Description of COVID-19 patients and mapping nursing data to ICNP 2021 reference set in SNOMED CT.

AIM: To describe nursing care of COVID-19 patients with International Classification for Nursing Practice (ICNP) 2019, ICNP 2021 reference set, and Systematized Nomenclature of Medicine-Clinical Terms (SNOMED CT). BACKGROUND: From the beginning of the COVID-19 pandemic, nurses have realised the importance of documenting nursing care. INTRODUCTION: It is important to recognise how real nursing data match the ICNP reference set in SNOMED CT as that is the terminology to be used in Iceland. METHODS: A descriptive study with two methods: (a) statistical analysis of demographic and coded clinical data identified and retrieved from Electronic Health Record (EHR) and (b) mapping of documented nursing diagnoses and interventions in EHRs into ICNP 2019, ICNP 2021 and SNOMED CT 2021. RESULTS: The sample consisted of all (n = 91) adult COVID-19 patients admitted to the National University Hospital between 28 February and 30 June 2020. Nurses used 62 different diagnoses and 79 interventions to document nursing care. Diagnoses and interventions were best represented by SNOMED CT (85.4%; 100%), then by ICNP 2019 version (79.2%; 85%) and least by the ICNP 2021 reference set (70.8; 83.3%). Ten nursing diagnoses did not have a match in the ICNP 2021 reference set. DISCUSSION: Nurses need to keep up with the development of ICNP and submit to ICN new terms and concepts deemed necessary for nursing practice for inclusion in ICNP and SNOMED CT. CONCLUSION: Not all concepts in ICNP 2019 for COVID-19 patients were found to have equivalence in ICNP 2021. SNOMED CT-preferred terms cover the description of COVID-19 patients better than the ICNP 2021 reference set in SNOMED CT. IMPLICATIONS FOR NURSING AND HEALTH POLICY: Through the use of ICNP, nurses can articulate the unique contribution made by the profession and make visible the specific role of nursing worldwide.

The prevalence and characteristics of yoga or meditation users in Iceland: Results of a national health survey.

BACKGROUND: Use of yoga or meditation has increased decisively in recent years. Factors associated with the use of yoga and meditation are not well understood. The aim was to focus on the relationship of yoga and meditation to sociodemographic background, religiosity, healthcare-related attitudes, mental and physical health, and physician visits. MATERIALS AND METHODS: This study builds on data from a national health survey of a random sample of Icelandic adults, aged 18-75 (n = 1599; response rate of 58%). RESULTS: The overall use of yoga or meditation reached 19.3% in 2015. This is an increase of 12.5% points over a nine-year period. The increase was much greater for women. Yoga or meditation use was positively related to the female gender, younger age, higher levels of education, and not belonging to a religious denomination. It was also positively related to higher anxiety, previous visits to a physician, and a positive attitude toward CAM services, but it was negatively related to having chronic medical conditions. CONCLUSION: Increased use of yoga or meditation may reflect public interest in Icelander's self-care and health promotion. Further studies are needed to better understand the predictors and effects of yoga and meditation.

A shorter breastfeeding duration in late preterm infants than term infants during the first year.

AIM: Little attention has been paid to breastfeeding late preterm (LPT) infants. This study compared breastfeeding, worries, depression and stress in mothers of LPT and term-born infants throughout the first year. We also described factors associated with shorter breastfeeding duration of LPT infants. METHODS: This longitudinal cohort study of the mothers of singleton infants-129 born LPT and 277 born at term-was conducted at Landspitali-The National University Hospital of Iceland, which has the country's only neonatal intensive care unit. The mothers answered questionnaires when their infants were 1, 4, 8 and 12 months of age. RESULTS: Mothers breastfed LPT infants for a significantly shorter time than term infants: a median of 7 months (95% confidence interval 5.53-8.48) vs 9 months (95% confidence interval 8.39-9.61) (P < .05). Starting solids at up to 4 months was the strongest risk factor for LPT breastfeeding cessation during the first year, after adjusting for confounders (P < .001). Their mothers reported more worries about their infants' health and behaviour during the first year and were more likely to experience depression at 4 months. CONCLUSION: Mothers with LPT infants are vulnerable and need greater practical breastfeeding and emotional support in hospital and at home.

The use of complementary and alternative medicine in Iceland: Results from a national health survey.

Background: The use of complementary and alternative medicine (CAM) has increased in Western societies in recent years. In a national health survey conducted in 2006 in Iceland, 31.8% of the population had used CAM in the past 12 months; however, the trend of CAM use since then is unknown. This study's aim was to describe participants' use of CAM providers in Iceland in 2015 and compare it to the results of the previous survey. The current study explored the relationship between the participants' use of CAM and their background, religiosity, healthcare attitudes, mental and physical health, and physician visits. Methods: The study was based on a national health survey conducted in the Spring of 2015. The questionnaire was mailed to a random sample of Icelandic adults, aged 18-75. Altogether 1599 respondents returned valid questionnaires (response rate 58%). The standardized questions were developed and tested in previous health surveys. Results: Nearly 40% of respondents had used CAM in the past 12 months. This is an estimated 8.4% increase since 2006. Women and people with more education were more likely than other participants to use CAM. Repeated physician visits were related to increased likelihood of CAM use. Individuals with high anxiety were more likely than others to use CAM. Conclusions: Icelanders use CAM providers to a considerable degree, and CAM use has increased in recent years. Most CAM users appear to use CAM to complement care received in the general health system.

Disclosure of intimate partner violence in current marital/partner relationships among female university students and among women at an emergency department.

Detecting intimate partner violence (IPV) might empower women to start working on the impact that the abuse experience has had on their lives. Little, however, is known about disclosure of abuse in community and in clinical settings. The purpose of this study was to explore whether there was a difference in the disclosure of abuse experience among women who were attending the emergency department (ED) at Landspitali University Hospital or were located at a university site, that is, at the University Square at the University of Iceland. A cross-sectional research design was used. Data were collected at the same time in 2009 over a period of 9 months from N = 306 women ranging in age from 18 to 67 years (n = 166 at the University Square and n = 140 at the ED). A significantly higher proportion of the women at the ED reported that they were victims of IPV in their current marital/partner relationship and scored higher on the Women Abuse Screening Tool total scale than the women at the university site. This gave a clear indication that the women at the ED experienced significantly more frequent and more severe IPV in their current marital/partner relationship compared with the women at the university site. Identifying IPV in primary and clinical settings might, therefore, function as a protective factor if these women are offered appropriate first response and interventions.

Reaching Out To Women Who Are Victims of Intimate Partner Violence.

PURPOSE: To evaluate if disclosure of abuse among female university students and among women at an emergency department varied based on three different types of data collection method used; and to explore women's development of symptoms of post-traumatic stress disorder (PTSD) and the outcome on health. DESIGN AND METHOD: Cross-sectional research design was used (N = 306 women). FINDINGS: The women who experienced intimate partner violence (IPV) in their current relationship, and had symptoms of PTSD, reported significantly lower physical and mental health. In addition, the women who experienced three types of abuse (physical, mental, and sexual) reported significantly more symptoms of PTSD. PRACTICE IMPLICATIONS: Detecting IPV and screening for PTSD in clinical settings might benefit women who suffer from violence in their intimate relationships.

Development of an International School Nurse Asthma Care Coordination Model.

AIM: To identify and compare how school nurses in Reykjavik, Iceland and St. Paul, Minnesota coordinated care for youth with asthma (ages 10-18) and to develop an asthma school nurse care coordination model. BACKGROUND: Little is known about how school nurses coordinate care for youth with asthma in different countries. DESIGN: A qualitative descriptive study design using focus group data. METHODS: Six focus groups with 32 school nurses were conducted in Reykjavik (n = 17) and St. Paul (n = 15) using the same protocol between September 2008 and January 2009. Descriptive content analytic and constant comparison strategies were used to categorize and compare how school nurses coordinated care, which resulted in the development of an International School Nurse Asthma Care Coordination Model. FINDINGS: Participants in both countries spontaneously described a similar asthma care coordination process that involved information gathering, assessing risk for asthma episodes, prioritizing healthcare needs and anticipating and planning for student needs at the individual and school levels. This process informed how they individualized symptom management, case management and/or asthma education. School nurses played a pivotal part in collaborating with families, school and healthcare professionals to ensure quality care for youth with asthma. CONCLUSIONS: Results indicate a high level of complexity in school nurses' approaches to asthma care coordination that were responsive to the diverse and changing needs of students in school settings. The conceptual model derived provides a framework for investigators to use in examining the asthma care coordination process of school nurses in other geographic locations.

The international school nurse asthma project: barriers related to asthma management in schools.

AIM: This article is a report of an international study of barriers to asthma care from the perspectives of school nurses in Reykjavik, Iceland and St. Paul, Minnesota, in the context of their schools, communities and countries. BACKGROUND: Globally, asthma affects the health and school performance of many adolescents. School nurses play a key role by providing care to adolescents with asthma in school settings. Understanding universal barriers to asthma management in schools is important for developing interventions that are effective in multiple societal contexts. DESIGN: Exploratory, descriptive study. METHODS: Parallel studies were conducted from September 2008-January 2009, through six focus groups among school nurses (n = 32, in Reykjavik n = 17 and St. Paul n = 15) who were managing asthma in adolescents. Focus groups were audio-recorded and transcribed verbatim in English or Icelandic. The Icelandic transcripts were translated into English. Descriptive content analytic techniques were used to systematically identify and categorize types of barriers to asthma care. RESULTS: School nurses in both countries identified common barriers, such as time constraints, communication challenges and school staff barriers. The primary difference was that St. Paul school nurses identified more socio-economic and health access barriers than school nurses in Reykjavik. CONCLUSION: Greater cultural and linguistic diversity and socio-economic differences in the student population in St. Paul and lack of universal healthcare coverage in the US contributed to school nurses' need to focus more on asthma management than school nurses in Reykjavik, who were able to focus more on asthma prevention and education.

Evaluation of the clinical effect of an on-line course for community nurses on post-partum emotional distress: a community-based longitudinal time-series quasi-experiment.

About 14% of Icelandic women suffer post-partum from frequent depressive symptoms, and of those, 12% also report a high degree of parenting stress. Education of nurses and midwives on post-partum distress is crucial in reducing its degree. The purpose of the study is to evaluate the clinical effect of an on-line course for community nurses on post-partum emotional distress. A community-based, longitudinal, time-series quasi-experiment was conducted in four stages from 2001 to 2005. Mothers attending 16 health centres throughout Iceland and scoring ≥ 12 on the Edinburgh Postnatal Depression Scale (EPDS) at the 9th week post-partum were eligible to participate. Health centres were divided into experimental (EHC) and control centres (CHC), and control centres were crossed over to experimental centres the following year and new control centres recruited. Nurses at EHC attended an on-line course on post-partum emotional distress. Participating mothers answered the EPDS; the Parenting Stress Index/Short form and the Fatigue Scale. Nursing diagnoses and interventions were recorded at all study centres. Of the women who were eligible (n = 163), 57% (n = 93) participated. At baseline, 9 weeks post-partum, there were no significant differences between groups of women in the rate of depressive symptoms, fatigue or parenting stress. Women in all groups improved on all distress indicators over time; however, those from the EHC improved statistically and clinically significantly more on depressive symptoms than those from the CHC. Documentation of particular nursing diagnoses and interventions was significantly more frequent at the EHC, but referrals to specialists were significantly less frequent. On-line education for nurses on post-partum emotional distress is feasible and is related to improvement in post-partum depressive symptoms.

Icelandic and United States families of adolescents with asthma: predictors of health-related quality of life from the parents' perspective.

AIMS: To evaluate cultural differences in sociodemographic factors, illness severity and parents' perception of their adolescent's quality of life for Icelandic and USA families of adolescents with asthma; and to determine predictors of parent-rated quality of life. BACKGROUND: Asthma is known to have an impact on the quality of life of affected adolescents and their families, but few studies have addressed parents' perception of their adolescent's health-related quality of life. DESIGN: Cross-sectional exploratory study. METHOD: The study involved families of adolescents with asthma included 15 from Iceland and 15 from USA, recruited from paediatric practices. Parent and adolescent participants completed questionnaires; this study is based on the parent responses. Data were collected from January-May 2006. FINDINGS: While parents from Iceland and USA were similar in demographic characteristics, parents from Iceland rated their children's health-related quality of life (PedsQL(TM) 3.0, Varni 1998) more positively than did USA parents, even though Icelandic parents were more likely than their USA counterparts to report that their adolescent's asthma is severe. Significant predictors of parent-rated quality of life included location (higher scores for Icelandic parents), gender (higher scores for parents of boys), exposure to second hand smoke in the home (higher scores for those not exposed) and frequency of troublesome wheezing (higher scores for lower frequency). CONCLUSION: Quality of life has been acknowledged as an essential health outcome measure. Even though gender difference was not found in asthma severity, parents of boys perceived their adolescent's quality of life as more positive compared with parents of girls. It might be helpful for Icelandic and USA families to integrate into care delivery models, cultural differences in parent-rated quality of life. RELEVANCE TO CLINICAL PRACTICE: Asthma management interventions may improve quality of life for adolescents with asthma by reducing symptoms. Interventions promoting smoke-free homes and enhanced self-monitoring to prevent exacerbations may improve quality of life.

Intimate partner abuse factors associated with women's health: a general population study.

AIM: This paper is a report of a study to investigate the correlates of physical and psychological health in a general population-based sample of Icelandic women who experienced abuse in close relationships. BACKGROUND: Most studies examining the health concerns associated with intimate partner abuse have been based on clinical populations; however, their findings may not be representative of the general population of women experiencing intimate partner abuse. METHOD: A cross-sectional correlational study was conducted. The Women's Response to Battering Model was used to guide the choice of variables. Questionnaires were mailed to 7523 randomly-selected Icelandic women. Data collection started in December 2005 and ended a year later. A total of 1974 married and 772 cohabiting women answered the questionnaires (n = 2746). Independent t-tests and stepwise regression were used to analyse the data. FINDINGS: Health risk behaviours (e.g. alcohol misuse, smoking), chronic health conditions/illnesses (e.g. sleep disturbance, depression, eating disorders) and currently being victim of intimate partner violence predicted the women's physical and psychological health. CONCLUSION: Interventions designed to decrease health risk behaviours, treat chronic health conditions/illnesses and offer best practice first response to women who are victims of intimate partner violence can be offered to reduce the short- and long-term effects of violence on their physical and psychological health. Public health policy needs to focus specifically on intimate partner violence against women and the role that public health nurses can have in early identification and offering appropriate interventions within primary healthcare settings.

Adolescents with asthma: predictors of quality of life.

AIM: This paper is a report of a study to determine the demographic, personal, interpersonal and illness factors associated with asthma quality of life (QOL), as self-reported by adolescents from the United States of America (USA) and Iceland. BACKGROUND: Asthma affects 12% of children in the USA and an estimated 9% in Iceland. Limited research has addressed asthma QOL for adolescents. METHODS: This cross-sectional exploratory study included adolescents with asthma (n = 15 from the USA; n = 15 from Iceland), aged 13-17 years, primarily recruited from paediatric practices in central Kentucky, USA and Reykjavik, Iceland. Data were collected in 2006. Adolescents in the USA (47% male) had a mean age of 14.1 years (sd = 1.5); Icelandic adolescents (73% male) had a mean age of 15.1 years (sd = 1.4). Participants completed questionnaires measuring sociodemographic and asthma characteristics, degree of limitations due to asthma, self-rated health, depressive symptoms and asthma QOL. Multiple regression was used to determine predictors of asthma QOL. RESULTS: Gender was statistically significantly associated with QOL. The difference in QOL between adolescents in the USA and Iceland was not statistically significant. Statistically significant predictors of higher asthma QOL were a better rating of overall health (P < 0.01), not having had a severe asthma attack in the last 6 months (P < 0.01), and lower depressive symptoms (P < 0.05). CONCLUSION: Interventions designed to decrease depression and prevent asthma exacerbations may improve QOL for adolescents with asthma.

Identifying abuse among women: use of clinical guidelines by nurses and midwives.

AIM: This aim of this study to identify the incidence of violence against women seeking healthcare services and evaluate the use of clinical guidelines to identify interpersonal violence. METHODS: A cross-sectional survey was carried out. Data were collected over a period of 7 months in 2005 and 2006. The samples consisted of 14 nurses, 10 midwives and 208 women in Iceland (101 women visiting the Emergency Department and 107 receiving prenatal care at the High Risk Prenatal Care Clinic). RESULTS: Twenty women (19.6%) who visited the Emergency Department and 21 women (19.8%) who came to the High Risk Prenatal Care Clinic had been sexually abused at some point in their lives by close family members. Within the preceding 12 months, 18 women at the Emergency Department (19.1%) and eight at the High Risk Prenatal Care Clinic (7.5%) reported physical abuse, and 22 women (22.2%) at the Emergency Department and 12 (11.5%) at the High Risk Prenatal Care Clinic reported emotional abuse. A majority of the nurses and midwives indicated that the guidelines were efficient for assessing/screening for gender violence in emergency and high risk clinical settings. CONCLUSION: Screening for abuse of women at emergency and high risk clinics is crucial, not only to offer the women the immediate interventions they might need, but also to ensure the future provision of appropriate healthcare services.

Effect of abuse by a close family member on health.

PURPOSE: To examine the effects of physical, sexual, and emotional abuse on physical and psychological health among Icelandic women visiting an emergency department (ED) or high-risk prenatal care clinic (HRPCC). We hypothesized that the women's previous experience of abuse by a close family member and current experiences of abuse by an intimate partner, would predict their physical and psychological health. METHOD: A cross-sectional study design was used. Data were collected using questionnaires (e.g., Women Abuse Screening Tool (WAST) and semistructured interviews, from a sample of 208 women (101 visiting the ED and 107 visiting the HRPCC). RESULTS: For the women seen in the ED, their experience of previous sexual abuse by a close family member, emotional abuse within the preceding year, and current abuse predicted the women's psychological health. For the women seen at the HRPCC, their previous experience of physical abuse, sexual abuse by a close family member, and being currently in an abusive relationship significantly predicted the women's psychological health. CONCLUSIONS: Women in Iceland, who are survivors of abuse, seek healthcare services from EDs and high-risk prenatal clinics. The complex effects of both former and current abuse on women's health indicates the importance of regular screening for abuse against women. CLINICAL RELEVANCE: Offering appropriate interventions within emergency departments and high-risk prenatal clinics to women who are victims of abuse is vital.

Use of NIDSEC-compliant CIS in community-based nursing-directed prenatal care to determine support of Nursing Minimum Data Set objectives.

If the Nursing Minimum Data Set elements, specifically the nursing care elements, are included in a clinical information system, nursing will be able to measure outcomes and contributions to both healthcare and nursing to build knowledge using clinical data. The purpose of the reported study was to determine whether a Nursing Information and Data Set Evaluation Center-compliant clinical information system using the Omaha System could support the Nursing Minimum Data Set goal to describe nursing care in a community health setting. The secondary data set analysis was conducted. The findings showed that although the clinical information system was compliant with the standard, used a recognized American Nurses Association nursing vocabulary, and supported the collection of the Nursing Minimum Data Set, the data were not sufficient to address the purposes of the Nursing Minimum Data Set. The implications for nursing research and clinical practice are outlined.

Health-related quality of life in Icelandic school children.

This study evaluated generic health-related quality of life (HRQOL) among 10 to 12-year-old Icelandic school age children who were either with or without chronic health condition. The children and their parents answered self-report questionnaires. For the 480 children who participated, girls were found to perceive their HRQOL significantly higher than the boys, children who visited the school nurse over a one-week period and children who indicated they were bullied by other children, perceived their HRQOL to be significantly lower than children who did not visit the school nurse over this time period or children who did not indicate they were bullied by other children in school. From the stepwise regression analysis, perception of health, school connectedness, health promotion, bullying victimization, visits to the school nurse and age, significantly predicted 43.8% of the variance of the girls' perception of their HRQOL. However, perception of health, school connectedness, and chronic health condition/illnesses, bullying victimization and after school activities predicted 48.1% of the boys' perception of their HRQOL. Children with chronic health condition or illnesses, reported their HRQOL to be significantly lower than children without chronic health condition. Assessing HRQOL among 10 to 12-year-old children might be helpful to take preventive action early on in children's life and development.

Comparison of health-related quality of life among 10- to 12-year-old children with chronic illnesses and healthy children: the parents' perspective.

The purpose of this study was to evaluate mothers' and fathers' perception of their child's health-related quality of life (HRQOL) among 10- to 12-year-old Icelandic children with or without chronic health condition or illness. A total of 912 Icelandic parents (510 mothers and 402 fathers) and 480 children (209 boys and 271 girls) participated in the study. The Icelandic fathers of children who visited the school nurse over a period of 1 week perceived HRQOL of their children to be significantly lower than the mothers. A gender difference was found between the parents; mothers perceived their children to have significantly higher school functioning than fathers. Both mothers and fathers of children with chronic health condition/illness perceived their children to have significantly lower HRQOL than did the parents of children without a chronic health condition. The findings underline the importance for school nurses to develop and test interventions for school-age children with chronic health conditions or illnesses.