Toril Merete Nysæter

• Skavern, Hege Jansen; Martinsen, Randi; Gardulf, Ann; Smaradottir, Anna Brynja; Nysæter, Toril Merete & Stensvehagen, Marianne Torp (2025). Norske intensiv-, operasjon og kreftsykepleiestudenters selvrapporterte kompetanse ved oppstart av masterstudiet - en tverrsnittsstudie | Inspira. Inspira – tidsskrift for anestesi-, operasjon- og intensivsykepleiere. ISSN 0809-9707. 20(2), s. 44–57. doi: 10.23865/inspira.v20.7241. Fulltekst i vitenarkiv Vis sammendrag

  Bakgrunn: I 2021 fastsatte Kunnskapsdepartementet nye nasjonale forskrifter for utdanningene innen intensiv-, operasjons-, og kreftsykepleie, som sikrer et nasjonalt likeverdig faglig nivå og felles sluttkompetanse for kandidater. Det er et presserende behov for å utdanne flere spesialsykepleiere innen disse områdene i Norge, for å opprettholde kvaliteten i helsetjenestene. Det er begrenset kunnskap i en nordisk kontekst om masterstudenters egenrapporterte profesjonelle kompetanse. Hensikt: Studiens hensikt var å kartlegge hvordan masterstudenter ved klinisk spesialisering i intensiv-, operasjons- og kreftsykepleie vurderte sin selvrapporterte kompetanse innen seks viktige sykepleiefaglige områder ved oppstart av studiet. Metode: En tverrsnittstudie ble gjennomført blant masterstudenter på et av universitetene i Norge. Data ble samlet inn via et nettbasert spørreskjema. Den norske versjonen av The Nurse Professional Competence Scale – Short Form ble benyttet til å måle sykepleiefaglig kompetanse.  Resultater: Høyest gjennomsnittsskår ble funnet for kompetanseområdet «Medisinsk og teknisk omsorg», mens lavest gjennomsnittsskår ble funnet for «Fagutvikling, faglig ledelse og organisering av sykepleie». Kvinner rapporterte en signifikant høyere kompetanse innen «Medisinsk og teknisk omsorg» sammenlignet med menn. Masterstudentene i aldersgruppen 41-50 år rapporterte en signifikant høyere kompetanse innen «Verdibasert sykepleie». Det var ingen signifikante forskjeller i selvrapportert kompetanse mellom studentgruppene i de tre ulike spesialiseringene. Masterstudentene fremhevet at deltidsutdanning som var samlingsbasert gav dem mulighet til å kombinere utdanning med andre forpliktelser som familie, jobb og økonomi. Konklusjon: Det er viktig å sikre at fagutvikling, faglig ledelse og organisering av sykepleie får mer fokus i masterutdanningene for å styrke fremtidige spesialsykepleieres kompetanse i intensiv-, operasjons- og kreftsykepleie. Deltidsutdanning gjør det lettere for studentene å kombinere studiene med andre forpliktelser.  ENGLISH ABSTRACT Norwegian intensive care, operating room and cancer nursing students’ self-reported competence at the start of their master’s degree - a cross-sectional study Background: In 2021, the Ministry of Education established new national regulations for education in intensive, perioperative, and oncology nursing, ensuring a nationally equivalent professional academic level and common final competencies for graduates. There is an urgent need to educate more specialized nurses in in these areas in Norway to maintain the quality of healthcare services. There is limited knowledge in a Nordic context regarding master’s students’ self-reported professional competence. Aim: The study aimed to map how master’s students specializing in intensive-, perioperative-, and oncology nursing assessed their self- reported professional competence in six important nursing areas at the start of their studies. Method: A cross-sectional study was conducted among master’s students at one of the universities in Norway. Data was collected via an online questionnaire. The Norwegian version of the Nurse Professional Competence Scale – Short Form was used to measure self-reported professional competencies. Results: The highest mean score was found in the competence area «Medical and Technical Care,», while the lowest mean score was found for «Professional Development, Management, and Organization of Nursing Care.» Women reported significantly higher competence in «Medical and Technical Care» compared to men. Master’s students aged 41-50 reported significantly higher competence in «Value-Based Nursing.» There were no significant differences in self-reported competence among the student groups in the three different specializations. The students emphasized that part-time education, which was gathering-based, allowed them to combine education with other commitments such as family, work and finances. Conclusion: It is important to ensure that professional development, leadership and organization of nursing care receive more focus in master’s programs to strengthen the future competencies of specialist nurses in intensive, perioperative, and oncology nursing. Part- time education facilitates students’ ability to manage their studies alongside other responsibilities. 

• Nysæter, Toril Merete; Olsson, Cecilia; Mytting, Tuva Helene Sandsdalen; Hov, Reidun Helene & Larsson, Maria (2024). Family caregivers’ preferences for support when caring for a family member with cancer in late palliative phase who wish to die at home – a grounded theory study. BMC Palliative Care. 23. doi: 10.1186/s12904-024-01350-5. Fulltekst i vitenarkiv Vis sammendrag

  Background Family caregivers are essential in end-of-life care for cancer patients who wish to die at home. The knowledge is still limited regarding family caregivers needs and preferences for support and whether the preferences change during the patient’s illness trajectory. Therefore, the aim was to explore family caregivers’ preferences for support from home care services over time when caring for a family member with cancer at the end of life who wished to die at home. Methods A qualitative method was applied according to Grounded Theory. Data was collected longitudinally over the illness trajectory by means of repeated individual interviews (n = 22) with adult family caregivers (n = 11). Sampling, data collection and data analysis were undertaken simultaneously in line with the constant comparative method. Results The findings are captured in the core category “hold out in duty and love”. The categories “having control and readiness for action” and “being involved in care” describe the family caregivers’ preferences for being prepared and able to handle procedures, medical treatment and care, and to be involved by the healthcare personnel in the patient’s care and decision making. The categories “being seen and confirmed” and “having a respite” describe family caregivers’ preferences for support according to their own needs to be able to persevere in the situation. Conclusion Despite deterioration in the patient’s illness and the increasing responsibility family caregiver struggle to hold out and focus on being in the present. Over time together with deterioration in the patient’s illness and changes in the situation, they expressed a need for more intense and extensive support from the home care services. To meet the family caregivers’ preferences for support a systematic implementation of a person-centred care model and multicomponent psycho- educational interventions performed by nurses can be proposed. Moreover, we suggest developing a tool based on the conceptual model generated in this study to identify and map family caregivers’ needs and preferences for support. Such a tool can facilitate communication and ensure person-centred interventions.

• Nysæter, Toril Merete; Olsson, Cecilia; Sandsdalen, Tuva; Larsson, Bodil Wilde; Hov, Reidun & Larsson, Maria (2022). Preferences for home care to enable home death among adult patients with cancer in late palliative phase - a grounded theory study. BMC Palliative Care. 21(1), s. 49–49. doi: 10.1186/s12904-022-00939-y. Fulltekst i vitenarkiv Vis sammendrag

  Background: The wish to be cared for and to die at home is common among people with end‑stage cancer in the western world. However, home deaths are declining in many countries. The aim of this study was to explore the preferences for home care over time to enable home death among adult patients with cancer in the late palliative phase. Methods: A qualitative method was applied according to grounded theory (Corbin & Strauss, 2008). Data was collected using individual interviews (n= 15) with nine adult patients. One to two follow up interviews were conducted with four patients. Sampling, data collection and constant comparative analysis were undertaken simultaneously. Results: The findings are presented as a conceptual model of patients’ preferences for care to enable home death. The core category “Hope and trust to get the care I need to die at home” showed that the preference to die at home seemed stable over time and did not change with deterioration in health status and progression in illness. Five categories were related to the core category. The categories “being in the present”, “be safe and in charge” and “be seen and acknowledged” describe the patients’ preferences to live a meaningful life until death and be the same person as always. These preferences depended on the categories describing characteristics of healthcare personnel and the organisation of care: “reliable, compassionate and competent healthcare personnel” and “timely, predictive, continuous and adaptive organisation”. Conclusion: An important preference over time was to be here and now and to live as meaningful a life as possible until death. Moreover, the patients preferred to retain control over their lives, to be autonomous and to be seen as the person they had always been. To achieve this, person‑centred care provided by healthcare personnel with competence, skills and enough/ample time were required. In addition, home care needed to be organised in a way that ensured continuity and predictability. Systematic implementation of a person‑centred care model and the use of advanced home care plans with continued re‑evaluation for patients’ preferences of home care were proposed measures to enable home death. Keywords: Patients’ preferences, Cancer, Palliative care, End‑of‑Life (EOL) Care, Home death, Grounded Theory

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• Nysæter, Toril Merete (2025). Enabling Home Death: From the Perspectives of Patients, Family Caregivers and Healthcare Personnel. Universitet i Innlandet / University of Inland Norway. ISSN 9788283805604. Fulltekst i vitenarkiv Vis sammendrag

  Overgripende hensikt: Den overordnede hensikten med denne doktorgradsavhandlingen var å utforske preferanser for omsorg i hjemmet og støtte blant kreftpasienter i sen palliativ fase og deres pårørende for å muliggjøre hjemmedød, samt helsepersonells erfaringer med forhåndssamtaler i kommunehelsetjenesten med pasienter i sen palliativ fase som bor i eget hjem. Metode og design: Studie 1 og 2 er kvalitative studier som anvender grounded theory. Studiene ble utført parallelt og over tid, datainnsamlingen ble gjennomført med individuelle intervjuer med pasienter (n = 9) og pårørende (n = 11). Oppfølgingsintervjuer ble gjennomført 1- 4 ganger. Studie 3 er en kvalitativ metasyntese som anvender meta-etnografi og inkluderer 9 studier, hentet fra 6 databaser og referanselister. Hovedfunn: Pasientenes ønske om å dø hjemme holdt seg stabilt og endret seg ikke over tid. Deres preferanser for omsorg handlet om å leve et meningsfylt liv til døden og å bevare sitt menneskeverd, og ble fanget opp i; å være i nuet, være trygg og ansvarlig, og å bli sett og anerkjent. Preferansene var avhengige av å møte pålitelig, medfølende og kompetent helsepersonell, og en rettidig, forutsigbar, kontinuerlig og adaptiv organisering av pleien (Studie 1). Pårørendes preferanser for støtte økte over tid og var først og fremst knyttet til pasientens pleie, herunder å være involvert i pleien og å ha kontroll og handlingsberedskap. Deres egne behov var sekundære og handlet om å bli sett og bekreftet og å få et pusterom (Studie 2). Helsepersonellets erfaringer med forhåndsplanlegging av pleie og omsorg (ACP) ble delt inn i individuelle erfaringer: mangel på kunnskap og usikkerhet om hvordan man bruker ACP og om å finne det rette tidspunktet for ACP, og kontekstuelle erfaringer: involvering av familien i forhåndsplanlegging og hjemmet som arena for forhåndsplanlegging (Studie 3). Konklusjon: Pasienter og pårørende foretrekker pleie, omsorg og støtte i hjemmet ved livets slutt, slik at de kan beholde kontrollen i eget liv og leve et så meningsfylt liv som mulig. Implementering av en personsentrert omsorgsmodell og tidlig integrering og kontinuerlig bruk av forhåndssamtale kan være en måte å imøtekomme disse preferansene på, og dermed bidra til å gjøre hjemmedød mulig.

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