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Background

Home Care Services for older adults vary widely across countries regarding how they are structured, organised, and funded. Contextual factors such as workload, staffing challenges, and variability in educational backgrounds may influence participation in communication training. Previous evaluations of the ACTION programme (A person-centred CommunicaTION programme for nursing assistants (NAs) in home care for older adults) have shown promising feasibility and acceptability, providing the basis for the current scaled-up evaluation. This study aimed to evaluate the impact of ACTION on NAs in Swedish home care, using a mixed-methods cluster design.

Methods

This study used a convergent mixed-methods cluster quasi-experimental design Data were collected from both intervention and control groups using pre- and post-intervention surveys assessing person-centred care, empathy, job satisfaction, and communication self-efficacy. The intervention group also completed a programme evaluation with open-ended questions upon completing the training modules.

Results

Quantitative results showed no statistically significant differences between groups after cluster-corrected analysis, while qualitative findings indicated increased awareness and reflection regarding communication.

These findings highlight the importance of considering contextual factors and providing ongoing support when implementing person-centred communication interventions in elder care. The evaluation shows both strengths and methodological limitations. While some positive qualitative changes were observed, the findings emphasise the need to include the perspectives of older adults and their relatives in future research.

Conclusions

While quantitative effects were limited, the training programme contributed to meaningful qualitative improvements in communication awareness. Longer follow up and larger samples are needed to determine measurable effects.

Background/Objectives: Valid and time-efficient measurement instruments for the assessment of perinatal distress beyond depressive symptoms are yet to be determined. The main objective was to analyse the psychometric measurement properties of the Depression Anxiety Stress Scales (DASS) short forms in Swedish pregnant women during the third trimester. The secondary objective was to analyse the measurement properties of DASS short forms for the postnatal period. Methods: Data from the Scania Birth Cohort study including 78 women followed prospectively from the third pregnancy trimester to one year postpartum were used. The DASS-21, DASS-12, DASS-9 (two versions), and the 12-item Mini-DASS were analysed using confirmatory factor analysis (CFA), inter-item analysis, and Spearman's rho subscale cross-correlations. Postnatal analysis at infant ages 1, 6, and 12 months was performed using CFA and inter-item analysis. Results: When used with third-trimester pregnant women, the DASS-9 version 1 and the Mini-DASS exhibited overall acceptable psychometric properties in terms of internal consistency (McDonald's omega >= 0.77) and structural and discriminant validity (e.g., CFI > 0.90 and SRMR < 0.08 for all DASS-9 two- and three-factor models; and CFI > 0.95 and SRMR < 0.08 for one-factor models of the Mini-DASS subscales - including a modified anxiety scale - and for the Mini-DASS depression and anxiety two-factor model). Support for these DASS short forms postpartum was also indicated. Conclusions: Although preliminary, the current results support the DASS-9 and the Mini-DASS as parsimonious tools for the assessment of perinatal distress and its subtypes. Further validation in the perinatal context is warranted.

Problem: Due to the varied support available for students, a need was identified to ensure quality and evidence-based supervision on equal terms for clinical studies. Background: Midwifery preceptors are vital to clinical education as they support students in developing practical and professional skills. The Learning in Pairs (LiP model) encourages peer collaboration. Aim: To describe the experiences of preceptors and students in midwifery education during the implementation and use of the LiP model in delivery wards. Methods: Four focus group interviews were conducted with ten midwifery preceptors and six students. Data were collected using open-ended questions and analysed through content analysis. Findings: The LiP model supports collaboration, reflective practice, and development for midwifery students and preceptors. Clear guidelines and balanced distribution of tasks were key elements in creating a structured and supportive learning environment. The model fostered growth, confidence, and independence, symbolised by the theme “Planting Seeds for a Garden of Learning”, which reflects sustainable learning in clinical education. Discussion: Active support from preceptors facilitated student learning. Collaboration and role rotation contributed to increased independence and confidence. The LiP model fostered autonomy and teamwork, aligning with national guidelines that recommend two midwives working collaboratively during the active phase of the second stage of labour. Further follow-up research is warranted. Conclusion: Implementing the LiP model in midwifery education may create a win-win situation by fostering a learning environment and enabling more efficient use of supervisory resources through scheduling of students in pairs. It may facilitate students' learning processes by ensuring high-quality supervision during clinical education. 

This mixed methods study aimed to first quantitatively compare single fathers’ levels of depressive symptoms, coparenting relationship quality, and father–infant bonding with coupled fathers, and then explore single fathers’ experiences and needs regarding professional support during the perinatal and early parenting period. Fathers (n = 1,589, of which 25 were single fathers) completed an online survey regarding their depressive symptoms, coparenting relationship, and father–infant bonding. From the quantitative survey, six single fathers (mean age 35 years) consented to participate in an individual digital interview. Mann–Whitney U tests and chi-square tests were used to compare coupled and single fathers, while qualitative content analysis was used to analyze the interviews. Single fathers reported having more depressive symptoms and weaker coparenting relationships compared to coupled fathers but had similar levels of infant bonding. After qualitatively exploring single fathers’ professional support needs during the transition to parenthood, one overarching theme was emphasized: Wanting to be an equal parent. This theme broke down into three categories: Desire to be included, Need of support and Relationship with the child. Single fathers can benefit from professional clinical support, where this support helps foster stronger coparenting relationships, improves paternal mental health, and promotes gender equality in parenting. For this to happen, fathers in general, and single fathers specifically, need to be seen as clients, with their own care needs. Guidelines and recommendations should be reviewed and clarified to encourage more egalitarian parenting, including considering giving fathers their own medical records and individualized visits. There is a need for further studies regarding single fathers’ experiences and support needs.

The COVID-19 pandemic has had a profound impact on society, including on physical and mental health. This study investigated changes in mental health parameters among a Swedish sample during and after the pandemic. Using a longitudinal study, we investigated the relationships among life dissatisfaction, psychological distress, and worries, with factors such as age, sex, education, severe illness, and job loss due to the pandemic among 588 men (mean age 54.9 years), and 653 women (mean age 52.9 years). The results reveal sex differences in life dissatisfaction and psychological distress; in addition, younger individuals reported more life dissatisfaction, and psychological distress compared with older groups. Women were 4.5 times more likely than men to report worries in 2021 and 2.3 times more likely in 2022, even after adjusting for age, education, severe illness, and job loss. This study shows how societal expectations and sex roles may exacerbate these differences in mental well-being during a time of crisis. The conclusions emphasize the importance of considering factors such as sex, age, education, and employment status when developing interventions and support systems during a global crisis. The COVID-19 pandemic will continue to affect society for a long time, indicating a need for ongoing research into population-level consequences.

To investigate the effects of different types of parental health status on child development and health, valid parental distress measurement instruments are needed. The aim was to assess the psychometric measurement properties of the 21-item Depression Anxiety Stress Scales (DASS-21) used during the postnatal year in community samples of Swedish mothers and fathers.MethodsData were collected at postnatal months 1, 6 and 12 from 66 mothers (mean age 31 years) and 58 fathers (mean age 32 years). Psychometric measurement properties were assessed with interitem analysis and intra-individual measurements cross-correlations. As part of assessing construct validity, the hypotheses that the levels of the different types of postnatal distress as measured by the DASS-21 would be higher in mothers than in fathers were tested.ResultsThe DASS-21 internal consistencies were good for both parent groups. The DASS-21 depression scale correlated strongly with the Edinburgh Postnatal Depression Scale (EPDS) in mothers and moderately strongly in fathers at each timepoint. Correlations between the DASS-21 anxiety scale and the EPDS 'anxiety component' were mostly in the low-to-moderate range. The DASS-21 stress scale significantly distinguished parental distress levels in the expected direction, as did the total DASS-21 scale.ConclusionsSimilar DASS-21 psychometric properties to those demonstrated for non-perinatal adult populations were indicated. The results suggest the usefulness of the DASS-21 during the early, middle and late postnatal periods for measuring types of as well as general maternal and paternal distress. Further analysis in larger perinatal parental samples for more conclusive results is warranted.