may explain their levels of self-efficacy.

För att möta dagens och morgondagens samhällsutmaningar krävs kunskap ur ett bredare och större perspektiv. På Linnéuniversitetet samlar vi därför framstående forskning, utbildning och samverkan i något vi kallar kunskapsmiljöer. Våra kunskapsmiljöer är tvärvetenskapliga för att ta ett mångsidigt grepp om utmaningarna.

Inom kunskapsmiljön Hållbar hälsa arbetar vi för att främja hälsa och välbefinnande för alla människor i alla åldrar. Några av de utmaningar som vi tar oss an är:

·        Demografiska förändringar

·        Ändrade mönster för funktionshinder och sjukdomar

·        Traumatiska händelser 

·        Brist på delaktighet 

·        Organisatoriska utmaningar

Men med en åldrande befolkning och fler personer som lever länge med kroniska sjukdomar både ökar och förändras vårdbehoven samtidigt. Dessa faktorer, tillsammans med ökad migration, globalisering samt förändrade behov av hälsovård, är de demografiska utmaningar vi behöver inrikta oss mot. De förändringar i livsstilar som vi ser idag, till exempel näringsbrist på grund av mindre hälsosamma matvanor och en ökande psykisk ohälsa måste också adresseras. 

Den digitala utvecklingen ger oss helt nya möjligheter till en mer effektiv global hälsovård. Men även här finns utmaningar; ökad digitalisering kan leda till att människor stängs ute på grund av att de saknar kompetens eller den digitala utrustningen som krävs.

För att svara upp mot dessa utmaningar arbetar vi inom kunskapsmiljön brett med forskning, utbildning och samverkan inom en rad olika forskningsområden såsom:

·        e-Hälsa 

·        Palliativ vård 

·        Livsmedelsvetenskap

·        Ögon, syn och optometri

·        Humaniora, hälsa och medicin

·        Åldrande och handikapp

Vanligtvis kommunicerar vi i kunskapsmiljön vår forskning genom artiklar i vetenskapliga tidskrifter, på konferenser eller genom pressmeddelande till media. Denna bok tar ett annorlunda grepp och använder konstens metoder för att illustrera kunskapsmiljöns arbete. Boken har kommit till genom ett samarbete med Det kulturella universitetet som arbetar med att koppla samman konst och vetenskap för en fördjupad förståelse av komplex komplexa och ibland motsägelsefulla förhållanden

Objective

To describe who seeks care and for what reasons at a nurse-led primary healthcare walk-in center in an immigrant-dense area. Studies evaluating the use of nurse-led walk-in centers in primary healthcare, emphasizing migrants, are limited. Due to language difficulties and a healthcare system based on telephone consultations, access to care is limited/problematic for the care seeker and the healthcare provider. The center aims to provide migrants and Swedish-born persons equal access to primary healthcare. Care was integrated into a healthcare center with a multi-professional environment, offering Arabic and Somali interpreters.

Design

Cross-sectional descriptive registry study.

Sample

All consecutive patients visiting during 1-month.

Results

Most individuals (70%) seeking care at the nurse-led walk-in center were non-European migrants from Syria, Iraq and Somalia, but Swedish-born persons (30%) also consulted the clinic. Women, middle-aged, and lower-educated patients dominated. Reasons for seeking care included different kinds of pain, ear/nose/throat issues, and skin problems. Migrants prioritized non-specific pain and dizziness/headaches, while Swedes sought help primarily for upper respiratory tract infections. About 25% of the migrants needed interpreters, mostly females.

Conclusion

The nurse-led walk-in center provides accessible care in a multi-professional team, if needed, serving migrants and Swedish-born persons, promoting equal healthcare for all.

Aim:Based on previous qualitative studies, it was hypothesised that dissimilarities in beliefs about illness, which influence healthcare-seeking behaviour, exist between foreign- and native-born persons diagnosed with type 2 diabetes living in Sweden (in the following termed 'Swedish-born'). Background:Beliefs about illness are individual, culturally related, based on knowledge, and guide health-related behaviour, and thus have an impact on health. The question is whether beliefs differ between foreign- and native-born persons diagnosed with type 2 diabetes. No previous comparative studies have been found on this. Based on previous qualitative studies, it was hypothesised that dissimilarities in beliefs about illness, which influence healthcare-seeking behaviour, exist between foreign- and native-born (Swedish) persons diagnosed with type 2 diabetes living in Sweden. Methods:Cross-sectional survey, 138 participants, comprising 69 foreign- and 69 Swedish-born persons aged 33-90 vs 48-91 years. Data were analysed with descriptive and analytic statistics. Findings:Beliefs about illness differed between foreign- and Swedish-born persons concerning causes of diabetes and healthcare-seeking behaviour. Foreign-born persons more often than Swedish-born persons reported uncertainty or lack of knowledge about whether heredity (67% vs 90%, P = 0.002) and pancreatic disease (40% vs 62%, P = 0.037) could cause diabetes. To a higher extent than Swedish-born persons, they reported that emotional stress and anxiety could cause the disease. Furthermore, they claimed they had sought care due to diabetes during the last 6 months to a higher extent than Swedish-born persons (30% vs 4%, P = 0.000).The findings confirmed that dissimilarities in beliefs about illness, including the causes of diabetes and healthcare-seeking behaviour, exist between foreign- and Swedish-born persons with type 2 diabetes.

Background: Based on findings from previous qualitative studies comparing migrants and Swedish-born persons with diabetes mellitus type 2, it was hypothesized that dissimilarities exist in beliefs about health, including factors of importance for health between groups. Methods: A survey in a diabetes clinic in a migrant-dense area in Sweden. Results: Migrants generally perceived their health as poorer than Swedes, although it was not significantly different. Health mainly meant feeling well, being alert, and healthy and learning to live with disease despite of person’s origin. Studying factors of importance for health, migrants perceived knowledge about the body and treatment to influence health to a lower extent (p 0.009) and use of nature cure remedies to a higher extent (p 0.029) than Swedish-born persons. Conclusions: The findings partly supported the hypothesis that dissimilarities in factors of importance for health exist between migrants and Swedish-born persons, and need to be assessed.

Background

One challenge for healthcare professionals when delivering palliative care can be their lack of confidence. The Self-efficacy in Palliative Care Scale (SEPC) is considered a valid and reliable assessment scale to evaluate confidence when delivering palliative care. Currently, there is not a reliable instrument aimed to measure healthcare professionals’ confidence in palliative care in Swedish. Therefore, this study aimed to translate, culturally adapt, and validate the SEPC-scale for use in a Swedish healthcare context.

Methods

This study applied the World Health Organization’s (WHO) guidelines for translating and adapting instruments, using forward and back-translation, an expert panel, and cognitive interviews. Swedish experts in palliative care (n = 6) assessed the Swedish version of the SEPC-scale based on its relevance, understandability, clarity, and sensitivity on a Likert scale. Methods involved calculation of content validity index (CVI) with modified kappa statistics and cognitive interviewing with healthcare professionals (n = 10) according to the “think-aloud” method.

Results

Calculation of I-CVI (Item-CVI) showed that the Swedish SEPC-scale was considered relevant but needed some modifications to improve its understandability and clarity. The experts recognized an absence of precision in some items that affected clarity and understanding. Likewise, the healthcare professionals highlighted some challenges with understandability and clarity. They indicated that the scale was relevant, but a few items needed adjustment to fit a broader range of healthcare professionals. Items that referred to death and dying could be sensitive but were considered relevant.

Conclusions

The SEPC-scale is considered valid for use in Swedish healthcare practice, for a broad range of healthcare professionals, and for diagnoses other than cancer. This study shows that cultural adaptation is necessary for establishing relevance and enabling acceptance to various healthcare professionals and contexts in the target country.

Aim:

This study evaluates a healthcare walk-in centre in an immigrant-dense area from the perspective of Swedish-born patients.

Background:

The studied healthcare centre started a walk-in centre to increase healthcare accessibility for immigrants. This form of care is not primarily for Swedish-born patients although everyone is welcome. For this reason, it is important to evaluate the walk-in centre from different perspectives: the healthcare workers, the immigrant patients, and in this study focusing on the Swedish-born patients.

Method:

This qualitative exploratory study used content analysis to analyse data collected from semi-structured interviews. Semi-structured interviews were held with 12 purposively sampled Swedish-born patients visiting a healthcare centre in Sweden.

Findings:

Most informants characterised the care they received as professional and timely and noted that accessibility was the main reason they sought care at the walk-in centre. In addition, they noted that being able to seek care on the day they want creates a feeling of security. However, Swedish-born informants seemed to prefer a traditional healthcare centre, although they viewed the walk-in centre as legitimate because everyone has access to it.

Conclusion:

As the walk-in centre was perceived as having good accessibility, participants experienced that they could easily receive help for minor health problems. However, they also identified several ways the walk-in centre could be improved. For example, some participants preferred to remain outside while awaiting their turn to see a healthcare provider and wanted immigrant patients to leave their relatives at home when possible to minimise the risk of spreading infection. In addition, some participants thought a triage system could be implemented so that more severe cases could advance more quickly in the queue. The homogeneous sample of informants raises questions about whether this healthcare model is indeed accessible to everyone.