The Professional Nurse Self-Assessment Scale II - Translation and cultural adaptation for Nordic countries.

BACKGROUND: It is important to map the clinical competence of newly graduated nurses in Nordic countries. The use of a common Nordic instrument could provide insights into nurses' levels of self-assessed clinical competence and perceptions of their need for professional development. AIM: To translate and culturally adapt the original Norwegian version of the Professional Nurse Self-Assessment Scale II (PROFFNurse SAS II) into (1) Danish, (2) Finnish and (3) Icelandic versions. METHOD: The PROFFNurse SAS II was translated and cross-culturally adapted. This translation was inspired by the process used in the Guidelines for Cross-Cultural Adaptation. RESULT: The translation and cultural adaptation processes employed the required steps and provided specific details. In addition, practical issues encountered during the translation process while translating and adapting instruments that may influence future translations were revealed. This study found that having a professional bilingual/bicultural agency translator was partly problematic in the process of translation and found that it is important to adjust the translations to each country's specific words used in nursing. CONCLUSION: Translating the PROFFNurse SAS II instrument into all Nordic languages enables us to use the instrument from a Nordic perspective and across various countries. This is important when comparing self-awareness and reflecting on nurses' clinical competencies. Professional development is central to valuing and developing clinical competence and allowing for the discovery of gaps in clinical competence.

Living in limbo while one's identity is changing: Patients' existential experiences 6 months after a kidney transplantation with a living donor.

AIM: To investigate patients' existential experiences in everyday life after a kidney transplantation with a living donor. DESIGN: A qualitative study anchored in a hermeneutic-phenomenological approach inspired by Ricoeur's theory of narrative and interpretation. METHOD: Eleven patient interviews were conducted approximately 6 months after a kidney transplantation with a living donor. The interviews were conducted between August 2017-May 2019. Analysis and interpretation are based on Ricoeur's theory of interpretation. RESULTS: Four themes were identified: Experiencing bodily vulnerability while getting back to life; Feeling guilt while experiencing gratitude; Living in limbo while one's identity is changing; and Facing the future with hope while having reservations. CONCLUSION: This study reveals that patients experience multifaceted existential challenges in their everyday lives during the transition of the kidney transplantation process. Post-surgery complications for donors lead to feelings of guilt in patients; plus, they must adapt to a new existence, including a new identity. The patients feel they are in limbo, as they experience their existence as uncertain and their identity as unknown. IMPACT: The study highlights a need for developing a rehabilitation programme to address the individual and various existential challenges faced by patients who need to undergo a kidney transplantation.

Existential Contradictions in Living With End-Stage Renal Disease: A Qualitative Metasynthesis.

A qualitative metasynthesis following Sandelowski and Barroso's method was conducted to explore what characterizes the existential experiences of individuals living with end-stage renal disease. The findings show that patients with end-stage renal disease live with several existential contradictions characterized by the following: perception of the body-oscillating between connection and separation, maintaining life-oscillating between freedom and captivity, uncertainty-oscillating between hope and despair, and enduring technology-oscillating between being perceived as an object and subject. Consequently, living with end-stage renal disease is challenging for patients; hence, the support of nurses is important to alleviate patients' vulnerability.

Living in one's own world, while life goes on: Patients' experiences prior to a kidney transplantation with a living donor.

AIMS AND OBJECTIVES: To investigate patients' existential experiences in everyday life prior to a kidney transplantation with a living donor. BACKGROUND: Kidney transplantation is a well-established treatment for patients with end-stage kidney disease. The prevalence of patients living with end-stage renal disease is increasing. Simultaneously, kidney transplantations with a living donor are increasing. However, patients experience challenging existential aspects concerning kidney transplantation. DESIGN: A qualitative study with a hermeneutic-phenomenological approach inspired by Ricoeur was chosen. METHODS: Fourteen interviews with patients living with end-stage kidney disease were conducted 7-14 days before a planned kidney transplantation with a living donor. Analysis and interpretation were based on Ricoeur's theory of interpretation. We applied the Criteria for Reporting Qualitative Research (see Appendix S1). RESULTS: Four themes were identified: living with subjective feelings of illness while objectifying the body; living in one's own world while the world outside goes on; feeling grateful while being concerned for the donor; and hoping for the best, while preparing for the worst. CONCLUSION: Patients' existential challenges are multifaceted. Patients articulate their kidney function in numeric terms, trying to make the invisible visible for themselves and others. Sustaining normality becomes important for patients, and the waiting time from donor evaluation to transplantation triggers excitement, hope and frustration. RELEVANCE TO CLINICAL PRACTICE: The results increase insights into individuals' existential experiences in their everyday lives. Hereby, the results articulate the need for support from health professionals prior to a kidney transplantation.

Career dreams among health care students: I want to make a difference.

There is a continuous increase in demand for health services in most countries because people who are older are living longer. Health care for people who are older is not, generally, an attractive career option for undergraduate health professionals. This study investigated career dreams among undergraduates studying a variety of health care subjects to understand what motivates them. Eighteen focus groups were conducted with 90 students, and template analysis was performed within a sociological framework. Four themes emerged from the analysis: no plans to work with people who are older, dreaming of making a difference, seeking variety, and the impact of clinical placements on stimulating or reducing interest in working with people who are older. Geriatrics and gerontology do not offer the opportunities that students are looking for in their future careers. There is a need to change the way we talk about adults who are older everywhere, not just in health care training. However, health care educators should also help students to understand the value of care provided to adults who are older.