User satisfaction with antenatal care in Norway.

BACKGROUND: In Norway, antenatal care is delivered free of charge in the municipality. Satisfaction with care is considered to be an important predictor of utilization of health care. The aim of this study was to examine women's satisfaction with antenatal care, and to identify factors that predict overall satisfaction with the service. METHODS: A total of 611 women completed a survey that collected information on demographic variables, pregnancy variables, and aspects of antenatal care; it also contained one open-ended question. A hierarchical multiple regression analysis was conducted to predict Overall Satisfaction with antenatal care based on four specific scales: User Participation, Accessibility, Information, and Midwife, adjusted for demographic variables. RESULTS: Survey responses showed that 95% of women were satisfied with antenatal care in general. The expectant mother's age, having Norwegian as the native language, and the scales User Participation, Information, and Midwife were all significant predictors of Overall Satisfaction with antenatal care. The open-ended user comments underlined the important role of midwifes in antenatal care. CONCLUSIONS: The results of this study indicate that women who attended antenatal care in Norway were satisfied with the care they received. Midwives had an important role, and their relational and professional competence was highly valuated by expectant mothers. The findings also suggest that there are still opportunities to improve satisfaction with antenatal care, for example, by increasing the focus on mental health during antenatal consultations.

How do public health nurses in Norwegian school health services support siblings of children with complex care needs?

AIMS: There is a paucity of data regarding the care and support provided by Norwegian school health services to siblings of children with complex care needs. Public health nurses are an integral part of these universal services, which focus on health promotion and disease prevention in primary and secondary schools. This study aimed to explore health promotion interventions by public health nurses for siblings in Norwegian schools and to identify regional differences. METHODS: An online national questionnaire was distributed to Norwegian public health nurses and leaders of public health nursing services (N = 487). The questions were related to how the nurses support siblings of children with complex care needs. The quantitative data were analysed using descriptive statistics. An inductive thematic analysis of free-text comments was conducted. ETHICAL APPROVAL: The study was approved by the Norwegian Centre for Research Data. RESULTS: The majority of public health nursing leaders (67%) reported that the services in their municipality had no system to identify siblings or to provide them with routine care. However, 26% of public health nurses reported that routine support was provided to siblings. Regional differences were identified. STUDY LIMITATIONS: This study included responses from 487 PHNs from all four health regions in Norway. The study design is limited and gives a brief outline of the current situation. Further data are needed to provide in-depth knowledge. CONCLUSIONS: This survey provides important knowledge for health authorities and professionals working with siblings, about inadequate support and regional differences in care provided to siblings by school health services.

Psychological factors and performance in women's football: A systematic review.

The amount of research conducted on female football players, compared to male players, is sparce. Even though research on female football players has increased the past decade, there is still a lack of studies of how psychological factors affect their performance. The objective of the current systematic review was therefore to summarize existing quantitative research into the relationship between psychological factors and performance in women's football. Literature was sourced from MEDLINE/PubMed, Embase, and PsychInfo. Two independent reviewers applied the selection criteria and assessed the quality of the studies. A total of 14 studies met the inclusion criteria. The total number of participants was 1449, and 15 psychological factors were examined in relation to football performance. The results revealed a tendency for higher leveled players to score higher on psychological factors like mental toughness, conscientiousness, and executive functions. They also had lower levels of anxiety. Enjoyment and a perceived mastery climate were related to increased levels of performance and perceived competence. Mood was unrelated to performance. Limitations and implications for future research are discussed.

The psychometric properties and norm data of the Norwegian military personality inventory (NMPI).

The five-factor structure is a well-established model for personality. The five traits covary with job-performance and work-relevant outcomes. The practical administration of existing big-five measurement scales is, however, somewhat limited, in a Norwegian setting, as existing scales are impractically large or have unknown psychometric properties. Because of this, a new brief Norwegian personality assessment tool has been developed by the Norwegian Armed Forces. This study aims to uncover the psychometric properties of the 50-item Norwegian military personality inventory (NMPI-50) and establish norm data for practical use. The inventory was administered to the 2002 cohort of Norwegian 17-year olds (N = 54,355), and analyzed with factor analysis, graded response models and tests of gender invariance. The five scales of the NMPI-50 showed satisfactory internal consistency, yielded high information across a broad range of the five traits, and conformed to a bi-factor structure with one general factor and five specific factors. The general factor was positively associated with motivation for military service, indicating some measurement bias. The openness scale is less clearly psychometrically defined, compared to the other scales, and both extroversion and openness show some evidence of multidimensionality. The scales also showed scalar invariance between genders except for the openness scale. Overall, the results support the use of NMPI-50 in personnel assessment and research.

Fit for fight - self-reported health in military women: a cross-sectional study.

BACKGROUND: Substantial research has found that women assess their health as poor relative to men, but the reasons for this are not fully understood. Military women are characterised by good health and the ability to work in an archetypically male culture. Thus, studies on the gender pattern of self-reported health in military personnel could generate hypotheses for future research on the possible associations between gender and health. However, such studies are rare and limited to a few countries. The aim of this study was to examine self-reported physical and mental health in Norwegian military women. METHODS: We compared responses on self-reported health of 1068 active duty military women in Norway to those of active duty military men (n = 8100). Further, we compared the military women to civilian women working in the Norwegian Armed Forces (n = 1081). Participants were stratified into three age groups: 20-29; 30-39; and 40-60 years. We used Pearson Chi-square tests, Students t-tests and regression models to assess differences between the groups. RESULTS: The military women in our study reported physical illness and injuries equal to those of military men, but more military women used pain relieving and psychotropic drugs. More military women aged 20-29 and 30-39 years reported mental health issues than military men of the same age. In the age group 30-39 years, twice as many military women assessed their health as poor compared to military men. In the age group 40-60 years, more military women than men reported musculoskeletal pain. Military women used less smokeless tobacco than military men, but there were few differences in alcohol consumption and smoking. Military women appeared to be more physically healthy than civilian women, but we found few differences in mental health between these two groups. CONCLUSION: Most military women reported physical symptoms equal to those of military men, but there were differences between the genders in mental health and drug use. More favourable health compared to civilian women was most evident in the youngest age group and did not apply to mental health.

Linking interprofessional work to outcomes for employees: A meta-analysis.

The aim of this meta-analysis of studies of workers in the health and social care sector was to examine the relationship between interprofessional work and employee outcomes of job stress, autonomy, burnout, engagement, job satisfaction, turnover intention, and perceived service quality, and to examine the influence of different moderators on those relationships. A systematic literature search of the PsycInfo, Embase, Medline, and the Cumulative Index to Nursing and Allied Health Literature databases was conducted to identify relevant articles. A total of 45 articles with results for 53 independent samples was included in the meta-analysis. A random effects model was used to estimate the mean effect sizes (correlations). Most employees were nurses working in hospitals. Interprofessional work was weakly negatively associated with job stress, burnout, and turnover intention (range mean r = -.13 to -.22); and was moderately positively associated with autonomy, engagement, job satisfaction, and perceived service quality (range mean r =.33 to .46). When feasible, interprofessional work was categorized as teamwork (most intensive), collaboration, or cooperation. Teamwork, the most intense of three forms of interprofessional work, promoted lower burnout and turnover intention. The results of this meta-analysis suggest that interprofessional work is linked to better well-being for employees in health and social care.

The Placebo Analgesic Effect in Healthy Individuals and Patients: A Meta-Analysis.

OBJECTIVE: The present meta-analysis investigates whether the magnitude of placebo analgesia is different in patients compared with healthy individuals and whether placebo analgesia is different in experimentally induced pain compared with clinical pain in patients. METHODS: A literature search in Web of Science (ISI) on the terms "placebo analgesia" and "placebo analgesic" was conducted. The search resulted in 71 studies, including 4239 participants. Fifty-five studies included healthy individuals and 16 studies included patients. Of the 16 studies with patients, five studies investigated clinical pain and 11 studies investigated experimentally induced pain. RESULTS: The average effect size was 1.24 for healthy individuals and 1.49 for patients. In the studies with patients, the average effect sizes of placebo treatment were 1.73 for experimentally induced pain and 1.05 for clinical pain. A χ test revealed that there were relatively more studies with patients compared with healthy volunteers in which there was a clinically significant reduction in pain (p = .040). CONCLUSIONS: The findings suggest that patients benefited from placebo treatment to a greater degree than healthy individuals did and that studies on healthy individuals may underestimate the magnitude of the placebo analgesic effect in patients. Patients' clinical pain and experimentally induced pain respond to placebo to the same degree.

Reorganisation of healthcare services for children and families: Improving collaboration, service quality, and worker well-being.

This study is an evaluation of a reorganisation of different services for children and their families in a Norwegian municipality. The main aim of the reorganisation was to improve interprofessional collaboration through integrating different social services for children and their parents. The evaluation was guided by the Job Demands-Resources Model with a focus on social and healthcare workers' experiences of their work, including job demands and resources, service quality, and well-being at work. The survey of the employees was conducted at three measurement points: before (T1) and after (T2, T3) the reorganisation took place, and included between 87 and 122 employees. A secondary aim was to examine the impact of different job resources and job demands on well-being (burnout, engagement, job satisfaction), and service quality. A one-way ANOVA indicated a positive development on many scales, such as collaboration, work conflict, leadership, and perceived service quality, especially from T1 to T2. No changes were detected in burnout, engagement, or job satisfaction over time. Moderated regression analyses (at T3) indicated that job demands were particularly associated with burnout, and job resources with engagement and job satisfaction. Perceived service quality was predicted by both job demands and resources, in addition to the interaction between workload and collaboration. The reorganisation seems to have contributed to a positive development in how collaboration, work conflict, leadership, and service quality were evaluated, but that other changes are needed to increase worker well-being. The value of the study rests on the findings that support co-locating and merging services for children and their families, and that collaboration is an important resource for healthcare professionals.

The comorbidity of personality disorders in eating disorders: a meta-analysis.

PURPOSE: The present meta-analysis summarized the proportion of comorbid personality disorders (PDs) in patients with anorexia (AN) and bulimia nervosa (BN), respectively, and examined possible moderating variables. METHODS: A search of the databases PsychINFO, Embase, and Medline for the period 1980-2016 identified 87 studies from 18 different countries. RESULTS: The mean proportion of PDs among patients with any type of eating disorder (ED) was .52 compared to .09 in healthy controls. There were no statistically significant differences between AN (.49) and BN (.54) in proportions of any PD or PD clusters except for obsessive-compulsive PD (.23 vs .12 in AN and BN, respectively). CONCLUSIONS: Both ED diagnoses had a similar comorbidity profile with a high prevalence of borderline and avoidant PDs. Moderator analyses conducted for any ED and any PD yielded significant differences for diagnostic systems with respect to EDs, method for assessing PD as well as patient weight and age.

Preventing alcohol use with a universal school-based intervention: results from an effectiveness study.

BACKGROUND: The effectiveness of the universal school-based alcohol prevention program "Unge & Rus" [Youth & Alcohol] was tested by an independent research group. The program aims to prevent alcohol use and to change adolescents' alcohol-related attitudes. The main outcome measure was frequency of monthly alcohol use, favorable alcohol attitudes, perceived behavioral control (PBC), positive alcohol expectancy and alcohol-related knowledge. METHODS: Junior high school students (N = 2,020) with a mean age of 13.5 years participated in this longitudinal pre, post and one-year follow-up study with a quasi-experimental design, involving an intervention group and a comparison group recruited from 41 junior high schools in Norway. Multilevel analysis was used to account for the repeated observations (level 1) nested within students (level 2) who in turn were clustered within school classes (level 3). RESULTS: Results showed an increased level of alcohol-related knowledge in the intervention group (p < .005) as compared to the comparison group at one-year follow-up. However, no significant difference in change was found between the intervention group and the comparison group in frequency of monthly alcohol use, alcohol-related attitudes, PBC or alcohol expectancy at one-year follow-up. CONCLUSIONS: This study offers adequate data on the effectiveness of a school-based alcohol prevention program widely implemented in Norway. Under its current method of implementation, use of the program cannot be supported over the use of standard alcohol curriculum within schools.

Personality disorders in eating disorder not otherwise specified and binge eating disorder: a meta-analysis of comorbidity studies.

A meta-analysis was conducted to identify the proportion of comorbid personality disorders (PDs) in patients with eating disorder not otherwise specified (EDNOS) and binge eating disorder (BED). A search identified 20 articles in the period of 1987 to 2010. For EDNOS and BED, the comorbid proportions for any PD were 0.38 and 0.29, respectively; for cluster C PDs, 0.38 and 0.30, respectively (avoidant PD, 0.18 and 0.12, and obsessive-compulsive PD, 0.11 and 0.10, respectively); and for cluster B PDs, 0.25 and 0.11, respectively (borderline, 0.12 and 0.10). This pattern converged with findings on anorexia nervosa and bulimia nervosa, except being lower. Because the comorbidity profiles for EDNOS and BED were highly similar, their underlying PD pathology seems similar. Few moderators were significant, except for interviews yielding lower estimates than that of questionnaires. The variance statistic for any PD comorbidity was wide for EDNOS and narrow for BED, thus partly supporting BED as a distinct eating disorder category and EDNOS as a potentially more severe condition than BED.

Implementing new routines in adult mental health care to identify and support children of mentally ill parents.

BACKGROUND: Mental health problems are often transmitted from one generation to the next. This knowledge has led to changes in Norwegian legislation, making it mandatory to assess whether or not patients have children, and to provide necessary support for the children of mentally ill patients. The main purpose of this study was to evaluate the process of implementing new routines in adult mental health services to identify and support children of mentally ill parents. METHODS: The design was a pre-test post-test study. The sample (N = 219 at pre-test and N = 185 at post-test) included mental health professionals in the largest hospital in the region, who responded to a web-based survey on the routines of the services, attitudes within the workforce capacity, worker's knowledge on the impact of parental mental illness on children, knowledge on legislation concerning children of patients, and demographic variables. RESULTS: The results of this study indicated that some changes are taking place in clinical practice in terms of increased identification of children. Adult mental health services providing support for the children was however not fully implemented as a new practice. CONCLUSION: The main finding in this study is that the identification frequency had increased significantly according to self-reported data since the Family Assessment Form was implemented. The increase in self-reported identification behavior is however taking place very slowly. Three years after the legislation was changed to making it mandatory to assess whether or not patients have children, it was still not fully incorporated in the routines of the entire workforce. In terms of support for the families affected by parental mental illness, the changes are not yet significant.

Early drinking onset: a study of prevalence and determinants among 13-year-old adolescents in Norway.

Early drinking onset is associated with different psychosocial adjustment problems among adolescents. The aim of this study was to assess determinants associated with early drinking and to identify factors predicting early drinking onset among adolescents. The study included 1,550 eighth-graders with a mean age of 13.5 years from 41 schools. A total of 24% (boys 29%, girls 19%) had ever drunk alcohol, while 14% had drunk some alcohol in the last 30 days. Further, early drinking was associated with gender, religion, school performance, smoking and bullying in the bivariate tests. Predictors of early drinking onset were identified by generalized linear mixed models with two multivariable models created. The first model included social and environmental variables. Entering intentions, expectancies, attitudes and norms into the multivariable analysis resulted in a significant improvement of the model fit constituting 86% in the second model. The percentage correctly classified those (56%) who had been drinking in the second model which was two times higher compared to the first model. Gender, religion and smoking emerged as significant predictors of drinking in both models.

A global meta-analysis of depression, anxiety, and stress before and during COVID-19.

OBJECTIVE: This meta-analysis compared negative emotions (NEs) as depression, anxiety, and stress, from before the pandemic to during the pandemic. METHOD: A total of 59 studies (19 before, 37 during-pandemic, and 3 that included both) using the Depression, Anxiety and Stress Scale (DASS) were included. A random effects model estimated the means of NEs before and during the pandemic. RESULTS: Studies from 47 countries involving 193,337 participants were included. Globally, NEs increased during the pandemic, and depression had the largest elevation. In Asia, depression and stress were elevated, whereas in Europe, only depression increased, and in America, no differences in NEs between before and during the pandemic were observed. The later time phase of the pandemic was associated with lower stress globally, and lower stress and anxiety in Europe. Being younger was associated with more stress globally, and being older was associated with higher anxiety in Asia. Students had higher anxiety globally, and higher NEs in all three aspects in Europe compared to the general population. The COVID-19 infection rate was associated with more stress globally, and stress and anxiety in Europe. During the pandemic, females reported higher levels of depression, anxiety, and stress compared to males, most pronounced in Europe. CONCLUSION: NEs increased during the pandemic, with younger and student populations, females and Asians having the highest elevations. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

A Universal Mental Health-Promoting Mobile App for Adolescents: Protocol for a Cluster Randomized Controlled Trial.

BACKGROUND: In times of increasing mental health problems among young people, strengthening efforts to improve mental health through mental health promotion and prevention becomes increasingly important. Effective measures that support young people in coping with negative thoughts, feelings, and stress are essential, not just for the individual but also for society. OBJECTIVE: The aim of this paper is to provide a description of a cluster randomized controlled trial that will be conducted to examine the effectiveness of Opp, a universal mental health-promoting mobile app for adolescents aged 13 to 19 years that provides information and exercises to better cope with stress, negative thoughts, and negative feelings. The protocol was developed in accordance with the SPIRIT checklist. METHODS: An effectiveness study will be conducted with 3 measurement points: preintervention (T1), 2 weeks after the intervention (T2), and about 1 month after the intervention (T3). Adolescents will be recruited from middle and high schools in Norway and randomly assigned to the intervention or control groups. Randomization will be conducted on the school level. Opp can be downloaded from the Google Play or App Store but is password protected with a 4-digit code, which will be removed after study completion. Participants in the intervention group will receive a text message with the code to unlock the app. The participants in the intervention group can use Opp without limits on length or time of use. Objective data on how long or how often the participants use the app will not be collected. However, the second and third questionnaires for the intervention group contain app-specific questions on, for example, the use of the app. RESULTS: Recruitment and data collection started in August and September 2022. So far, 381 adolescents have answered the first questionnaire. Data collection was expected to end in December 2022 but has had to be prolonged to approximately June 2023. The results of the study will be available in 2023 at the earliest. CONCLUSIONS: This project will contribute unique knowledge to the field, as there are few studies that have examined the effects of universal health-promoting mobile apps for adolescents. However, several limitations have to be taken into account when interpreting the results, such as randomization on the school level, the short time frame in which the study was conducted, and the lack of objective data to monitor the use of the app. TRIAL REGISTRATION: ClinicalTrials.gov NCT05211713; https://www.clinicaltrials.gov/ct2/show/NCT05211713. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/42119.

Beyond physical ability-predicting women's football performance from psychological factors.

Introduction: Even though there is a clear agreement among researchers that psychological factors are a vital part of a football player's performance, the topic has not been investigated thoroughly. The present study aimed to examine the predictive value of psychological factors on female football players' match performance. Methods: A sample of 156 players from the top two leagues in Norway completed the following questionnaires: Perceived Motivational Climate in Sport Questionnaire 2 (PMCSQ-2), Big Five Inventory (BFI-20), Self-Regulated Learning questionnaire, and Grit-S and Sport Mental Toughness Questionnaire (SMTQ). Match performance data were collected from the online database of the performance analysis company InStat. Results: Results from a linear mixed model analysis showed that perceived mastery climate and extraversion were the only significant predictors of performance. Other relevant indicators, such as mental toughness, self-regulated learning, and grit, did not predict performance. Discussion: These findings suggest that the team climate facilitated by coaches may be more important for predicting match performance than individual psychological factors.

General Measurement Tools for Assessing Mental Health Problems Among Children and Adolescents with an Intellectual Disability: A Systematic Review.

There is a need for more knowledge of valid and standardized measures of mental health problems among children and adolescents with intellectual disability (ID). In this study, we systematically reviewed and evaluated the psychometric properties of instruments used to assess general mental health problems in this population. Following PRISMA guidelines, we reviewed empirical research published from 1980 through February 2020 with an updated search in March 2021 in Medline, Embase, PsycINFO, Health and Psychological Instruments, CINAHL, ERIC, and Web of Science databases. Forty-nine empirical articles were included in this review. Overall, the review indicated consistently better documentation of the reliability and validity of instruments designed for the ID population compared to instruments developed for the general child population.

IQ as a predictor of clinician-rated mental health problems in children and adolescents.

OBJECTIVE: Previous studies indicate that low IQ is a substantial risk factor for developing mental health problems. Based on these results, we hypothesized that IQ may predict some of the variance in clinician-rated severity of children's mental health problems measured with the Children's Global Assessment Scale (CGAS) and Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA). The other aims of this study were to examine if there was any difference in the predictive ability of the different IQ scores of the Wechsler Intelligence Scale for Children, Third edition (WISC-III) and to examine if parent-rated measure of child mental health problems could predict the scores on CGAS and HoNOSCA after controlling for IQ, age, and gender. METHODS: In this study, 132 patients at three outpatient clinics in North Norway were assessed with the parent version of the Strength and Difficulties Questionnaire (SDQ), HoNOSCA, CGAS, and with the WISC-III. RESULTS: Hierarchical regression analyses were conducted with HoNOSCA and CGAS as dependent variables. Demographics, WISC-III IQ scores, and SDQ were entered as independent variables. The model with HoNOSCA as the dependent variable predicted 25% of the total variance. The WISC-III full-scale IQ predicted an additional 6% of the variance. The analyses with CGAS as the dependent variable gave no significant results. CONCLUSION: When a patient has a high HoNOSCA score, an intelligence test in addition to an evaluation of symptoms on mental health should be considered. Future research ought to examine whether HoNOSCA's ability to detect change might be affected by patients IQ.

Improving interprofessional collaboration in a community setting: relationships with burnout, engagement and service quality.

The main purpose of this study was, firstly, to evaluate the effect of an intervention aimed at improving interprofessional collaboration and service quality, and secondly, to examine if collaboration could predict burnout, engagement and service quality among human service professionals working with children and adolescents. The intervention included the establishment of local interprofessional teams and offering courses. The sample was recruited from six different small municipalities in Northern Norway (N = 93) and a comparison group from four similar municipalities (N = 58). Participation in the project increased the level of collaboration in the intervention group significantly (Hedges' g = 0.36), but not the perceived level of service quality. Hierarchical regression analyses were used to test a model for predicting burnout, engagement and perceived service quality using work-related factors, including collaboration as predictors. Both burnout and engagement were predicted by job demands and resources after controlling for demographic variables and participation in the project. Service quality was mostly predicted by collaboration. Increasing collaboration seems possible by introducing practice-based changes; however, this intervention did not have the desired effect on perceived service quality.

Agreement on Web-based Diagnoses and Severity of Mental Health Problems in Norwegian Child and Adolescent Mental Health Services.

OBJECTIVE: This study examined the agreement between diagnoses and severity ratings assigned by clinicians using a structured web-based interview within a child and adolescent mental health outpatient setting. METHOD: Information on 100 youths was obtained from multiple informants through a web-based Development and Well-Being Assessment (DAWBA). Based on this information, four experienced clinicians independently diagnosed (according to the International Classification of Diseases Revision 10) and rated the severity of mental health problems according to the Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA) and the Children's Global Assessment Scale (C-GAS). RESULTS: Agreement for diagnosis was κ=0.69-0.82. Intra-class correlation for single measures was 0.78 for HoNOSCA and 0.74 for C-GAS, and 0.93 and 0.92, respectively for average measures. CONCLUSIONS: Agreement was good to excellent for all diagnostic categories. Agreement for severity was moderate, but improved to substantial when the average of the ratings given by all clinicians was considered. Therefore, we conclude that experienced clinicians can assign reliable diagnoses and assess severity based on DAWBA data collected online.