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Purpose: Support after cancer treatment can improve health-related quality of life for cancer survivors. Contact nurses play a key role in patient care following cancer treatment. The contact nurse is responsible for providing support, encouraging patient participation in care, and assessing and managing individual needs throughout the cancer trajectory. This study aims to explore contact nurses' perceptions of how organisational conditions influence patient care provision after cancer treatment.

Methods: A descriptive qualitative study design was used. Semi-structured individual interviews were conducted with 12 contact nurses from seven hospitals in northern Sweden, between February 2022 and January 2024. Data was analysed using qualitative content analysis.

Results: Contact nurses perceive that they are: working around resource limitations, navigating unclear responsibilities, pursuing inter-professional collaboration and envisioning integrative follow-up. The results highlight the challenges that contact nurses face when maneuvering between the formal and informal boundaries they perceived within the organisation. They struggled to work according to their job descriptions and felt hindered by existing structures.

Conclusion: Contact nurses experienced that organisational prerequisites hindered their ability to fulfil their role when providing care to patients after cancer treatment. They strived to adopt a person-centred approach and improve patient support, but felt hindered by unclear structures within the organisation. By addressing these challenges, organisational conditions for contact nurses may be enhanced to improve patient care after cancer treatment.Keywords: Cancer care navigator; Cancer survivors; Contact nurse; Curative treatment; Experience; Nursing; Oncology care coordinator; Organisation; Qualitative research; Support.

Aim: This study aimed to examine the stress and burden experienced by parents of children with type 1 diabetes (T1D).

Design: A quantitative cross-sectional approach was used, including the results from an online questionnaire about stress and burden in parents of children (10–17 years) with T1D.

Methods: The data were collected using the Swedish-translated version of the Parental Stress Scale and the Zarit Scale of Caregiver Burden, analysed and presented through descriptive and inferential statistics.

Results: Parents with a university education reported lower stress, burden, role strain, and personal strain but higher satisfaction compared to those with a high school education. Cohabiting participants reported lower stress than singles (d = 0.301), though these differences were not statistically significant. No significant differences were found regarding age, number of children, or place of living. Satisfaction was negatively correlated with stress, personal strain, and role strain, while stress was positively correlated with personal and role strain.

Conclusion: Parents with higher education and greater caregiving satisfaction reported lower stress, while single parents and those experiencing high role strain were most vulnerable. These findings highlight the importance of family-centered interventions and accessible psychosocial support to reduce stress and enhance outcomes for children with T1D.

Patient or Public Contribution: The findings highlight the importance of identifying parents who need support in medical, educational, emotional, and psychological areas. Healthcare professionals must implement family-centered interventions to create a supportive environment and enhance health outcomes for the entire family.

Objective: This study describes patterns of self-management ease and difficulty among older adults with long-term health conditions and the associations with gender, level of education, number of conditions, depression and/or health status.

Materials and methods: Cross-sectional data were collected between 2021–2022 in a municipality in northern Sweden. The survey included demographic and health-related questions. To assess self-management ease or difficulty and symptoms of depression, the Patient Reported Inventory of Self-Management of Chronic Conditions (PRISM-CC) and the Geriatric Depression Scale were used. 516 older adults between 72–73 years of age with long-term health conditions were included. Descriptive statistics and logistic regression were used to describe patterns of self-management ease and difficulty and to examine which factors were associated with self-management difficulty.

Results: Most older adults did not experience self-management difficulty. There were, however, differences between the seven PRISM-CC domains. The Internal domain (managing negative emotions and stress) had the highest percentage (25.39%) of older adults with self-management difficulty. In all domains, there was also a subgroup of individuals (n = 26) that had noticeably lower PRISM-CC scores (more difficulty). A strong association between having depressive symptoms or having poor health status and self-management difficulty was found.

Conclusion: This study highlights the need for regular mental health screenings and individualized self-management support for older adults. Future research should explore intervention strategies that integrate mental health support into self-management programs for individuals with long-term health conditions.

Purpose: Developed simultaneously in English and Swedish, the Patient Reported Inventory of Self-Management of Chronic Conditions (PRISM-CC) assesses patients’ perceived difficulty managing life with long-term health conditions. This study assessed the comparability of the PRISM-CC across sociodemographic groups, number of health conditions and language (English and Swedish).

Methods: Differential item functioning (DIF) and differential test functioning (DTF) were analysed by age, gender, education level, and number of conditions using independent English and Swedish datasets. Language-based DIF and DTF were examined using pooled data. An iterative hybrid ordinal logistic regression approach was applied to identify potential DIF across the PRISM-CC’s seven domains. The impact of flagged items on total scores (DTF) was evaluated by comparing test characteristic curves.

Results: Few items were flagged for potential DIF in the English, Swedish or pooled data, and only at low cutoff values. The impact of items with potential DIF on DTF was negligible.

Conclusion: The absence of meaningful DIF and DTF in either the English or Swedish version of the PRISM-CC or between English and Swedish versions provides further support for the PRISM-CC as a valuable tool for assessing self-management ease and difficulty. These results also demonstrate the value of simultaneous development of instruments in two languages. Further evaluation of DIF is necessary in populations with greater self-management challenges, such as among people with severe disease burden.

Objective: This study aimed to translate and preliminarily evaluate the Swedish translation of the Parental Stress Scale. Background: Parenting is influenced by a complex mix of personal, social, and cultural factors, often leading to stress and exhaustion from competing demands. In Sweden, supportive policies like parental leave and childcare services encourage shared responsibilities and work–life balance. Despite these supports, many parents experience stress related to time constraints, mental health issues, and limited resources, which can impact both their parenting and their child's development.

Method: A quantitative psychometric design was used. The Parental Stress Scale was translated into Swedish and tested among parents of children aged 0–5 years at two Child Health Centers. The data were examined through psychometric analysis, and a confirmatory factor analysis was performed to assess model fit.

Results: The goodness of fit of the translated Parental Stress Scale was acceptable, indicating that the translation is appropriate for use in a Swedish context. The chi-square test revealed a significant p value, likely due to the small sample size, and the relative chi-square (1.48) fell within the recommended range (2.0–5.0).

Conclusion: These findings suggest that the translated Parental Stress Scale should be used with caution, as it more accurately measures parental stress than satisfaction among this group of parents. Its use at Child Health Centers enables early stress detection among parents, supports interventions, and complements screening. In research, the scale can help evaluate parenting programs and long-term studies, promoting international comparison.

Purpose: Cancer rehabilitation guidelines emphasise the importance of providing individualised support to meet each patient's unique needs. Contact nurses have an essential role in providing such support. This study aims to explore contact nurses' experiences of supporting patients after cancer treatment.

Method: This descriptive qualitative study was undertaken between February 2022 and January 2024. Semi-structured individual interviews were conducted with 12 contact nurses who were purposively recruited from seven hospitals in northern Sweden. Data were analysed using qualitative content analysis with an inductive approach.

Results: Three themes were revealed. Providing a sense of stability was achieved through creating order despite chaos, always being reachable and giving information to reassure patients. Creating trustful relationships involved being a confidant who assisted patients to cope and acknowledged their challenged existence. Navigating within limitations meant that contact nurses provided support while dealing with the unknown and facing their own inadequacy. The results highlight the ways that contact nurses support patients' self-management and well-being after curative cancer treatment.

Conclusion: Contact nurses experienced that patients had multifaceted physical, psychosocial and relational needs following cancer treatment. They described their role as inherently solitary and struggled to uphold care ideals while lacking support themselves. It was challenging to provide person-centred support when patient needs were not clearly identified or expressed, or when the required support was beyond the contact nurses' scope of practice. The contact nurse role was extensive but lacked clarity regarding how it could be optimised to best support patients following cancer treatment.

Background: Studies show that healthcare professionals encounter ethically difficult situations in everyday clinical practice, and there is a need for interprofessional communication in organised forms. Ethics communication in groups (ECG), based on Habermas’s theory of communicative actions, is a form of support for interprofessional communications about ethical issues. The ‘one to five method’ is a practical tool for healthcare professionals with education in ethics to facilitate ECG in everyday clinical practice.

Research aim: To evaluate the effects of organised ECG using the ‘one to five’ method for health care professionals concerning moral distress and ethical climate at wards with round-the-clock care compared with a control group.

Research design: This was a prospective cluster randomised study with an open, non-blinded design.

Methods: Nine wards with different medical specialisations at one university hospital were purposefully and then randomly allocated to an intervention group (IG) (n = 5) and a control group (CG) (n = 4). An ECG was performed monthly for six months in the intervention group. Prospective assessments were made at 3 and 6 months using the Measure of Moral Distress-Healthcare Professionals (MMD-HP), Moral Distress Thermometer (MDT), and the Swedish Ethical Climate Questionnaire (SwECQ).

Result: Between-group analyses showed no significant differences in moral distress over time. Within-group analysis revealed that the intervention group scored lower moral distress concerning clinical causes at the patient level at the 3-month measurement point but returned to the same level as the control group at six months. The ethical climate was rated higher in the intervention group at 3 and 6 months.

Conclusion: Participation in ECG likely fosters shared values and an enhanced ethical climate, though no significant differences in moral distress were observed. Moral distress may persist despite interventions, but open dialogue and professional growth can foster moral resilience. This study found a positive relationship between an ethical climate and participation in ethics communication groups (ECG) using the ‘one to five method.’ However, the small sample size limited statistical power. Future research should include larger-scale, multicentre studies and qualitative research to explore experiences with ECG.

Trial registration: ClinicalTrials.gov: NCT05146102 (2021-11-05).

Introduction: The Swedish child health care (CHC) program provides voluntarily, at no cost, services for children from birth to 5 years old. Participation rates are 99% of Swedish parents enrolling their children in some form of CHC program. Parental groups, comprising parents with similar experiences, can help reduce parental stress and foster the development of effective coping strategies. The study is aimed at evaluating a digital support intervention involving parents, child health nurses, and researchers.

Methods: This cluster-randomized, prospective pilot intervention study, conducted in northern Sweden, had three follow-up points: baseline, 4 months, and 8 months. Data were collected from autumn 2022 to late spring 2023 and evaluated effects on parental stress and satisfaction, eHealth literacy, and satisfaction with CHC, accessibility, and support. The 18-item Parental Stress Scale was used to assess parental stress and satisfaction. eHealth literacy was measured using the 10-item eHEALS scale, and parental satisfaction and opinions on accessibility to CHC were measured using a three-item Visual Analogue Scale. The intervention group was offered to participate in various digital activities, while the control group received the usual CHC.

Results: Parental satisfaction and stress levels within and between the intervention and control groups showed no significant changes from baseline to 8 months. Regarding eHealth literacy, differences were observed between the groups; however, both groups demonstrated improvement at the 8-month follow-up. The control group scored higher in eHealth literacy from baseline. The same pattern was identified regarding the parents’ perceptions of internet usability and importance. Concerning satisfaction with CHC, accessibility, and support, the control group scored higher at baseline. Interestingly, the lines of the intervention and control groups crossed over at the 8-month follow-up.

Conclusion: Despite a limited outcome change, the results showed a tendency to benefit some parents. Our findings suggest that further evaluation, possibly with other more suitable measurements or questionnaires, an extended intervention period, and a larger sample, is necessary to understand the implications of these results fully.

Introduction: Young adults living with type 1 diabetes face unique challenges as they transition to greater independence, balancing diabetes management in all other dimensions of life. In Sweden, the transfer from pediatric to adult diabetes care at the age of 18 adds to these challenges. This study aimed to translate and evaluate the Swedish version of the T1DAL (Type 1 Diabetes and Life) self-report questionnaire for young adults living with type 1 diabetes.

Method and Materials: The T1DAL questionnaire was translated into Swedish and was completed by 191 young adults aged 18–25 who were registered at a diabetes clinic in three Swedish hospitals. An expert group tested content validity. To determine the number of underlying factors, a parallel analysis (PA) was conducted. The questionnaire’s latent structure was further examined through exploratory factor analysis, in which the items were constrained to a four-factor solution as recommended and found in the original version.

Results: The content validity index of the total score was 0.94. The response distribution analysis revealed the presence of floor or ceiling effects. An EFA with a four-factor solution was conducted, yielding a Model Fit Measure with a χ² of 326.68 and df = 249, resulting in a cmin/df of 1.31, an RMSEA of 0.04, and a TLI of 0.92. Internal consistency was assessed for the subscales suggested by the factor structure, based on the items that loaded onto each factor. Cronbach’s alpha values ranged from 0.75 to 0.89, indicating acceptable to high internal consistency. The four-factor solution explained 45.04% of the total variance.

Conclusion: The Swedish T1DAL questionnaire showed good factorial validity and reliability. The Swedish version requires further testing with potential item reduction; however, it is still expected to be valuable in assessing health-related quality of life among young adults living with type 1 diabetes.

Clinical implications: The Swedish T1DAL questionnaire, particularly its domains related to emotional experiences, managing diabetes effectively, and peer relationships outlines the characteristics of young adulthood and can be used to empower the target group, and is expected to be feasible to implement in clinical practice.

Introduction: Sweden has an extensive national child health care programme (CHCP) implying that all parents are offered support to raise their children and support them for healthy development. The programme is today built on personal physical contacts and digital components unusual. Although the digital world could be frightening and insecure, it also has benefits, because it is not dependent on face-to face meetings and is accessible more hours. In order to develop a digital channel to complement the CHPC, for the support of parents of children within child health care (CHC), parents' perspectives must be investigated. The aim of the study was therefore to describe parents' needs and expectations of digital support in the context of child health care.

Methods: The study had a qualitative approach using workshop discussions with parents as data. The interview data were analysed using qualitative content analysis.

Results: The main theme highlights that parents expected that a digital support channel would be something that might strengthen them towards independence concerning the care of their children, in a positive way. However, they also felt that they needed personal support and that relationships with other parents and the child health care nurse were significant and meaningful. Another parental desire that emerged was that a future digital channel would facilitate and simplify access to care and they suggested having both planned and urgent times available for parents to book. The digital channel was expected to make this possible and be a good complement to the physical contacts the traditional child health care currently offers.

Discussion/Conclusions: The parents in this study believed that digital solutions could increase their parental power in relation to the care of their children. Examples were given as digital nurse-led parent groups where parents with similar problems and experiences around their children could support each other and were expected to strengthen them over time. The parents stressed that a planned digital support channel also needs satisfactory solutions for both contact and response and have bookable digital meetings for both planned and urgent needs.