Jan Ivar Nilsson

• Engström, Maria; Xu, Lijuan; Nilsson, Jan; Carlsson, Marianne & Flodén, Anne (2026). Development and validation of two brief versions of the Nurse Professional Competence (NPC) Scale: The NPC-6 and NPC-12. Nurse Education Today. ISSN 0260-6917. 164. doi: 10.1016/j.nedt.2026.107141. Full text in Research Archive Show summary

  Background: Several instruments for measuring nurse professional competence have been tested in different countries and shown to be both reliable and valid. However, there remains a lack of shorter, validated instruments suitable for use in different countries, in large-scale research settings and for longitudinally tracking trends and educational interventions. Aim: The aim of this study was to develop and validate two shortened versions of the Nurse Professional Competence (NPC) Scale, comprising items across the six established competency factors. Design: A cross-sectional, methodological study design, with two secondary data analyses, was conducted. Participants: Participants with NPC data were 612 Swedish registered nurses and 2135 Chinese registered nurses. Methods: Items were selected from the 35-item scale (NPC-35) based on highest corrected item–total correlations, theoretical considerations, and discussions within the research group. Two versions were developed: a 6-item scale (NPC-6) and a 12-item scale (NPC-12). NPC-6 intended to be used only as a total score and NPC-12 to be used both as a total score and as factor scores. The psychometric properties of the shortened scales were evaluated by examining their associations with NPC-35, as well as their reliability and validity. Results: The Swedish and Chinese NPC-6 and -12 scales contained the same items and showed strong associations with the NPC-35 scale (r = 0.925–0.990), after removing overlapping items. Both versions had high internal consistency, with Cronbach's alpha and McDonald's omega values ranging from 0.86 to 0.98. Principal component analyses, using one factor/total scale, indicated that the Swedish and Chinese NPC-12 scales explained 55% and 81% of the variance, respectively, while the NPC-6 scales explained 60% and 82%, respectively. Tests of known-groups validity showed statistically significantly higher scores, NPC-6 and -12, among specialist nurses than non-specialist nurses. Confirmatory factor analyses of the NPC-12 confirmed the original factor structure with six competency factors. Conclusions: The findings indicate that the NPC-6 is a psychometrically acceptable instrument in both countries and the NPC-12 in China when used among registered nurses. The Swedish NPC-12 explained only 55.3% of the variance in nurse professional competence when used as a total score and needs further testing. However, the six competency factors of the NPC-12 might be used instead, as indicated by factor analyses. NPC-6 is intended for total score use only, whereas NPC-12 can be scored using both total and factor scores. Additional psychometric testing is warranted to confirm structural stability, test-retest reliability, and sensitivity to change in different settings and samples.

• Stephen, Divya Anna; Nilsson, Jan; Johansson, Unn Britt & Nordin, Anna (2026). Experiences of Adults With Type 1 Diabetes Using Digital Health Technology for Diabetes Self-Care: Qualitative Study. JMIR Diabetes. 11. doi: 10.2196/79704. Full text in Research Archive
• Lusmilasari, Lely; Perdana, Melyza; Pangastuti, Heny Suseani; Pertiwi, Ariani Arista Putri; Nilsson, Jan & Lepp, Margret (2025). Translation, Cross‐Cultural Adaptation and Validation of the Nurse Professional Competence Scale Into Bahasa Indonesia. International Journal of Nursing Practice. ISSN 1322-7114. 31(5), p. 1–10. doi: 10.1111/ijn.70064. Full text in Research Archive Show summary

  ABSTRACT Aims The aim of this study was to evaluate the cross‐cultural adaptation and examine the psychometric properties of the Indonesian version of the 35‐item Nurse Professional Competence Scale Short Version (NPC Scale SV). Method This descriptive cross‐sectional study involved translation, cross‐cultural adaptation and evaluation of psychometric properties. Data were collected from 352 registered nurses (RNs) working in various healthcare settings across Indonesia. The NPC Scale SV was translated into Bahasa Indonesia. Preliminary psychometric testing was conducted with content validation using an expert panel and pilot testing. Psychometric testing included confirmatory factor analysis (CFA), construct reliability, and finally the Model Fit. Results The 35‐item Bahasa Indonesia version (NPC Scale SV‐INA) demonstrated six domains evident from the CFA. This was confirmed with fit indices: CMIN/df 1.346; GFI 0.914; NFI 0.967; TLI 0.989; CFI 0.991; and RMSEA 0.031. Factor loadings in each domain were more than 0.5 and showed good construct reliability (> 0.7). Conclusion The NPC Scale SV‐INA has been tested among RNs across Indonesia and evaluated from a cultural perspective.

• Halabi, Jehad O.; Nilsson, Jan & Lepp, Margret (2025). Evaluating the Impact of a 1-Year Internship Program on Professional Competence, Self-Efficacy, and Perceived Health Among Saudi Arabian Newly Graduated Nurses. Journal of Transcultural Nursing. ISSN 1043-6596. p. 1–10. doi: 10.1177/10436596251382487. Full text in Research Archive Show summary

  Introduction: Transitioning from academic education to clinical practice is challenging for newly graduated nurses. This study evaluated a 12-month culturally tailored internship on professional competence, self-efficacy, and perceived health among newly graduated Saudi nurses. Methods: A longitudinal design with repeated measures was used to recruit 147 female Saudi newly graduated nurses who completed an internship program at two tertiary hospitals. Data were collected at beginning, 8 months, and completion of the program. The Nurse Professional Competence Scale–Short Form, General Self-Efficacy Scale, and self-reported health measures were used. Statistical analyses were conducted using analysis of variance (ANOVA) with post hoc comparisons. Results: Significant improvements were found in professional competence, especially in leadership, documentation, and administrative skills. Value-based care competence remained high. Self-efficacy and perceived health were also improved. Discussion: Culturally tailored internship programs are effective in enhancing newly graduated nurses’ professional competence and perceived health. Such internship programs may effectively help to enhance training for practice-ready nurses.

• Flodén, Anne; Lepp, Margret; Tilander, Per; Svensson, Ann & Nilsson, Jan (2025). Nurses' Self-Reported Professional Competence: A Cross-Sectional Study at a Regional Teaching Hospital in Sweden. Journal of Clinical Nursing (JCN). ISSN 0962-1067. 35, p. 788–803. doi: 10.1111/jocn.70057. Full text in Research Archive Show summary

  Aim: To investigate and compare the self-assessed professional competence of registered nurses, specialist nurses and midwives at a regional teaching hospital in Sweden. Moreover, to explore associations between potential predictive background factors and self-assessed professional competence. Design: A cross-sectional study. Methods: Convenience sample of 615 nurses answered a questionnaire; sociodemographic data, 35-item Nurse Professional Competence Scale, Occupational Self-Efficacy Scale. Statistical analyses: Fisher's non-parametric permutation test, Kruskal–Wallis test, Mantel–Haenszel chi-square test, Spearman rank correlation test, calculating sum score. Multiple linear regressions and reliability testing with Cronbach's alpha. Results: Response rate, 58.7%; mean age, 44.7 years; work experience, 0.2 years to 45 years (mean 16.4 years); 83.4% women. 82.4% bachelor's degree; out of these, 34.3% with an additional master's degree. 17.6% nursing diploma without an academic degree. The highest mean scores for the NPC Scale were in Value-based nursing care, Medical and technical care. The lowest were in Care pedagogics and Development, leadership and organisation of nursing care. Total mean score 84.3, (79.3–90.0). Specialist nurses scored higher in all areas except Care pedagogics. Predictive factors indicated being a woman was positively associated with higher competence scores in all six areas, β coefficients 2.2–5.3 with p < 0.05. Longer nursing experience was positively associated with higher competence in Nursing care (β 0.17 per year, p = 0.01), Medical and technical care (β 0.14 per year, p = 0.01). The occupational self-efficacy scale was strongly positively associated with higher competence in all areas, β per scale step 0.42–0.63 with p < 0.0001. Nurses without academic degree had lower competence scores in several areas compared to bachelor's degree, β ranges from −3.47 to −2.31, p < 0.05. Conclusion: Utilising competence data, the Swedish Enhanced Competence Development Model (vKUM) can effectively support the planning and management of ongoing professional competence development.

• Stephen, Divya Anna; Nordin, Anna; Johansson, Unn-Britt & Nilsson, Jan (2025). eHealth Literacy and Its Association With Demographic Factors, Disease-Specific Factors, and Well-Being Among Adults With Type 1 Diabetes: Cross-Sectional Survey Study. JMIR Diabetes. 10. doi: 10.2196/66117. Full text in Research Archive Show summary

  Background: The use of digital health technology in diabetes self-care is increasing, making eHealth literacy an important factor to consider among people with type 1 diabetes. There are very few studies investigating eHealth literacy among adults with type 1 diabetes, highlighting the need to explore this area further. Objective: The aim of this study was to explore associations between eHealth literacy and demographic factors, disease-specific factors, and well-being among adults with type 1 diabetes. Methods: The study used data from a larger cross-sectional survey conducted among adults with type 1 diabetes in Sweden (N=301). Participants were recruited using a convenience sampling method primarily through advertisements on social media. Data were collected between September and November 2022 primarily through a web-based survey, although participants could opt to answer a paper-based survey. Screening questions at the beginning of the survey determined eligibility to participate. In this study, eHealth literacy was assessed using the Swedish version of the eHealth Literacy Scale (Sw-eHEALS). The predictor variables, well-being was assessed using the World Health Organization-5 Well-Being Index and psychosocial self-efficacy using the Swedish version of the Diabetes Empowerment Scale. The survey also included research group–developed questions on demographic and disease-specific variables as well as digital health technology use. Data were analyzed using multiple linear regression presented as nested models. A sample size of 270 participants was required in order to detect an association between the dependent and predictor variables using a regression model based on an F test. The final sample size included in the nested regression model was 285. Results: The mean Sw-eHEALS score was 33.42 (SD 5.32; range 8‐40). The model involving both demographic and disease-specific variables explained 31.5% of the total variation in eHealth literacy and was deemed the best-fitting model. Younger age (P=.01; B=–0.07, SE=0.03;95% CI –0.12 to –0.02), lower self-reported glycated hemoglobin levels (P=.04; B=–0.06, SE=0.03; 95% CI –0.12 to 0.00), and higher psychosocial self-efficacy (P<.001; B=3.72, SE=0.53; 95% CI 2.68-4.75) were found associated with higher Sw-eHEALS scores when adjusted for demographic and disease-specific variables in this model. Well-being was not associated with eHealth literacy in this study. Conclusions: The demographic and disease-specific factors explained the variation in eHealth literacy in this sample. Further studies in this area using newer eHealth literacy tools are important to validate our findings. The study highlights the importance of development and testing of interventions to improve eHealth literacy in this population for better glucose control. These eHealth literacy interventions should be tailored to meet the needs of people in varying age groups and with differing levels of psychosocial self-efficacy.

• Stephen, Divya Anna; Nordin, Anna; Johansson, Unn-Britt & Nilsson, Jan (2024). Psychosocial Self‐efficacy and its Association with Selected Potential Factors Among Adults with Type 1 Diabetes: A Cross‐Sectional Survey Study. Diabetes Therapy. p. 1–13. doi: 10.1007/s13300-024-01581-y. Full text in Research Archive Show summary

  Introduction The management of type 1 diabetes, a non-preventable chronic disease, leads to a high physical and psychological burden on the individual. Digital health technology can improve a person’s psychosocial self-efficacy and thereby contribute to improved diabetes self-care. The aim of this study was to explore associations between psychosocial self-efficacy and demographic-, disease specific-, well-being as well as digital health technology (DHT) related factors among adults with type 1 diabetes. Methods A primarily web-based cross sectional survey was conducted among adults with type 1 diabetes in Sweden (n = 301). Psychosocial self-efficacy was assessed using the Swedish version of the Diabetes Empowerment Scale, Swe-DES-23. The survey also contained questions related to demographic-, disease specific-, well-being as well as digital health technology related variables. Results Higher well-being scores and lower HbA1c levels were associated with higher psychosocial self-efficacy in multiple linear regression analysis. In multivariate analysis, gender, body mass index, well-being scores, and HbA1c levels showed association with psychosocial self-efficacy. None of the DHT factors were found associated with psychosocial self-efficacy. Conclusions In this study, higher well-being score and lower self-reported HbA1c levels were associated with higher psychosocial self-efficacy in both univariate- and multivariate analysis and accounted for 30% of the variation in psychosocial self-efficacy in the regression model. Thus, measures to improve psychosocial self-efficacy in adults with type 1 diabetes may help maintain their psychological well-being and blood glucose control.

• Andersson, Ingrid; Eklund, Anna Josse; Nilsson, Jan & Bååth, Carina Barbro (2024). First-line managers´ perceptions of missed nursing care in community health care for older people–A phenomenographic study. Scandinavian Journal of Caring Sciences. ISSN 0283-9318. 00(4), p. 1–9. doi: 10.1111/scs.13291. Full text in Research Archive Show summary

  Introduction First-line managers in Swedish communities have responsibility for that care to older people is provided, staffing is sufficient and the budget is balanced in their unit. It is a struggle with limited resources due to a growing population in need of care. This can lead to missed nursing care. The aim was to describe first-line managers´ perceptions of missed nursing care in community health care for older people. Methods A qualitative design with a phenomenographic approach, interviewing 24 first-line managers. Ethics approval for the study was received from the Research Ethics Committee at Karlstad University (Dnr HNT 2020/566). Results The results are shown in six descriptive categories containing 15 perceptions. The descriptive categories are ‘occurrence of missed nursing care’, ‘becoming aware of missed nursing care’, ‘reasons for missed nursing care’, ‘missed nursing care has consequences for the older persons’, ‘missed nursing care has consequences for the staff’ and ‘taking action to decrease missed nursing care’. Conclusions It is important for first-line managers to become aware of the existence and reasons for missed nursing, as it has consequences for older people and staff. Managers need to take missed nursing care seriously in order to work with improvements for maintaining good quality of care and patient safety.

• Glawing, Carina; Karlsson, Ingela; Kylin, Camilla & Nilsson, Jan (2023). Work-related stress, stress reactions and coping strategies in ambulance nurses: A qualitative interview study. Journal of Advanced Nursing. ISSN 0309-2402. 00. doi: 10.1111/jan.15819. Full text in Research Archive Show summary

  Aim: To describe experiences of work- related stress, stress reactions and coping strategies among registered nurses (RNs) in the ambulance service (AS).Design: A descriptive and qualitative design.Methods: Participants were recruited from eight different ambulance stations from dif-ferent geographical locations in central Sweden. Data were collected from 14 RNs dur-ing the period from January 2022 to May 2022 using a semi-structured interview guide. Qualitative content analysis was used to analyse data using an abductive approach.Results: Three categories describe the RNs' experiences; (1) Situations that cause work- related stress, (2) Reactions and feelings that occur and (3) Management of work- related stress. These three main categories included a total of 12 subcatego-ries. Work- related stress was experienced when participants were a part of traumatic events or experienced insufficient cooperation or a disturbing event in the work en-vironment. The different causes lead to different kinds of reactions with feelings of frustration, fear and loneliness being prominent. To manage the work- related stress, RNs used different kinds of strategies and support from colleagues or lack thereof seemed to have a major impact.Conclusions: Findings revealed the importance of having competent colleagues in the AS. Working with a competent colleague can reduce experiences of stress and prevent feelings of loneliness. It is important for the AS to provide stress- reduction support, to promote cooperation and to maintain and develop RNs' professional com-petence to ensure quality care and patient safety in the AS.

• Halabi, Jehad o.; Nilsson, Jan & Lepp, Margret (2023). The nurse professional competence scale: Self‑reported professional competence among newly graduated nursing students in Saudi Arabia. Saudi Journal for Health Sciences. ISSN 2278-1900. 12(1), p. 16–23. doi: 10.4103/sjhs.sjhs_151_22. Full text in Research Archive Show summary

  Background: Nursing students should develop sufficient professional competence during their nursing education as a prerequisite for providing safe care of high quality utilizing a holistic approach that suits the caring context of their patients. Despite the abundance of studies on professional competence in international literature such as the Scandinavian countries, there are no studies conducted in the Middle East in general and in Saudi Arabia in particular. Aim: The current report is part of a larger study that assessed the self-reported professional competence of newly graduated nursing students in Saudi Arabia. Setting and Design: A cross-sectional correlational study was carried out with a convenience sample of 317 senior Saudi students at the point of graduation from a nursing college affiliated with a public university in Saudi Arabia. Materials and Methods: Data was collected using the Nurse Professional Competence (NPC) Scale – a short version consisting of 35 items and the 10-item General Self-Efficacy (GSE) Scale. Statistical Analysis: The mean scores were calculated for the competency areas, and the median score and interquartile were used for nonparametric variables that were not normally distributed (Shapiro–test). The Chi-square test for data between groups, the Kruskal–Wallis test for comparing more than two independent groups, and Mann–Whitney U-test for comparing two independent groups. In addition, Spearman correlation coefficients to test correlations between groups and the NPC Scale. Results: Students scored highest in the competence areas of nursing care, value-based nursing care, and care pedagogics and lowest scores in the areas of documentation and administration of nursing care, development, leadership and organization of nursing care, and medical and technical care. Professional competence was significantly associated with students' quality of health and GSE. Conclusion: It is important to incorporate competencies in the nursing program and to assess newly graduated students' competence upon graduation. We suggest a follow-up study of these graduates to assess the development of professional competencies and self-efficacy across their internship years.

• Andersson, Ingrid; Bååth, Carina Barbro; Nilsson, Jan & Eklund, Anna Josse (2023). Validation of the Basel Extent of Rationing of Nursing Care for Nursing Homes and Home Care, a Swedish version. Nursing Open. 10(7). doi: 10.1002/nop2.1692. Full text in Research Archive Show summary

  Aim: The aim of the study was to translate, adapt and validate the instrument Basel Extent of Rationing of Nursing Care for Nursing Homes and Home Care for use in the Swedish community health care context.Design: A cross-sectional study. Data were collected from October 2019 to January 2020, and the questionnaire was sent to Registered Nurses, Enrolled Nurses and as-sistant nurses.Methods: The study was performed in four phases: (1) translation, (2) adaptation of the Basel Extent of Rationing of Nursing Care for Nursing Homes and Home Care to the Swedish context, (3) content validity testing, and (4) evaluation of psychometric properties. The collected data resulted in 611 responses. Explorative factor analysis was performed to explore the interrelationship, and Cronbach's alpha was used to evaluate the internal consistency.Results: Explorative factor analysis presented six factors/subscales: (1) fundamental care, (2) timely needed- based care, (3) dignity and support, (4) ensuring respectful treatment, (5) social activities, and (6) documentation, planning and reporting. The Cronbach's alpha for the components showed values between 0.7 and 0.9.Conclusion: The analyses indicate an instrument to be usable for Enrolled Nurses and nurse assistants in community health care. Additional tests, can contribute to refin-ing the content of the items and further test reliability and validity of the instrument.No patient or public contribution: As this is a study of translation and validation of the instrument Basel Extent of Rationing of Nursing Care for Nursing Homes and Home Care.

• Stephen, Divya Anna; Nordin, Anna; Nilsson, Jan & Persenius, Mona (2022). Using mHealth applications for self-care – An integrative review on perceptions among adults with type 1 diabetes. BMC Endocrine Disorders. 22(1). doi: 10.1186/s12902-022-01039-x. Full text in Research Archive Show summary

  Background Individually designed interventions delivered through mobile health applications (mHealth apps) may be able to effectively support diabetes self-care. Our aim was to review and synthesize available evidence in the literature regarding perception of adults with type 1 diabetes on the features of mHealth apps that help promote diabetes self-care, as well as facilitators and barriers to their use. An additional aim was to review literature on changes in patient reported outcome measures (PROMs) in the same population while using mHealth apps for diabetes self-care. Methods Quantitative and qualitative studies focusing on adults aged 18 years and over with type 1 diabetes in any context were included. A systematic literature search using selected databases was conducted. Data was synthesised using narrative synthesis. Results We found that features of mHealth apps designed to help promote and maintain diabetes self-care could be categorized into self-care data monitoring, app display, feedback & reminders, data entry, data sharing, and additional features. Factors affecting the use of mHealth apps reported in the literature were personal factors, app design or usability factors, privacy and safety factors, or socioeconomic factors. Quality of life and diabetes distress were the most commonly reported PROMs in the included studies. Conclusion We are unable to reach a conclusive result due to the heterogeneity of the included studies as well as the limited number of studies reporting on these areas among adults with type 1 diabetes. We therefore recommend further large-scale studies looking into these areas that can ultimately improve mHealth app use in type 1 diabetes self-care.

• Willman, Anna; Nilsson, Jan & Bjuresäter, Kaisa (2022). Professional development among newly graduated registered nurses working in acute care hospital settings: A qualitative explorative study. Journal of Nursing Management. ISSN 0966-0429. p. 1–9. doi: 10.1111/jonm.13771. Full text in Research Archive Show summary

  Aim To explore newly graduated registered nurses' perceptions of their work situation and management of nursing care in complex patient situations after 18 months of work experience. Background Newly graduated registered nurses working in acute care hospital settings play a critical role in providing safe nursing care. Methods An explorative qualitative design, with four focus group interviews with 14 newly graduated registered nurses working in acute care hospital settings. Results One theme emerged: ‘Clarity and security in one's own nursing role despite facing challenges that hinder professional development’ and three categories: ‘Independency due to one's own efforts and experience’, ‘Well-functioning teamwork’ and ‘Challenges in the work situation’. Conclusion After 18 months in the profession, the nurses were considered to be advanced beginners; at the same time, the most experienced nurses on their respective wards. They found it challenging and need to further develop competences concerning managing and organizing the nursing care of several complex patient situations or new patient groups, as well as supervising novice registered nurses and nursing students. Implication for Nursing Management Powerful and urgent action is needed to be taken by national healthcare policymakers as well a hospital and nurse managers to develop long-term strategies to improve working conditions for newly registered graduated nurses.

• Andersson, Ingrid; Eklund, Anna Josse; Nilsson, Jan & Bååth, Carina Barbro (2022). Prevalence, type, and reasons for missed nursing care in municipality health care in Sweden – A cross sectional study. BMC Nursing. 21(1). doi: 10.1186/s12912-022-00874-6. Full text in Research Archive Show summary

  Background With an ageing population, there is an increasing need for care, both as home care and in nursing homes. However, some needed care is not carried out for different reasons, which can affect patient safety. The aim of the study was to describe prevalence, type, and reasons for missed nursing care in home care and nursing homes, from nurses’ perspective. Methods A cross sectional design with quantitative and qualitative approach. A Swedish version of Basel Extent of Rationing of Nursing Care for nursing homes and 15 study specific questions were answered by 624 registered nurses, enrolled nurses, or nurse assistants. Both descriptive and analytical, independent-samples t-test, analyses were used. Qualitative content analysis was used for the open-ended question. Results The care activity most often missed in home care was: ‘set up or update care plans’ (41.8%), and in nursing homes: ‘scheduled group activity’ (22.8%). Reasons for missed nursing care were lack of preparedness for unexpected situations, obstacles in a deficient work environment, unsatisfactory planning in the organisation, and/or shortcomings related to the individual. Conclusion Not all care activities needed are performed, due to reasons such as lack of time or organisational issues. Missed nursing care can lead to adverse events and affect patient safety. It is important to be aware of missed nursing care and the reasons for it, which gives a possibility to initiate quality improvement work to ensure patient safety.

• Unis, Brian; Bjuresäter, Kaisa & Nilsson, Jan (2022). The Interplay of Multiple Influences on the Development of Sexuality in Late-Adolescence—A Grounded Theory Study. American Journal of Sexuality Education. ISSN 1554-6136. doi: 10.1080/15546128.2022.2111010. Full text in Research Archive Show summary

  The aim of this grounded theory study was to explore late-adolescents’ process of sexual development along with their information- and support-seeking behaviors in a Swedish context. Data were collected in semi-structured interviews with late-adolescents aged between 18 and 21 years in high schools in central Sweden. The results showed that late-adolescents’ sexual development involved seeking for knowledge, discussing norms and attitudes, learning through interactions, and growing through practice and experience. Information- and support-seeking behaviors were observed throughout their developent. This study highlights that, in order to be able to provide adequate help and support, healthcare professionals need to have an awareness of the changing information and support needs of adolescents in our constantly changing and diverse society.

• Xu, Lijuan; Nilsson, Jan Ivar; Zhang, June & Engström, Maria (2021). Psychometric evaluation of Nurse Professional Competence Scale—Short-form Chinese language version among nursing graduate students. Nursing Open. doi: 10.1002/nop2.1036. Full text in Research Archive Show summary

  The aim of the study was to determine the psychometric properties, construct validity and internal consistency of the Chinese language version of the Nurse Professional Competence scale short form. Questionnaire data from 260 nursing students nearing graduation from 2 universities in China were analysed using confirmatory factor analysis, known- group validity and internal consistency.The confirmatory factor analysis revealed that the model was acceptable, and the analyses for known- group validity revealed statistically significant differ-ences in all factors and the total scale of the Nurse Professional Competence scale short form. Internal consistency revealed that Cronbach's alpha values exceeded 0.70 for all factors and the total scale. The Chinese language version of the Nurse Professional Competence scale short form has acceptable construct validity and good internal consistency.

• Andersson, Ingrid; Bååth, Carina Barbro; Nilsson, Jan Ivar & Eklund, Anna Josse (2021). A scoping review—Missed nursing care in community healthcare contexts and how it is measured. Nursing Open. 9. doi: 10.1002/nop2.945. Full text in Research Archive Show summary

  Aim To examine the extent and nature of missed nursing care in elderly care in community healthcare contexts from the perspective of healthcare staff, and to identify instruments used to measure missed nursing care and the content of these instruments. Design Scoping review. Methods Searches were conducted in the CINAHL, PubMed, Scopus and Google Scholar databases in March 2020. The selection process followed the PRISMA flow diagram. Results Sixteen research papers were found from nine countries. The instruments used in the studies were Basel Extent of Rationing of Nursing Care for nursing homes (BERNCA-NH), modified MISSCARE survey and study-specific instruments or items. The item content differed, as did the number of items, which was between one and 44. The studies reported values for missed nursing care, as well as described reasons for and/or the relation between missed nursing care and organization, working climate and patient outcomes.

• Jansson, Jörgen; Larsson, Maria & Nilsson, Jan Ivar (2021). Advanced paramedics and nurses can deliver safe and effective pre-hospital and in-hospital emergency care: An integrative review. Nursing Open. doi: 10.1002/nop2.866. Full text in Research Archive Show summary

  Abstract Aim: To explore and present an overview of scope of practice among registered nurses and paramedics with an advanced level of education in pre-hospital and inhospital emergency care. Design: An integrative literature review. Method: Studies published between 2006 and 2018 were retrieved by searching the databases CINAHL, PubMed, Scopus and Web of Science. Studies were selected by three independent researchers, and data were synthesized using thematic analysis. Results: The 25 studies identified focused on in-hospital (n = 15) and pre-hospital emergency care (n = 10) and included 13 professional titles originated from seven countries. The thematic analysis disclosed four themes; “Versatile care,” “Safe care based on precision and accuracy,” “Autonomous performance within boundaries” and “Beneficial towards patients and society.” Advanced paramedics’ and advanced nurses’ services are characterized as safe, of high quality and of public benefit. Their services are being used in everyday practice as well as directed to certain categories of patients.

• Unis, Brian; Nilsson, Jan Ivar & Bjuresäter, Kaisa (2021). Sexual Health Promotion among Swedish Adolescents–Professionals’ Experiences. International Journal of Sexual Health. ISSN 1931-7611. doi: 10.1080/19317611.2021.1921893. Full text in Research Archive Show summary

  In this grounded theory study the aim was to explore professionals’ experiences of promotion of adolescents’ sexual health, and views on inter-professional collaboration in relation to this subject. Data collection was by five focus group interviews and two pair interviews with professionals working with sexual health promotion in health care and schools. The results showed that professionals were reaching out to young people through competence and trusting relationships along with working on a broader front. In conclusion, professionals need to be knowledgeable about the world of young people, accessible and able to offer adequate support, and improve their inter-professional collaborations.

• Halabi, Jehad O.; Nilsson, Jan & Lepp, Margret (2021). Professional Competence Among Registered Nurses Working in Hospitals in Saudi Arabia and Their Experiences of Quality of Nursing Care and Patient Safety. Journal of Transcultural Nursing. ISSN 1043-6596. 32(4), p. 425–433. doi: 10.1177/1043659621992845. Full text in Research Archive

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• Nilsson, Jan & Martinsen, Randi (2025). Capacity Building in Nursing Education in Indonesia (CABNEI). Full text in Research Archive Show summary

  The Project's Goal The CABNEI project strengthens nursing education and clinical practice in Aceh by empowering nurse educators with international competencies, advancing health outcomes, and supporting key UN Sustainable Development Goals. Specific Needs Addressed by the Project 1. Educational Quality and Relevance: Aligns nursing education with national and international standards, ensuring competency-based programs that meet quality benchmarks and reflect population health needs. 2. Faculty Development: Enhances pedagogical skills, clinical expertise, and use of modern teaching technologies among nurse educators. 3. Policy Alignment: Supports WHO’s Global Strategic Directions for Nursing and Midwifery (2021–2025), particularly in education, and contributes to goals related to jobs, leadership, and service delivery. 4. Systemic Improvement in Aceh: Improves nursing curricula, strengthens clinical practice, promotes health over disease treatment, and integrates global approaches like Person-Centred Care and transcultural nursing. Key Elements of Distinction and Importance The project employed an evidence-based methodology with pre- and post-assessments to evaluate nurse educators’ competencies. It successfully transitioned to digital teaching and remote project management during the COVID-19 pandemic. The final international conference, attended by approximately 400 participants, fostered academic exchange and launched a web-based writing initiative, resulting in three published articles (with four in manuscript) and two project members beginning PhD studies. Relevance for the University and Higher Education Sector • Digital Internationalization: Facilitates cross-border collaboration and learning through digital platforms. • Evidence-Based Capacity Building: Uses measurable, research-driven methods to enhance educator competencies and support sustainable academic development. • Scientific Dissemination: Publishes outcomes in international peer-reviewed journals, contributing to global academic discourse and best practices in nursing education.

• Nilsson, Jan (2025). Green HealthCare: Sustainable hospital practices and carbon reduction strategies - Nurses´ Professional Competence in Climate-Responsive Global Health. Full text in Research Archive
• Nilsson, Jan & Randi, Martinsen (2025). Capacity Building in Nursing Education in Indonesia - Nurse Educators Professional Development. Full text in Research Archive
• Eriksson, Mia; Nordin, Anna; Ullsten, Alexandra & Nilsson, Jan (2025). Building Empathic Professionalism: How to best build rapport with family members in intensive care in a person-centered manner. Full text in Research Archive
• Hollsten, Anna; Willman, Anna; Carlsson, Marianne; Gardulf, Ann & Nilsson, Jan (2025). Self-Assesses Professional Competence Among Retired Nurses. Full text in Research Archive
• Halabi, Jehad O.; Nilsson, Jan & Lepp, Margret (2023). Professional Competence of Registered Nurses Working in Saudi Arabian Hospitals and their Experiences of Nursing Care Quality and Patient Safety. Full text in Research Archive
• Halabi, Jehad O.; Nilsson, Jan & Lepp, Margret (2023). Assessing Self-Reported Competence among Registered Nurses Working in Public Hospitals in the Kingdom of Saudi Arabia as a Culturally Diverse Workforce. Full text in Research Archive
• Nilsson, Jan & Lepp, Margret (2023). A pedagogical tool for promoting nursing students professional development and lifelong learning: the use of the Nurse Professional Competence (NPC) Scale. Full text in Research Archive
• Stephen, Divya Anna; Nordin, Anna; Nilsson, Jan & Persenius, Mona (2023). Using mHealth applications for self-care - An integrative review on perceptions among adults with type 1 diabetes. Full text in Research Archive
• Bjuresäter, Kaisa; Olsson, Cecilia; Larsson, Maria & Nilsson, Jan (2022). Self-reported Professional Competence Among Swedish Contact Nurses in Cancer Care: A Cross-sectional Study. Cancer Care Research Online. doi: 10.1097/CR9.0000000000000024. Full text in Research Archive Show summary

  Background: Since 2011, patients in Swedish cancer care have been offered a contact nurse (CN). The CN role is to improve patient participation, care continuity, and provide information and manage patients’ symptoms and needs across the whole continuum of the cancer pathway. A competence profile for the CN role is yet to be developed, and it is important to assess CNs’ self-reported competence to assure that they are well equipped for the role. Objectives: To assess self-reported professional competence among contact nurses working in Swedish cancer care and relate the findings to education level and clinical experience. Methods: The Nurse Professional Competence scale short form (35 items) was used to assess the nurses’ professional competence. Data were collected through a web-based survey in 2017 in 2 regional cancer centers in Sweden. Results: One hundred eight CNs participated in the study and reported highest scores in “value-based nursing care” and lowest scores in “development, leadership, and organization of nursing care.” Higher age, extended clinical work experience, and academic degree were significantly associated with higher competence. Conclusions: CNs with extensive work experience and CNs with an academic degree reported higher scores concerning their generic competence. There is a need in future studies to assess CNs’ specific competence in cancer care. Implications for Practice: There is room for improvement in the competence development of CNs, primarily in the areas of leadership and organization of nursing care. What is Foundational: CNs’ competence regarding leadership and organization should be improved, preferably as part of academic education.

• Martinsen, Randi; Nilsson, Jan; Grøndahl, Vigdis Abrahamsen & Suwarni, Abubakar (2023). CABNEI International Conference Guide and Abstract book. Quality Improvement of Nursing Education. Inland Norway University of Applied Sciences. ISSN 9788283804195. Full text in Research Archive

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