Ann Gardulf

• Martinsen, Randi; Ahlin-Søvde, Sigrid; Grov, Ellen Karine; Andersson, Ewa K & Gardulf, Ann (2024). Self-reported competence among advanced practice nursing students in Denmark, Finland and Norway: a cross-sectional multicentre study. BMC Nursing. ISSN 1472-6955. 23(1). doi: 10.1186/s12912-024-01930-z. Vis sammendrag

  Background The health care systems in the Nordic countries and worldwide are under pressure due to increasedlongevity and a shortage of nurses. Providing nurses with a high level of education, such as advanced practicenursing, is of great importance to ensure effective, safe and high-quality care.Aim The aim of this study was to investigate self-reported competence using the Nurse Professional CompetenceScale Short-Form for the first time among master’s students of advanced practice nursing in the Nordic countries andto relate the findings to age, work obligations, child-rearing responsibilities, level of education and clinical nursingexperience.Methods A multicentre, cross-sectional design was used in this study conducted at five universities in Denmark,Finland and Norway. The Nurse Professional Competence Scale Short-Form consisting of six competence areas wasused with a maximum score of 7 per item for the analysis of single items and a transformed scale from 14.3 to 100 foranalysing the competence areas (higher score equals higher self-reported competence). Descriptive and comparativestatistics were used to analyse the data.Results The highest mean score was found for the competence area ‘Value-based nursing care’. Students livingwith home-dwelling children (≤ 18 years) reported significantly higher competence in ‘Nursing care’, while students≥33 years reported significantly higher competence in ‘Nursing care’ and ‘Value-based nursing care’. No significantdifferences were found between students working and those not working alongside their studies, between studentswith and without further nursing-related education, or between students with long and short experience as nurses.Conclusions The findings from this study might help to further develop curricula in advanced practice nursingmaster’s programmes to ensure high-quality nursing and sustainable health care in the future. Future high-qualitymaster’s programmes might benefit from systematic collaboration between Nordic higher education institutionsas also Sweden is planning master’s programme. Higher age, having children at home and working while studyingshould not be considered causes for concern.

• Pergent, Martine; Haerynck, Filomeen; Hoste, Levi & Gardulf, Ann (2023). COVID-19 vaccination in patients with primary immunodeficiencies: an international survey on patient vaccine hesitancy and self-reported adverse events. Frontiers in Immunology. ISSN 1664-3224. 14. doi: 10.3389/fimmu.2023.1166198. Fulltekst i vitenarkiv Vis sammendrag

  Introduction: The Sars-CoV-2 pandemic caused great concern for this novel virus among patients with primary immunodeficiency (PID) or inborn errors of immunity (IEI) and their families. When COVID-19 vaccination program started, no data existed on adverse events (AEs) in this particular patient population, nor if patients felt hesitancy being vaccinated. Objectives: To explore i) reasons for COVID-19 vaccination hesitancy, ii) the number and symptoms of AEs and their severity, durability and management. Method: The organisations International Patient Organisation for Primary Immunodeficiencies (IPOPI), European Society for Immunodeficiencies (ESID) and International Nursing Group for Immunodeficiencies (INGID) distributed a global self-administered online survey. Results: The survey was completed by 1317 patients (mean 47, range 12-100, years) from 40 countries. 41.7% of the patients denoted some hesitancy to COVID-19 vaccination, mainly having doubts about postvaccination protection related to their underlying PID and concerns about negative long-term effects. More women (22.6%) reported “very” or “pretty much” hesitancy compared to men (16.4%) (P<0.05). The most common systemic AEs were fatigue, muscle/body pain and headache, usually the same day or the day after the vaccination and lasting for 1-2 days. 27.8% of the respondents reported severe systemic AEs after any dose of COVID-19 vaccine. Only a minority (7.8%) of these patients visited a health-care professional and 20 patients (1.5%) were hospitalized or seen at emergency room without specifying subsequent admission at the hospital. Significantly more local and systemic AEs were reported after the second dose. No differences regarding AEs were observed across different PID subgroups or vaccine types. Conclusion: At the time of the survey, almost half of the patients reported having felt hesitancy to COVID-19 vaccination highlighting the importance and need of developing joint international guidelines and education programs about COVID-19 vaccination. The types of AEs were comparable to healthy controls, but more frequent AEs were reported. Clinical studies and prospective, detailed registration of AEs related to COVID-19 vaccines in this patient population is of great importance. It is crucial to elucidate whether there is a coincidental or causal association between COVID-19 vaccine and some severe systemic AEs. Our data do not contradict that patients with PID can be advised to be vaccinated against COVID-19, in accordance with applicable national guidelines.

• Gardulf, Ann; Florin, Jan; Carlsson, Marianne; Leksell, Janeth; Lepp, Margret & Lindholm, Christina [Vis alle 10 forfattere av denne artikkelen] (2019). The Nurse Professional Competence (NPC) Scale : a tool that can be used in national and international assessments of nursing education programmes . Nordic journal of nursing research. ISSN 2057-1585. 39(3), s. 137–142. doi: 10.1177/2057158518824530.
• Gardulf, Ann; Abolhassani, Hassan; Gustafson, Rolf; Eriksson, Lars E & Hammarström, Lennart (2018). Predictive markers for humoral influenza vaccine response in patients with common variable immunodeficiency. Journal of Allergy and Clinical Immunology. ISSN 0091-6749. doi: 10.1016/j.jaci.2018.02.052.
• Nilsson, Jan; Gardulf, Ann & Lepp, Margret (2016). Process of translation and adaptation of the Nurse Professional Competence (NPC) Scale. Journal of Nursing Education and Practice (JNEP). ISSN 1925-4040. 6(1), s. 100–103. doi: 10.5430/jnep.v6n1p100.
• Nilsson, Jan; Johansson, Eva; Carlsson, Marianne; Florin, Jan; Leksell, Janeth & Lepp, Margret [Vis alle 11 forfattere av denne artikkelen] (2016). Disaster nursing: Self-reported competence of nursing students and registered nurses, with focus on their readiness to manage violence, serious events and disasters. Nurse Education in Practice. ISSN 1471-5953. 17, s. 102–108. doi: 10.1016/j.nepr.2015.09.012. Vis sammendrag

  The World Health Organization and the International Council of Nurses recognises the importance of nurses' involvement in disaster preparedness and response. The aim of this study was to describe and compare self-reported disaster nursing competence (DNC) among nursing students (NSs) and among registered nurses (RNs) with professional experience. Further to investigate possible associations between self-reported DNC and background factors. A cross-sectional study was conducted of 569 NSs and 227 RNs. All respondents completed the 88-item Nurse Professional Competence Scale, including three items assessing DNC. Significant differences were found among the NSs depending on which University/University College they had attended. RNs reported significantly higher overall DNC and better ability to handle situations involving violence, and to apply principles of disaster medicine during serious events. RNs working in emergency care reported significantly better DNC ability, compared with RNs working in other areas of healthcare. Multiple linear regression analysis showed that working night shift and working in emergency care were positively associated with high self-reported overall DNC. The results indicate that workplace experience of serious events increase the readiness of registered nurses to handle violence, to act in accordance with safety regulations, and to apply principles of disaster medicine during serious events

• Gardulf, Ann; Nilsson, Jan; Florin, Jan; Leksell, Janeth; Lepp, Margret & Lindholm, Christina [Vis alle 11 forfattere av denne artikkelen] (2016). The Nurse Professional Competence (NPC) Scale: Self-reported competence among nursing students on the point of graduation. Nurse Education Today. ISSN 0260-6917. 36, s. 165–171. doi: 10.1016/j.nedt.2015.09.013. Vis sammendrag

  Background International organisations, e.g. WHO, stress the importance of competent registered nurses (RN) for the safety and quality of healthcare systems. Low competence among RNs has been shown to increase the morbidity and mortality of inpatients. Objectives To investigate self-reported competence among nursing students on the point of graduation (NSPGs), using the Nurse Professional Competence (NPC) Scale, and to relate the findings to background factors. Methods and participants The NPC Scale consists of 88 items within eight competence areas (CAs) and two overarching themes. Questions about socio-economic background and perceived overall quality of the degree programme were added. In total, 1086 NSPGs (mean age, 28.1 [20–56] years, 87.3% women) from 11 universities/university colleges participated. Results NSPGs reported significantly higher scores for Theme I “Patient-Related Nursing” than for Theme II “Organisation and Development of Nursing Care”. Younger NSPGs (20–27 years) reported significantly higher scores for the CAs “Medical and Technical Care” and “Documentation and Information Technology”. Female NSPGs scored significantly higher for “Value-Based Nursing”. Those who had taken the nursing care programme at upper secondary school before the Bachelor of Science in Nursing (BSN) programme scored significantly higher on “Nursing Care”, “Medical and Technical Care”, “Teaching/Learning and Support”, “Legislation in Nursing and Safety Planning” and on Theme I. Working extra paid hours in healthcare alongside the BSN programme contributed to significantly higher self-reported scores for four CAs and both themes. Clinical courses within the BSN programme contributed to perceived competence to a significantly higher degree than theoretical courses (93.2% vs 87.5% of NSPGs). Summary and conclusion Mean scores reported by NSPGs were highest for the four CAs connected with patient-related nursing and lowest for CAs relating to organisation and development of nursing care. We conclude that the NPC Scale can be used to identify and measure aspects of self-reported competence among NSPGs

• Theander, Kersti; Larsson, Bodil Wilde; Carlsson, Marianne; Florin, Jan; Gardulf, Ann & Johansson, Eva [Vis alle 9 forfattere av denne artikkelen] (2016). Adjusting to future demands in healthcare: Curriculum changes and nursing students' self-reported professional competence. Nurse Education Today. ISSN 0260-6917. 37, s. 178–183. doi: 10.1016/j.nedt.2015.11.012. Vis sammendrag

  Background Nursing competence is of significant importance for patient care. Newly graduated nursing students rate their competence as high. However, the impact of different designs of nursing curricula on nursing students' self-reported nursing competence areas is seldom reported. Objectives To compare newly graduated nursing students' self-reported professional competence before and after the implementation of a new nursing curriculum. The study had a descriptive comparative design. Nursing students, who graduated in 2011, having studied according to an older curriculum, were compared with those who graduated in 2014, after a new nursing curriculum with more focus on person-centered nursing had been implemented. Setting A higher education nursing program at a Swedish university. Participants In total, 119 (2011 n = 69, 2014 n = 50) nursing students responded. Methods Nursing students' self-reported professional competencies were assessed with the Nurse Professional Competence (NPC) scale. Results There were no significant differences between the two groups of nursing students, who graduated in 2011 and 2014, respectively, with regard to age, sex, education, or work experience. Both groups rated their competencies as very high. Competence in value-based nursing was perceived to be significantly higher after the change in curriculum. The lowest competence, both in 2011 and 2014, was reported in education and supervision of staff and students. Conclusions Our findings indicate that newly graduated nursing students – both those following the old curriculum and the first batch of students following the new one – perceive that their professional competence is high. Competence in value-based nursing, measured with the NPC scale, was reported higher after the implementation of a new curriculum, reflecting curriculum changes with more focus on person-centered nursing.

• Leksell, Janeth; Gardulf, Ann; Nilsson, Jan & Lepp, Margret (2015). Self-reported conflict management competence among nursing students on the point of graduating and registered nurses with professional experience. Journal of Nursing Education and Practice (JNEP). ISSN 1925-4040. 5(8), s. 82–89. doi: 10.5430/jnep.v5n8p82.
• Nilsson, Jan; Carlsson, Marianne; Johansson, Eva; Egmar, Ann-Charlotte; Florin, Jan & Leksell, Janeth [Vis alle 12 forfattere av denne artikkelen] (2014). Nursing in a Globalized World: Nursing Students with International Study Experience Report Higher Competence at Graduation. Open Journal of Nursing. ISSN 2162-5336. 4, s. 848–858. doi: 10.4236/ojn.2014.412090. Vis sammendrag

  Due to globalization, there is a need for nurses with skills and competence in providing safe, competent and culturally appropriate care. The aim of the study was to investigate whether International Study Experiences (ISE) in other countries during basic nursing education had an impact on newly graduated nurses as regards to self-reported competence. Moreover, a second aim was to explore what background factors that facilitated or constituted a hindrance for nursing students to choose to conduct part of their basic nursing education abroad. At 11 universities/University Colleges (henceforth called Higher Education Institutions [HEIs]) in Sweden, 565 nursing students responded to the Nurse Professional Competence (NPC) Scale. Students with ISE rated their competence significantly higher on three NPC competence areas—“Legislation in nursing and safety planning”, “Leadership and development of nursing” and “Education and supervision of staff/students”. Background factors that significantly seemed to enhance ISE were living alone, not having children or other commitments in relation to family, international focus at the HEI and previous international experience. Lack of financial means was reported to prevent students from choosing ISE. The study implies that several background factors are of importance whether students choose ISE or not. ISE during basic nursing education might result in better self-reported competence in leading and developing nursing care, including education of future nurses, and in providing safe care.

• Nilsson, Jan; Johansson, Eva; Egmar, Ann-Charlotte; Florin, Jan; Leksell, Janeth & Lepp, Margret [Vis alle 12 forfattere av denne artikkelen] (2014). Development and validation of a new tool measuring nurses self-reported professional competence - The nurse professional competence (NPC) scale. Nurse Education Today. ISSN 0260-6917. 34(4), s. 574–580. doi: 10.1016/j.nedt.2013.07.016. Vis sammendrag

  Objectives To develop and validate a new tool intended for measuring self-reported professional competence among both nurse students prior to graduation and among practicing nurses. The new tool is based on formal competence requirements from the Swedish Board of Health and Welfare, which in turn are based on WHO guidelines. Design A methodological study including construction of a new scale and evaluation of its psychometric properties. Participants and settings 1086 newly graduated nurse students from 11 universities/university colleges. Results The analyses resulted in a scale named the NPC (Nurse Professional Competence) Scale, consisting of 88 items and covering eight factors: “Nursing care”, “Value-based nursing care”, “Medical/technical care”, “Teaching/learning and support”, “Documentation and information technology”, “Legislation in nursing and safety planning”, “Leadership in and development of nursing care” and “Education and supervision of staff/students”. All factors achieved Cronbach's alpha values greater than 0.70. A second-order exploratory analysis resulted in two main themes: “Patient-related nursing” and “Nursing care organisation and development”. In addition, evidence of known-group validity for the NPC Scale was obtained. Conclusions The NPC Scale, which is based on national and international professional competence requirements for nurses, was comprehensively tested and showed satisfactory psychometrical properties. It can e.g. be used to evaluate the outcomes of nursing education programmes, to assess nurses' professional competences in relation to the needs in healthcare organisations, and to tailor introduction programmes for newly employed nurses.

• Uwe, Nicolay; Eva, Östblom; Ann-Charlotte, Egmar; Nordström, Gun & Gardulf, Ann (2012). Validation of a Disease-Specific Questionnaire for Measuring Parent-Reported Health-Related Quality of Life in Children with Allergies. Scandinavian Journal of Caring Sciences. ISSN 0283-9318. 26(4), s. 679–687. doi: 10.1111/j.1471-6712.2012.00980.x. Vis sammendrag

  Purpose:  To evaluate the properties and suitability of a disease-specific questionnaire to assess parent-reported health-related quality of life (HRQL) of children and parents of children suffering from food hypersensitivity (FHS) or allergy to furred pets (AFP). Methods:  The parents of 202 children with FHS and of 131 children with AFP filled in questionnaires comprising the CHQ-PF28 and the Food-Pet-Allergy in Children (FPAC) Questionnaire. Psychometric properties of the FPAC questionnaire were evaluated separately for FHS and AFP. Results:  Analyses resulted in five proposed scales: Limitations of Family/Child Activities (I), Parents’ Distress (II), Child’s Emotions (III), Child in School (IV) and Family Conflicts (V). Convergent/discriminant validity for scales I, II and III of both questionnaires was high; for scale IV it was moderate. All five FHS and four AFP scales were able to distinguish significantly between children with and without clinical allergy symptoms (known-group validity). Internal consistency reliability was good for scales I, II and III, but poor for scale IV. Conclusion:  Three valid scales were determined for both FHS and AFP (Limitations of Family/Child Activities, Parents’ Distress and Child’s Emotions) and can be used in clinical research.

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• Gardulf, Ann; Berg, Marit; Nakrem, Sigrid & Martinsen, Randi Elisabeth (2023). Norwegian Nursing Students' Self-Reported Competence Related to Fortcoming Work as Nursing During the COVID-19 Pandemic - a Cross Sectional Study.
• Martinsen, Randi Elisabeth; Søvde, Sigrid Ahlin; Grov, Ellen Karine & Gardulf, Ann (2023). Self-reported Competence among Advanced Practice Nursing students in Norway, Finland and Denmark - A Cross-sectional study.
• Martinsen, Randi; Ahlin-Søvde, Sigrid; Andersson, Ewa K; Grov, Ellen Karine & Gardulf, Ann (2022). Self-Reported Competence among Nurse Practitioners’ students in Norway, Finland and Denmark – a Pilot Study.

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