While physical activity during cancer treatment is found beneficial for breast cancer patients, evidence indicates ambiguous findings concerning effects of scheduled exercise programs on treatment-related symptoms. This study investigated effects of a scheduled home-based exercise intervention in breast cancer patients during adjuvant chemotherapy, on cancer-related fatigue, physical fitness, and activity level. Sixty-seven women were randomized to an exercise intervention group (n = 33, performed strength training 3x/week and 30 minutes brisk walking/day) and a control group (n = 34, performed their regular physical activity level). Data collection was performed at baseline, at completion of chemotherapy (Post1), and 6-month postchemotherapy (Post2). Exercise levels were slightly higher in the scheduled exercise group than in the control group. In both groups, cancer-related fatigue increased at Post1 but returned to baseline at Post2. Physical fitness and activity levels decreased at Post1 but were significantly improved at Post2. Significant differences between intervention and control groups were not found. The findings suggest that generally recommended physical activity levels are enough to relief cancer-related fatigue and restore physical capacity in breast cancer patients during adjuvant chemotherapy, although one cannot rule out that results reflect diminishing treatment side effects over time.

"This is the pre-peer reviewed version of the following article: Husebø, A. M. L., Karlsen, B., Allan, H., Søreide, J. A. and Bru, E. (2015) Background. Earlier research show that women with breast cancer decrease physical activity following the cancer diagnosis, and that adhering to exercise interventions can be a challenge.Research is needed to identify motivational factors and barriers for exercise adherence among women during treatment for breast cancer.Design. This was a qualitative study to explore patient's perceptions of the challenges to exercise adherence during a randomized, controlled trial.Methods. Twenty-seven women with early stage breast cancer were purposively sampled for focus group interviews during 2011-2012 from their participation in the exercise intervention group during 2010-2012. Five focus groups were performed, and data analysis was completed using the Systematic Text Condensation method.Results. During the focus group study five main themes were identified which described factors participants perceived to influence their adherence to exercise during chemotherapy, and were: 'side-effects of breast cancer treatment as a barrier to exercise', 'restoring and maintaining normality in daily life motivates exercise', 'other valued activities compete with exercise', 'constructive support enhances exercise' and 'positive beliefs about efficacy and outcomes motivate exercise'. Conclusion.Adherence to exercise in women with breast cancer is challenged by internal and external conditions, and may be improved by attention to the impact of treatment sideeffects, and by supporting patient self-efficacy towards changing health behavior.Relevance to clinical practice. Nurses should be aware that exercise adherence could be a challenge among women with breast cancer. They should help identify obstacles to exercise  Nurses should acknowledge exercise adherence as a challenge to women with breast cancer, help identify barriers to exercise, and support the women in their exercise performance.

Background. This review identifies the content of virtual visits in community nursing services to older adults and explores the manner in which service users and the nurses use virtual visits. Design. An integrative literature review. Method. Data collection comprised a literature search in three databases: Cinahl, Medline, and PubMed. In addition, a manual search of reference lists and expert consultation were performed. A total of 12 articles met the inclusion criteria. The articles were reviewed in terms of study characteristics, service content and utilization, and patient and health care provider experience. Results. Our review shows that in most studies the service is delivered on a daily basis and in combination with in-person visits. The findings suggest that older home-dwelling patients can benefit from virtual visits in terms of enhanced social inclusion and medication compliance. Service users and their nurses found virtual visits satisfactory and suitable for care delivery in home care to the elderly. Evidence for cost-saving benefits of virtual visits was not found. Conclusions. The findings can inform the planning of virtual visits in home health care as a complementary service to in-person visits, in order to meet the increasingly complex needs of older adults living at home.

An optimal learning environment can be ensured by thorough preplacement preparations in academia and in nursing home wards, continuous supervision and facilitation of team learning.

Aims and objectives To explore chronic heart failure patients’ perceptions of the burden related to treatment and self‐care. Background Living with chronic heart failure entails following a demanding treatment regimen, with daily self‐care, which could make patients vulnerable to experiencing treatment burden. Burden of treatment is defined as the “work” the healthcare system passes on to the patients with respect to self‐care at home, and the impact this has on well‐being and quality of life. However, the burden of treatment is an emergent framework, and further research exploring burden among heart failure patients is required. Design Qualitative study employing semi‐structured interviews and content analysis. The study complied with the Consolidated Criteria for Reporting Qualitative Research (COREQ). Methods A sample of 17 heart failure patients recruited from an outpatient clinic in Norway. Interview transcripts were coded in Nvivo 11 and analysed using Malterud's systematic text condensation. Results Two main themes “emotional challenge” and “troublesome self‐care” emerged from the analysis. The first theme contained the following subthemes: “a new life situation,” “monitoring body signals,” “difficult transitions” and “feelings of guilt.” The second theme consisted of the subthemes “poor care coordination,” “lack of information and education” and “troublesome medication.” Conclusion Heart failure treatment constitutes challenges related both to self‐care and to emotional burden. The latter not previously clearly articulated in the concept of burden of treatment. Many patients are struggling emotionally, and this affects their self‐care ability in addition to affecting their well‐being and quality of life. Relevance to Clinical Practice Nurses are in a strategic position to play a pivotal role in identifying and responding to the emotional burden of treatment in heart failure patients, furthermore to guide and support in discharge planning and in outpatient setting to reduce the patients’ emotional distress and fear of failing.

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Aims and objectives To explore registered nurses’ mentorship practices of first‐year nursing students in nursing home placements. Background Enabling nursing students to develop professional competence through clinical placements relies heavily on registered nurses’ mentorship practices. Despite renewed interest in nursing homes as an important clinical placement setting, studies are scarce on registered nurses’ mentorship practices in this context. Design An exploratory, qualitative mixed‐methods design. Methods The data consisted of 126 h’ observation of two registered nurse mentor–student dyads, supplemented by in‐depth interviews (n = 12) with registered nurse mentors. The data were collected in three Norwegian nursing homes and analysed using content analysis. The consolidated criteria for reporting qualitative research (COREQ) checklist were used to report the findings. Results The registered nurses’ mentorship practices of first‐year nursing students in nursing home clinical placement were characterised by (1) variability and uncertainty in pedagogical supervisory approaches, (2) lack of management support and engagement of staff members in supervision, (3) lack of supervisory continuity and (4) a peripheral role in formal assessment discussions. Conclusions A marginal nursing home context, alongside a mismatch between registered nurses’ roles and first‐year students’ learning objectives, introduces considerable vulnerability that impedes effective mentorship practices. Targeted efforts to enhance mentorship practices in nursing homes are warranted to promote full use of the learning potential in this context. Developing and testing educational interventions is necessary to effectively enhance registered nurses’ pedagogical competence, alongside engagement and support from nurse managers and nurse educators. Relevance to clinical practice This study provides insight into barriers to effective mentorship practices of first‐year nursing students in nursing home placements. These barriers warrant attention from nursing home managers and nurse education institutions towards improvements that enhance effective mentorship practices vital for students’ learning, professional growth and future recruitment to care for older people.