Arnstein Finset

• Sagen, Ulrike; Finset, Arnstein; Moum, Torbjørn Åge; Vik, Tom Gunnar & Dammen, Toril (2022). The longitudinal course of anxiety, depression and apathy through two years after stroke. Journal of Psychosomatic Research. ISSN 0022-3999. 162. doi: 10.1016/j.jpsychores.2022.111016. Fulltekst i vitenarkiv Vis sammendrag

  Objective: Estimate the prevalence of anxiety disorders, depressive disorders and apathy two years after stroke, examine their longitudinal course, describe the course of psychological distress through two years after stroke, and evaluate Hospital Anxiety and Depression Scale HADS-A and HADS-D cut-off scores of ≥4 and ≥ 8 for detection of anxiety and depressive disorders two years after stroke. Methods: In a longitudinal cohort study of 150 consecutive stroke patients in a stroke unit, 103 were assessed four months and 75 two years after stroke. Anxiety and depression disorders and symptoms were assessed by the Structured Clinical Interview for DSM-IV and HADS, apathy by the Apathy Evaluation Scale. Results: Prevalence of at least one anxiety disorder or one depressive disorder decreased from four months to two years (23% vs 9%, P = 0.026, 19% vs 10%, P = 0.17). Apathy remained stable at 48% vs 50%. After two years, 80%, 79% and 19% of those with anxiety, depression or apathy at four months had recovered. Recovery-rates among patients with anxiety were 83% for panic disorder, 60% for generalized anxiety disorder (GAD), and 50% for social phobia. Conclusions: In contrast to apathy, recovery from anxiety and depression was high. About half of the patients with GAD, social phobia or agoraphobia did not recover. Co-morbid depression and apathy at four months implied a high risk for not recovering at two years. HADS-A and HADS-D cut-off scores of ≥8 were feasible for detection of anxiety and depression disorders two years after stroke.

• Mellblom, Anneli; Ruud, Ellen; Loge, Jon Håvard; Lie, Hanne Cathrine & Finset, Arnstein (2022). From Observation to Action: Developing and Pilot-Testing a Communication Tool for Follow-up Consultations with Adolescent Cancer Survivors. Journal of Adolescent and Young Adult Oncology. ISSN 2156-5333. 11(4), s. 419–426. doi: 10.1089/jayao.2021.0123. Fulltekst i vitenarkiv Vis sammendrag

  Purpose: Efficient physician communication with adolescent cancer survivors (ACS) during follow-up consultations is important to enable survivors to take responsibility for their health. The present study had two aims: to develop a communication tool to enhance structured consultations and improve clinician communication in follow-up consultations, and to pilot-test the tool in physicians' consultations with ACS. Methods: Clinicians and communication experts collaborated closely to develop the 7 Memory Hooks (7MH) communication tool and a corresponding coding scheme for scoring communication behavior in consultations. Thirty-seven follow-up consultations between ACS and physicians were video-recorded (22 before intervention and 15 after intervention). The intervention consisted of a didactic lecture, a group workshop, and individual coaching to provide feedback to physicians on the communication skills observed in the pre-intervention videos. We then compared physicians' communication behavior both before and after intervention. Results: Fourteen physicians participated in the 7MH training. The mean total score on the 7MH scheme was significantly higher post-intervention compared with pre-intervention (p = 0.001). Six behaviors changed significantly after the intervention. At a group level, physicians were more likely to be alone with the adolescent (p = 0.004) and to prepare the patient for transition to adult heath care (p = 0.040). They asked more often about the patients' expectations (p = 0.007) and resources ((p = 0.019). And they acknowledged patients' concerns more often (p = 0.016) but talked significantly less about physical activity (p = 0.012). Conclusion: A physician communication tool, designed bottom-up and developed in collaboration with the clinic, shows promising effects on physicians' communication behavior at follow-up consultations with ACS

• Brodahl, Knut Ørnes; Storøy, Hanne-Lise Eikeland; Finset, Arnstein & Pedersen, Reidar (2022). Medical students’ experiences when empathizing with patients’ emotional issues during a medical interview – a qualitative study. BMC Medical Education. 22. doi: 10.1186/s12909-022-03199-9. Fulltekst i vitenarkiv Vis sammendrag

  Background There is evidence that empathy decreases as medical students go through clinical training. However, there are few in-depth studies investigating the students’ own experiences when trying to empathize in concrete clinical encounters. We therefore wanted to explore medical students’ perceptions, experiences, and reflections when empathizing with patients expressing emotional issues. Methods A qualitative content analysis of semi-structured interviews with third year medical students (N = 11) was conducted using video-stimulated recall from their own medical interview with a simulated chronically ill patient. Students were led to believe that the patient was real. Results Five themes which may influence student empathy during history-taking were identified through analysis of interview data: (1) Giving priority to medical history taking, (2) Interpreting the patient’s worry as lack of medical information, (3) Conflict between perspectives, (4) Technical communication skill rather than authentic and heart-felt and (5) The distant professional role. Conclusions The participating students described conflicts between a medical agenda, rules and norms for professional conduct and the students’ own judgments when trying to empathize with the patient. To our knowledge, this is the first study ever to document the students’ own perspective in concrete situations as well as how these reported experiences and reflections affect their empathy towards patients. Since we now know more about what is likely to hinder medical students’ empathy, educators should actively encourage group reflection and discussion in order to avoid these negative effects of history taking both inside and outside of the clinical setting.

• Karlsen, Marte-Marie Wallander; Finset, Arnstein; Heggdal, Kristin & Heyn, Lena (2022). Caught between ideals and reality: Phenomenological-hermeneutic study of healthcare providers’ experiences while interacting with mechanically ventilated patients. Journal of Interprofessional Care. ISSN 1356-1820. 36(4), s. 492–499. doi: 10.1080/13561820.2021.1967303. Fulltekst i vitenarkiv Vis sammendrag

  This study aimed to explore healthcare providers’ experiences of their communication and interaction with conscious patients on mechanical ventilation in intensive care. Nurses, physicians, and physiothera- pists were interviewed after they had been video recorded in naturally occurring interactions with patients. The interviews were analyzed using a phenomenological-hermeneutical approach. Three themes were identi!ed: The willingness to engage and understand the mechanically ventilated patient, the potential risk of neglecting the patient in the encounters, and provider interdependence as the core of intensive care. The themes elicited how providers handled the dissonance between their own personal ideals of care and their real-world encounters with patients and other professionals. The healthcare providers were aware of how easily patients could be neglected while being non-vocal, and therefore invested time and effort communicating with the patients. Based on their personal ideals of patient participation and autonomy, it was di#cult to perform procedures, such as weaning off the ventilator or mobilization, to which the patient was opposed. Interprofessional collaboration was valued by the providers in such situations. The study revealed that providers need to consider the communication barriers that exist on the individual and team levels when interacting with patients on mechanical ventilation

• Lundeby, Tonje; Finset, Arnstein; Kaasa, Stein; Wester, Torunn Elin; Hjermstad, Marianne Jensen & Dajani, Olav [Vis alle 8 forfattere av denne artikkelen] (2022). A complex communication skills training program for physicians providing advanced cancer care–content development and barriers and solutions for implementation. Journal of Communication in Healthcare. ISSN 1753-8068. doi: 10.1080/17538068.2022.2039468. Fulltekst i vitenarkiv Vis sammendrag

  Background : Early integration of oncology and patient-centered palliative care is the recommended clinical practice model for patients with advanced cancer. General and specific communication skills are necessary to achieve integrated patient-centered care, but require organized training to be adequately mastered. Challenges and barriers on several levels, i.e. organizational, professional and individual may, however, hamper implementation. The development, implementation, and evaluation of such an educational program focusing on communication skills contain many steps, considerations and lessons learned, which are described in this article. Methods : A multi-professional faculty developed, implemented, and evaluated an educational program through a 5-step approach. The program was part of a Norwegian cluster-randomized controlled trial aiming to test the effect of early integration of oncology and palliative care for patients with advanced cancer. Results : The result is the PALLiON educational program; a multi-faceted, evidence-based, and learner-centered program with a specific focus on physicians’ communication skills. Four modules were developed: lectures, discussion groups, skills training, and coaching. These were implemented at the six intervention hospitals using different teaching strategies. Evaluation in a subgroup of participants showed a positive appraisal of the group discussions and skills training.

• Brodahl, Knut Ørnes; Eikeland, Hanne-Lise; Finset, Arnstein & Pedersen, Reidar (2021). The first steps towards professional distance: A sequential analysis of students’ interactions with patients expressing emotional issues in medical interviews. Patient Education and Counseling. ISSN 0738-3991. s. 1–7. doi: 10.1016/j.pec.2021.09.039. Fulltekst i vitenarkiv Vis sammendrag

  Objective Explore sequential patterns in students’ interactions with patients expressing emotional concerns in a medical interview. Methods Concepts and principles from conversation analysis (CA) were used to examine the turn-by-turn sequential organization of student actions in eleven video-taped medical interviews. We used results from an earlier coding with an interaction analysis system (VR-CoDES) in a previously published paper as a point of reference. Results By using CA instead of VR-CoDES as our primary investigative method we observed that student turns previously coded as elicitations to simulated patients’ expressions of emotion were often preceded by subtle patient initiatives. Students encouraged further elaboration by displaying their understanding of the emotional issue as a story telling still in progress. Students’ expressions of understanding however, gave little room for further elaboration. Finally, students often addressed emotional issues as a medical issue and offered professional advice. Conclusions Students’ actions seemed specifically designed to display interest in the patients’ initiatives to talk about emotional experiences without departing from their initial interview task or violating norms for professional conduct. Practice implications Educators and practitioners should reconsider how the medical interview may shape expectations for professional conduct and can thereby unintentionally restrict students’ empathy development.

• Brodahl, Knut Ørnes; Finset, Arnstein; Eikeland, Hanne-Lise & Pedersen, Reidar (2021). Medical students’ expressions of empathy: A qualitative study of verbal interactions with patients expressing emotional issues in a medical interview. Patient Education and Counseling. ISSN 0738-3991. 104(12), s. 2936–2943. doi: 10.1016/j.pec.2021.03.042. Fulltekst i vitenarkiv Vis sammendrag

  Objective Explore medical students’ verbal responses to patients expressing emotional issues in a medical interview. Methods Eleven third-year students were instructed to conduct a medical interview with a simulated chronically ill patient while being videotaped (but were led to believe that the patient was real). An interaction analysis system (VR-CoDES) was used to identify patient utterances containing emotional expressions as well as student utterances responding to these emotional expressions. A qualitative content analysis of student utterances was then conducted. Results Four categories that depicted student responses were identified: (1) questions focusing on a medico-professional agenda, (2) allowing disclosure of emotions without explicit acknowledgment of emotions, (3) attempts at reassurance, and (4) explicit recognition of emotions, but most often on a factual and descriptive level. Conclusions Our analysis indicate that these students gave priority to medico-professional tasks and responsibilities in their responses. They demonstrated some interest in the patient’s emotional experiences whilst most often leaving out their own personal perspectives. Practice implications Communication skills curricula should address how the medical interview affects empathy and interaction with patients and encourage discussion and reflection on how to retrieve medical information while paying adequate attention to the patient’s and own emotions, experiences, and perspectives.

• Puhr, Anita; Ruud, Ellen; Anderson, Vivki; Due-Tønnessen, Bernt Johan; Skarbø, Anne-Britt & Finset, Arnstein [Vis alle 7 forfattere av denne artikkelen] (2021). Executive Function and Psychosocial Adjustment in Adolescent Survivors of Pediatric Brain Tumor. Developmental Neuropsychology. ISSN 8756-5641. 46(2), s. 149–168. doi: 10.1080/87565641.2021.1900191. Fulltekst i vitenarkiv Vis sammendrag

  Adolescent survivors of pediatric brain tumor (PBT) are a sparsely studied subset of childhood cancer survivors. Sustaining a PBT may complicate the development of executive functions (EFs), which play a vital role in long-term psychosocial adjustment. In this study, 48 adolescent survivors and their parents completed questionnaires assessing EF, psychological symptoms, fatigue, and adaptive functioning, and 26 survivors underwent neuropsychological assessment. Survivors reported significantly more problems with adaptive functioning than a healthy control group, and this was most strongly associated to executive dysfunction, compared to psychological symptoms and fatigue. The findings have important implications for long-term follow-ups.

• Skovlund, Pernille Christiansen; Nielsen, Berit Kjærside; Thaysen, Henriette Vind; Schmidt, Henrik; Finset, Arnstein & Hansen, Kristian Ahm [Vis alle 7 forfattere av denne artikkelen] (2020). The impact of patient involvement in research: a case study of the planning, conduct and dissemination of a clinical, controlled trial. Research Involvement and Engagement. 6(1), s. 1–16. doi: 10.1186/s40900-020-00214-5. Fulltekst i vitenarkiv Vis sammendrag

  Background The interest in patient and public involvement (PPI) in health research is increasing. However, the experience and knowledge of PPI throughout the entire research process and especially in the analysis are limited. We explored ways to embrace the perspectives of patients in a research process, and the impact and challenges our collaboration has had on patients, researchers, and the research outcomes. Methods This is an explorative single case study of a Danish, clinical, controlled intervention trial and a nested intervention fidelity study included herein. Five patient representatives with metastatic melanoma were part of designing, undertaking and disseminating the trial where the effect of using patient-reported outcome (PRO)-measures as a dialogue tool in the patient-physician consultation was tested. In the fidelity study, audio-recorded consultations were analyzed after training in the Verona Coding Definitions of Emotional Sequences (VR-CoDES). Results were jointly disseminated at an international scientific conference. The outcomes, impact, and challenges were explored through a workshop. Results In the design phase, we selected PRO-measures and validated the dialogue tool. The information sheet was adjusted according to the patients’ suggestions. The analysis of the fidelity study showed that patients and researchers had a high consensus on the coding of emotional cues and concerns. The patients contributed with a new vocabulary and perspective on the dialogue, and they validated the results. PPI caused considerations related to emotional (sadness/sorrow and existential thoughts), administrative (e.g. arranging meetings, balancing work and small talk) and intellectual (e.g. avoiding information harm, continuing activities despite the death of patients) investments. A limitation of the study was the lack of use of a solid evaluation tool to determine the impact of PPI. Conclusion PPI throughout the process and co-creation in the analysis was feasible and beneficial. The case is unique in the degree of workable details, sustainability, and transparency. Moreover, the co-creation provides ideas of ways to operationalize PPI. An evaluation workshop revealed considerations about emotional, administrative and intellectual investments – best described as tacit, yet important ‘work’. This knowledge and experience can be applied to other studies where patients are partners in the research. Trial registration ClinicalTrials.gov ID: NCT03163433 , registration date: 8th May 2017.

• Karlsen, Marte-Marie Wallander; Happ, Mary Beth; Finset, Arnstein; Heggdal, Kristin & Heyn, Lena (2020). Patient involvement in micro-decisions in intensive care. Patient Education and Counseling. ISSN 0738-3991. 103(11), s. 2252–2259. doi: 10.1016/j.pec.2020.04.020. Fulltekst i vitenarkiv Vis sammendrag

  Objective The objective of this study was to explore how bedside micro-decisions were made between conscious patients on mechanical ventilation in intensive care and their healthcare providers. Methods Using video recordings to collect data, we explored micro-decisions between 10 mechanically ventilated patients and 60 providers in interactions at the bedside. We first identified the types of micro-decisions before using an interpretative approach to analyze the decision-making processes and create prominent themes. Results We identified six types of bedside micro-decisions; non-invited, substituted, guided, invited, shared and self-determined decisions. Three themes were identified in the decision-making processes: 1) being an observer versus a participant in treatment and care, 2) negotiating decisions about individualized care (such as tracheal suctioning or medication),and 3) balancing empowering activities with the need for energy restoration. Conclusion This study revealed that bedside decision-making processes in intensive care were characterized by a high degree of variability between and within patients. Communication barriers influenced patients’ ability to express their preferences. An increased understanding of how micro-decisions occur with non-vocal patients is needed to strengthen patient participation. Practice Implications We advise providers to make an effort to solicit patients’ preferences when caring for critically ill patients.

• Gulbrandsen, Pål; Lindstrøm, Jonas Christoffer; Finset, Arnstein & Hall, Judith A. (2020). Patient affect, physician liking for the patient, physician behavior, and patient reported outcomes: A modeling approach. Patient Education and Counseling. ISSN 0738-3991. 103(6), s. 1143–1149. doi: 10.1016/j.pec.2020.01.003. Fulltekst i vitenarkiv Vis sammendrag

  Objective To determine associations between patient affect and physician liking of the patient, and their associations with physician behavior and patient-reported outcomes. Methods Structural equation modeling based on coding of 497 videotaped hospital encounters, with questionnaires assessing pre-visit patient affect, post-visit patient affect and encounter evaluations, and physician liking of the patient, involving 71 physicians. Results In first visits, patient reported outcomes were strongly correlated with physician behavior and less so with physician liking, while in later visits, patient reported outcomes were directly related to physician liking and not mediated by physician behavior. Physician liking predicted physician behavior, more for female physicians in first visits. Patient negative affect before the visit was negatively associated with male physicians’ liking. When acquainted, both patient positive and negative affect were associated with physician liking. Conclusion Physician liking of the patient plays a dynamic role in a consultation, is influenced by patient pre-encounter affect, and influences physician behavior. The dynamics are different in first and later visits, and influenced by physician gender. Practice implications Physicians should be aware how patient affect influences their behavior, and administrators should take any prior relationship between patient and physician into account when evaluating patient reported outcomes.

• Puhr, Anita; Ruud, Ellen; Anderson, Vicki; Due-Tønnessen, Bernt Johan; Skarbø, Anne-Britt & Finset, Arnstein [Vis alle 7 forfattere av denne artikkelen] (2019). Social attainment in physically well-functioning long-term survivors of pediatric brain tumour; the role of executive dysfunction, fatigue, and psychological and emotional symptoms. Neuropsychological Rehabilitation. ISSN 0960-2011. s. 1–26. doi: 10.1080/09602011.2019.1677480. Fulltekst i vitenarkiv Vis sammendrag

  The purpose of this cross-sectional study was to investigate long-term social attainment in physically well-functioning adult survivors of pediatric brain tumour (PBT) and identify demographic, medical, and psychological factors related to poor social outcomes, with a special focus on the significance of executive dysfunction. One hundred and fourteen PBT survivors and a healthy control group provided personal data on social outcomes, i.e., education, work, and government benefits, and completed questionnaires on executive function (EF), psychological and emotional difficulties, and fatigue. A significantly higher number of survivors compared to healthy controls reported having received educational adjustments and substantial government benefits, and significantly more survivors than controls were currently not engaged in regular employment/training. PBT survivors and healthy controls did not differ on educational level or living situation. The factors most strongly associated with poor social outcomes were self-reported executive dysfunction, difficulties with adaptive functioning, and fatigue. The findings show that physically well-functioning PBT survivors are at risk of poorer social outcomes and financial dependence in adulthood compared to their healthy peers, and underline the importance of investigating EF in short- and long-term follow-ups. Future rehabilitation efforts should focus more on compensatory strategies for executive dysfunction and improving EF skills.

• Karlsen, Marte-Marie Wallander; Heggdal, Kristin; Finset, Arnstein & Heyn, Lena (2018). Attention‐seeking actions by patients on mechanical ventilation in intensive care units: A qualitative study. Journal of Clinical Nursing (JCN). ISSN 0962-1067. s. 1–14. doi: 10.1111/jocn.14633. Fulltekst i vitenarkiv Vis sammendrag

  Aims and objectives The aim of this study was to explore the interaction between mechanically ventilated patients and healthcare personnel in intensive care units, with a special emphasis on patients’ initiative to communicate. Background Patients on mechanical ventilation in intensive care units tend to be less sedated today compared to standard care in the past. Their experiences of being voiceless may cause emotional distress, and for many patients, communication is difficult. Healthcare personnel are reported to be the main initiators of the communication exchanges that occur. Design An observational study with a phenomenological–hermeneutical approach. Methods Video recording was used to collect data on the naturally occurring communication and interaction. Ten conscious and alert patients from two Norwegian intensive care units were recruited. Two relatives and a total of sixty healthcare personnel participated. Content analysis was conducted, with focus on both the manifest and latent content meaning. Results We found a total of 66 situations in which patients attempted to attract the attention of others on their own initiative in order to express themselves. Attention‐seeking actions, defined as the act of seeking attention and understanding without a voice, became an essential theme. Four patterns of interaction were identified: immediately responded to, delayed response or understanding, intensified attempts, or giving up. Patients had a variety of reasons for seeking attention, which were classified into four domains: psychological expressions, physical expressions, social expressions, and medical treatment. Conclusions Patients’ attention‐seeking actions varied in content, form, and the types of responses they elicited. The patients had to fight to first gain joint attention and then joint understanding. This was both energy draining and time consuming. Relevance to clinical practice Healthcare personnel need to spend more time for communication purposes, giving attention and being more alert to bodily or symbolic gestures to understand the patient's needs.

• Belfrage, Anna; Grotmol, Kjersti Støen; Tyssen, Reidar; Moum, Torbjørn Åge; Finset, Arnstein & Rø, Karin Isaksson [Vis alle 7 forfattere av denne artikkelen] (2018). Factors influencing doctors' counselling on patients' lifestyle habits: a cohort study. British Journal of General Practice Open. 2(3), s. 1–12. doi: 10.3399/bjgpopen18X101607. Fulltekst i vitenarkiv Vis sammendrag

  Background Lifestyle changes are important for prevention and treatment of many common diseases, and doctors have an important role in the lifestyle counselling of patients. It is important to know more about factors influencing lifestyle counselling. Aim To investigate the frequency of counselling about physical activity compared to that about alcohol habits; the impact of doctors’ own physical activity and alcohol habits on patient counselling about these lifestyle dimensions; and whether perceived mastery of clinical work or vulnerable personality have a confounding or moderating effect on these associations. Design & setting In this nationwide cohort survey, a total of 978 doctors in Norway were surveyed by postal questionnaires in 1993/94 and 2014. The response rate was 562/978 (57%). Method The outcome variables were questions on frequency of asking about alcohol and exercise habits. Explanatory variables were questions on doctors’ own exercise habits, drinking habits (using Alcohol Use Disorders Identification Test [AUDIT]), perceived mastery of clinical work, vulnerable personality, and specialty. Associations were studied by linear regression analysis. Results Of the 526 responders, 307 (58%) reported asking usually/often about exercise habits, while n = 140/524 (27%) usually/often asked about alcohol habits. A doctor's own physical activity level was associated with frequency of asking about physical activity (unstandardised regression coefficient [B] = 0.07; 95% confidence intervals [CI] = 0.01 to 0.13). There were no significant associations between doctors' own lifestyle habits and counselling on alcohol habits. Doctors with low levels of vulnerability asked more frequently about physical activity, regardless of their own physical activity habits (F = 2.41, P = 0.048). Conclusion Doctors’ own lifestyles influenced their preventive counselling about physical activity, but not about alcohol. Vulnerability moderated these effects, indicating the importance of early interventions to help doctors with a vulnerable personality to handle negative criticism from patients

• Puhr, Anita; Ruud, Ellen; Anderson, Vicki; Due-Tønnessen, Bernt Johan; Skarbø, Anne-Britt & Finset, Arnstein [Vis alle 7 forfattere av denne artikkelen] (2018). Self-reported executive dysfunction, fatigue, and psychological and emotional symptoms in physically well-functioning long-term survivors of pediatric brain tumor. Developmental Neuropsychology. ISSN 8756-5641. s. 1–17. doi: 10.1080/87565641.2018.1540007. Fulltekst i vitenarkiv
• Piccolo, Lidia del & Finset, Arnstein (2018). Patients' autonomic activation during clinical interaction: A review of empirical studies. Patient Education and Counseling. ISSN 0738-3991. 101(2), s. 195–208. doi: 10.1016/j.pec.2017.08.007. Fulltekst i vitenarkiv
• Skirbekk, Helge; Korsvold, Live & Finset, Arnstein (2018). To support and to be supported. A qualitative study of peer support centres in cancer care in Norway. Patient Education and Counseling. ISSN 0738-3991. 101(4), s. 711–716. doi: 10.1016/j.pec.2017.11.013. Fulltekst i vitenarkiv Vis sammendrag

  Objective: To explore what peer supporters, patients and their relatives want and gain from peer support in cancer care. Methods: Focus group interviews with peer supporters, and in-depth interviews with peer supporters, patients and relatives (N=38) and observations of daily activities in a Vardesenter (“Cairn Centre”). Results: Peer supporters helped cancer patients and relatives with coping in and outside the hospital in several ways: (1) conveying hope and providing ways to cope in situations where despair would often be prevalent, thus protecting against unhealthy stress; (2) being someone who had had the same experiences of disease and treatment, and thus providing a framework for positive social comparisons; and (3) to be an important supplement to family and health care providers. To be working as a peer supporter was also found to be positive and important for the peer supporters themselves. Conclusion: The peer support program represented a valuable supplement to informal support from family and friends and healthcare providers, and gave the peer supporters a new role as “professionally unprofessional”. Practice implications: Organised peer support represents a feasible intervention to promote coping for cancer survivors.

• Lie, Hanne Cathrine; Mellblom, Anneli; Brekke, Mette; Finset, Arnstein; Fosså, Sophie Dorothea & Kiserud, Cecilie E. [Vis alle 8 forfattere av denne artikkelen] (2017). Experiences with late effects-related care and preferences for long-term follow-up care among adult survivors of childhood lymphoma. Supportive Care in Cancer. ISSN 0941-4355. 25(8), s. 2445–2454. doi: 10.1007/s00520-017-3651-6. Fulltekst i vitenarkiv
• Finset, Arnstein & Brodahl, Knut Ørnes (2017). Empathy in the Clinician–Patient Relationship: The Role of Reciprocal Adjustments and Processes of Synchrony. Journal of Patient Experience (JPE). ISSN 2374-3735. 4(2), s. 64–68. doi: 10.1177/2374373517699271. Fulltekst i vitenarkiv
• Piccolo, Lidia Del; Finset, Arnstein; Mellblom, Anneli; Figueiredo-Braga, Margarida; Korsvold, Live & Zhou, Yuefang [Vis alle 8 forfattere av denne artikkelen] (2017). Verona Coding Definitions of Emotional Sequences (VR-CoDES): Conceptual framework and future directions. Patient Education and Counseling. ISSN 0738-3991. 100(12), s. 2303–2311. doi: 10.1016/j.pec.2017.06.026. Fulltekst i vitenarkiv
• Gude, Tore; Finset, Arnstein; Anvik, Tor; Baerheim, Anders; Fasmer, Ole Bernt & Grimstad, Hilde [Vis alle 7 forfattere av denne artikkelen] (2017). Do medical students and young physicians assess reliably their self-efficacy regarding communication skills? A prospective study from end of medical school until end of internship. BMC Medical Education. 17(107). doi: 10.1186/s12909-017-0943-y. Fulltekst i vitenarkiv Vis sammendrag

  Background This prospective study from end of medical school through internship investigates the course and possible change of self- reported self-efficacy in communication skills compared with observers’ ratings of such skills in consultations with simulated patients. Methods Sixty-two medical students (43 females) from four Norwegian universities performed a videotaped consultation with a simulated patient immediately before medical school graduation (T1) and after internship (internal medicine, surgery and family medicine, half a year each - T2). Before each consultation, the participants assessed their general self-efficacy in communication skills. Trained observers scored the videos and applied a well-validated instrument to rate the communication behaviour. Results from the two assessment methods were correlated at both time points and possible differences from T1 to T2 were explored. Results A close to zero correlation between self-efficacy and observed communication skills were found at T1. At T2, participants’ self-efficacy scores were inversely correlated with levels of observed skills, demonstrating a lack of concordance between young physicians’ own assessment of self-efficacy and observers’ assessment. When dividing the sample in three groups based on the observers’ scores (low <1/3-, medium 1/3 to 2/3-, high competence >2/3), the group of male physicians showed higher levels of self-efficacy than females in all the three performance groups at T1. At T2, those having a high performance score yielded a low self-efficacy, regardless of gender. Conclusions The lack of positive correlations between self-efficacy assessment and expert ratings points to limitations in the applicability of self-assessment measures of communication skills. Due to gender differences, groups of female and male physicians should be investigated separately. Those obtaining high-performance ratings from observers, through the period of internship, may become more conscious of how demanding clinical communication with patients may be. This insight may represent a potential for growth, but could in some physicians represent too much of a self-critical attitude. Active supervision of young physicians throughout internship is important in order to help physicians to be more aware of their strengths and weaknesses, in order to gain increased mastery in the art of doctoring.

• Berge, Torkil; Finset, Arnstein; Fjerstad, Elin; Henriksen, Lise Søvde; Hyldmo, Ingrid & Lang, Nina [Vis alle 8 forfattere av denne artikkelen] (2017). Kartlegging av depressive symptomer ved hjertesykdom : hjertesykdom øker risikoen for depresjon. Hvordan kan man best fange opp deprimerte hjertepasienter? Sykepleien Forskning. ISSN 1890-2936. 2017, s. 1–8. doi: 10.4220/Sykepleienf.2017.60372. Fulltekst i vitenarkiv
• Korsvold, Live; Mellblom, Anneli; Finset, Arnstein; Ruud, Ellen & Lie, Hanne Cathrine (2017). A content analysis of emotional concerns expressed at the time of receiving a cancer diagnosis: An observational study of consultations with adolescent and young adult patients and their family members. European Journal of Oncology Nursing. ISSN 1462-3889. 26, s. 1–8. doi: 10.1016/j.ejon.2016.10.005. Fulltekst i vitenarkiv
• Postma-Nilsenová, Marie; Holt, Erik; Heyn, Lena; Groeneveld, Kim & Finset, Arnstein (2016). A case study of vocal features associated with galvanic skin response to stressors in a clinical interaction. Patient Education and Counseling. ISSN 0738-3991. 99(8), s. 1349–1354. doi: 10.1016/j.pec.2016.03.006. Fulltekst i vitenarkiv Vis sammendrag

  Objective We investigated vocal characteristics associated with physiologically determined stressful episodes by means of post-hoc acoustic analyses of speech recorded in a clinical setting. Our research addressed the understudied question of which vocal features may serve as cues naturally occurring stress and is the first to explore this issue in a pitch accent language. Methods The vocal profile of a single female patient interacting with a physician was analyzed with standard speech analysis software for acoustic indicators of stress-related arousal determined by galvanic skin response measurements. Results Vocal jitter, representing an aspect of voice quality perceived as hoarseness, appeared to increase during and immediately after skin conductance response intervals. Skin conductance levels during the response intervals were negatively correlated with acoustic features used to approximate the perception of voice unsteadiness (slope and standard deviation of fundamental frequency). Conclusion An acoustic analysis of vocal properties of speech uttered during independently detected skin conductance response intervals revealed individual patterns for some acoustic features linked to stress in earlier studies. Practice implications Non-invasive methods of arousal detection in physician-patient communication based on acoustic analyses of vocal profiles may, in combination with other analyses, help identify stressful events and thus improve the process of medical information gathering and decision-making. Keywords Medical communication; Psychophysiology; Voice; Stress

• Mellblom, Anneli; Korsvold, Live; Ruud, Ellen; Lie, Hanne Cathrine; Loge, Jon Håvard & Finset, Arnstein (2016). Sequences of talk about emotional concerns in follow-up consultations with adolescent childhood cancer survivors. Patient Education and Counseling. ISSN 0738-3991. 99(1), s. 77–84. doi: 10.1016/j.pec.2015.07.021. Fulltekst i vitenarkiv
• Korsvold, Live; Lie, Hanne Cathrine; Mellblom, Anneli; Ruud, Ellen; Loge, Jon Håvard & Finset, Arnstein (2016). Tailoring the delivery of cancer diagnosis to adolescent and young adult patients displaying strong emotions: An observational study of two cases. International Journal of Qualitative Studies on Health and Well-being. ISSN 1748-2623. 11. doi: 10.3402/qhw.v11.30763. Fulltekst i vitenarkiv Vis sammendrag

  Delivering the bad news of a cancer diagnosis to adolescent and young adult (AYA) patients who display strong emotions is particularly challenging not the least because AYAs are at a vulnerable developmental stage. Due to the lack of research on how to personalize the delivery of bad news to AYA patients’ emotions we report a case study of the communicative behavior of oncologists in two such consultations to describe the complexity of the phenomena at study. We audio-recorded and transcribed consultations where oncologists delivered cancer diagnoses to nine AYAs aged 12–25 years. Two of these patients displayed particularly strong emotional behavior (anger, fear, and sadness) and were chosen as cases. An interpretative analysis in three steps was applied to investigate the oncologists’ communicative behavior when delivering bad news. The focus was on how the oncologists responded to the strong but different emotional behaviors of the AYAs. We also related the oncologists’ communicative behavior to elements from a widely used protocol for delivering bad news. We found that the oncologists applied five communication strategies: elicit patient perspective, provide information, respond to patient’s expression of emotion (acknowledging and containing emotions), encourage commitment to treatment, and provide hope. The findings illustrate how oncologists’ communicative behavior may be tailored to individual expressions of emotions in AYA cancer patients.

• Korsvold, Live; Mellblom, Anneli; Lie, Hanne Cathrine; Ruud, Ellen; Loge, Jon Håvard & Finset, Arnstein (2016). Patient-provider communication about the emotional cues and concerns of adolescent and young adult patients and their family members when receiving a diagnosis of cancer. Patient Education and Counseling. ISSN 0738-3991. 99(10), s. 1576–1583. doi: 10.1016/j.pec.2016.03.028. Fulltekst i vitenarkiv
• Lie, Hanne Cathrine; Hjermstad, Marianne Jensen; Fayers, Peter; Finset, Arnstein; Kaasa, Stein & Loge, Jon Håvard (2015). Depression in advanced cancer - Assessment challenges and associations with disease load. Journal of Affective Disorders. ISSN 0165-0327. 173, s. 176–184. doi: 10.1016/j.jad.2014.11.006. Fulltekst i vitenarkiv
• Mellblom, Anneli; Korsvold, Live; Finset, Arnstein; Loge, Jon Håvard; Ruud, Ellen & Lie, Hanne Cathrine (2015). Providing information about late effects during routine follow-up consultations between pediatric oncologists and adolescent survivors: A video-based, observational study. Journal of Adolescent and Young Adult Oncology. ISSN 2156-5333. 4(4), s. 200–208. doi: 10.1089/jayao.2015.0037. Fulltekst i vitenarkiv Vis sammendrag

  Purpose: Information about late effects is a prerequisite for survivors of childhood cancers to engage in selfmanagement of their health. Yet, many lack such knowledge. This study investigated to what extent: (1) potential late effects were discussed with adolescent and young adult (AYA)-aged survivors (of pediatric cancer), and (2) information about late effects was provided by the pediatric oncologists (POs) during routine follow-up consultations. Methods: Consultations were recorded with 10 POs and 66 adolescents, aged 12–20 years, treated for leukemia (72.7%) or lymphoma (21.2%), or who had received hematopoietic stem-cell transplantation for a benign disease (7.6%). Discussions of potential late effects were identified and coded, and then the amount of information about late effects provided was categorized into three levels: none, basic, and extended information. Results: Potential late effects were discussed in 85% of the consultations. Of these, 71% were PO initiated, and 60% concerned existing health problems. The POs provided none, basic, and extended information about late effects in 41%, 30%, and 29% of these discussions. Patients’ age, time since treatment, and risk of late effects were not associated with amount of potential late effects discussed, but the type of potential late effect (physical vs. psychosocial and current vs. future risk) and PO were. Conclusion: Potential late effects were frequently discussed, thus providing ample opportunity to provide information about late effects to adolescent cancer survivors. The observed PO variability in providing such information indicates a need for standardization of information practices.

• Søberg, Helene L.; Bautz-Holter, Erik; Finset, Arnstein; Røise, Olav & Andelic, Nada (2015). Physical and mental health 10 years after multiple trauma: A prospective cohort study. Journal of Trauma and Acute Care Surgery. ISSN 2163-0755. 78(3), s. 628–633. doi: 10.1097/TA.0000000000000541. Fulltekst i vitenarkiv
• Lundeby, Tonje; Gulbrandsen, Pål & Finset, Arnstein (2015). The Expanded Four Habits Model-A teachable consultation model for encounters with patients in emotional distress. Patient Education and Counseling. ISSN 0738-3991. 98(5), s. 598–603. doi: 10.1016/j.pec.2015.01.015. Fulltekst i vitenarkiv
• Lie, Hanne Cathrine; Loge, Jon Håvard; Fosså, Sophie Dorothea; Hamre, Hanne Mari; Hess, Siri Lothe & Mellblom, Anneli [Vis alle 8 forfattere av denne artikkelen] (2015). Providing information about late effects after childhood cancer: Lymphoma survivors' preferences for what, how and when. Patient Education and Counseling. ISSN 0738-3991. 98(5), s. 604–611. doi: 10.1016/j.pec.2015.01.016. Fulltekst i vitenarkiv
• Finset, Arnstein (2014). Talk-in-interaction and neuropsychological processes. Scandinavian Journal of Psychology. ISSN 0036-5564. 55(3), s. 212–218. doi: 10.1111/sjop.12127. Fulltekst i vitenarkiv
• Bjelland, Mona; Hausken, Solveig E. Sand; Sleddens, Ester FC; Andersen, Lene Frost; Lie, Hanne Cathrine & Finset, Arnstein [Vis alle 11 forfattere av denne artikkelen] (2014). Development of family and dietary habits questionnaires: the assessment of family processes, dietary habits and adolescents’ impulsiveness in Norwegian adolescents and their parents. International Journal of Behavioral Nutrition and Physical Activity. 11. doi: 10.1186/s12966-014-0130-z. Fulltekst i vitenarkiv Vis sammendrag

  Background There is a need for valid and comprehensive measures of parental influence on children's energy balance-related behaviours (EBRB). Such measures should be based on a theoretical framework, acknowledging the dynamic and complex nature of interactions occurring within a family. The aim of the Family & Dietary habits (F&D) project was to develop a conceptual framework identifying important and changeable family processes influencing dietary behaviours of 13-15 year olds. A second aim was to develop valid and reliable questionnaires for adolescents and their parents (both mothers and fathers) measuring these processes. Methods A stepwise approach was used; (1) preparation of scope and structure, (2) development of the F&D questionnaires, (3) the conducting of pilot studies and (4) the conducting of validation studies (assessing internal reliability, test-retest reliability and confirmatory factor analysis) using data from a cross-sectional study. Results The conceptual framework includes psychosocial concepts such as family functioning, cohesion, conflicts, communication, work-family stress, parental practices and parental style. The physical characteristics of the home environment include accessibility and availability of different food items, while family meals are the sociocultural setting included. Individual characteristics measured are dietary intake (vegetables and sugar-sweetened beverages) and adolescents' impulsivity. The F&D questionnaires developed were tested in a test-retest (54 adolescents and 44 of their parents) and in a cross-sectional survey including 440 adolescents (13-15 year olds), 242 mothers and 155 fathers. The samples appear to be relatively representative for Norwegian adolescents and parents. For adolescents, mothers and fathers, the test-retest reliability of the dietary intake, frequencies of (family) meals, work-family stress and communication variables was satisfactory (ICC: 0.53-0.99). Barratt Impulsiveness Scale-Brief (BIS-Brief) was included, assessing adolescent's impulsivity. The internal reliability (Cronbach's alphas: 0.77/0.82) and test-retest reliability values (ICC: 0.74/0.77) of BIS-Brief were good. Conclusions The conceptual framework developed may be a useful tool in guiding measurement and assessment of the home food environment and family processes related to adolescents' dietary habits, in particular and for EBRBs more generally. The results support the use of the F&D questionnaires as psychometrically sound tools to assess family characteristics and adolescent's impulsivity.

• Bakken, Linda N.; Kim, Hesook Suzie; Finset, Arnstein & Lerdal, Anners (2014). Subjective sleep quality in relation to objective sleep estimates: comparison, gender differences and changes between the acute phase and the six-month follow-up after stroke. Journal of Advanced Nursing. ISSN 0309-2402. 70(3), s. 639–650. doi: 10.1111/jan.12228. Fulltekst i vitenarkiv
• Eikeland, Hanne-Lise; Ørnes, Knut; Finset, Arnstein & Pedersen, Reidar (2014). The physician’s role and empathy – a qualitative study of third year medical students. BMC Medical Education. 14(1). doi: 10.1186/1472-6920-14-165. Fulltekst i vitenarkiv Vis sammendrag

  Background Empathy is important in ensuring the quality of the patient-physician relationship. Several studies have concluded that empathy declines during medical training, especially during the third year. However, there is little empirical research on what may influence a medical student’s empathy. In addition, studies of empathy in medicine have generally been dominated by quantitative approaches, primarily self-assessment questionnaires. This is a paradox given the complexity and importance of empathy. In this paper we explore medical students’ opinions of what may foster or inhibit empathy during medical school, with a particular emphasis on how empathy is influenced by the initiation into the physician’s role. Methods We performed semi-structured qualitative interviews with 11 third year medical students. Content analysis was used to analyse the transcribed interviews. Results Five aspects of the the physician’s role and the students’ role acquisition emerged when the students were asked to describe what may influence their empathy: 1) Becoming and being a professional, 2) Rules concerning emotions and care, 3) Emotional control, 4) The primary importance of biomedical knowledge, and 5) Cynicism as a coping strategy. Conclusion This study suggest that the described inhibitors of empathy may originate in the hidden curriculum and reinforce each other, creating a greater distance between the physician and the patient, and possibly resulting in decreased empathy. Mastering biomedical knowledge is an important part of the students’ ideals of the physician’s role, and sometimes objective and distanced ideals may suppress empathy and the students’ own emotions.

• Mellblom, Anneli; Finset, Arnstein; Korsvold, Live; Loge, Jon Håvard; Ruud, Ellen & Lie, Hanne Cathrine (2014). Emotional concerns in follow-up consultations between paediatric oncologists and adolescent survivors: A video-based observational study. Psycho-Oncology. ISSN 1057-9249. 23(12), s. 1365–1372. doi: 10.1002/pon.3568. Fulltekst i vitenarkiv
• Stensrud, Tonje Lauritzen; Gulbrandsen, Pål; Mjaaland, Trond Arne; Skretting, Sidsel & Finset, Arnstein (2014). Improving communication in general practice when mental health issues appear: Piloting a set of six evidence-based skills. Patient Education and Counseling. ISSN 0738-3991. 95(1), s. 69–75. doi: 10.1016/j.pec.2013.12.005. Fulltekst i vitenarkiv
• Kristjansdottir, Olöf Birna; Fors, Egil Andreas; Eide, Erlend; Finset, Arnstein; Stensrud, Tonje Lauritzen & Dulmen, Sandra van [Vis alle 8 forfattere av denne artikkelen] (2013). A smartphone-based intervention with diaries and therapist-feedback to reduce catastrophizing and increase functioning in women with chronic widespread pain. Part 2. 11-month results of a randomized controlled trial. Journal of Medical Internet Research (JMIR). ISSN 1439-4456. 15(3), s. 152–170. doi: 10.2196/jmir.2442. Fulltekst i vitenarkiv Vis sammendrag

  Background: Internet-based interventions are increasingly used to support self-management of individuals with chronic illnesses. Web-based interventions may also be effective in enhancing self-management for individuals with chronic pain, but little is known about long-term effects. Research on Web-based interventions to support self-management following participation in pain management programs is limited. Objective: The aim is to examine the long-term effects of a 4-week smartphone-intervention with diaries and therapist-written feedback following an inpatient chronic pain rehabilitation program, previously found to be effective at short-term and 5-month follow-ups. Methods: 140 women with chronic widespread pain, participating in a 4-week inpatient rehabilitation program, were randomized into two groups: with or without a smartphone intervention after the rehabilitation. The smartphone intervention consisted of one face-to-face individual session and 4 weeks of written communication via a smartphone, consisting of three diaries daily to elicit pain-related thoughts, feelings, and activities, as well as daily personalized written feedback based on cognitive behavioral principles from a therapist. Both groups were given access to an informational website to promote constructive self-management. Outcomes were measured with self-reported paper-and-pencil format questionnaires with catastrophizing as the primary outcome measure. Secondary outcomes included daily functioning and symptom levels, acceptance of pain, and emotional distress.

• Heyn, Lena; Finset, Arnstein; Eide, Hilde & Ruland, Cornelia (2013). Effects of an interactive tailored patient assessment on patient-clinician communication in cancer care. Psycho-Oncology. ISSN 1057-9249. 22(1), s. 89–96. doi: 10.1002/pon.2064. Fulltekst i vitenarkiv
• Vatne, Torun Marie; Finset, Arnstein; Ørnes, Knut; Holmstrøm, Henrik; Cvancarova, Milada S. & Ruland, Cornelia (2013). Effects of an interactive symptom communication tool for children with heart disease on patientprovider communication in outpatient care: Preliminary results. Journal of Communication in Healthcare. ISSN 1753-8068. 6(2), s. 106–114. doi: 10.1179/1753807612Y.0000000020. Fulltekst i vitenarkiv
• Gulbrandsen, Pål; Jensen, Bård Fossli; Finset, Arnstein & Blanch-Hartigan, Daniel (2013). Long-term effect of communication training on the relationship between physicians' self-efficacy and performance. Patient Education and Counseling. ISSN 0738-3991. 91(2), s. 180–185. doi: 10.1016/j.pec.2012.11.015. Fulltekst i vitenarkiv
• Kale, Emine; Skjeldestad, Kristin & Finset, Arnstein (2013). Emotional communication in medical consultations with native and non-native patients applying two different methodological approaches. Patient Education and Counseling. ISSN 0738-3991. 92(3), s. 366–374. doi: 10.1016/j.pec.2013.06.028. Fulltekst i vitenarkiv
• Færden, Ann; Barrett, Elizabeth Ann; Nesvåg, Ragnar; Friis, Svein; Finset, Arnstein & Marder, Stephen R. [Vis alle 10 forfattere av denne artikkelen] (2013). Apathy, poor verbal memory and male gender predict lower psychosocial functioning one year after the first treatment of psychosis. Psychiatry Research. ISSN 0165-1781. 210(1), s. 55–61. doi: 10.1016/j.psychres.2013.02.007. Fulltekst i vitenarkiv
• Finset, Arnstein; Heyn, Lena & Ruland, Cornelia (2013). Patterns in clinicians' responses to patient emotion in cancer care. Patient Education and Counseling. ISSN 0738-3991. 93(1), s. 80–85. doi: 10.1016/j.pec.2013.04.023. Fulltekst i vitenarkiv
• Heyn, Lena; Finset, Arnstein & Ruland, Cornelia (2013). Talking About Feelings and Worries in Cancer Consultations. Cancer Nursing. ISSN 0162-220X. 36(2), s. E20–E30. doi: 10.1097/NCC.0b013e318254af66. Fulltekst i vitenarkiv
• Kristjansdottir, Olöf Birna; Fors, Egil Andreas; Eide, Erlend; Finset, Arnstein; Stensrud, Tonje Lauritzen & Dulmen, Sandra van [Vis alle 8 forfattere av denne artikkelen] (2013). A smartphone-based intervention with diaries and therapist-feedback to reduce catastrophizing and increase functioning in women with chronic widespread pain: Randomized controlled trial. Journal of Medical Internet Research (JMIR). ISSN 1439-4456. 15(1), s. 41–62. doi: 10.2196/jmir.2249. Fulltekst i vitenarkiv Vis sammendrag

  Background: Internet-based interventions using cognitive behavioral approaches can be effective in promoting self-management of chronic pain conditions. Web-based programs delivered via smartphones are increasingly used to support the self-management of various health disorders, but research on smartphone interventions for persons with chronic pain is limited. Objective: The aim of this trial was to study the efficacy of a 4-week smartphone-delivered intervention with written diaries and therapist feedback following an inpatient chronic pain rehabilitation program. Methods: A total of 140 women with chronic widespread pain who participated in a 4-week inpatient rehabilitation program were randomized into 2 groups: with or without a smartphone intervention after the rehabilitation. The smartphone intervention consisted of 1 face-to-face session and 4 weeks of written communication via a smartphone. Participants received 3 smartphone diary entries daily to support their awareness of and reflection on pain-related thoughts, feelings, and activities. The registered diaries were immediately available to a therapist who submitted personalized written feedback daily based on cognitive behavioral principles. Both groups were given access to a noninteractive website after discharge to promote constructive self-management. Outcomes were measured with self-reported questionnaires. The primary outcome measure of catastrophizing was determined using the pain catastrophizing scale (score range 0-52). Secondary outcomes included acceptance of pain, emotional distress, functioning, and symptom levels. Results: Of the 140 participants, 112 completed the study: 48 in the intervention group and 64 in the control group. Immediately after the intervention period, the intervention group reported less catastrophizing (mean 9.20, SD 5.85) than the control group (mean 15.71, SD 9.11, P<.001), yielding a large effect size (Cohen’s d=0.87) for study completers. At 5-month follow-up, the between-group effect sizes remained moderate for catastrophizing (Cohen’s d=0.74, P=.003), acceptance of pain (Cohen’s d=0.54, P=.02), and functioning and symptom levels (Cohen’s d=0.75, P=.001). Conclusions: The results suggest that a smartphone-delivered intervention with diaries and personalized feedback can reduce catastrophizing and prevent increases in functional impairment and symptom levels in women with chronic widespread pain following inpatient rehabilitation. Trial Registration: Clinicaltrials.gov NCT01236209; http://www.clinicaltrials.gov/ct2/show/NCT01236209 (Archived by WebCite at http://www.webcitation.org/6DUejLpPY)

• Gulbrandsen, Pål; Benth, Jurate Saltyte; Dahl, Fredrik Andreas; Jensen, Bård Fossli; Finset, Arnstein & Hall, Judith A. (2012). Specialist Physicians' sensitivity to patient affect and satisfaction. Medical Care. ISSN 0025-7079. 50(4), s. 290–293. doi: 10.1097/MLR.0b013e318242313e. Fulltekst i vitenarkiv
• Søberg, Helene L.; Finset, Arnstein; Røise, Olav & Bautz-Holter, Erik (2012). The Trajectory of Physical and Mental Health From Injury to 5 Years After Multiple Trauma: A Prospective, Longitudinal Cohort Study. Archives of Physical Medicine and Rehabilitation. ISSN 0003-9993. 93(5), s. 765–774. doi: 10.1016/j.apmr.2011.08.050. Fulltekst i vitenarkiv
• Heyn, Lena; Ruland, Cornelia & Finset, Arnstein (2012). Effects of an interactive tailored patient assessment tool on eliciting and responding to cancer patients' cues and concerns in clinical consultations with physicians and nurses. Patient Education and Counseling. ISSN 0738-3991. 86(2), s. 158–165. doi: 10.1016/j.pec.2011.04.024. Fulltekst i vitenarkiv
• Grimsbø, Gro Hjelmeland; Engelsrud, Gunn; Ruland, Cornelia & Finset, Arnstein (2012). Cancer patients' experiences of using an Interactive Health Communication Application (IHCA). International Journal of Qualitative Studies on Health and Well-being. ISSN 1748-2623. 7. doi: 10.3402/qhw.v7i0.15511. Fulltekst i vitenarkiv Vis sammendrag

  Interactive Health Communication Applications (IHCAs) are increasingly used in health care. Studies document that IHCAs provide patients with knowledge and social support, enhance self- efficacy and can improve behavioural and clinical outcomes. However, research exploring patients’ experiences of using IHCAs has been scarce. The aim of this study was to explore cancer patients’ perspectives and experiences related to the use of an IHCA called WebChoice in their homes. Qualitative interviews were conducted with infrequent, medium and frequent IHCA users*six women and four men with breast and prostate cancer. The interviews were transcribed and analyzed inspired by interactionistic perspectives. We found that some patients’ perceived WebChoice as a ‘‘friend,’’ others as a ‘‘stranger.’’ Access to WebChoice stimulated particularly high frequency users to position themselves as ‘‘information seeking agents,’’ assuming an active patient role. However, to position oneself as an ‘‘active patient’’ was ambiguous and emotional. Feelings of ‘‘calmness’’, ‘‘normalization of symptoms’’, feelings of ‘‘being part of a community’’, feeling ‘‘upset’’ and ‘‘vulnerable’’, as well as ‘‘feeling supported’’ were identified. Interaction with WebChoice implied for some users an increased focus on illness. Our findings indicate that the interaction between patients and an IHCA such as WebChoice occurs in a variety of ways, some of which are ambivalent or conflicting. Particularly for frequent and medium frequency users, it offers support, but may at the same time reinforce an element of uncertainty in their life. Such insights should be taken into consideration in the future development of IHCAs in healthcare in general and in particular for implementation into patients’ private sphere.

• Lerdal, Anners; Lee, Kathryn A.; Bakken, Linda Nilsen; Finset, Arnstein & Kim, Hesook Suzie (2012). The Course of Fatigue during the First 18 Months after First-Ever Stroke: A Longitudinal Study. Stroke Research and Treatment. ISSN 2090-8105. 2012. doi: 10.1155/2012/126275. Fulltekst i vitenarkiv Vis sammendrag

  Background: Little is known about the course of poststroke fatigue. Objectives. To describe the course of poststroke fatigue in relation to the patient's level of physical functioning, depressive symptoms, and self-reported history of prestroke fatigue. Methods: A longitudinal study using structured face-to-face interviews, questionnaires, and patients' medical records. Data were collected from 95 patients in Norway with first-ever stroke. Fatigue was measured with the Fatigue Severity Scale 7 item version and assessed for change between the acute phase, six, 12, and 18 months after stroke using 2-way ANOVA repeated-measures analyses. Results: The patients' level of fatigue did not change over time. However, those who reported prestroke fatigue showed a relatively high level of fatigue over time in the poststroke period, while patients with no history of pre-stroke fatigue showed a stable course of relatively low fatigue over time. Conclusion: Studies on poststroke fatigue should control for the patient's pre-stroke fatigue level.

• Bakken, Linda Nilsen; Kim, Hesook Suzie; Finset, Arnstein & Lerdal, Anners (2012). Stroke patients’ functions in personal activities of daily living in relation to sleep and socio-demographic and clinical variables in the acute phase after first-time stroke and at six months of follow-up. Journal of Clinical Nursing (JCN). ISSN 0962-1067. 21(13-14), s. 1886–1895. doi: 10.1111/j.1365-2702.2011.04014.x. Fulltekst i vitenarkiv Vis sammendrag

  Aims and objectives.  To explore first-time stroke patients’ degree of independence in activities of daily life in relation to sleep and other essential variables that might influence activities of daily life. Background.  Sleep has received little attention in rehabilitation of activities of daily life in stroke patients. Design.  This is a longitudinal survey and observational study design from the acute phase to six months poststroke. Methods.  First-time stroke patients (n = 90) were recruited from two hospitals in eastern Norway in 2007 and 2008. Data were collected by survey interview, medical records and wrist actigraphy in the first two weeks at the hospital and at six months of follow-up. Actigraph measures patient activity and estimates sleep during the day and night. Results.  Linear regression showed that high dependence in personal activities of daily living was directly related to low estimated sleep time at night and higher estimated sleep during the day in the acute phase, controlling for socio-demographic and clinical variables. Furthermore, high estimated numbers of awakenings in the acute phase were related to lower activities of daily life functioning at six months of follow-up after controlling for socio-demographic and clinical variables. Stronger pain and a lower physical functioning showed direct relationships with lower independency level of in activities of daily life both in the acute phase and after six months. Conclusions.  Sleep patterns in the acute phase may influence the patients’ activities of daily life functioning up to six months poststroke. Furthermore, pain in the acute phase may influence the level of activities of daily life functioning in stroke patients. Relevance to clinical practice.  Nurses should pay attention to stroke patients’ sleep quality and pain in the rehabilitation period after a stroke. Facilitating good sleep conditions and screening for pain should be an integral part of the rehabilitation programme.

Se alle arbeider i NVA

• Gulbrandsen, Pål & Finset, Arnstein (2019). Skreddersydde samtaler - en veileder i medisinsk kommunikasjon. 2. utgave. Gyldendal Akademisk. ISBN 9788205523968. 181 s. Fulltekst i vitenarkiv
• Gulbrandsen, Pål & Finset, Arnstein (2014). Skreddersydde samtaler - en veileder i medisinsk kommunikasjon. Gyldendal Akademisk. ISBN 9788205449909. 174 s. Fulltekst i vitenarkiv

Se alle arbeider i NVA

• Finset, Arnstein; Street, Richard L. & Bylund, Carma L. (2023). Patient Education and Counseling and PEC Innovation: A brief status report. Patient Education and Counseling. ISSN 0738-3991. 107. doi: 10.1016/j.pec.2022.107593. Fulltekst i vitenarkiv
• Eide, Hilde; Ho, Evelyn Y.; Gilligan, Conor; Noordman, Janneke; Street, Richard L. & Finset, Arnstein (2023). Communication research in a post-COVID era: Special Section with invited papers from the International Conference on Communication in Healthcare 2022 (ICCH-2022). Patient Education and Counseling. ISSN 0738-3991. 115. doi: 10.1016/j.pec.2023.107945. Fulltekst i vitenarkiv
• Finset, Arnstein & Street, Richard L. (2023). Risk communication, shared decision making and health literacy. Patient Education and Counseling. ISSN 0738-3991. 116. doi: 10.1016/j.pec.2023.107983. Fulltekst i vitenarkiv
• Dulmen, Sandra van; Eide, Hilde & Finset, Arnstein (2023). Implementing lifestyle interventions in clinical practice: The importance of adherence. Patient Education and Counseling. ISSN 0738-3991. 109. doi: 10.1016/j.pec.2023.107651. Fulltekst i vitenarkiv
• Menichetti, Julia; Finset, Arnstein; Papageorgiou, Alexia; Sterie, Anca Christine; Yuan, Siyang & Vliet, Liesbeth van (2022). Setting the agenda for health communication research: topics and methodologies. Patient Education and Counseling. ISSN 0738-3991. doi: 10.1016/j.pec.2022.10.349. Fulltekst i vitenarkiv
• Haugen, Hans Morten; Agøy, Berit Hagen; Finset, Arnstein; Glad-Gjernes, Fredrik; Raaum, Kristin Gunleiksrud & Høybråten, Dagfinn [Vis alle 9 forfattere av denne artikkelen] (2020). Solidaritet og handling for Palestina og Israel (kun på verdidebatt.no). Fulltekst i vitenarkiv
• Lie, Hanne Cathrine; Mellblom, Anneli; Juvet, Lene Kristine; Heyn, Lena; Sundling, Vibeke & Brembo, Espen Andreas [Vis alle 12 forfattere av denne artikkelen] (2020). Spoken communication strategies for effective information provision in the medical consultation: A systematic review. Fulltekst i vitenarkiv
• Finset, Arnstein & Eide, Hilde (2020). Special Issue: Twenty-two review articles and papers from ICCH in San Diego 2019. Patient Education and Counseling. ISSN 0738-3991. 103(10), s. 1871–1872. doi: 10.1016/j.pec.2020.08.006. Fulltekst i vitenarkiv
• Karlsen, Marte-Marie Wallander; Happ, Mary Beth; Heggdal, Kristin; Finset, Arnstein & Heyn, Lena (2019). Decision making in intensive care units: A phenomenological-hermeneutical study. Fulltekst i vitenarkiv
• Rubinelli, Sara; Silverman, Jonathan D.; Aelbrecht, Karolien; Deveugele, Myriam; Finset, Arnstein & Humphris, Gerry [Vis alle 10 forfattere av denne artikkelen] (2019). Developing the International Association for Communication in Healthcare (EACH) to address current challenges of health communication. Patient Education and Counseling. ISSN 0738-3991. 102(6), s. 1217–1221. doi: 10.1016/j.pec.2019.01.004. Fulltekst i vitenarkiv
• Karlsen, Marte-Marie Wallander; Heggdal, Kristin; Finset, Arnstein & Heyn, Lena (2019). Communication and Collaboration with Mechanically Ventilated Patients in Intensive Care Units: A Study of Health-Care Personnel's Experiences in Clinical Practice. Fulltekst i vitenarkiv
• Finset, Arnstein (2018). Family involvement, patient engagement and benefits of patient education interventions. Patient Education and Counseling. ISSN 0738-3991. 101(6), s. 969–969. doi: 10.1016/j.pec.2018.04.008. Fulltekst i vitenarkiv
• Karlsen, Marte-Marie Wallander; Finset, Arnstein; Heggdal, Kristin & Heyn, Lena (2018). Patients` attention seeking actions during mechanical ventilation in intensive care units. Fulltekst i vitenarkiv
• Karlsen, Marte-Marie Wallander; Heyn, Lena & Finset, Arnstein (2018). Communication and interaction with patients during mechanical ventilation in intensive care units - analytic choices in a qualitative video recorded study. Fulltekst i vitenarkiv
• Finset, Arnstein (2018). May good clinical communication contribute to pain reduction? Patient Education and Counseling. ISSN 0738-3991. 101(2), s. 175–176. doi: 10.1016/j.pec.2018.01.010. Fulltekst i vitenarkiv
• Finset, Arnstein (2018). Why do doctors not learn how to explain “medically unexplained symptoms”? Patient Education and Counseling. ISSN 0738-3991. 101(5), s. 763–764. doi: 10.1016/j.pec.2018.03.022. Fulltekst i vitenarkiv
• Finset, Arnstein (2018). Among the topics of this issue: Health literacy and interpreter-mediated communication. Patient Education and Counseling. ISSN 0738-3991. 101(1), s. 1–1. doi: 10.1016/j.pec.2017.11.005. Fulltekst i vitenarkiv
• Finset, Arnstein (2018). Positive emotions?An interesting topic in clinical communication research. Patient Education and Counseling. ISSN 0738-3991. 101(4), s. 557–557. doi: 10.1016/j.pec.2018.03.008. Fulltekst i vitenarkiv
• Karlsen, Marte-Marie Wallander; Heggdal, Kristin; Finset, Arnstein & Heyn, Lena (2017). Communication in intensive care units: A scoping review. Fulltekst i vitenarkiv
• Wien, Tale Norbye; Hyldmo, Ingrid; Lang, Nina; Vevatne, Vegard; Fjerstad, Elin & Mensen, Lill Karin [Vis alle 7 forfattere av denne artikkelen] (2017). Refleksjonsgrupper – en metode for kvalitetssikring. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 137(7/8), s. 512–513. doi: 10.4045/tidsskr.17.0089. Fulltekst i vitenarkiv
• Finset, Arnstein (2017). Four review articles on relevant topics for patient education, counseling and communication in healthcare. Patient Education and Counseling. ISSN 0738-3991. 100(2), s. 181–182. doi: 10.1016/j.pec.2017.01.017. Fulltekst i vitenarkiv
• Finset, Arnstein; Bieber, Christiane; Brown, Richard F.; Deveugele, Myriam & Pieterse, Arwen (2017). The perspective of the person in healthcare: Listening to and engaging persons in healthcare. Patient Education and Counseling. ISSN 0738-3991. 100(11), s. 1967–1968. doi: 10.1016/j.pec.2017.08.012. Fulltekst i vitenarkiv
• Finset, Arnstein (2017). Special section on psychological aspects of cancer: Patient and clinician perspectives. Patient Education and Counseling. ISSN 0738-3991. 100(5), s. 793–794. doi: 10.1016/j.pec.2017.03.025. Fulltekst i vitenarkiv
• Finset, Arnstein (2017). Patients' values and preferences and communication about life expectancy: Combining honesty and hope. Patient Education and Counseling. ISSN 0738-3991. 100(10), s. 1777–11777. doi: 10.1016/j.pec.2017.07.020. Fulltekst i vitenarkiv
• Finset, Arnstein (2017). Five new associate editors in the editorial team of PEC. Patient Education and Counseling. ISSN 0738-3991. 100(9), s. 1621–1621. doi: 10.1016/j.pec.2017.06.037. Fulltekst i vitenarkiv
• Finset, Arnstein & Ørnes, Knut (2016). Clinician empathy is a complex phenomenon. Patient Education and Counseling. ISSN 0738-3991. 99(2), s. 171–172. doi: 10.1016/j.pec.2015.12.016. Fulltekst i vitenarkiv
• Søberg, Helene L.; Bautz-Holter, Erik; Finset, Arnstein; Røise, Olav & Andelic, Nada (2015). Physical and mental health 10 years after multiple trauma - a prospective cohort study. Fulltekst i vitenarkiv
• Ørnes, Knut; Finset, Arnstein & Pedersen, Reidar (2015). Empathic communication in medical students: Medical students’ emotional, cognitive and behavioral responses to emotional behavior in simulated patients. Fulltekst i vitenarkiv
• Ørnes, Knut; Korsvold, Live & Finset, Arnstein (2015). Some issues for discussion regarding division into units of analysis. Fulltekst i vitenarkiv
• Ørnes, Knut; Eikeland, Hanne-Lise; Finset, Arnstein & Pedersen, Reidar (2015). Persona non-grata: medical students’ perspectives and reflections on own communicative behavior in emotional simulated medical encounters. Fulltekst i vitenarkiv
• Søberg, Helene L.; Bautz-Holter, Erik; Finset, Arnstein; Røise, Olav & Andelic, Nada (2015). Physical and mental health 10 years after multiple trauma - a prospective cohort study. Fulltekst i vitenarkiv
• Groeneveld, Kim; Postma-Nilsenová, Marie; Holt, Erik; Heyn, Lena & Finset, Arnstein (2014). Combining psycho-physiological and social signal processing methods in health communication: 389 Acute stress detection. Fulltekst i vitenarkiv
• Heyn, Lena; Holt, Erik; Finset, Arnstein & Ruland, Cornelia (2014). Talking about emotions in follow-up cancer consultations. Fulltekst i vitenarkiv
• Søberg, Helene L.; Bautz-Holter, Erik; Finset, Arnstein & Røise, Olav (2013). Psychological aspects in rehabilitation of patients with multiple trauma. Journal of Rehabilitation Medicine. ISSN 1650-1977. 45, s. 248–949. Fulltekst i vitenarkiv
• Mellblom, Anneli; Lie, Hanne Cathrine; Ruud, E & Finset, Arnstein (2013). Expression of Negative Emotion During Follow-up Consultations After Childhood Cancer With Adolescents: A Video-Based Observational Study. Psycho-Oncology. ISSN 1057-9249. 22, s. 65–66. Fulltekst i vitenarkiv
• Skirbekk, Helge & Finset, Arnstein (2013). Likemannsprosjektet: Rapport fra undersøkelse av likemannstjenesten ved Vardesenteret på Radiumhospitalet 2013. Fulltekst i vitenarkiv
• Skirbekk, Helge & Finset, Arnstein (2013). Likemannsprosjektet. Fulltekst i vitenarkiv
• Skirbekk, Helge & Finset, Arnstein (2013). Likemannsprosjektet. Fulltekst i vitenarkiv
• Korsvold, Live; Finset, Arnstein; Loge, Jon Håvard; Ruud, Ellen & Lie, Hanne Cathrine (2013). DELIVERING BAD NEWS TO ANGRY ADOLESCENT PATIENTS - A LITERATURE REVIEW AND A CASE ILLUSTRATION. Pediatric Blood & Cancer. ISSN 1545-5009. 60, s. 179–179. Fulltekst i vitenarkiv
• Mellblom, Anneli; Lie, Hanne Cathrine; Loge, Jon Håvard; Ruud, Ellen & Finset, Arnstein (2013). WHAT ARE THEY WORRIED ABOUT? THE CONTENT OF EMOTIONAL CONCERNS EXPRESSED AT FOLLOW-UP CONSULTATIONS WITH ADOLESCENTS AFTER CHILDHOOD CANCER: A VIDEO-BASED OBSERVATIONAL STUDY. Pediatric Blood & Cancer. ISSN 1545-5009. 60, s. 21–22. Fulltekst i vitenarkiv
• Sorteberg, Angelika; Nordermark, Tonje Haug; Finset, Arnstein; Lindegaard, Karl-Fredrik; Lundar, Tryggve & Sorteberg, Wilhelm (2013). Over-aggressive treatment of grade V SAH patients. Neurosurgery. ISSN 0148-396X. 73(3), s. 560–561. Fulltekst i vitenarkiv
• Kristjansdottir, Olöf Birna; Fors, Egil Andreas; Eide, Erlend; Finset, Arnstein; Dulmen, Sandra van & Wigers, Sigrid Hørven [Vis alle 7 forfattere av denne artikkelen] (2012). Smartphone-Based Diaries and Feedback to Enhance Wellbeing in Women with Chronic Widespread Pain - Follow-up Results of a Randomized Trial. Fulltekst i vitenarkiv
• Lerdal, Anners; Lee, Kathryn A.; Bakken, Linda Nilsen; Finset, Arnstein & Kim, Hesook Suzie (2012). Fatigue etter hjerneslag – en forløpstudie. Fulltekst i vitenarkiv Vis sammendrag

  Bakgrunn: Hvert år rammes omlag 15 000 nordmenn av hjerneslag. Studier viser at fatigue forekommer hos 38 – 77% av dem som får hjerneslag. Fatigue kan defineres som ”en overveldende, vedvarende følelse av utmattelse, tretthet og redusert kapasitet for fysisk og mentalt arbeid på normalt nivå”. Hensikten: med studien var å beskrive utviklingen av fatigue over tid hos personer med hjerneslag relatert til kjønn, grad a fysisk funksjon, depressive symptomer og om de hadde hatt langvarig fatigue før slaget. Metode: Studien hadde et longitudinelt design. Data ble samlet inn ved hjelp av intervjuer etter standardiserte spørreskjemaer, tilsendte spørreskjemaer og pasientjournaler og ble samlet inn i løpet av de to første ukene etter sykehusinnleggelsen og etter 6, 12 og 18 måneder. Fatigue ble målt med Fatigue severity scale, og hver pasient fikk utregnet sin gjennomsittskåren på 7 spørsmål. Skalaen går fra 1 (ingen fatigue) til 7 (svært plaget av fatigue). Etthundre-og-nitten pasienter med første gang klinisk hjerneslag ble rekruttert fortløpende etter innleggelse på slagavdelinger ved to sykehus i Østlandsområdet. Av disse deltok 95 på alle måletidspunktene og hadde fullstendige data som kunne analyseres. Resultater: Gjennomsnittlig fatiguenivå hos pasientene var stabilt de første 18 månedene etter slaget. Pasienter som hadde hatt langvarig fatigue før slaget hadde relativt høyt nivå av fatigue i oppfølgingsperioden, mens pasientgruppen som ikke hadde vært plaget av langvarig fatigue før hjerneslaget rapporterte relativt lavt fatiguenivå i tiden etter slaget. Når helsearbeidere skal kartlegge fatigue hos slagrammende, bør det også innhentes opplysninger om pasientens erfaringer med fatigue før slaget. Studien er publisert og gratis tilgjengelig i fulltekst: Lerdal, A., Lee, K.A., Bakken, L.N., Finset, A., Kim, H.S. 2012. The course of fatigue during the first18 months after first-ever stroke - a longitudinal study. Stroke Research and Treatment; 2012. 126275

• Nes, Andrea; Eide, Hilde; Dulmen, Sandra van & Finset, Arnstein (2017). Exploring change processes within a smartphone-delivered intervention using electronic diaries and written situational feedback to support self-management in persons with a chronic illness. Universitetet i Oslo. Fulltekst i vitenarkiv
• Finset, Arnstein & Skirbekk, Helge (2014). ””Du trenger ikke trekke kølapp!” Rapport fra Likepersonsprosjektet. En kvalitativ undersøkelse av likepersonstjenesten ved Vardesenteret på Radiumhospitalet. Kreftforeningen. Fulltekst i vitenarkiv

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