Background: Rapid changes in healthcare and digitalization underscore the importance of continuing professional development (CPD) in nursing. However, participation is often limited by high workloads, staffing shortages, and insufficient organizational support. Telenursing is a growing field with specific competence requirements, yet previous research indicates demanding working conditions and limited development opportunities. Further evidence is needed regarding CPD participation, its association with work-related outcomes, and nurses' perceived CPD needs.

Aim: The aim of the study was to compare nurse-rated quality of working life and satisfaction with given care among nurses working in telenursing services who had participated in CPD during the previous year and those who had not. A further aim was to explore nurses' preferences and perceived needs related to CPD activities.

Methods: A cross-sectional survey among nurses in Sweden's national healthcare advisory service (1177) measured quality of working life four instruments were used. Emotional thriving was measured using a brief four-item scale. Telenursing working conditions were assessed using a telenursing-specific instrument. Growth opportunities were measured with a six-item factor from the instrument Safety, Communication, Operational Reliability and Engagement and job satisfaction using the four-item Brief Index of Affective Job Satisfaction scale. Satisfaction with given care was measured using the eight-item Satisfaction with Given Care scale. Participation in continuing professional development (CPD) was assessed by self-reported number of CPD days during the past year, including none, and an open-ended question capturing desired areas of competence development.

Results: Nurses who had participated in CPD reported significantly higher emotional thriving, as well as higher ratings for management and collegial support and growth opportunities, compared with those not participating in CPD. No group differences were found regarding satisfaction with given care. Identified CPD needs included strengthened clinical knowledge, reflective and self-directed learning, and improved communication skills.

Conclusion: Participating in CPD during the previous year is associated with more positive work-related outcomes among telenursing nurses such as thriving, growth opportunities, better management and collegial support but not with nurse-sensitive outcomes such as nurse satisfaction with given care. Nurses described clear preferences and needs for clinically relevant, reflective, and self-directed professional development.

Objective

Despite having high healthcare needs and being suitable candidates for digital health consultations, older adults (OAs) use these practices less commonly, and are more likely to encounter challenges, which reduces digital health equity. The objective of this study was to examine the experiences of OAs and healthcare staff (HS) using and participating in digital consultations.

Methods

A descriptive approach was employed, using both structured and semi-structured interviews with OAs (≥65 years) and HS who had completed a digital health consultation via video or asynchronous chat within the past week. Interview data were analysed with thematic analysis and descriptive statistics.

Results

The descriptive data (N = 33 OAs; 13 HS, each reporting on the same 33 consultations) indicated that both OAs and HS gave mainly positive feedback about their recent digital health consultations, while the qualitative data offered a more nuanced perspective. About half of the OAs would choose a digital consultation again for the same health issue, if given the choice. Practical benefits and professional benefits were highlighted, though benefits for care were also noted by both OAs and HS. Barriers were primarily technical, affecting the conversation in various ways. Barriers to care also arose, mainly relating to experiences of deteriorated contact with the HS.

Conclusion

Digital health consultations offer significant practical benefits for both OAs and HS, and sometimes also benefit care. However, persistent technical and relational barriers highlight the need for improved usability and adaptability. Addressing these challenges and supporting individual preferences are essential steps toward increasing accessibility and ensuring equitable access to digital consultations for OAs.

Background: Nursing staff working in healthcare are exposed to high job demands, leading to turnover, stress, and decreased motivation. Work-life balance, empowered structures, and thriving have been shown to contribute positively to their psychosocial work environment. This study examined the relationships between job demands, job resources, and the outcomes of thriving, burnout, and work-life conflict among nursing staff.

Methods: A cross-sectional descriptive correlational design was employed, involving 192 nursing staff within somatic in-patient care. Data were collected using the Copenhagen Psychosocial Questionnaire, the Thriving scale, and the Conditions of Work Effectiveness Questionnaire II. Descriptive statistics, Pearson's correlation coefficients, and multiple regression analyses were conducted to assess the relationships between job demands, job resources, and outcomes.

Results: Job resources, quantified as structural empowerment, showed a positive relationship with thriving and negative relationships with both burnout and work-life conflict. Among job demands, quantitative demands, emotional demands, and work pace demonstrated negative relationships with thriving and positive relationships with burnout and work-life conflict. All resources and demands remained statistically significant in multiple regression models except for emotional demands and work pace on thriving. Regarding interaction effects, structural empowerment moderated the relationship between work pace and both thriving and burnout but did not moderate the relationship with work-life conflict. The interaction between structural empowerment and emotional demands was also statistically significantly positively related to thriving.

Conclusion: The findings of this study underscore the value of adopting strategies that enhance access to empowering job resources, through both top-down and bottom-up approaches, to improve staff well-being. Recognizing and addressing the complex relationships between job demands, resources, and staff outcomes is important for meeting the diverse needs and staffing challenges in healthcare settings.

In Swedish special service housing, support staff are expected to translate rights-based ambitions concerning autonomy and participation into everyday support. In practice, this work often involves negotiating self-determination alongside concerns about protection, routines and organisational responsibility. This study aimed to explore and describe how support staff understand and enact their role in promoting autonomy and participation. A phenomenographic design was employed. Semistructured interviews were conducted with 12 support staff members working in nine publicly operated special service housing settings across seven municipalities in mid-Sweden. The analysis identified three interrelated ways of understanding this role: supporting a functioning everyday life as a basis for autonomy and participation, enabling autonomy without becoming controlling and working relationally within organisational conditions. Across the categories, autonomy was described as something worked out in everyday interactions: by asking, waiting, encouraging, adapting support and responding to organisational limits. The findings indicate that autonomy-promoting support depends on staff judgement, continuity, team reflection and organisational flexibility.

Objective: To examine relationships between working conditions, remote work and the outcomes job satisfaction, thriving and burnout among nurses engaged in telenursing.

Methods: The study had a cross-sectional and correlational design. Questionnaire data from 182 telenurses were collected during 2023 using a web-based survey and analysed using multiple linear regression models.

Results: For job satisfaction and thriving, the regression models revealed that nurses who rated better working conditions and worked remotely (fully or partially) scored statistically significantly higher in job satisfaction and thriving. In addition, older age was statistically significantly associated with better job satisfaction in the model. For burnout, remote work was non-significant; however, better working conditions and older age were statistically significantly associated with lower burnout scores. The three models' explanatory power (R2 Adjusted) for each outcome were 39% of the variance in job satisfaction, 38% in thriving and 47% in burnout.

Conclusion: Remote work among telenurses is related to higher job satisfaction and thriving compared to solely office-based work. Given the cross-sectional design, causal interpretations cannot be made.

Background: Rising demand and workforce shortages challenge European healthcare systems. Unscheduled healthcare, including out-of-hours (OOH) primary care, is often managed through telephone triage. Improving triage quality is essential to maintain accessible and sustainable unscheduled care across Europe.

Aim: To describe the role and organization of telephone triage in OOH primary care services that provide care for patients with urgent unscheduled health problems.

Design: A cross-national questionnaire-based expert study.

Methods: We developed a web-based questionnaire that was distributed to members of a European research network on OOH primary care (EurOOHnet), aiming to have one informant per country. Questionnaire data were validated through email consultation with informants.

Results: Expert informants from 16 countries completed the survey. Most countries had general practice care, ambulance care, and emergency departments to provide urgent unscheduled care. Access routes to unscheduled care varied considerably between countries; 11 countries used telephone triage. Three triage models were identified: 1) Triage to care, 2) Advice and referral, and 3) Advice helplines. Self-advice tools, triage preparation tools, and chatbots were uncommon.

Conclusion: We identified three triage models that had different roles related to access to unscheduled care. Telephone triage is used frequently to fit demand to available resources.

Background

Nursing acuity measurements refer to the assessments of the intensity of nursing care required by a patient, helping to determine appropriate levels of nursing resources and staffing requirements. The aim of this paper is to describe the development and validation of a tool for measuring nursing acuity within adult somatic in-patient care settings, distinguishing between advanced nursing tasks and basic nursing tasks.

Method

The nursing acuity tool was developed through an iterative process in the context of a Swedish healthcare region. The methodological process involved a literature search, exploration of non-validated tools used within Swedish healthcare, and nursing staff discussions to reach a conceptual tool. This tool underwent pilot testing across five wards, as well as testing for content- and construct validity, and inter-rater reliability.

Results

After an iterative process of development and testing, we reached a final version of a tool, subsequently named the Swedish Nursing Acuity Measurement (NAM-S). The results demonstrated acceptable validity and inter-rater reliability.

Conclusions

Our study provided support that the NAM-S can be used for assessing nursing acuity within adult somatic in-patient care. To refine the model, further examinations of its usefulness and experiences of the practical use of NAM-S are warranted.

Background

Nurses work in a knowledge-intensive sector with high demands for lifelong learning. Thriving is a positive psychological state, including a sense of mutual learning and vitality at work. Research on thriving, its antecedents and outcomes is called for. The study aim was to examine thriving as a mediator in the relationships between telephone nurses’ structural empowerment and the outcomes work-personal life benefits, job performance, work-related stress symptoms and turnover intentions, as well as to psychometrically test the Thriving Scale (Swedish version).

Methods

Questionnaire data, a national sample of 409 Swedish telephone nurses, were collected, and relationships were examined using multiple regression analyses with PROCESS macro. Factorial validity of the Thriving Scale was tested using confirmative factor analyses.

Results

There were statistically significant relationships between structural empowerment and the outcomes (work-personal life benefits, job performance, stress symptoms, turnover intentions), and these relationships were mediated by thriving. The Thriving Scale showed good internal consistency, and an acceptable to borderline mediocre fit for factorial validity. Thirty-two percent reported turnover intentions.

Conclusions

Good access to structural empowerment increases nurses’ thriving, which in turn improves work-personal life benefits, job performance, and decreases stress symptoms and turnover intentions. Managers should strive to improve nurses’ thriving at work, emphasizing good access to empowering structures.

Background

The aim of this paper is to develop a maturity model (MM) for demand and capacity management (DCM) processes in healthcare settings, which yields opportunities for organisations to diagnose their planning and production processes, identify gaps in their operations and evaluate improvements.

Methods

Informed by existing DCM maturity frameworks, qualitative research methods were used to develop the MM, including major adaptations and additions in the healthcare context. The development phases for maturity assessment models proposed by de Bruin et al. were used as a structure for the research procedure: (1) determination of scope, (2) design of a conceptual MM, (3) adjustments and population of the MM to the specific context and (4) test of construct and validity. An embedded single-case study was conducted for the latter two - four units divided into two hospitals with specialised outpatient care introducing a structured DCM work process. Data was collected through interviews, observations, field notes and document studies. Thematic analyses were carried out using a systematic combination of deductive and inductive analyses - an abductive approach - with the MM progressing with incremental modifications.

Results

We propose a five-stage MM with six categories for assessing healthcare DCM determined in relation to patient flows (vertical alignment) and organisational levels (horizontal alignment). Our application of this model to our specific case indicates its usefulness in evaluating DCM maturity. Specifically, it reveals that transitioning from service activities to a holistic focus on patient flows during the planning process is necessary to progress to more advanced stages.

Conclusion

In this paper, a model for assessing healthcare DCM and for creating roadmaps for improvements towards more mature levels has been developed and tested. To refine and finalise the model, we propose further evaluations of its usefulness and validity by including more contextual differences in patient demand and supply prerequisites.