BACKGROUND:Collaborative Health Care (CHC) is an integrated health care model in Sweden in which municipal and regional health care resources are coordinated to provide fast, coherent, and seamless health care in patients' homes. AIM:Explore registered nurses' experiences of working within the Collaborative Health Care model. METHODS:A qualitative, inductive design was used and was reported in accordance with the COREQ checklist. Semi-structured individual interviews were conducted via video with eight registered nurses-six women and two men aged 27-65 years-with experience working in the CHC health care model. The interviews lasted between 40 and 105 min and were recorded and transcribed verbatim. RESULTS:The findings consist of three categories, divided into nine subcategories and illustrated by quotes. The CHC is experienced as a work model in progress, spurring initial feelings of anxiety and frustration. Working in the health care model is described as challenging due to uncontrolled increase in workload, complex assessments, and limited knowledge about the patient. Participants found CHC to be beneficial in several ways for patients and their relatives, for health care professionals, for participating organizations, and for society at large. CONCLUSION:Implementing an integrated health care model like CHC can initially be experienced as challenging. Health care professionals can experience initial feelings of frustration and anxiety, since the usual workload may be affected by unexpected assignments, requiring knowledge to conduct complex, and sometimes novel, assessments. Working in CHC is a learning process resulting in increased competence. Participants found CHC to be beneficial in several ways, making the most out of resources in organizations and society at large to provide coordinated integrated care to patients in their homes.

Abstract BackgroundArtificial intelligence (AI) has the potential to enhance patient safety, particularly in the prevention of in-hospital falls. Recent advances in sensor-based AI systems allow for the analysis of complex, multimodal data to generate real-time alerts, enabling health care professionals to intervene before a fall occurs. By shifting from reactive responses to proactive risk management, these technologies may enable reductions in fall incidence and improvements in care outcomes. As a result, hospitals across Europe are increasingly adopting such systems. Nevertheless, empirical evidence concerning their routine implementation remains limited, particularly concerning their impact on patient safety, clinical workflows, and the usage of health care resources. Addressing these gaps is essential for effective and sustainable integration into hospital care. ObjectiveThis paper outlines the protocol for the multicenter, multimethod project SAFE (Safe AI-Assisted Fall Prevention Through Evidence), which investigates the implementation and impact of AI-assisted fall prevention in Swedish hospitals. MethodsThe research project is a collaboration between Halmstad University and hospitals in the Västra Götaland Region (VGR) and will, during 2026‐2028, investigate an ongoing large-scale AI system implementation in VGR hospitals, covering up to 2400 patient beds. Using surveys, interviews, observations, and a retrospective study, it will track the implementation and impact over time. Two learning laboratories involving patients, their relatives, and health care professionals will be conducted to codevelop strategies for the implementation of AI-assisted fall prevention. ResultsThe project will provide evidence-based insights and practical guidance on AI-assisted fall prevention. The findings will be relevant not only to patients, health care professionals, and hospital organizations, but also to policymakers and stakeholders involved in the digital transformation of health care. ConclusionsAlthough VGR serves as the primary research setting, the project’s results will inform future similar initiatives in Sweden and offer transferable lessons for other health care systems internationally. This study will contribute to the evidence base on AI-assisted fall prevention in health care, supporting the responsible and scalable integration of such systems across diverse health care environments.

Abstract Background Health promotion in higher education may support sustainable health among future healthcare and social work professionals, who face elevated risk of poor health when entering working life. The aim of this study was to describe associations between general health, health-promoting resources, lifestyle factors, and social factors among final-semester students in nursing, healthcare, and social work programs and newly graduated nurses and healthcare and social work professionals. In addition, the study compared groups reporting excellent/very good general health with those reporting good, fair, or poor health. Methods Data were collected through a web-based questionnaire, between 2020 and 2023, which included items on health and lifestyle factors, along with validated instruments measuring health-promoting resources (sense of coherence, salutogenic health, emotional intelligence, occupational balance) and social support. Analyses included chi-square tests, non-parametric tests, and logistic regression. Results This study included 343 final-semester students in nursing, healthcare, and social work programs and 115 newly graduated professionals. In the final semester, excellent/very good health was most strongly associated with absence of sleep problems (OR 3.3), no oral tobacco use (OR 2.7), and exercising > 60 min/week (OR 2.8). Higher scores in sense of coherence, emotional intelligence, occupational balance were also linked to better health. Among newly graduated professionals, absence of sleep problems (OR 6.8), daily activity > 150 min/week (OR 3.5), and low alcohol use (OR 2.7) were associated with excellent/very good health. At both time points, groups with excellent or very good general health reported higher scores in sense of coherence, salutogenic health, emotional intelligence, and occupational balance. No significant differences in health or health-promoting resources were found between final-semester students and newly graduated professionals. Conclusion Participants reporting excellent or very good health had higher health-promoting resources and better sleep during their final semester in nursing, healthcare, and social work programs and as newly graduated professionals. Neither health nor health-promoting resources changed upon entering work-life, however, this observation should be interpreted cautiously given the study’s limitations and confirmed in future research. Health promotion during higher education and in early work-life may therefore be crucial for sustainable health. As some of the data were collected during the COVID-19 period, results should be interpreted with awareness that pandemic-related circumstances may have influenced lifestyle and perceived health.

BACKGROUND:The aging population is increasing due to advancements in medical research and public health, leading to a growing demand for healthcare services and special housing facilities (SHF). Welfare technology (WT) has been introduced to support older adults by enhancing safety, independence, and care efficiency. Despite its potential, WT adoption remains limited, and research on older adults' experiences, particularly in SHFs, is scarce. This study explores the experiences of older adults using a digital alarm system with a safety sensor and camera function (DASSCF) in SHFs. METHODS:An inductive qualitative study was conducted using semi-structured interviews with older adults (3 men, 14 women, aged 67-98) in SHF equipped with DASSCF in a municipality in western Sweden. Data were collected between April and September 2024 and analyzed using qualitative content analysis. RESULTS:Experiences of DASSCF resulted in balancing vulnerability, tolerance, and having peace of mind in daily life categorized into: emotional aspects, where DASSCF contributed to security in everyday life but also raised concerns about privacy; integrity aspects, highlighting the process of learning to live with surveillance and the tension between safety and autonomy; and technological aspects, which focused on usability challenges and the desire to have control over the system. CONCLUSIONS:When integrating DASSCF into SHF, WT should be as supportive as possible without being too intrusive, allowing older adults to feel strengthened while ensuring their safety and independence.

Aim To illuminate nursing students’ interactions during age suit simulation from the perspective of being a blind older person and being an attendant guiding the blind person. Background Nursing students’ understanding of age related and long-term, often multiple health problems are crucial for providing person-centred care in the home. In age suit simulation students take the perspectives of an older person which can improve their general attitudes towards older persons. However, focusing on blindness in age suit simulation is a novel concept. Design The research design of this study is qualitative. During the autumn of 2022 to the spring of 2024 as a part of a larger intervention study project, nursing students (n = 68) were video-recorded during age suit simulation. The data was analysed through reflexive thematic analysis. Results Three main themes were constructed: (1) Pulling through together, (2) Dialogue is key when adapting to health problems and (3) Detached from each other. The third theme signifies the importance of being able to communicate in a meaningful way to adapt to each other’s health problems. Students took different approaches to this challenge, which is reflected in the ways the students interacted with each other. Conclusion The results of this study can be used to formulate a learning strategy to teach nursing students about the perspectives of being an older person with health problems. The simulations can also be utilized to enhance nursing students’ knowledge and skills when guiding a blind person in the context of a home environment. Furthermore, the results can be useful in highlighting a holistic perspective regarding care needs as a shared experience by older couples, which is relevant knowledge for any health and social care profession. This embodied understanding of health problems can be used to support and practice person-centred care for older persons.

Digital technology in health and social care can improve the well-being of people with long-term health conditions, but prior research has identified factors that hinder its adoption, particularly accessibility issues and challenges to its integration into everyday life. It is therefore important to fully understand both the facilitators and hindrances to the adoption of such technology. To explore the facilitators and hindrances to the adoption of digital technology in the everyday lives of adults with long-term health conditions. This scoping review systematically mapped relevant research following the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews). Thematic analysis was used to critically analyze the identified articles. Forty-six articles were selected that examined 5,018 adults aged 18 and over. Six themes were identified: personal characteristics and preconditions; perceived usefulness in everyday life; design and technical functionality; support and guidance; human interaction; and integrity and trustworthiness. The findings are discussed in relation to the key constructs of the Unified Theory of Acceptance and Use of Technology (UTAUT): performance expectancy, effort expectancy, social influence, and facilitating conditions. Digital technologies support the daily lives of adults with long-term health conditions, but several challenges remain, including functionality that is not adapted to specific diseases or ages and a perceived lack of human interaction. Thus, digital technology is not a one-size-fits-all solution but should be an adaptable tool that accommodates individual preferences and contexts and that complements in-person human interactions.

BACKGROUND:Effective health-promoting interventions can support older adults in maintaining and regaining good health and can foster healthy aging. The Reflective STRENGTH-Giving Dialogues (STRENGTH) intervention was created to optimise a holistic healthcare delivery that supports older adults in learning to live with long-term musculoskeletal pain. Findings from previous studies indicate that the dialogues contributed to an increased sense of well-being and had an immediate pain-alleviating effect. The aim of this extended study was to explore the health effects of the STRENGTH intervention among older community-dwelling adults living with long-term health problems. METHODS:Older adults (n = 47) in Sweden completed questionnaires inquiring about levels of well-being, impact of health problems on daily life, depression symptom occurrences, health-related quality of life, physical performance, and consumption of care using a quasi-experimental design. Descriptive statistics were used to explain and compare results within groups. Data were collected before, during, and after the STRENGTH intervention in autumn 2017 and spring 2018. It consisted of health-care professionals engaging in recurrent dialogues to guide and support older adults in ways that increase sense of well-being, joy, strength, and meaning in life through carrying out small and large life projects. RESULTS:According to self-reports, the STRENGTH intervention had immediate positive effects on perceived well-being and health problems. From a longitudinal perspective, although no significant differences in health outcomes were found based on comparisons of baseline and follow-up data within groups, positive effects were shown. CONCLUSIONS:To contribute to healthy aging, HCPs need favourable conditions for conversations in care encounters, extensive knowledge about the importance and potential of dialogues, and an understanding of how to integrate dialogues into health and social care.

Objective To explore patients’ expressions of emotional distress and subsequent Registered Nurses’ (RNs’) responses in primary care consultations. Methods This observational study included a consecutive sample of 147 audio recorded RN-led consultations with adult patients seeking primary care for a new health problem. Expressions of emotional distress were analysed using the Verona Coding Definitions of Emotional Sequences. Results Patients expressed emotional distress in one-third of the recorded consultations. A total of 165 expressions of emotional distress were identified, comprising 140 cues and 25 concerns. The RNs’ responses primarily provided space for further disclosure of the emotional expressions (125, 75.8%). No statistically significant differences in RNs’ response types, such as providing or reducing space, were found based on patients’ sex, age, or native language. Conclusion RNs demonstrated proficiency in recognising patients’ expressions of emotional distress and in facilitating further disclosure in an inclusive manner that aligns with principles of person-centred care. Practice implications Encouraging recognition of emotional distress through active listening and an engaged communication approach may enhance RN communication and optimise conditions for person-centred care.

OBJECTIVE:The couple's relationship is affected by the transition to parenthood, but research findings are mixed, with some studies showing positive effects on the relationship and others indicating negative impacts. This study aims to explore first-time mothers' and their partners' perceived quality of dyadic relationship (QDR36) during pregnancy and the following eight years after childbirth as well as what factors that are associated with a higher QDR36. METHODS:A prospective longitudinal cohort study on 917 Swedish parents, with repeated questionnaires at: gestational week 25 (T1); first week after childbirth (T2); six months (T3); one year (T4); two years (T5); four years (T6), and eight years (T7) after childbirth. Non-parametric tests and Cohen's effect size calculation were conducted to analyze change over time in QDR36. Multiple linear regressions were carried out with index for QDR36 as dependent variable, at all time points (T1-T7). RESULTS:QDR36 varied over time among both first-time mothers and partners, showing an increase between T1 and T2, followed by a decrease between each point in time. QDR36 was statistically lower at T7 compared to all other points in time (T1-T6). Variations were observed in the variables that were associated with a higher QDR36 at different time points, however higher sense of coherence (SOC-13) and social support (MSPSS) were consistently associated. CONCLUSION:First-time mothers and partners' perceived quality of couple relationship declines the first eight years after birth. To support them in their couple relationship, healthcare professionals should acknowledge parents' sense of coherence and social support.

Trait emotional intelligence (EI) is often assessed using the 30-item Trait Emotional Intelligence Questionnaire-Short Form (TEIQue-SF). However, previous research using item response theory (IRT) modelling has identified several underperforming items. This study aimed to psychometrically evaluate, refine, and optimize the TEIQue-SF using IRT, with the goals of identifying and eliminating underperforming items, and examining whether items in the refined version function differently across sexes. Furthermore, the study sought to further validate the Swedish version of the TEIQue-SF. This cross-sectional study surveyed 845 first-year students aged 19–59 (87

Newly graduated healthcare and social work professionals can experience stress and a perceived lack of competence when transitioning from academia to clinical practice, which can lead to health problems or leaving the profession. Globally, creating healthy workplaces remains a challenge. The aim of this study, which had a salutogenic approach, was to explore health-promoting resources and workplace experiences among newly graduated healthcare and social work professionals. This multicenter cross-sectional study included Swedish healthcare and social work professionals in their second year after graduation, recruited from six universities. Data were collected in March 2023 via a self-reported, web-based survey using validated instruments: the salutogenically oriented 13-item Sense of Coherence (SOC) Scale, the Salutogenic Health Indicator Scale (SHIS), and the 32-item Work Experience Measurement Scale (WEMS), along with questions on health, well-being, lifestyle and social factors at work, including three from the General Nordic Questionnaire (QPSNordic). Data were analyzed in SPSS 28 with nonparametric tests and Spearman correlations. A total of 115 newly graduated healthcare and social work professionals completed the questionnaire. The results indicated that those who expressed they were sure to stay in the profession reported a higher total WEMS score (p < 0.001), as well as higher scores in five out of six dimensions: supportive working conditions (p < 0.001), internal work experience (p < 0.001), autonomy (p < 0.001), time experience (p = 0.006), and management (p = 0.029). Participants who rated their well-being as good scored higher in supportive working conditions (p = 0.025) and the change process (p = 0.008). Those living with children reported higher internal work experience scores (p = 0.019). The results revealed positive and medium-strong to strong correlations between WEMS, SHIS, and SOC total scores. Specifically, there were medium-strong correlations between SHIS and SOC and two dimensions of WEMS: supportive working conditions and time experience, and between SHIS and the change process dimension. This study highlights the importance of salutogenic resources in supporting newly graduated professionals. Factors such as supportive working conditions, autonomy, and internal work experience were linked to well-being and intention to stay in the profession. Understanding these factors can inform workplace interventions to promote retention and health in early career stages.

Introduction In ambulance services, personnel often work together in teams. There are two personnel in ambulances, at least one of whom is a registered nurse. Besides leading nursing work, the registered nurse should be able to lead and work in teams. The registered nurse develops an intuitive approach through work experience, enabling them to act without analysing their actions. Aim This study illuminates registered nurses’ perceptions of factors affecting teamwork and solo work in ambulance care. Method The sample consisted of ten registered nurses from ambulance stations in western Sweden. Semi-structured individual interviews were analysed using qualitative content analysis, according to Graneheim and Lundman (2004). Results Ambulance healthcare nurses emphasise continuous teamwork, where clear roles and effective communication are key. Team continuity fosters trust among colleagues for a safer work environment. Striking a balance between new and experienced staff is crucial. Experience and reflection are vital for building professional knowledge, instilling confidence, and fostering an intuitive approach. Conclusion Secure teamwork and solo work require experience, continuity, distinct roles, communication, and reflection.

Older persons’ use of digital technology is becoming more prominent due to society’s heavy reliance on mobile and web applications. A positive attitude has been detected among older persons regarding the use of mobile solutions. Digital technology is increasingly used in the provision of health and social care, which can help older persons continue to be independent, and in turn can contribute to older persons’ overall well-being and sense of safety. However, current digital technology has been found to be difficult for older persons. Additional explorations into older persons’ experiences using digital technology are therefore relevant. A qualitative design was used with data collected using semi-structured interviews with 17 older persons in the age span 72–101, living in 12 different municipalities. The older persons were admitted to municipality health care. Interviews were conducted in the older persons home, and were audio recorded. The recordings were transcribed and analyzed through a qualitative conventional content analysis. The study method was compliant with the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist. The analysis resulted in two main categories; Enrichment, dependance and mixed feelings of using digital technology in daily life and Divided preferences and use of digital technology in contact with health and social care. The first is divided into three sub-categories; divided usage and feelings about digital technology, enriching daily life with digital technology, and need for support when using digital technology. The second is divided into two; divided experiences regarding digital communication with health and social care and a longing for information about healthcare through digital technology. The diversity showed how older persons cannot be seen as a homogeneous group regarding the use of digital technology. Individual preferences of older persons should be acknowledged by health care professionals and policy makers prior to deciding whether the use of digital technology is preferable, and in which situations. Support and education for older person in using digital technology is essential, as is involving older persons in designing the digital technology that is developed for them to use. Otherwise, older persons may become more dependent on others to manage their everyday life.

The meal environment is the first impression of a meal, and, if it is not appealing, it lowers the willingness to eat. Malnutrition is the registered nurses’ (RN) responsibility in the municipality. However, the responsibility of the meal environment is unclear. Therefore, semi-structured interviews with 10 nurses were held, aiming to explore RNs’ experiences of meal environment within long-term care facilities for older persons, analyzed through qualitative content analysis. The study method was compliant with the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist. The meal environment became a grey area of responsibility, overshadowed by focus on nutrition for the RN. The RN expressed how they did not consider it part of their role to create a positive mealtime environment, avoiding the meal environment at mealtimes. However, they experienced an obstacle of raising these needs were lack of time and a stagnant view of the division of labor between the RN and assistant nurse, leading to the meal environment becoming no one’s responsibility.

AIM:This study described healthcare professionals' experiences of tasks that contribute to job satisfaction. DESIGN:A qualitative descriptive study was conducted. METHODS:Data were collected through a survey questionnaire with an open-ended question on job satisfaction. 5464 healthcare professionals responded to the questionnaire. Data were analysed through manifest qualitative content analysis. RESULTS:The theme 'Enhancing healthcare professionals' job satisfaction through coherence, manageability, and meaningfulness' emerged with the following five categories: Enhancing person-centred care, Enhancing education, mentorship, and patient communication, Enhancing active participation in organisational development and transformation, Enhancing multi-professional teamwork and collaborative care, and Enhancing rewards and support. CONCLUSION:This study emphasises that job satisfaction among healthcare professionals depends on meaningful caring activities, a supportive work environment, and workplace resources. These factors boost resilience, reduce stress, and improve retention and patient care. A resource-based, salutogenic approach promotes both professional and personal well-being, fostering healthier, more effective healthcare environments. PATIENT OR PUBLIC CONTRIBUTION:No patient or public contribution.

Abstract Background To effectively utilize available healthcare resources, integrated care models are recommended. According to such model’s, registered nurses have the potential to increase patient access to health care services and alleviate organizational workload. Studies on acute home consultation assessments by registered nurses are sparse. The aim was to describe the reasons and actions for unscheduled same-day face-to-face registered nurse consultation at home offered to patients calling the national telephone helpline for healthcare in Sweden (SHD 1177), according to the integrated Collaborative Health Care model. Methods A descriptive cross-sectional study was designed. Data from registered nurses (n = 259) working within the Collaborative Health Care model, who performed unscheduled consultations at home (n = 615) using a data collection tool from 2017 to 2018 were collected. Results Among the 615 unscheduled home consultations performed by registered nurses, > 50% of the patients were managed at home as their health problems were not deemed as requiring a same-day referral to a clinic when assessed by the registered nurses. The most frequent health problems and reasons for contact were urinary tract problems, followed by medical and surgical conditions. Social factors, including living alone, impacted referral. Those living with a partner received care at home to a greater extent than those who lived alone. Conclusion An integrated model for healthcare involving registered nurses direct assessment, action and accountability seems to be an efficient option for providing integrated care at home and reducing acute clinic visits.

There is a national call for digital health innovations in the provision of health and social care, especially for older adults in the context of home. The Reflective STRENGTH-Giving Dialogue (STRENGTH) method is used to provide individual and holistic care using recurrent dialogues. The SelfSTRENGTH application (app) was developed to support reflection and stimulate activity that enables achievement of meaningful life projects. The objective of the study was to describe how the use of the SelfSTRENGTH app is perceived by older adults living with long-term health problems. A qualitative, descriptive and inductive design. Data, analyzed using a phenomenographic approach, consisted of individual qualitative interviews with older adults (age range = 74-96) conducted before (n = 34) and after (n = 27) participation in the STRENGTH intervention. The results consist of five categories of description: Resistance to use apps and digital tools; Health problems hinder its usefulness; Need of assistance is a prerequisite to be able to use the app; the app supports memory and reflection; and Using the app disperses thoughts and creates motivation. The outcome space thus contains descriptions of both barriers and possibilities regarding how the use of the SelfSTRENGTH app is perceived. The potential of using technology such as applications in health care is immense. However, long-term health problems in older adults, along with care providers' attitudes and opportunities to support, must be taken into consideration when implementing apps in health and social care.

Abstract Background It has been suggested that the university environment, to improve students’ health status and educational outcomes, should be based on a health promoting approach. More knowledge is needed about health promoting resources and lifestyle factors that may be of value for students in higher education and their future work-life balance. The aim of this study was to explore health-promoting resources, general health and wellbeing, and health promoting lifestyle factors among fourth and final semester students in higher education in healthcare and social work. Methods This longitudinal study is based on self-reported data collected through a web-based questionnaire that included questions about general health, wellbeing, and healthy lifestyle factors and made use of instruments: the Sense of Coherence (SOC) scale, the Salutogenic Health Indicator Scale (SHIS), and five questions from the General Nordic Questionnaire (QPS Nordic). The questionnaire was distributed among students enrolled in seven different healthcare and social work programmes at six universities in Sweden. Data was collected when students were in their fourth (2019/2020) and final (2020/2021) semesters analysed with multiple linear and logistic regressions. Results The survey included responses from students during the fourth (n = 498) and the final (n = 343) semester of higher education programmes in health and social work. Total SOC scores decreased between the fourth semester and the final semester. The prevalence of the health promoting lifestyle factor of physical exercise decreased between the fourth and final semesters. Students in their final semester reported valuing group work more highly than did students in their fourth semester. Despite this, students in both the fourth and the final semester reported high SOC, low levels of good general health and perceived wellbeing, and sleeping problems. Conclusions Students’ report of good general health were associated with wellbeing, high-intensity physical training, and no sleeping problems A high SOC level was associated with good general health, perceived wellbeing, and no sleeping problems. A higher SHIS level was also associated with wellbeing and no sleeping problems. Therefore, we suggest further research focusing on how to prepare students in healthcare and social work during higher education for a future work-life in balance targeting effects on sleep quality.

Objective The aim was to explore whether occupational balance is associated with health, health-promoting resources, healthy lifestyle and social study factors among students during higher education within healthcare and social work.Design The study has a multicentre repeated cross-sectional design. Data were collected via a self-reported, web-based questionnaire based on the validated instruments: the 11-item Occupational Balance Questionnaire (OBQ11), the Sense of Coherence (SOC) Scale, the Salutogenic Health Indicator Scale (SHIS) and five questions from the General Nordic Questionnaire (QPS Nordic) together with questions about general health and lifestyle factors.Setting Students at six universities in western Sweden at one of the following healthcare or social work programmes: biomedical scientists, dental hygienists, nurses, occupational therapists, physiotherapists, radiology nurses and social workers.Participants Of 2283 students, 851 (37.3%) participated.Results The students experienced that occupational balance increased during education. The total OBQ11 score was higher among students in semesters 4 and 6/7, compared with semester 1 students. Students with higher OBQ11 also reported higher SOC throughout their education, while health seemed to decrease. Students who reported higher levels of OBQ11 reported lower levels of health and well-being in semesters 4 and 6/7, compared with semester 1. There was an opposite pattern for students reporting lower levels of OBQ11.Conclusions The association between higher levels of OBQ11 and lower levels of health and well-being is remarkable. There is a need for more research on this contradiction and what it means for students’ health and well-being in the long run.