Ongoing changes in many Western countries have resulted in more healthcare services being transferred to municipalities and taking place in patients’ homes. This greatly impacts nurses’ work in home care, making their work increasingly diverse and demanding. In this study, we explore home‐care nursing through a critical discourse analysis of focus group interviews with home‐care nurses. Drawing on insights from positioning theory, we discuss the content and delineation of their work and the interweaving of contextual changes. Nurses hold a crucial position in home healthcare, particularly in ensuring care for sicker patients with complex needs. Assessing health needs, performing advanced care, and at the same time, providing customized solutions in various homes were identified as distinctive for home‐care nurses’ work. Changes have made nurses’ work become driven by comprehensive tasks and acute medical needs that require much of their competence and time. Urgent care seems to take precedence in nurses’ work, leaving less time and attention for other tasks such as conversations and support for coping with everyday life. This underlines the need to investigate and discuss the content and scope of nurses’ work to help shape the further development of home‐care nursing.

Changes in the occurrence and severity of these seven symptoms were variable. All seven symptoms occurred at relatively high rates and were of moderate severity. Findings can be used to identify patients who are at higher risk for more severe symptoms.

Aim To explore prevailing discourses on nursing competence in homecare nursing to boost understanding of practice within this field. Design A qualitative study with a social constructivist perspective. Methods Six focus‐group interviews with homecare nurses in six different municipalities in Norway. Adapting a critical discourse analysis, data were linguistically, thematically and contextually analysed in the light of theories on competence, institutional logic and discourses. Results The analysis found homecare nursing to be a diverse and contradictory practice with ever‐increasing work tasks. Presented as binary oppositions, we identified the following prevailing discourses: individualized care versus organizing work; everyday‐life care versus medical follow‐up; and following rules versus using professional discretion. The binary oppositions represent contradictory requirements that homecare nurses strive to balance. The findings indicate that medical follow‐up and organizational work have become more dominant in homecare nursing, leaving less time and attention paid to relational and everyday‐life care.

Context. Lung cancer surgery is among the surgical procedures associated with the highest prevalence of pain, but prospective longitudinal studies following the pain trajectory are scarce. Objectives. We aimed to describe the pain trajectory in patients undergoing surgery for primary lung cancer and to investigate whether distinct groups of patients could be identified based on different pain trajectories. Methods. Patients (n = 264, 95% thoracotomies) provided data on the average and worst pain intensity, pain location, and comorbidities before, and at 1, 5, 9, and 12 months after surgery. Pain profiles were analyzed by latent class mixed models (LCMMs). Results. The occurrence of any pain increased from 40% before surgery to 69% after 1 month, and decreased to 56%, 57%, and 55% at 5, 9, and 12 months, respectively. LCMMs identified two classes both for average and worst pain; one class started low with high ratings after one month, then returning to a level slightly higher than baseline. The other class started higher with similar scores through the trajectory. Patients reporting no pain (8%) were placed in a separate class. Higher comorbidity score, preoperative use of pain and psychotropic medicine characterized the class with overall highest pain for average and/or worst pain. Conclusion. Pain was highly prevalent after surgery and subgroups could be identified based on different pain trajectories. Patients reported both postoperative pain and pain from chronic conditions. Knowledge about vulnerable patients and risk factors for pain is important to tailor interventions and information about pain.

These findings can be used to educate patients about the normal course of postoperative recovery. Clinicians need to assess for these symptoms and develop effective interventions to improve symptom management for these patients.