8^th International Conference on Public Health and Nursing August 14-15, 2019 Tokyo, Japan

Erika Berggren is currently working as a Health Care Development Leader at the Academic Primary Health Care Centre, Stockholm County Council and affiliated with Karolinska Institute's Department of Neurobiology, Care Sciences and Society.

Primary health care professionals can find it difficult to participate in continuing education despite their need for up-to-date knowledge. Suitable models for addressing this problem are rare. This study aimed to evaluate a continuing educational model tailored for primary health care circumstances (ConPrim). The model considers the need for inter-professional education to facilitate teamwork; pedagogical theory and methods to achieve a deeper level of understanding; and content adapted to the circumstances of primary health care to help fill knowledge gaps and make attendance more attractive. ConPrim consists of three steps that build on each other: a web-based program, a practical exercise, and a case seminar. This study tested ConPrim by using it to develop and evaluate an intervention in the subject “Nutritional care of patients cared for at home.” District nurses/registered nurses and general practitioners/physicians (n=87) working with home care at 10 primary health care centers in Stockholm, Sweden, completed a post-intervention questionnaire about the model. The professionals found the design attractive and user-friendly and the pedagogical methods to promote inter-professional and interactive learning. They rated the time spent as acceptable for all parts except the practical exercise; found the design suitable to primary health care; and thought the intervention increased their knowledge about a subject they viewed as useful and relevant to their work. ConPrim seems well-suited for continuing inter-professional education in primary health care. Future studies could test the model in other subject areas where there is a gap between evidence-based knowledge and practice.

Erika Berggren is currently working as a Health Care Development Leader at the Academic Primary Health Care Centre, Stockholm County Council and affiliated

with Karolinska Institute's Department of Neurobiology, Care Sciences and Society.

Primary health care professionals can find it difficult to participate in continuing education despite their need for up-to-date knowledge. Suitable models for addressing this problem are rare. This study aimed to evaluate a continuing educational model tailored for primary health care circumstances (ConPrim). The model considers the need for inter-professional education to facilitate teamwork; pedagogical theory and methods to achieve a deeper level of understanding; and content adapted to the circumstances of primary health care to help fill knowledge gaps and make attendance more attractive. ConPrim consists of three steps that build on each other: a web-based program, a practical exercise, and a case seminar. This study tested ConPrim by using it to develop and evaluate an intervention in the subject “Nutritional care of patients cared for at home.” District nurses/registered nurses and general practitioners/physicians (n=87) working with home care at 10 primary health care centers in Stockholm, Sweden, completed a post-intervention questionnaire about the model. The professionals found the design attractive and user-friendly and the pedagogical methods to promote inter-professional and interactive learning. They rated the time spent as acceptable for all parts except the practical exercise; found the design suitable to primary health care; and thought the intervention increased their knowledge about a subject they viewed as useful and relevant to their work. ConPrim seems well-suited for continuing inter-professional education in primary health care. Future studies could test the model in other subject areas where there is a gap between evidence-based knowledge and practice.

Lena Lund has completed PhD in Medical Science from Karolinska Institute in 2015. She is currently working as a Head of the Lifestyle Unit at the Academic Primary Health Care Centre in Stockholm.

Chronic Obstructive Pulmonary Disease (COPD) is mostly caused by smoking and patients’ prognoses are related to whether or not they continue to smoke after diagnosis. Quitting is therefore crucial to COPD treatment, but many patients find it difficult to stop smoking. To investigate which factors influence quit attempts among patients with COPD, our research group interviewed smokers with COPD to identify factors associated with success in quitting. These factors were used to develop the Trying to quit smoking Questionnaire (TTQ), which measures pressure-filled mental states, use of destructive pressure-relief strategies and ambivalent thoughts about quitting. This study evaluated whether the TTQ could predict smoking cessation outcomes in smokers with COPD. One hundred and nine smokers ompleted the TTQ at baseline and three months later. Logistic regression was used to measure the association between TTQ scores and making at least one quit attempt, reducing the intensity of smoking, and achieving abstinence. Higher total TTQ scores were significantly associated with a lower probability of at least one quit attempt. In a secondary analysis, we found that patients who were ready to make a quit attempt but also experienced pressure-filled mental states had a lower probability of attempting to quit. However, patients who did not feel ready to quit and who simultaneously experienced pressure-filled mental states halved the number of cigarettes they smoked. The TTQ can identify specific mental processes related to success in quitting and can be useful when counselling patients with COPD who need to quit smoking.

Liisa Samuelsson has completed her MSc in Medical Science at Karolinska Institute in 2017. She works as a Health Care Development Leader in the field of nutritional care, developing and providing continuing professional education for primary health care personnel in Stockholm County.

In 2011, the Stockholm County Council gave District Nurses (DNs) the right to prescribe Oral Nutritional Supplements (ONS). DNs are registered nurses who have completed an additional year of specialist education in primary care. The council charged the academic primary health care center with developing a course that would give DNs the knowledge they needed and the right to prescribe ONS. A group at the center used the Structure of the Observed Learning Outcome (SOLO) taxonomy to design a two-and-a-half-day course that covers identifying and analyzing older patients’ nutritional problems, planning and carrying out nursing care measures, prescribing ONS and following up and evaluating the measures. This questionnaire study evaluated participants’ perceived nutritional care and actual level of knowledge about nutritional care before and after the course. A total of 493 district nurses in Stockholm County participated in the course, which was given over a period of two to three months. Before and after the intervention, participants completed a study-specific questionnaire that covered their perceived nutritional care and actual level of knowledge. There were significant improvements in participants work with nutrition care and in their knowledge of all subject areas covered after the course (p=0.000-0.014). However, all participants did not fully achieve all learning objectives. DNs’ improvements as a result of the intervention lay the foundation for good nutritional care for older patients in primary care. The results have been used to improve the course, and an assessment of the revised course is ongoing.