Lene Lunde

• Borge, Christine Råheim; Eik, Hedda; Wahl, Astrid Klopstad; Bragstad, Line Kildal; Sylwander, Charlotte & Hjorthaug, Kristin [Show all 26 contributors for this article] (2026). Health literacy research in primary healthcare services – A scoping review. Patient Education and Counseling. ISSN 0738-3991. 149, p. 109675–109675. doi: 10.1016/j.pec.2026.109675. Full text in Research Archive Show summary

  Objective To systematically map existing evidence on health literacy among people with non-communicable diseases (NCDs) in primary healthcare. Methods An interdisciplinary research group conducted a scoping review following the Arksey and O’Malley framework, refined by Levac and Peters, and reported according to PRISMA-ScR. The review was registered in OSF and applied the Population–Concept–Context framework to define inclusion criteria. Searches were conducted in Medline, APA PsycInfo, Scopus, and Cochrane for studies published between 2000–2025. Peer-reviewed studies were screened in Rayyan, and data were charted and thematically analyzed through team-based consensus. Results The search identified 7952 studies, of which 106 studies met the inclusion criteria. Participants’ mean age was 59 years; 56% were female. Studies originated from 29 countries, mainly the USA, China, and Canada, with an increase after 2013. Three main themes were identified: (1) health literacy, social status, and ethnicity, (2) health literacy, disease, and health outcomes, and (3) health literacy, NCD knowledge, and self-management. Many studies reported associations between health literacy, and self-management, quality of life, and some clinical outcomes, but findings across designs and outcomes were heterogeneous and not consistently positive. Conclusions Improved communication, greater cultural competence, and tailored health literacy interventions are associated with better self-management and disease outcomes in non-communicable diseases, but most evidence is associative rather than causal, intervention effects are mixed, and research on health literacy experiences remains limited. Practice Implications More rigorously designed intervention studies and broader conceptualization and measurement of health literacy with multidimensional instruments are needed to strengthen the evidence and clarify how health literacy relates to social status, disease outcomes, and self-management in primary healthcare. Training healthcare professionals to assess and address health literacy is essential to promote equity and effective patient engagement.

• Maurud, Sigurd; Lunde, Lene; Moen, Anne & Opheim, Randi (2025). Mapping conditional health literacy and digital health literacy in patients with inflammatory bowel disease to optimise availability of digital health information: a cross-sectional study. Scandinavian Journal of Gastroenterology. ISSN 0036-5521. doi: 10.1080/00365521.2025.2497952. Full text in Research Archive
• Maurud, Sigurd; Lunde, Lene; Moen, Anne & Opheim, Randi (2024). Exploring the foundations of a digital health information service for patients with inflammatory bowel disease: a mixed method study in Gravitate-Health. BMC Gastroenterology. 24(1). doi: 10.1186/s12876-024-03272-1. Full text in Research Archive Show summary

  Background Providing relevant digital health information of high quality may promote treatment adherence and self-management for patients with inflammatory bowel disease. The development of digital health services is optimised by considering end users’ needs. Aim To identify key aspects required for digital promotion of inflammatory bowel disease patients’ self-management by exploring their health information needs and the preferences of both patients and healthcare professionals in relation to the digital provision of inflammatory bowel disease health services. Methods Data from an audit of 1,481 electronic health record summaries from an inflammatory bowel disease help line, 17 semi-structured interviews with inflammatory bowel disease patients and 2 focus group interviews with 11 healthcare professionals were analysed. Results Patients primarily contacted the hospital due to concerns about symptoms, examinations and tests, and medicines. Their concerns appeared to vary according to diagnosis, gender, age and disease duration. The interviews identified two overarching themes: (1) the available health information and patients’ health information needs, and (2) whishes, thoughts and preferences for a digital solution in IBD care with relevant and individualised information. Conclusions The findings delineate key aspects for developing a suitable digital health information service. Patients seek information from healthcare professionals about treatment; however, in a digital solution, they want access to relevant and practical information about the disease, treatment and self-management. Both patients and healthcare professionals saw opportunities for increasing health data availability to patients. However, healthcare professionals expressed concerns about adapting, maintaining and ensuring the relevance of patient health information without increasing their workload and, thus, reducing quality of care.

• Heltveit-Olsen, Silje Rebekka; Lunde, Lene; Brænd, Anja Maria; Spehar, Ivan; Høye, Sigurd & Skoglund, Ingmarie [Show all 10 contributors for this article] (2024). Local management of the COVID-19 pandemic in Norway: a longitudinal interview study of municipality chief medical officers. Scandinavian Journal of Primary Health Care. ISSN 0281-3432. 42(1), p. 214–224. doi: 10.1080/02813432.2023.2301562. Full text in Research Archive Show summary

  Objective - To explore the experiences and views of Norwegian Municipality Chief Medical Officers (MCMOs) on preparedness, collaboration, and organization during the COVID-19 pandemic to gain insight into local crisis management of value for future pandemic responses.<p> <p>Design - Longitudinal qualitative interview study. We conducted semi-structured digital interviews with nine MCMOs working in different municipalities in Norway from September to December 2020. Five MCMOs were re-interviewed from January to April 2021. We used thematic analysis to analyze the data.<p> <p>Results - Through the analysis, three major themes were identified in the material; 1) The view of preparedness changed from being low-priority and dormant to the desire to strengthen preparedness as a permanent measure; 2) The nature of the pandemic forced a change in internal and external communication and collaboration for the MCMOs towards direct dialogue, teamwork and digital networking; 3) The pandemic changed the role and position of the MCMO within the municipal organization. Although most MCMOs were given a leading role in the municipal pandemic response, some MCMOs experienced that they were not positioned to fully exercise their intended role. In our material, de-authorization of the MCMO role seemed to coincide with the increasing size and organizational complexity of the municipality.<p> <p>Conclusions - The Norwegian pandemic response and outcome have been regarded as successful internationally. Although the MCMOs managed to implement flexible and quick responses facilitated by teamwork, dialogue, and joint sensemaking, they also identified several challenges and shortcomings of the Norwegian pandemic preparedness requiring organizational and financial changes to sustain future health system resilience.

• Lunde, Lene; Moen, Anne; Jakobsen, Rune Bruhn; Møller, Britta; Rosvold, Elin Olaug & Brænd, Anja Maria (2022). A preliminary simulation‑based qualitative study of healthcare students’ experiences of interprofessional primary care scenarios. Advances in Simulation. 7(1). doi: 10.1186/s41077-022-00204-5. Full text in Research Archive Show summary

  Background: Introducing interprofessional education (IPE) in healthcare curricula can prepare students for healthcare practices that have become increasingly complex. The use of simulation is promoted to support IPE. This study explores healthcare students’ experiences of participating in common, sub-acute patient scenarios that routinely occur in clinical practice in primary care. More specifically, it looks at how sub-acute patient scenarios from primary care can help develop interprofessional collaborative competence. Methods: Medical students (N=10), master’s students in advanced geriatric nursing (N=8) and bachelor’s students in nursing (N=9) participated in the simulations. The students were in their last or second-to-last year of education. We conducted five semi-structured focus group interviews with the participants’ directly after the simulation training to elicit experiences related to the scenarios, the simulation and interprofessional collaboration. The transcripts were analysed using systematic text condensation. To supplement the focus group interviews, the students also completed the interprofessional collaborative competency attainment survey (ICCAS), which measures the students’ self-assessed interprofessional competence. Results: Three main themes emerged from the analysis of the focus group interviews: Realism, Uncertainty, and Reflection. The students emphasised the importance of authentic and recognisable scenarios. They said the vague and unspecific patient symptoms created uncertainty in the situation, making it difficult to understand the patient’s diagnosis. Despite that uncertainty, they described the experience as positive. Further, the students expressed that the simulation increased their confidence in interprofessional collaboration and prepared them for future work. The results from the ICCAS questionnaire showed that the students reported a subjective positive change in their interprofessional competence after participating in the scenarios. Conclusions: This study showed that simulation-based IPE with sub-acute primary care scenarios contributes to develop interprofessional collaborative competence in healthcare education. Sub-acute scenarios can supplement the more common approaches with acute-care scenarios and aid in developing the collaborative competence required to work in healthcare teams.

• Heltveit-Olsen, Silje Rebekka; Lunde, Lene; Brænd, Anja Maria Lyche; Spehar, Ivan; Høye, Sigurd & Skoglund, Ingmarie [Show all 10 contributors for this article] (2022). Experiences and management strategies of Norwegian GPs during the COVID-19 pandemic: a longitudinal interview study. Scandinavian Journal of Primary Health Care. ISSN 0281-3432. doi: 10.1080/02813432.2022.2142796. Full text in Research Archive Show summary

  Objective: When the COVID-19 pandemic reached Norway, primary health care had to reorganize to ensure safe patient treatment and maintain infection control. General practitioners (GPs) are key health care providers in the municipalities. Our aim was to explore the experiences and management strategies of Norwegian GPs during the COVID-19 pandemic - over time, and in the context of a sudden organizational change.<p> <p>Design: Longitudinal qualitative interview study with two interview rounds. The first round of interviews was conducted from September–December 2020, the second round from January–April 2021. In the first interview round, we performed eight semi-structured interviews with GPs from eight municipalities in Norway. In the second round, five of the GPs were re-interviewed. Consecutive interviews were performed 2–4 months apart. To analyze the data, we used thematic analysis. <p>Results: The COVID-19 pandemic required GPs to balance several concerns, such as continuity of care and their own professional efforts. Several GPs experienced challenges in the collaboration with the municipality and in relation to defining their own professional position. Guided by The Norwegian Association of General practitioners, The Norwegian College of General Practice and collegial support, they found viable solutions and ended up with a feeling of having adapted to a new normal. <p>Conclusions: Although our study demonstrates that the GPs adapted to the changing conditions, the current municipal health care models are not ideal. There is a need for clarification of responsibilities between GPs and the municipality to facilitate a more coordinated future pandemic response.

• Lunde, Lene; Moen, Anne; Jakobsen, Rune Bruhn; Rosvold, Elin Olaug & Brænd, Anja Maria (2021). Exploring healthcare students' interprofessional teamwork in primary care simulation scenarios: collaboration to create a shared treatment plan. BMC Medical Education. 21. doi: 10.1186/s12909-021-02852-z. Full text in Research Archive Show summary

  Background Primary care providers assume responsibility for patients with increasingly complex problems requiring interprofessional collaboration. Introducing interprofessional education in healthcare curricula prepares healthcare students for this reality. Solving simulation scenarios as an educational strategy is promoted to support interprofessional education in health care, and is mostly used in acute clinical situations. This paper aims to explore how healthcare students’ actions influence interprofessional collaboration and treatment plan identification when they solve common, sub-acute patient scenarios in primary care situations. Methods Interaction analysis of video recordings from the simulation scenarios was performed with a focus on the students’ joint actions; specifically how these actions unfold and how productive the students were in terms of developing treatment plans. Results We found variation in the groups’ interactions, the paths they followed, and the quality of their knowledge output in their shared treatment plan. The groups with the capacity to collaborate and engage in sharing information, and explain and elaborate on concepts, were more successful in developing comprehensive treatment plans. Furthermore, these groups managed the duality of defining and solving the immediate problem and collaboratively preparing for future care. Conclusions Analysis of the activities in our scenarios showed the students’ potential to practice interprofessional collaboration. Our study illustrates that simulation of sub-acute scenarios in primary care is an underexplored but suitable arena to train communication and teamwork in complex situations. The simulation scenarios are also feasible for use on-site in an educational facility or in practice with minimal equipment and resources.

• Lunde, Lene; Baerheim, Anders; Johannessen, Ane; Aase, Ingunn; Almendingen, Kari & Andersen, Irene Aasen [Show all 11 contributors for this article] (2020). Evidence of validity for the Norwegian version of the interprofessional collaborative competency attainment survey (ICCAS). Journal of Interprofessional Care. ISSN 1356-1820. p. 1–8. doi: 10.1080/13561820.2020.1791806. Full text in Research Archive Show summary

  This was a validation study of the Norwegian version of The Interprofessional Collaborative Competency Attainment Survey (ICCAS). ICCAS consists of 20 retrospective pre- and post-questions, where respondents rate their agreement with regard to self-assessed competencies after participating in interprofessional education courses. It has been validated across various settings. The questionnaire was translated using the back-translation technique. We investigated evidence of validity regarding content, response process, and internal structure. Data were obtained from health and social care students (n = 1440, response rate 42.8%) participating in 12 different interprofessional courses in seven education institutions in Norway using a cross-sectional design. Exploratory factor analysis indicated one retracted factor for pre-scores and one retracted factor for post-scores. High McDonald’s omega values indicated good internal consistency. Item deletion did not improve the scale’s overall consistency on pre- or post-scores. We observed higher mean post-scores than pre-scores with moderate-to-large effect sizes, indicating a positive change in self-assessed interprofessional capabilities after training. Our findings indicate that the Norwegian version of ICCAS is a valid tool that may be implemented across a wide range of interprofessional education courses. Finally, our findings support earlier recommendations that ICCAS should be analyzed at an overall level to address change in interprofessional capabilities.

• Kristensen, Dorte Vesterager; Johnsen, Nina T.; Amthor, Karl-Friedrich; Lunde, Lene; Strømmen, Lene Beate & Vestby, Eva Marie [Show all 7 contributors for this article] (2020). Validert oversettelse av NIHSS med kulturell tilpasning. Sykepleien Forskning. ISSN 1890-2936. 15(82736). doi: 10.4220/Sykepleienf.2020.82736. Full text in Research Archive Show summary

  Bakgrunn: National Institutes of Health Stroke Scale (NIHSS) er et anerkjent amerikansk skåringsverktøy som benyttes av helsepersonell for å kartlegge nevrologiske utfall ved mistanke om hjerneslag. Testen har vært anvendt av sykepleiere og leger på slagenheter i Norge siden 1990-tallet. Den norske versjonen av NIHSS som brukes i dag, er ikke validert. Hensikt: Å redegjøre for validert oversettelse og kulturell tilpasning av NIHSS. Metode: En prosjektgruppe bestående av sykepleiere og leger fra slagenheter i Vestre Viken HF gjennomførte, i samarbeid med Universitetet i Sørøst-Norge og en profesjonell translatør, en validert oversettelse av NIHSS med kulturell tilpasning. Oversettelsesprosessen fulgte trinnene i ReKS' modifiserte oversettelsesmetode. Vi gjennomførte en pilottest der flere slagenheter deltok. Resultat: Den validerte NIHSS-versjonen samsvarte i stor grad med den ikke-validerte når det gjaldt begrepsbruken. Beskrivelsen IT (ikke testbar) i validert NIHSS samsvarer med den originale NIHSS-versjonen. Bilder og tekstark fra original NIHSS ble inkludert i den validerte NIHSS-versjonen med noen justeringer. Totalskår og tidsbruk ved skåring var sammenliknbare med den ikke-validerte NIHSS-versjonen. Konklusjon: Validering av NIHSS var påkrevd for å sikre kulturell tilpasning og språk fra den amerikanske originalversjonen. Viktige faktorer i valideringsprosessen var å involvere slagenheter, prøve ut et pilotprosjekt og sette sammen prosjektgruppen med erfarne leger og sykepleiere. Resultatet er en norsk validert versjon av NIHSS med veileder som er tro mot den originale amerikanske versjonen og samtidig harmonisert i henhold til den ikkevaliderte eksisterende versjonen.

• Lunde, Lene; Moen, Anne & Rosvold, Elin Olaug (2018). Learning clinical assessment and interdisciplinary team collaboration in primary care. MOOC for healthcare practitioners and students. Studies in Health Technology and Informatics. ISSN 0926-9630. 250. doi: 10.3233/978-1-61499-872-3-68. Full text in Research Archive Show summary

  Novel ways to build sufficient capacity to meet the need for competent healthcare providers in primary care are in strong demand. We developed a massive, open, online course (MOOC) to introduce and promote clinical skills development for healthcare workers (physicians, nurse practitioners, nurses, and nurse aids) and students in healthcare education (medical students and master and bachelor students in nursing) focusing on systematic health assessment and strengthening clinical decision making in primary care. Results from the pilot supports that the MOOC was relevant and highly useful for the participants, and has potential to contribute to interdisciplinary collaboration and discussions.

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• Lunde, Lene; Hurlen, Petter; Almeida, João; Villadsen, Jens Kristian; Leoni, Riccardo & Moen, Anne (2024). Support for patient self-management and digital health literacy with more relevant health information. Full text in Research Archive
• Lunde, Lene; Maurud, Sigurd; Bønes, Erlend; Connolly, Leona; McCabe, Catherine & Moen, Anne (2024). Support for patient self-management and digital health literacy with more relevant health information. Full text in Research Archive
• Heltveit-Olsen, Silje Rebekka; Lunde, Lene; Brænd, Anja Maria; Spehar, Ivan; Høye, Sigurd & Skoglund, Ingmarie [Show all 10 contributors for this article] (2022). Experiences and management strategies of Norwegian GPs during the COVID-19 pandemic: A longitudinal interview study. Full text in Research Archive
• Janson, Astri Letnes; Moen, Anne & Lunde, Lene (2020). En avatar som brobygger: fra forskningsfunn til pårørendestøtte. Full text in Research Archive
• Lunde, Lene; Brænd, Anja Maria; Jakobsen, Rune Bruhn; Moen, Anne & Rosvold, Elin Olaug (2020). Simulation strengthens interprofessional collaboration for healthcare students in primary care. Full text in Research Archive Show summary

  Background Primary healthcare providers are responsible for patients with increasingly complex problems. Introducing interprofessional collaboration in healthcare curricula prepares students to meet these challenges. Simulation-based learning may be a powerful facilitator for active and safe learning, but is mostly used in acute clinical situations. We explore simulation as a strategy to train students in interprofessional collaboration in sub-acute clinical scenarios in primary healthcare. Summary of work We tested two low-fidelity simulation scenarios with common, sub-acute patient situations from primary healthcare: An older patient stays at a nursing home after having a hip fracture and surgery, and he develops a urinary tract infection or a pneumonia. Healthcare students (n=27) in their final stage of education (medical students, master students in advanced geriatric nursing and bachelor students in nursing) were allocated to ten groups. The groups were assigned to do a clinical assessment, agree on a probable diagnosis and develop a treatment plan during both scenarios. The facilitators guided the groups from briefing through to debriefing with focus on collaboration and communication. The study is an exploratory, qualitative study with interaction analysis of segments from video recordings of the simulations. Summary of results Different forms of interaction and communication affected interprofessional collaboration, especially during the development of a care plan. The content and structure of the care plan and the team’s efficiency in settling a plan as a team depended on 1) the ability to recognize each other’s contribution, 2) mutual knowledge development and 3) the awareness of setting and roles. This emerged through dialogue, gestures, gaze and body language. During debriefing, several groups reflected on clarifying concepts such as close monitoring and deterioration of the patient. Discussion and conclusions The sub-acute scenarios show potential to identify interactions and communication affecting collaboration. Using the scenarios in healthcare education may help students to develop productive interactions strengthening interprofessional collaboration. Furthermore, the simulation scenarios are feasible to use on-site in an education facility with minimal technical equipment. Take home message Low-fidelity, on-site simulation scenarios based on common, sub-acute clinical situations shows promise in training students in interprofessional collaboration preparing for the complexity of primary healthcare.

• Lunde, Lene; Moen, Anne; Jakobsen, Rune Bruhn; Brænd, Anja Maria & Rosvold, Elin Olaug (2020). Simulering styrker tverrfaglig samarbeid i helsefaglig utdanning. Full text in Research Archive
• Østensen, Elisabeth; Askøy, Helene; Kumlin, Marianne; Lunde, Lene; Rostad, Hanne Marie & Kolstadbråten, Knut Magne [Show all 7 contributors for this article] (2020). Utdatert profesjonskamp i en tid hvor samarbeid burde vært i fokus? Full text in Research Archive
• Lunde, Lene; Moen, Anne; Jakobsen, Rune Bruhn & Rosvold, Elin Olaug (2019). Using simulation to train interprofessional collaboration for healthcare students in primary care. Full text in Research Archive
• Rosvold, Elin Olaug; Lunde, Lene & Moen, Anne (2018). Clinical assessment and interdisciplinary collaboration in primary care. Use of a massive, open, online course (MOOC) to train students and health personnel. Full text in Research Archive
• Janson, Astri Letnes; Rosvold, Elin Olaug; Lunde, Lene & Moen, Anne (2018). MOOC -Styrke veiledningskompetanse i primærhelsetjenesten-. Full text in Research Archive
• Lunde, Lene; Moen, Anne & Rosvold, Elin Olaug (2018). MOOC (Massive Open Online Course) to improve clinical assessment skills and interdisciplinary collaboration in primary care. Full text in Research Archive
• Lunde, Lene; Moen, Anne & Rosvold, Elin Olaug (2018). Erfaringer med utvikling av en MOOC (massivt, åpent onlinekurs) for studenter og ansatte i primærhelsetjenesten. Full text in Research Archive
• Lunde, Lene; Moen, Anne; Egilsdottir, H. Ösp; Byermoen, Kirsten Røland; Wibe, Torunn & Eide, Hilde [Show all 7 contributors for this article] (2018). KlinPrim – MOOC for systematisk klinisk vurdering og tverrfaglig samarbeid i primærhelsetjenesten. Full text in Research Archive
• Lunde, Lene; Moen, Anne; Spiru, Luiza; Andrushevich, Aliaksei & Duzha, Armend (2017). CarerSupport–Usability and usefulness of an integrated ICT-platform supporting informal caregivers of people with dementia. P01.41. Alzheimer Europe. Full text in Research Archive
• Lunde, Lene; Moen, Anne & Rosvold, Elin Olaug (2017). MOOC – utvikling av nye e-læringsressurser. Full text in Research Archive
• Lunde, Lene; Moen, Anne & Rosvold, Elin Olaug (2017). Utvikling av artikkel - skriveseminar. Full text in Research Archive
• Lunde, Lene; Moen, Anne & Rosvold, Elin Olaug (2017). MOOC – rettet mot livslang læring i arbeidslivet og helsevesenet. Full text in Research Archive
• Lunde, Lene; Moen, Anne; Egilsdottir, H. Øsp; Byermoen, Kirsten Røland; Wibe, Torunn & Eide, Hilde [Show all 7 contributors for this article] (2017). MOOC – Ny e-læringsressurs til studenter og ansatte i primærhelsetjenesten. Full text in Research Archive
• Lunde, Lene; Moen, Anne; Spiru, Luiza; Andrushevich, Aliaksei & Duzha, Armend (2017). CarerSupport–Usability and usefulness of an integrated ICT-platform supporting informal caregivers of people with dementia. Full text in Research Archive
• Lunde, Lene & Moen, Anne (2016). CarerSupport -an innovative approach to informal carers’ training and collaboration. Full text in Research Archive
• Lunde, Lene; Holmene, Birgitte & Moen, Anne (2016). CarerSupport - Internettbasert plattform for pårørende til personer med demens. Full text in Research Archive
• Lunde, Lene & Moen, Anne (2015). Kunnskap om multiresistente bakterier gir sykepleiere trygghet. Full text in Research Archive

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