Background: Restless legs syndrome (RLS) is a long-term sensory-motor illness impacting individuals and their family members, yet little is known about the family members' everyday experiences.Aim: To explore and describe the everyday life experiences of family members of individuals with RLS.

Methods: An inductive, qualitative exploratory design was used. Telephone interviews were conducted with 25 family members (e.g. partner, child) and analysed using qualitative content analysis.

Results: Family members described adjusting their routines and social activities to accommodate the individual with RLS, often balancing these changes with their own needs. This adaptation affected their everyday lives, as conflicting desires required balancing personal needs with sleep disruptions, resulting in tiredness. Despite these challenges, they employed strategies such as shared activities and self-care to manage the impact on the individuals with RLS.

Conclusions and contribution to nursing: This study highlights the importance of family involvement in RLS care and the need for a family nursing approach in guidelines. Healthcare professionals could invite both family members and individuals with RLS in shared decision-making. Policies and practices could provide resources to support flexible coping strategies and reduce isolation. Future research could explore social support to better understand family members' experiences.

Background: Restless legs syndrome (RLS) is a prevalent neurological condition affecting daily life. Symptoms can vary and worsen during the evening and night, with sleep problems as a common consequence. Few, if any, qualitative studies have explored how patients with RLS experience their sleep problems.

Aim: The aim was to explore and describe how patients with RLS experience their sleep problems, the subsequent daytime consequences, and self-care activities used to improve sleep.

Methods: An inductive, descriptive, qualitative design was used, including semi-structured interviews with 28 strategically selected patients from a national RLS organisation. Data were analysed with manifest qualitative content analysis and reported according to the COREQ checklist.

Results: RLS-related ailments affecting sleep were: noticing initial symptoms in the evening, enduring stressful RLS symptoms at night, and being concerned about not having symptom-relieving treatment. Struggles with daytime consequences of poor sleep were: feeling excessive fatigue and managing social interactions. Self-care actions to improve sleep included trust in daily routines, benefiting from the use of various distractions, and actively seeking effective medical treatment.

Conclusions and contribution to nursing: Knowledge about various RLS-related ailments affecting sleep can be used by nurses to provide adequate education about the disease and potential nursing interventions to improve sleep.

Introduction: Restless legs syndrome (RLS) is a prevalent disorder that disrupts sleep and impairs quality of life. Establishing effective treatment is complex, and shared decision-making (SDM) might reduce decisional conflicts. No previous study has examined SDM or factors linked to decisional conflicts in RLS. Therefore, this study aimed to explore and compare sociodemographic and clinical factors associated with SDM in general and decisional conflicts in particular among patients with RLS. Methods: A cross-sectional design using a postal survey (June-September 2022), inviting all similar to 1500 members of the national RLS patient organization. Comparative statistical analyses and logistic regression models examined associations with sociodemographic and clinical factors, using the instruments: Restless Legs Syndrome-6 scale (RLS symptoms), Pittsburgh Sleep Quality Index (sleep), Patient Health Questionnaire-9 (depressive symptoms), eHEALS (e-health literacy), CollaboRATE (SDM), and SURE (decisional conflicts). Ad hoc items regarding treatment satisfaction and informational needs were also used. Results: In total, 788 patients, 65% women, mean age 70.8 (standard deviation = 11.3) were included. Fifty-eight percent reported a low SDM experience, and 78% experienced decisional conflicts. Multiple logistic regression analysis showed that RLS symptoms at nighttime (odds ratio [OR] = 1.073, P = 0.020), RLS treatment dissatisfaction (OR = 2.077, P < 0.001), low e-health literacy (OR = 0.964, P = 0.007), and a low SDM experience (OR = 0.800, P < 0.001) were associated with decisional conflicts. Conclusion: Most patients experienced low levels of SDM and decisional conflicts, with several factors associated with their experiences. Awareness among healthcare professionals can support a collaborative approach, using SDM to prevent treatment-related decisional conflicts in RLS care.

Background: A sustainable working life for nurses involves creating conditions that allow productivity and well-being to be maintained throughout a nursing career. To address nurses' health and well-being, as well as the ongoing shortage of nurses, it is essential to understand the key elements that contribute to a sustainable working life for nurses.

Objective: The aim was to explore and describe nurses' actions in situations that are important to sustainability in their working lives, as well as why these actions matter and how they contribute to sustainable working life across the career span.

Design: An exploratory descriptive design using a qualitative research approach based on Flanagan's critical incident technique (CIT).

Setting and Participants: Forty-seven nurses (general and specialist) from diverse fields of care within three healthcare regions in Sweden were interviewed between April and October 2024.

Methods: A two-step sampling approach was used. Data were analyzed inductively, in line with the guidelines for CIT.

Results: Nurses employed various individual-, organizational-, and team-oriented strategies to maintain a sustainable working life. Organizational support played a vital role. Supportive leadership adopting a "person-first" approach and a positive organizational culture facilitated work-life balance, professional development, and effective teamwork. Negative organizational cultures, such as excessive workloads and ethical conflicts, reduced nurses' well-being and willingness to remain with the organization.

Conclusions and Implications for Nursing Management: Sustainability in nursing emerged as a dynamic process shaped by the interaction between nurses' adaptive strategies and organizational conditions, particularly supportive leadership and a positive organizational culture. This underscores the importance of integrated, long-term management approaches that balance individual needs, professional development, and supportive work environments to sustain nurses' engagement across the career span.

Background: As open-heart surgery can be stressful for the patient and their family, the objective of this study was to generate knowledge on how to support families in relation to open-heart surgery based on important situations.

Aim: The aim was to explore and describe the experiences and actions of important situations of family involvement as expressed by family members of patients who underwent elective open-heart surgery in Sweden.

Methodological Design and Justification: The critical incident technique used is a qualitative method appropriate for identifying issues relating to clinical problems.

Ethical Issues and Approval: Ethical approval was obtained from the Swedish Ethical Review Authority. Allowance was made for the unexpected presence of the patient.

Research Methods: Individual interviews with 29 family members of patients who underwent open-heart surgery in Sweden in 2023 were analysed using the critical incidence technique, as applied in nursing and healthcare sciences.

Results: The family members experienced being—or not being—seen as significant and were fearing the loss of normal life in relation to open-heart surgery. Actions taken during important situations were building confidence to relinquish control and relieving burdens to improve well-being.

Conclusions: Family involvement, in terms of being informed and welcomed, led to an improved ability to care for their loved ones. Emotionally supportive interventions targeting families should be considered in relation to a loved one's open-heart surgery.

Restless Legs Syndrome (RLS) affects 3% of the world's population, causing tingling sensations primarily in the legs. Incorporating self-care activities could improve the management of RLS symptoms, yet knowledge about effective self-care actions is limited. This study employs the Capability, Opportunity, and Motivation-Behaviour (COM-B) model to explore self-care behaviours in individuals with RLS, as research in this area is sparse. Qualitative content analysis of interviews with 28 participants with RLS, 26 subcategories emerged, aligning with the COM-B model's components. The first part, Capability, highlighted the importance of being able to be in motion, while the second, Opportunity referred to situations where there was a lack of trust and guidance for self-care. The third part, Motivation, emphasised the importance of fixed routines of sleep, rest, and activity. These identified prerequisites can inform the development of screening instruments and patient-reported outcome measures to evaluate self-care needs and interventions for individuals with RLS.

Forest fires, or wildfires, are expected to increase due to warmer and drier summerscaused by climate change. When the forest is on fire, all forest owners are by lawresponsible to assist the fire and rescue services. Hence, the aim of this study wasto describe private forest owners’ experiences of forest fires on their property. Indepthinterviews were conducted and analyzed by using qualitative content analysisto describe 20 private forest owners’ experiences of forest fires. The result mergedin the overarching theme: “Powerlessness in fighting the forest fire alleviates bytogetherness in a desire to help and to be helped”. Meaning, a forest fire is a disasterboth in economical and emotional terms, causing destruction to the forest thathas been in the private forest owners’ care for generations. The forest owner feelsresponsibility and expresses an unquestionable will to act. The invaluable supportfrom the local community helps the forest owner to manage this difficult. However,the forest owner expects to be allowed to contribute, therefore, the fire and rescueservices need a proactive plan that involves private forest owners to ensure a safework environment for all involved. In addition, the strong and differentiated networkof family and neighbors that mobilize brings strength and local knowledgeimportant to the operation. Though worrying of new forest fires will remain, it isa burden that needs to be taken seriously. A positive outcome is that through collaboration,security and resilience enhances in the local community.

Nursing science works within a clinical–practical field that requires robust research methods to capture and understand the complexity of nursing care. The Critical Incident Technique (CIT) is one such robust research method used to explore and describe individuals’ as well as society’s complexity, in terms of behavior. By the mid-1980s, CIT, originating in psychology, was considered useful for use in nursing care research, but criticism has advanced over the years from both philosophical (ontological and epistemological) and scientific (methodological and methods) perspectives. It is therefore important to know what is universal today and preferable when it comes to the choice of scientific theoretical paradigm, research design, data collection- and data analysis structure. The aim of this theoretical study was therefore to describe and elucidate CIT evolution in nursing science through philosophical and scientific reasoning and scrutinization over a 40-year period. Grounded in a humanistic and human-centered view, CIT has gained scientific support for its coherent and sound philosophic and scientific approach, under which continuous and successful periods of evolution have been undertaken over the years. Today, CIT principally uses an inductive explorative design that is analyzed using a qualitative research method, usually at the manifest descriptive level, as the original CIT once commenced with an essential focus on studying human behaviors, still in terms of actions but now also including the experiences that led to those actions. Future improvements should be in the spirit of the founder of CIT, who emphasized CIT as a flexible set of principles that must be modified and adapted to meet personal as well as societal specific needs.

Background: An increased use of the internet and digital health care for patients with long-term conditions implies a need for assuring digital health literacy skills. Patients with restless legs syndrome (RLS) represent a group where digital sources of information are highly valued. This is due to a difficult diagnosis and complex treatment situation that contributes to patients seeking out digital resources themselves to handle the perceived shortcomings in their care. To benefit from these resources, patients need to have the digital skills to explore information to optimize their understanding of the disease and its treatments. The eHealth Literacy Scale (eHEALS), which has been used in both general populations and patients with long-term conditions, could, if proven valid, be used by researchers and clinicians to assess digital health literacy among patients with RLS to inform the development of patient-centered digital health care information and interventions.

Objective: The aim of the study is to investigate the psychometric properties of eHEALS in patients with RLS to determine its adequacy and potential utility.

Methods: A cross-sectional design including patients with RLS from the Swedish national RLS patient organization was used. Data were collected via a mail-based survey comprising back-and-forth translated Swedish versions of the following instruments: eHEALS, Restless Legs Syndrome-6 Scale (RLS symptoms), Pittsburgh Sleep Quality Inventory (sleep quality), Epworth Sleepiness Scale (daytime sleepiness), Patient Health Questionnaire-9 (depressive symptoms), and CollaboRATE (shared decision-making). Confirmatory factor analysis and Rasch models were used to assess the validity and reliability of the eHEALS. Measurement invariance, unidimensionality, and differential item functioning across age, gender, medication use, sleep quality, level of depressive symptoms, and participation in care decisions were assessed.

Results: A total of 788 patients with a mean age of 70.8 (SD 11.3) years participated. Among them, 64.7% (n=510) were women, 73.8% (n=582) were married or living together, and 43.5% (n=343) had attained a university education. A median eHEALS score of 28 (IQR 22-33) was reported. The unidimensionality of the eHEALS was supported by the confirmatory factor analysis and the Rasch model. The reliability of the eHEALS was confirmed using composite reliability and Cronbach alpha. No differential item functioning was identified for age, gender, medication use, shared decision-making condition, depressive symptoms, or sleep quality, meaning that these groups do not have different probabilities of endorsing a given item after controlling for the overall score.

Conclusions: The eHEALS showed good validity and reliability and operated equivalently for men and women of different ages with various clinical and treatment conditions related to RLS. Accordingly, health care professionals can use eHEALS as a psychometrically sound tool to explore the digital health literacy level among patients with RLS.

Aim

There are discrepancies between the information patients desire about adverse drug reactions (ADRs) and the information they receive from healthcare providers; this is an impediment to shared decision-making. This study aimed to establish whether patients received information about ADRs resulting from prescribed pharmacotherapy, before hospital discharge, after percutaneous coronary intervention (PCI) and to determine whether receiving information about ADRs was associated with incidence of self-reported ADRs or concerns related to prescribed pharmacotherapy.

Methods

CONCARD^PCI, a prospective multicentre cohort study including 3,417 consecutive patients after PCI, was conducted at seven high-volume referral PCI centres in two Nordic countries. Clinical data were collected from patients’ medical records and national quality registries. Patient-reported outcome measures were registered 2 months (T1), 6 months (T2), and 12 months (T3) after discharge. Covariate-adjusted logistic regression yielded adjusted odds ratios (aORs) with 95% confidence intervals (CIs).

Results

At discharge, 38% of participants had been informed about potential ADRs. For these patients, the incidence of self-reported ADRs was significantly lower at T1 (aOR 0.61, 95% CI 0.50–0.74; p<0.001), T2 (aOR 0.60, 95% CI 0.49–0.74; p<0.001), and T3 (aOR 0.57, 95% CI 0.46–0.71; p<0.001). Those who were not informed reported higher levels of concern about prescribed pharmacotherapy at all measuring points (p<0.001 for all comparisons). Those living alone (aOR 0.73, 95% CI 0.57–0.92; p=0.008), who were female (aOR 0.57, 95% CI 0.44–0.72; p<0.001), and with three or more versus no comorbidities (aOR 0.61, 95% CI 0.44–0.84; p=0.002) were less likely to receive information.

Conclusion

A substantial proportion of patients were not informed about potential ADRs from prescribed pharmacotherapy after PCI. Patients informed about ADRs had lower incidences of self-reported ADRs and fewer concerns about prescribed pharmacotherapy.