Oral health-related side effects are common in patients with both untreated and PAP-treated OSA and can hinder adherence to PAP treatment. Despite extensive research on OSA and PAP, oral health experiences of PAP professionals remain unexplored. The aim was to describe PAP professionals' experiences and management of symptoms and treatment effects on oral health in patients with OSA before and during PAP treatment. The study has a qualitative design with an inductive approach, where 17 strategically selected PAP professionals (physicians, nurses, and biomedical scientists) at nine Swedish PAP clinics participated in semi-structured in-depth interviews. The data was analysed with content analysis. Four categories described PAP professionals' experiences before and during PAP treatment. The categories Acknowledging oral health aspects when exploring the clinical data and Exploring the patients' oral health-related experiences described the OSA diagnosis, intra-oral visual features, and shared signs between OSA and oral health. The categories Adjusting the PAP device related to oral health and Managing oral health-related situations during PAP treatment described the oral health-related challenges in patient collaboration and individualised PAP treatment. In conclusion, oral dryness was an oral health-related symptom of OSA and a side effect of PAP treatment, noted by PAP professionals. Management of oral health-related situations and treatment effects was difficult as there was a lack of knowledge and no established remedial routine.

Background: Restless legs syndrome (RLS) is a long-term sensory-motor illness impacting individuals and their family members, yet little is known about the family members' everyday experiences.

Aim: To explore and describe the everyday life experiences of family members of individuals with RLS.

Methods: An inductive, qualitative exploratory design was used. Telephone interviews were conducted with 25 family members (e.g. partner, child) and analysed using qualitative content analysis.

Results: Family members described adjusting their routines and social activities to accommodate the individual with RLS, often balancing these changes with their own needs. This adaptation affected their everyday lives, as conflicting desires required balancing personal needs with sleep disruptions, resulting in tiredness. Despite these challenges, they employed strategies such as shared activities and self-care to manage the impact on the individuals with RLS.

Conclusions and contribution to nursing: This study highlights the importance of family involvement in RLS care and the need for a family nursing approach in guidelines. Healthcare professionals could invite both family members and individuals with RLS in shared decision-making. Policies and practices could provide resources to support flexible coping strategies and reduce isolation. Future research could explore social support to better understand family members' experiences.

Background: Restless legs syndrome (RLS) is a prevalent neurological condition affecting daily life. Symptoms can vary and worsen during the evening and night, with sleep problems as a common consequence. Few, if any, qualitative studies have explored how patients with RLS experience their sleep problems.

Aim: The aim was to explore and describe how patients with RLS experience their sleep problems, the subsequent daytime consequences, and self-care activities used to improve sleep.

Methods: An inductive, descriptive, qualitative design was used, including semi-structured interviews with 28 strategically selected patients from a national RLS organisation. Data were analysed with manifest qualitative content analysis and reported according to the COREQ checklist.

Results: RLS-related ailments affecting sleep were: noticing initial symptoms in the evening, enduring stressful RLS symptoms at night, and being concerned about not having symptom-relieving treatment. Struggles with daytime consequences of poor sleep were: feeling excessive fatigue and managing social interactions. Self-care actions to improve sleep included trust in daily routines, benefiting from the use of various distractions, and actively seeking effective medical treatment.

Conclusions and contribution to nursing: Knowledge about various RLS-related ailments affecting sleep can be used by nurses to provide adequate education about the disease and potential nursing interventions to improve sleep.

Introduction: Restless legs syndrome (RLS) is a prevalent disorder that disrupts sleep and impairs quality of life. Establishing effective treatment is complex, and shared decision-making (SDM) might reduce decisional conflicts. No previous study has examined SDM or factors linked to decisional conflicts in RLS. Therefore, this study aimed to explore and compare sociodemographic and clinical factors associated with SDM in general and decisional conflicts in particular among patients with RLS. Methods: A cross-sectional design using a postal survey (June-September 2022), inviting all similar to 1500 members of the national RLS patient organization. Comparative statistical analyses and logistic regression models examined associations with sociodemographic and clinical factors, using the instruments: Restless Legs Syndrome-6 scale (RLS symptoms), Pittsburgh Sleep Quality Index (sleep), Patient Health Questionnaire-9 (depressive symptoms), eHEALS (e-health literacy), CollaboRATE (SDM), and SURE (decisional conflicts). Ad hoc items regarding treatment satisfaction and informational needs were also used. Results: In total, 788 patients, 65% women, mean age 70.8 (standard deviation = 11.3) were included. Fifty-eight percent reported a low SDM experience, and 78% experienced decisional conflicts. Multiple logistic regression analysis showed that RLS symptoms at nighttime (odds ratio [OR] = 1.073, P = 0.020), RLS treatment dissatisfaction (OR = 2.077, P < 0.001), low e-health literacy (OR = 0.964, P = 0.007), and a low SDM experience (OR = 0.800, P < 0.001) were associated with decisional conflicts. Conclusion: Most patients experienced low levels of SDM and decisional conflicts, with several factors associated with their experiences. Awareness among healthcare professionals can support a collaborative approach, using SDM to prevent treatment-related decisional conflicts in RLS care.

Background Neonatal cardiopulmonary resuscitation (CPR) requires a skilled team including pediatric registered nurses (pRNs) who must manage complex, high-stress situations. This study aimed to describe pRNs' experiences of neonatal CPR and to interpret these in relation to two levels of clinical expertise, novice and expert, using Benner's framework. Design and methods A qualitative secondary analysis included two strategically selected novices and two experts from three level III and IV NICUs in Sweden. Data were analyzed using abductive content analysis framed by the Swedish competence description for pRNs and Benner's nursing theory. Results Novices relied on guidelines and familiar team members to manage stress and ensure patient safety. Experts demonstrated confidence in team dynamics, anticipatory decision-making, and mentoring behaviors. Conclusion The findings highlight differences in how novice and expert pRNs experience neonatal resuscitation and emphasize the importance of mentorship and structured support for professional development.

OBJECTIVES: Adequate sleep and a schedule aligned with circadian rhythms are essential for healthy development in adolescents. One strategy to improve sleep, mental health, and academic performance is to delay school start times. A few Swedish schools have implemented later school start times, but these changes or the perceptions of these changes have not been formally studied. The present study aimed to illuminate adolescents' concerns and positive expectations regarding later school start times.

METHODS: The study included 314 adolescents aged 13-15 years (52% self-identified as girls) at 2 secondary schools in Sweden. Adolescents were to start their school days an hour later, from 8:00-9:00 am, beginning in August 2024. Data were collected from June 2024-August 2024 through 28 individual interviews and one open-ended survey question answered by 286 adolescents. These data were analyzed using inductive qualitative content analysis.

RESULTS: Adolescents' concerns and positive expectations were summarized into 4 categories. They expected the change to result in altered morning routines, as well as improved well-being and performance during the school day. They also anticipated changes in leisure time, with more energy but less free time, and both improvements (longer sleep duration and easier sleep onset) and potential drawbacks (later bedtimes) regarding sleep. Their views reflected both enthusiasm and apprehension, thereby highlighting ambivalence toward the upcoming change.

CONCLUSION: The impending shift to later school start times was largely viewed positively, offering hopes of better sleep and well-being, including longer sleep duration and an easier time falling asleep due to reduced pressure to go to bed early. However, the impending shift also raised concerns regarding longer school days and less leisure time. These findings indicate a predominantly positive perspective, although some ambivalence remains about both opportunities and challenges. Follow-up research should further clarify adolescents' experiences.

Purpose: This study aimed to translate the T-14 questionnaire into Swedish and validate it in a Swedish pediatric population with tonsil-related disease.

Methods: A prospective validation study was conducted across five Swedish otorhinolaryngology departments from October 2022 to June 2024. Translation followed a standardized forward-backward procedure. Caregivers of patients (< 16 years) scheduled for tonsil surgery completed the Swedish T-14 and EQ-5D-Y VAS (EuroQol five-Dimensional questionnaire for Youth, Visual Analog Scale [VAS]) at baseline, 2weeks later, and 6months postoperatively. A healthy control group was included for comparison. Psychometric evaluation included known-groups validity (Mann-Whitney U), construct validity (confirmatory factor analysis), convergent validity (Spearman's correlation), internal consistency (Cronbach's alpha), test-retest reliability (intraclass correlation coefficient), and responsiveness (Wilcoxon signed-rank, Cohen's d).

Results: A total of 249 participants were included (case group 169, control group 80). Known-groups validity was confirmed, with significantly higher baseline T-14 scores in the case group (p < 0.001). Confirmatory factor analysis supported the predefined two-factor model (comparative fit index = 0.94, Tucker-Lewis index = 0.92, standardized root mean square residual = 0.061), although root mean square error of approximation (0.099) indicated some misfit. Convergent validity was demonstrated by a weak but significant negative correlation with EQ-5D-Y VAS (rs = -0.32; p < 0.001). Internal consistency was good (alpha= 0.83), and test-retest reliability showed good stability (ICC = 0.77). Responsiveness was strong, with a large reduction in T-14 scores 6 months after surgery (p < 0.001; Cohen's d = 1.89).

Conclusion: T-14 demonstrated good validity, reliability, and responsiveness, effectively distinguishing patients from healthy controls. It is suitable for clinical use and enables comparisons with international studies.

Level of Evidence: Level III—non-randomized controlled cohort.

Background: The Bergen Social Media Addiction Scale (BSMAS) is one of the most widely used measures to assess problematic social media use (PSMU). However, no validated Swedish version for adolescents is available. Methods: The BSMAS was translated and culturally adapted into Swedish following established guidelines and psychometrically evaluated among a school-based sample of 658 adolescents aged 13-17 years from three schools (332 boys, 313 girls, and 13 with undisclosed gender; 580 Swedish-born and 78 non-Swedish-born). Reliability and construct validity were examined using classical test theory (CTT) and Rasch modeling. Confirmatory factor analysis (CFA) was conducted to assess dimensionality, and measurement invariance was tested across gender and country of birth. Evidence based on relationships to other variables was further explored using structural equation modeling and network analysis, including associations with social media use duration and symptoms of anxiety and depression assessed using the PROMIS Pediatric Depression and Anxiety Scales. Results: Among the competing CFA models, the best fit was obtained for a two-factor structure in which (i) salience and tolerance reflected peripheral criteria, and (ii) mood modification, relapse, withdrawal, and conflict reflected core criteria. Internal consistency was acceptable for both the peripheral factor (Cronbach's alpha = 0.793; McDonald's omega = 0.795) and the core factor (Cronbach's alpha = 0.764; McDonald's omega = 0.786). Rasch analyses indicated acceptable item fit and limited differential item functioning across gender and country of birth. Multigroup CFA supported configural, metric, and scalar invariance across both gender and country of birth. Network analyses showed that social media use duration was related to BSMAS symptoms but was not central in the symptom network. Structural equation modeling further showed that both peripheral and core criteria were positively associated with anxiety and depression, with stronger associations observed for core criteria. Conclusions: The Swedish version of the BSMAS showed acceptable reliability and validity among adolescents, with findings supporting a two-factor representation that distinguishes peripheral from core criteria. The scale appears suitable for adolescent research, school-based studies, and early screening contexts.

Aim: This repeated cross-sectional study examined trends and behavioral correlates of excessive screen time among Swedish adolescents across 2017, 2020 and 2023. Specifically, this study examined 1) temporal trends of variables used, 2) correlates of pooled screen time, and 3) correlates of specific screen modalities (gaming, social media, and film/TV viewing).

Methods: Data were collected from n=8,300 upper secondary school students in Jönköping County (n=2,319 in2017; n=3,056 in 2020; n=2,925 in 2023). Measures used included risk behaviors (e.g., alcohol, smoking), physical activity, psychosocial trust, exposure to violence and victimization, sleep duration, psychosomatic symptoms, absenteeism and living arrangement. General linear models (GLM; UNIANOVA) were conducted, adjusting for relevant covariates.

Results: Alcohol use, smoking, shorter sleep duration, higher psychosomatic symptoms, and school absenteeism were associated with higher pooled screen time, whereas physical activity, female gender, and living with both parents were associated with lower pooled screen time. Across modality-specific analyses, shorter sleep duration, lower physical activity, living without both parents, and school absenteeism were consistently associated with higher screen use across gaming, social media, and film/TV viewing, while substance-use and gender associations varied by modality.

Conclusion: Sleep, physical activity, family structure, and school absenteeism appear to be robust correlates across screen modalities, supporting the importance of targeting these factors in adolescent health promotion and digital media guidance. These findings highlight the need for parents, researchers, and health professionals to pay closer attention to adolescents’ digital media use.