BACKGROUND:In most Western countries, senior workers have increased their participation in the workforce. However, at the same time, early retirement also increases. The reasons behind this early exit from the workforce are still unclear.

OBJECTIVE:This qualitative study aims to explore the antecedents of and experiences with a voluntary exit from working life before the expected retirement age of 65 in Sweden.

METHODS:Data consist of semi-structured interviews with 18 participants who exited working life between the ages of 61–63. In Sweden, these ages are considered as an early exit from working life since, for many years, the expected retirement age has been 65. Qualitative content analysis with an abductive approach was utilized.

RESULTS:The analysis revealed four sub-themes: 1) Health benefits with an early exit from working life (with the categories: own health status, the possibility for recovery time, and avoidance of strain); 2) Having economic conditions that enable an early exit from working life (with the categories: offers from the employer and financial compromises); 3) Social benefits with an early exit from working life (with the categories: enabling more time with my social network and avoidance of unsatisfying social work environment); 4) Self-fulfillment activities during the senior years (with the categories: enabling time for activities beyond work and avoidance of decreased job satisfaction.

CONCLUSION:This variety of antecedents of and experiences with a voluntary early exit from working life before the expected retirement age highlights that the ongoing increased statutory retirement age also increases the risk for extended inequalities among the aging population.

Background

In Sweden, becoming a registered nurse with a Bachelor of Science degree in nursing requires three years of full-time study, including an independent 15-credit thesis. Nursing undergraduates have limited access to ongoing research projects and clinical settings, which often prioritize master’s students and faculty-led studies. Thus, many nursing programs default to a literature-review norm, which reduces methodological diversity. This study focuses solely on non-traditional approaches, such as blog analyses, autobiographical analyses, and other innovative designs. The study seeks to disclose how these methods contribute to understanding patient experiences and advancing nursing education and research.

Aim

The aim of the study was to systematically map and critically analyze the methodological and theoretical diversity within Swedish bachelor’s theses in nursing that employ alternative research methods.

MethodA scoping review was conducted. Searches were performed in the DiVA portal (title-only list of 22 145 records) and in three university repositories (2 861 records), followed by an abstract-inclusive DiVA search (491 records). Screening and full-text review yielded 380 final inclusions. The national digital science archive was used to access theses completed between 2013 and 2023. Descriptive and inferential statistics were employed to analyze the data.

Results

Autobiographical works were the most frequently used sources (n = 220), followed by blogs (n = 126). Dictionaries, internet forums, and combined sources were rare. Few theses used dictionaries, social media or internet forums. A descriptive research design was employed in most of the theses, and the majority focused on adults, primarily women. The theoretical content mainly covered themes related to existential issues and suffering, but several bachelor’s theses lacked a formal theoretical framework.

Conclusion

Descriptive designs predominated, while exploratory and theory-integrated approaches were rare. Addressing these gaps requires pedagogical reforms that support use of diverse data sources and encourage inclusive research.

Background: Brain natriuretic peptide (BNP) is a hormone secreted from the heart in response to fluid overload. In patients with chronic kidney disease (CKD), inadequate fluid management during haemodialysis may cause fluid overload and overhydration (OH), risk factors for mortality. The aim of this exploratory pilot study was to analyse the relationships between BNP, OH and all-cause mortality in patients with CKD and haemodialysis.

Methods: In this prospective observational study, five-year survival was analysed in 64 patients with CKD and haemodialysis. Bivariate correlations were performed to analyse the relationships between BNP, OH, and all-cause mortality. Cox regression analysis was performed to adjust the relationship between BNP and all-cause mortality for selected clinical and biochemical characteristics, collected at baseline.

Results: By the end of the study, 33 patients (52%) had died. In bivariate correlation analysis age (r = 0.38), BNP (r = 0.48), handgrip strength (r=-0.34), lean tissue index (r=-0.41) and CRP level (r=-0.34, p = 0.007) were significantly associated with all-cause mortality. In a linear regression model, BNP was found to be a significant predictor of all-cause mortality (HR 2.61). However, after adjusting for age, handgrip strength, and CRP, BNP was no longer a statistically significant predictor of all-cause mortality. Instead, age, handgrip strength and CRP were significant predictors of all-cause mortality (HR 1.04; HR 0.95 and HR 2.61, respectively).

Conclusions: In this study, BNP was correlated with all-cause mortality in patients with CKD and haemodialysis, but OH was not. When adjusting for other clinical and biochemical factors, age, inflammation, and handgrip strength were found to be independent and more important predictors of all-cause mortality than BNP.

Background

First-line healthcare managers navigate complex organizational demands to ensure a good work environment and quality care. Key factors such as expanded span of control, leadership and management performance, and work-related stress significantly influence their job satisfaction. However, how these factors evolve over time in organizational settings remains unclear.

Objective

To examine expanded span of control, leadership and management performance, work-related stress, and job satisfaction among first-line healthcare managers and assess whether the relationships between these variables remained stable over time.

Methods

A repeated cross-sectional design was used to collect annual data from 2020 to 2023 among first-line managers in a Swedish healthcare organization. The Ottawa Hospital Span of Control tool, the Leadership and Management Inventory, the Health & Safety Executive stress tool, and a single-item job satisfaction measure were used to collect data. Kruskal-Wallis tests and Spearman correlation analysis were performed.

Results

An expanded span of control negatively impacted job satisfaction in certain years. Leadership and management performance showed a positive but inconsistent association with job satisfaction. Factors in work-related stress, particularly high demands and strained relationships, consistently had a negative relationship with job satisfaction, whereas control and support positively contributed to greater job satisfaction.

Conclusions

Work-related stress, driven by high demands and poor relationships, significantly decreases job satisfaction. Leadership and management performance influence satisfaction, but inconsistently. Reducing workload and improving support structures can enhance job satisfaction and managerial effectiveness.

Background and purpose: The number of people diagnosed with autism is increasing globally, and autism is associated with poorer health outcomes. However, there is a lack of knowledge regarding how physical healthcare is experienced and perceived by adult autistic patients. The purpose of this scoping review is to provide an overview of the research on adult autistic patients’ experiences and perceptions of physical health care. Results: Sixteen articles from four databases were included. They originated from the US, Europe, and Australia. Most of the articles were published between 2022 and 2024 and employed qualitative, quantitative, or mixed-methods approaches. Adult autistic patients’ experiences and perceptions of physical healthcare concerned various aspects, including the healthcare organization, rooms and spaces, healthcare staff, and physical examinations and treatments. The patients need opportunities to engage in written communication with healthcare staff, as well as waiting room environments that are low-sensory in nature. Conclusions: Overall, the findings indicated that the healthcare needs of adult autistic patients were not being met, particularly concerning communication and sensory impressions. Additionally, there is a need for further research on inpatient hospital care as well as physical examinations and treatments.

Purpose

The purpose of this study is to examine if and how an expanded span of control, management performance and work-related stress indicators (control, support and relationships) influence the time until first-line managers leave their position.

Design/methodology/approach

A prospective longitudinal cohort design involving 87 first-line managers in a Swedish health-care region. Cox proportional hazards regression was used to analyse expanded span of control, work-related stress indicators and management performance as predictors of turnover.

Findings

The findings indicate that first-line managers who were categorized as having moderate concern and a need for improvement in the work-related stress indicators control and manager support had a significantly higher risk of turnover. In contrast, expanded span of control and the number of employees managed per first-line manager did not significantly influence turnover risk. In addition, the work-related stress indicator relationships was not significantly associated with risk of turnover.

Originality/value

This study expands the understanding of actual turnover among first-line managers in health care by exploring how organizational factors influence the decision to leave. Unlike previous research, which primarily examines turnover intentions, this study takes a longitudinal perspective, capturing real turnover events over time. The findings contribute to future research on organizational conditions, providing a basis for developing strategies to improve retention and working conditions for first-line managers in health care.

BackgroundThe Utrecht Work Engagement Scale is a frequently used instrument for measuring work engagement. However, the instrument’s conceptual underpinnings, theoretical clarity and dimensional structure has been criticized, and its construct validity has not been evaluated appropriately in samples of nurses. The study purpose was to assess the psychometric properties of the Utrecht Work Engagement 9-item Scale (UWES-9) in a sample from the haemodialysis nurse population using approaches that take the ordinal nature of the data into account.

Methods

The psychometric properties were evaluated in accordance with classical test theory focusing on data completeness, unidimensionality, scaling assumptions, targeting and reliability. The analyses were conducted using data derived from a cross sectional study.

Results

Missing item responses were < 2%. Exploratory factor analysis based on polychoric correlations and parallel analysis identified one factor. Scaling assumptions were supported based on desirable levels of corrected item-total correlations. The targeting analyses displayed expected score distribution, no floor effect and acceptable ceiling effect. However, the mean total score was above the scale midpoint. The reliability, estimated using Ordinal alpha, was 0.93.

Conclusions

The study findings, evaluated using methods that consider the ordinal nature of the scale ratings, indicate that the UWES-9 is a reliable and valid unidimensional measure with high data completeness, strong internal consistency, and a supported factor structure. These results support the use of the UWES-9 in research and practice for assessing work engagement. However, further studies are recommended to examine its applicability across diverse populations and settings.

Background

Mental health problems are prevalent among university students, underscoring the need to improve access to effective interventions. Mental healthcare utilization is influenced by general and country-specific factors. This study aimed to identify and compare preferences and barriers to help-seeking for mental health problems among university students in three European countries.

Methods

A cross-sectional, web-based survey was conducted with a sample of 4960 university students from Portugal (n = 3399), Germany (n = 680), and Sweden (n = 881). Depressive symptoms (9-item Patient Health Questionnaire) and overall mental health (5-item Mental Health Index) were assessed. Students responded to questions regarding help-seeking preferences for and barriers to mental health problems.

Results

Rates of moderate to severe depressive symptoms ranged from 37.5 to 51.0 % and were highest among German students. A majority (76.3–89.3 %) of students indicated they would talk to a friend in case of mental health problems. Readiness to seek help was particularly high among Portuguese students. Readiness to use internet-based interventions was low among all students. Up to 51 % of students reported uncertainty regarding where they could seek help. Students with depressive symptoms versus those without were less likely to speak with a friend about emotional problems but were more likely to consider taking medications. Students with depressive symptoms were also more likely to endorse several help-seeking barriers.

Conclusion

Reducing structural barriers, improving awareness of treatment options and increasing acceptance of help-seeking for emotional problems may improve uptake of mental health services among students in these European countries.

Introduction

Effective self-management of fluid intake in hemodialysis relies on self-efficacy. Although regular assessments with valid tools are crucial, no suitable measurement exists for the Turkish population. This study evaluates the reliability, validity, and interpretability of the Turkish version of the Fluid Intake Appraisal Inventory.

Methods

This cross-sectional study collected data from December 2021 to November 2022. It analyzed reliability, validity, and interpretability.

Results

The 202 adults receiving hemodialysis were evaluated. The scale showed high internal consistency with Cronbach α = 0.954 and good test–retest reliability with intraclass correlation coefficients = 0.975, 95% confidence interval: 0.786–0.992, and no measurement error. It demonstrated excellent content validity with scale level content validity index ≥0.90 and good construct validity with a negative moderate correlation to interdialytic weight gain. For structural validity, the model fit indices were χ2/df = 5.7, root mean square error of approximation = 0.15, goodness of fit indexes = 0.58, Tucker-Lewis Index = 0.57, comparative fit index = 0.6, and standardized root mean square residual = 0.10.

Conclusion

This inventory is a valid and reliable tool for assessing self-efficacy in fluid intake among the Turkish hemodialysis population.