Unmet sexual health needs of young men in contemporary society regarding condom use: Qualitative study.

OBJECTIVE: In contemporary societies young men receive much misleading information about sex from friends, the media and the internet (porn) which can make them feel insecure and under pressure regarding sex. The purpose of this study is therefore to understand their sexual world better and learn about their sexual health needs, especially regarding condom use. METHODS: The study is based on two qualitative studies: focus groups and individual interviews. Recruitment of participants took place through schools, a Sexually Transmitted Infection (STI) Clinic and a Gay and Lesbian Organisation. The interviews were thematically analysed using the framework method. RESULTS: Forty-nine individuals, 18-25 years old, participated in both studies. The findings showed that the participants had a number of unmet needs regarding condom use which reduced this use. They described uncertainty regarding condom use by not prioritising them, showing lack of knowledge and communication skills. It was of high priority for them to seek sexual pleasure and not be disturbed in the process of having sex. CONCLUSIONS: The results suggest that young men have a great need to perform sexually and not to fail. This need represents insecurity in a sexual relationship. When insecurity, inability to communicate and feeling under pressure come together using a condom is not prioritised. These young men are in great need of holistic sex education that would enable them to become secure in mastering condom use.

Educational courses on non-pharmacologic complementary interventions for nurses across Europe: The INES mapping pilot study.

BACKGROUND: Pharmacological interventions still form the mainstay of the management of pain, anxiety, sleep problems and discomfort. In Europe, an estimated 100 million people use complementary non-pharmacological interventions (NPIs) for these conditions. In their pre-registration education, nurses do not generally learn about the various types of NPIs and how patients and health care professionals can include NPIs complementary to their standard care. Some nursing schools in Europe offer elective courses on NPIs, often relying on individual initiatives. Little is publicly available about the content of these programmes and how they relate to the current nursing curriculum for EU countries. OBJECTIVES: This pilot study aims to explore and map the field of nursing education with regard to complementary NPIs for nurses in Europe. DESIGN: A web-based open-access questionnaire administered through the online survey tool LimeSurvey® was designed by the authors. PARTICIPANTS: The questionnaire was sent to a purposive sample of 49 experts on nurse education and complementary NPIs from 16 European countries. All levels of education were eligible for inclusion. METHODS: The questionnaire consisted of 35 items regarding course content, teaching material, teaching methods and methods of assessment. In addition, respondents were invited to perform a strengths, weaknesses, opportunities and threats (SWOT) analysis in relation to their education programme. Qualitative data was analyzed using a directive content analysis approach. RESULTS: Between January and May 2020, thirty-one completed questionnaires from ten different countries were returned (response rate 63.3%). Massage, meditation, mindfulness and relaxation are the most taught interventions. Anxiety, stress, chronic pain, depression and sleep problems are the most common symptoms addressed. CONCLUSIONS: Currently, a consistent and European approach to education for nurses on complementary NPIs and integrative nursing is lacking. Although taught at regular nursing educational institutes, the courses discussed here are not yet embedded in mainstream education for nurses.

Pain, Sleep, and Health-Related Quality of Life after Multidisciplinary Intervention for Chronic Pain.

Multidisciplinary pain-management programs have the potential to decrease pain intensity, improve health-related quality of life (HRQOL), and increase sleep quality. In this longitudinal prospective cohort study, the aim was to investigate the long-term effects of multidisciplinary pain rehabilitation interventions in Iceland. More precisely, we (a) explored and described how individuals with chronic pain evaluated their pain severity, sleep, and HRQOL at pre-treatment and at one-year follow-up and (b) examined what predicted the participants' one-year follow-up HRQOL. Seventy-nine patients aged 20-68 years, most of whom were women (85%), responded. The participants scored their pain lower at one-year follow-up (p < 0.001). According to their response, most of them had disrupted sleep, mainly because of pain. One year after the treatment, more participants slept through the night (p = 0.004), and their HRQOL increased. Higher pre-treatment mental component summary (MCS) scores and having pursued higher education predicted higher MCS scores at one-year follow-up, and higher pre-treatment physical component summary (PCS) scores predicted higher PCS scores at one-year follow-up. Sleep problems, being a woman, and having children younger than 18 years of age predicted lower MCS scores at one-year follow-up. These findings are suggestive that patients should be examined with respect to their mental status, and it could be beneficial if they received some professional support after completing the intervention.

Pain Rehabilitation's Effect on People in Chronic Pain: A Prospective Cohort Study.

Multidisciplinary long-term pain rehabilitation programs with a team of healthcare professionals are an integrated approach to treat patients with chronic non-malignant pain. In this longitudinal prospective cohort study, we investigated the long-term effects of multidisciplinary pain rehabilitation on the self-reported causes of pain, pain self-management strategies, sleep, pain severity, and pain's interference with life, pre- and post-treatment. Eighty-one patients, aged 20-69 years, with chronic pain responded. The two most frequently reported perceived causes of pain were fibromyalgia and accidents. The difference in average self-reported pain severity decreased significantly at one-year follow-up (p < 0.001), as did pain's interference with general activities, mood, walking ability, sleep, and enjoyment of life. At one-year follow-up, participants (21%) rated their health as good/very good and were more likely to state that it was better than a year before (20%). No change was found in the use of pain self-management strategies such as physical training at one-year follow-up. The intervention was effective for the participants, as reflected in the decreased pain severity and pain interference with life.

The prevalence and characteristics of yoga or meditation users in Iceland: Results of a national health survey.

BACKGROUND: Use of yoga or meditation has increased decisively in recent years. Factors associated with the use of yoga and meditation are not well understood. The aim was to focus on the relationship of yoga and meditation to sociodemographic background, religiosity, healthcare-related attitudes, mental and physical health, and physician visits. MATERIALS AND METHODS: This study builds on data from a national health survey of a random sample of Icelandic adults, aged 18-75 (n = 1599; response rate of 58%). RESULTS: The overall use of yoga or meditation reached 19.3% in 2015. This is an increase of 12.5% points over a nine-year period. The increase was much greater for women. Yoga or meditation use was positively related to the female gender, younger age, higher levels of education, and not belonging to a religious denomination. It was also positively related to higher anxiety, previous visits to a physician, and a positive attitude toward CAM services, but it was negatively related to having chronic medical conditions. CONCLUSION: Increased use of yoga or meditation may reflect public interest in Icelander's self-care and health promotion. Further studies are needed to better understand the predictors and effects of yoga and meditation.

The use of complementary and alternative medicine in Iceland: Results from a national health survey.

Background: The use of complementary and alternative medicine (CAM) has increased in Western societies in recent years. In a national health survey conducted in 2006 in Iceland, 31.8% of the population had used CAM in the past 12 months; however, the trend of CAM use since then is unknown. This study's aim was to describe participants' use of CAM providers in Iceland in 2015 and compare it to the results of the previous survey. The current study explored the relationship between the participants' use of CAM and their background, religiosity, healthcare attitudes, mental and physical health, and physician visits. Methods: The study was based on a national health survey conducted in the Spring of 2015. The questionnaire was mailed to a random sample of Icelandic adults, aged 18-75. Altogether 1599 respondents returned valid questionnaires (response rate 58%). The standardized questions were developed and tested in previous health surveys. Results: Nearly 40% of respondents had used CAM in the past 12 months. This is an estimated 8.4% increase since 2006. Women and people with more education were more likely than other participants to use CAM. Repeated physician visits were related to increased likelihood of CAM use. Individuals with high anxiety were more likely than others to use CAM. Conclusions: Icelanders use CAM providers to a considerable degree, and CAM use has increased in recent years. Most CAM users appear to use CAM to complement care received in the general health system.

Facilitation of a Person-Centered Approach in Health Assessment of patients with chronic pain: An Ethnographic Study.

A phenomenologically derived assessment tool, Hermes, was developed in a rehabilitation setting for adopting the central ideals of person-centered care and patient participation into health-assessment practices in nursing. This focused ethnographic study aimed at exploring the feasibility of using Hermes for enabling the application of these ideals into assessment of patients with chronic pain upon admission to a rehabilitation center. Participants were patients with chronic pain, enrolled in rehabilitation, and their nurses. Data were collected by participant observation and interviews, and analyzed by thematic analysis. By the use of Hermes, the impact of illness was explored through supportive connection and dialogue with open, reflective, and interpretative features; understanding of the illness situation was enhanced; and possibilities provided in adjusting to health issues of concern. In sum, Hermes facilitated person-centered participation of patients with chronic pain in their health assessment and made a phenomenological philosophy usable in nursing-assessment practices.

Use of complementary therapies in nursing homes: Descriptive study.

INTRODUCTION: Complementary therapies may have positive effect on residents in nursing homes. The aim of this research was to investigate what kind of complementary therapies are provided in Icelandic nursing homes and who are the providers. Also whether the nursing homes need assistance to support the use of such therapies. METHOD: A questionnaire was mailed to all the nursing homes in Iceland (N = 59). Total of forty-five nursing homes replied or 76% response rate. RESULTS: Registered nurses and licenced practical did most of the planning and provision of complementary therapies. The most common therapies were: heat packs, physical exercise and massage. Managers would like to have more knowledge and support in providing complementary therapies. CONCLUSION: The use of some complementary therapies is common in Icelandic nursing homes. More knowledge is needed to support the use of CT in Icelandic nursing homes.

The experience of sudden cardiac arrest: becoming reawakened to life.

BACKGROUND: Sudden cardiac arrest (SCA) is an event that has tremendous impact on the physical, cognitive and emotional well-being of individuals. Clinical experience and results of various studies indicate that survivors, in addition to having problems related to the underlying disease, have unique needs as a result of the cardiac arrest. AIM: The main purpose of this study was to describe survivors' experiences following SCA and resuscitation in order to gain knowledge of the effect of this experience on the needs and concerns of the survivors. METHODS: This qualitative study draws on interpretive phenomenology. The sample was purposive and data were generated through two semi-structured interviews. RESULTS: Seven men aged 50 to 54 years participated. Participants' experience is reflected in the following themes: feelings of insecurity and the need for support; striving to regain former life; emotional challenges; responding to symptoms; and a new view on life. CONCLUSION: The findings illustrate complex effects of the cardiac arrest on the survivor's life. Support after hospital discharge needs to be organized in a more structured fashion. The need for security and support was fundamental and should be addressed with continuity and vigilance in health care.

Healing crisis in reflexology: becoming worse before becoming better.

PURPOSE: In the previous study the effects of reflexology on symptoms of fibromyalgia (FM) were investigated. In this paper it will be explored whether healing crisis is experienced after reflexology in the same sample of women. METHODS: Multiple case study method as developed by Stake was used to investigate the effects of reflexology on six cases of women with FM who were given ten weekly sessions of reflexology. Data were collected with observation, interviews and diary. Within and across case data analysis was employed. RESULTS: Several different symptoms were experienced by all of the women after reflexology sessions, although differently for each of them. The symptoms presented as mixture of pain, fatigue, and flu like along with a variety of some other symptoms. This constellation of symptoms was more in tune with descriptions of the healing crisis phenomenon than with fibromyalgia. It gradually became worse until rather abruptly started to diminish around the seventh and eighth session. CONCLUSIONS: For the majority of the women the healing crisis symptoms gradually became worse before they started to decrease. This has similarities with other health professionals' accounts in the literature. Nurses and health professionals need to be aware of healing crisis effects when offering reflexology to patients.

Effects of reflexology on fibromyalgia symptoms: a multiple case study.

PURPOSE: To explore the effects of reflexology on pain and other symptoms in women with fibromyalgia syndrome [FM]. METHODS: Multiple case study method as developed by Stake was used to investigate the effects of reflexology on six cases of women with FM which were given ten sessions of weekly reflexology. Data were collected with observation, interviews and diary and then analyzed within cases and across cases. RESULTS: Reflexology affected the symptom of pain in multiple areas such as head, neck and arms. Pain started to isolate and decrease. CONCLUSION: Reflexology may be helpful to decrease fibromyalgia symptoms. Qualitative research methods and individually tailored interventions are important when researching complementary and alternative therapies.

[Utilization of complimentary and alternative health services in Iceland]. / Notkun óhefdbundinnar heilbrigdisþjónustu á Íslandi.

OBJECTIVE: Westerners increasingly use complimentary and alternative (CAM) methods for curing illness and promoting health. The central ideas of CAM appear to resonate with large segments of the general public. Little is known about CAM use in Iceland. The purpose of the study was to assess the scope of utilization of CAM providers and the likely explanatory factors. MATERIAL AND METHODS: The data come from a national postal health survey that took place during the Fall of 2006. A sample of Icelandic adults, age 18-75, was randomly drawn from the National Register. 1532 individuals responded to the survey yielding a 60% response rate. RESULTS: Almost 32% of the respondents had used a CAM provider in the past 12 months, an estimated increase of 6% since 1998. Women and high income individuals were more likely to use a CAM provider than men and lower income individuals. Physical and mental distress was also related to the likelihood of CAM use. Individuals having negative or positive attitude toward physician services were more likely to use a CAM provider than those expressing a neutral attitude. Finally, repeated physician visits were related to an increased likelihood of CAM use. CONCLUSIONS: Icelanders use CAM providers to a considerable degree, and CAM use has increased in recent years. It appears that some clients regard the care they receive in the general health system as insufficient. Most CAM users appear to use CAM treatments as a supplement to the care received in the general health system.

Does the experimental design capture the effects of complementary therapy? A study using reflexology for patients undergoing coronary artery bypass graft surgery.

AIM: Our purpose was to pilot test whether reflexology may reduce anxiety in patients undergoing Coronary Artery Bypass Graft Surgery in Iceland. BACKGROUND: Nurses need to study the effects of complementary therapies in general and particularly those that may be beneficial to decrease patients' anxiety. It has been assumed that reflexology lessens anxiety, but research is needed to substantiate such expectations. DESIGN: A pilot study using randomized design with experimental and control groups. METHODS: Nine patients were recruited and randomly assigned into groups with five patients assigned into an experimental group receiving reflexology for 30 minutes and four patients into control group which rested for 30 minutes. Anxiety and physiological variables were measured pre- and post-reflexology sessions once a day over five days. RESULTS: The anxiety scores were lower for patients in the control group on all measures. Systolic blood pressure lowered significantly more in the control group than in the treatment group. No significant changes were observed for other variables. Patients' comments and responses overwhelmingly suggested increased well-being due to both experimental and control intervention. CONCLUSION: This study showed little evidence to support reflexology as a mean of reducing anxiety in CABG patients. Several methodological problems were identified that need to be considered further. RELEVANCE TO CLINICAL PRACTICE: It is suggested that reflexology should be tailored to individual needs and research methods used that allow for capturing its holistic nature. Further scholarly work is warranted to explore several methodological issues in studying complementary therapies in a highly complex treatment situation.

The experience of using a combination of complementary therapies: a journey of balance through self-healing.

Literature on complementary or alternative therapies from the perspective of personal experience is limited, and to date, there are no published studies using a qualitative approach to study the contextual effects of combined complementary therapies. Evaluating the use of combinations of complementary therapies from the perspective of those who experience them is important in understanding their beneficial and synergistic effects. This article is a report of the findings of a hermeneutic phenomenological study on the lived experience of 8 guests participating in a structured naturopathic program that used combinations of complementary/alternative therapies to promote healing in illness.