Background: Adequate sleep is crucial for children's health, especially for children with ADHD and concurrent sleep problems. There is a need for more studies focusing on sleep problems in children with ADHD as these problems may exacerbate ADHD symptoms and vice versa, impacting negatively on everyday life. The aim of this study was to investigate the differences in health-related factors between children with ADHD without clinically relevant sleep problems and those with clinically relevant sleep problems after a sleep intervention.

Methods: This cross-sectional study involved 83 children diagnosed with ADHD and sleep problems, 46 boys and 37 girls; aged 6-14 years, divided into two groups after a sleep intervention according to the parent-reported Children's Sleep Habits Questionnaire (CSHQ) and a cut-off for clinically relevant sleep problems. Data from a 16-week follow-up of the sleep intervention were analysed in terms of the following health-related measures: The Insomnia Severity Index (ISI), The short form of State-Trait Anxiety Inventory (Short-STAI), The Child Outcome Rating Scale (CORS), The EQ-5D-Y-3L (child-reported), and The Swanson, Nolan, and Pelham Rating Scale (SNAP-IV) (parent-reported). The Mann-Whitney u-test, Independent samples t-test, and Chi-square/Fisher's exact test were used for the analysis.

Results: Forty-two of the 83 children (50.6%) were grouped as having clinically relevant sleep problems and 41 (49.4%) as being without the same. The results indicated that the group without clinically relevant sleep problems reported less insomnia (ISI, total score p = 0.011), less tension in the anxiety scale (Short-STAI, tense p = 0.047), and their parents reported less ADHD symptoms (SNAP-IV, total score for attention deficit, p < 0.001). No group differences were observed for life functioning (CORS) or health-related quality of life (EQ-5D-Y-3 L).

Conclusions: This study showed that children with ADHD without parent-reported clinically relevant sleep problems had fewer health-related issues after a sleep intervention, including self-reported insomnia, tension, and parent-reported ADHD symptoms, compared to children with clinically relevant sleep problems. Longitudinal studies are necessary to fully comprehend the long-term impact of sleep problems and various health-related factors in this cohort. © 2025. The Author(s).

Introduction Absence of structured guidelines to navigate the complexities of implementing AI-based applications in healthcare is recognized by clinicians, healthcare leaders, and policy makers. AI implementation presents challenges beyond the technology development which necessitates standardized approaches to implementation. This study aims to explore the activities typical to implementation of AI-based systems to develop an AI implementation process framework intended to guide healthcare professionals. The Quality Implementation Framework (QIF) was considered as an initial reference framework.Methods This study employed a qualitative research design and included three components: (1) a review of 30 scientific articles describing differences empirical cases of real-world AI implementation in healthcare, (2) analysis of qualitative interviews with healthcare representatives possessing first-hand experience in planning, running, and sustaining AI implementation projects, (3) analysis of qualitative interviews with members of the research groups network and purposively sampled for their AI literacy and academic, technical or managerial leadership roles.Results The data were deductively mapped onto the steps of QIF using direct qualitative content analysis. All the phases and steps in QIF are relevant to AI implementation in healthcare, but there are specificities in the context of AI that require incorporation of additional activities and phases. To effectively support the AI implementations, the process frameworks should include a dedicated phase to implementation with specific activities that occur after planning, ensuring a smooth transition from AI's design to deployment, and a phase focused on governance and sustainability, aimed at maintaining the AI's long-term impact. The component of continuous engagement of diverse stakeholders should be incorporated throughout the lifecycle of the AI implementation.Conclusion The value of this study is the identified processual phases and activities specific and typical to AI implementations to be carried out by an adopting healthcare organization when AI systems are deployed. The study advances previous research by outlining the types of necessary comprehensive assessments and legal preparations located in the implementation planning phase. It also extends prior understanding of what the staff's training should focus on throughout different phases of implementation. Finally, the overall processual, phased structure is discussed in order to incorporate activities that lead to a successful deployment of AI systems in healthcare. © 2025 Nair, Nygren, Nilsen, Gama, Neher, Larsson and Svedberg.

Health is multifaceted, with divergent interpretations in diverse cultures and groups of individuals. The ways individuals understand health might aid in developing future interventions. There is scant knowledge on how adolescents with depression conceptualise health. A descriptive qualitative design with a phenomenographic approach was used to describe the different ways adolescents with depression conceptualise health. Interviews were performed with adolescents 13–17 years old (n = 33) who participated in a randomised controlled trial evaluating the effects of aerobic group exercise versus leisure group activities for adolescents with depression. The results were interpreted into four metaphors to embody the understanding of health as described by adolescents with depression: 1) establishing sound routines by managing everyday life, 2) connecting to others by having access to social resources, 3) managing depression symptoms by having control over the mental illness, and 4) attaining inner drive by experiencing joy in everyday life. The various conceptions of health among adolescents with depression provide valuable insights for enhancing evidence-based treatments with person-centred care. Key aspects include establishing routines, fostering connections, finding strategies for symptom control, and incorporating joy through exercise. Given that adolescents highlighted these aspects as essential to health, future research could explore individualised health promotion, particularly focusing on routine-building, social connections, or finding an inner drive as an add-on to evidence-based treatments for adolescent depression. © 2025 Danielsson et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. 

Background: Children with Attention Deficit Hyperactivity Disorder (ADHD) often experience significant sleep difficulties, which can impair daily functioning and exacerbate ADHD symptoms. Sleep-related challenges, such as difficulties with sleep initiation, not only affect the child but also disrupt family dynamics, thereby impacting general family well-being. Understanding the factors that facilitate better sleep initiation could provide valuable insights to inform the development of targeted interventions to support children with ADHD and associated sleep problems.

Aim: This study aimed to explore the experiences of facilitators supporting sleep initiation among children with ADHD and sleep problems.

Method: An exploratory, inductive qualitative design was used. Individual interviews were conducted with 21 children (11 boys and 10 girls) aged 6–12, diagnosed with ADHD and sleep problems. Data were analyzed through qualitative content analysis, resulting in five subcategories and two main categories.

Results: The findings revealed that children with ADHD and sleep difficulties identified both behavioral and environmental factors that facilitate sleep initiation. Behavioral factors included engaging in physical exercise, regulating digital device use, and maintaining a balance between activity and rest. Environmental facilitators included a calming sleeping environment and the maintenance of consistent evening routines. The children highlighted the importance of individualized approaches to the integration of these strategies, to effectively support sleep initiation.

Conclusions: This study highlights the relevance of both behavioral and environmental aspects in supporting sleep initiation among children with ADHD. These exploratory findings may inform future research and practice by emphasizing the value of integrating children’s own perspectives and preferences when designing supportive strategies. © The Author(s) 2025.

Background: Physical exercise is part of the recommended treatment for individuals with axial spondyloarthritis (axSpA). High-intensity interval training (HIIT) is an effective way to improve cardiovascular health without risk of increased disease activity. Nevertheless, there is a lack of knowledge regarding facilitating factors for digitally-based HIIT among individuals with axSpA. Objective: This study aimed to explore facilitators influencing participation in a twelve-week digitally-based HIIT intervention among individuals with axSpA. Methods: Individuals with axSpA (9 females/7 males) were recruited from the intervention group of a randomized controlled trial. The intervention included three high-intensity training sessions, two of which would be interval training, weekly for twelve weeks with digitally-based coaching by a physiotherapist. Individual semi-structured interviews were conducted with the participants after completing the intervention. At baseline, the median (min-max) age was 47 (28–65), disease activity (BASDAI) was 2.6 (0.2–5.5) and aerobic capacity was 31 ml O2/kg/min (24–54). A qualitative content analysis was used to bring out manifest content from the interviews. The analysis revealed three categories and eight sub-categories. Results: The participants described that HIIT was facilitated by intervention design, encouragement, and feelings of well-being. The intervention design facilitated HIIT to be feasible to perform, adaptable to everyday life, and by use of digital tools. The importance of inner drive, need for individual coaching, and support of social networks were highlighted as keys for encouragement. Feelings of well-being facilitated HIIT through perceived health effects and improved self-efficacy. Conclusion: A self-managed digitally-based HIIT intervention coached by a physiotherapist but performed outside the healthcare settings could be used as an additional non-pharmacological treatment for individuals with axSpA. © The Author(s) 2025

Tyngdtäcke har använts inom vården som ett icke-farmakologiskt behandlingsalternativ. Evidens har dock saknats om effekter av tyngdtäcke på sömnen. En crossover randomiserad kontrollerad studie har genomförts för att utvärdera effekten av tyngdtäcke på sömnbesvär hos barn 6-14 år med ADHD. Resultatet visade på ökad total sömntid, ökad sömneffektivitet och minskad tid i vakenhet under natten, men ingen skillnad i insomning vid användning av tyngdtäcke jämfört med ett lättare kontrolltäcke. Föräldrarna rapporterade att barnens sömnproblem minskade. Barnen rapporterade att sömnkvalitén ökade, däremot sågs ingen skillnad i självrapporterade sömnproblem vid användning av tyngdtäcke jämfört med ett kontrolltäcke. © 2025 Maria Lönn, Katarina Aili, Petra Svedberg, Jens Nygren, Håkan Jarbin, Ingrid Larsson.

Aims: The aim of this study was to explore healthcare leaders' perceptions of the contribution of artificial intelligence (AI) to person-centred care (PCC). Methods: The study had an explorative qualitative approach. Individual interviews were conducted from October 2020 to May 2021 with 26 healthcare leaders in a county council in Sweden. An abductive qualitative content analysis was conducted based on McCormack and McCance's framework of PCC. The four constructs (i.e. prerequisites, care environment, person-centred processes and expected outcomes) constituted the four categories for the deductive analysis. The inductive analysis generated 11 subcategories to the four constructs, representing how AI could contribute to PCC. Results: Healthcare leaders perceived that AI applications could contribute to the four PCC constructs through (a) supporting professional competence and establishing trust among healthcare professionals and patients (prerequisites); (b) including AI's ability to facilitate patient safety, enable proactive care, provide treatment recommendations and prioritise healthcare resources (the care environment); (c) including AI's ability to tailor information and promote the process of shared decision making and self-management (person-centred processes); and (d) including improving care quality and promoting health outcomes (expected outcomes). Conclusions: The healthcare leaders perceived that AI applications could contribute to PCC at different levels of healthcare, thereby enhancing the quality of care and patients' health. © Author(s) 2025.

Background: Hard-to-heal wounds pose a significant challenge to healthcare systems globally. While person-centred care (PCC) has been proposed as a means to improve wound management, there is a scarcity of research examining its practical application in healthcare. An increased understanding of healthcare professionals' perceptions of PCC in wound management and the challenges associated with its application is thus warranted. Such an understanding can facilitate the implementation of PCC and, consequently, enhance the quality of care. Aim: To explore healthcare professionals' perceptions of PCC in wound management in primary care services. Method: The study had an explorative abductive design involving semi-structured interviews with 23 healthcare professionals in primary care working with wound management. An abductive qualitative content analysis was conducted using the PCC framework, incorporating three routines related to, respectively, initiation, working, and safeguarding the partnership. Results: The findings illustrated healthcare professionals' perceptions regarding initiating, practising, and safeguarding PCC in wound management. Initiating such care entailed having a holistic perspective, considering both the patient and the underlying causes of the wound, using the patient's goals and preferences to establish wound management, and motivating them to commit to the care. Practising PCC in wound management involved establishing a relationship of trust with the patient, tailoring wound management to her/his needs and circumstances, and minimising symptoms that had a negative impact on everyday life. Safeguarding PCC in wound management involved documenting continuously, keeping updated on patient medical records, and facilitating the exchange of information between healthcare professionals. Conclusion: Healthcare professionals acknowledge the significance of PCC in wound management. The findings also highlight challenges, particularly in practising shared decision-making, ensuring closeness and continuity of wound management, and documenting person-centred care. These findings offer insights into key factors that support the implementation of PCC. © 2025 The Author(s). Scandinavian Journal of Caring Sciences published by John Wiley & Sons Ltd on behalf of Nordic College of Caring Science.

Background: Newly graduated healthcare and social work professionals can experience stress and a perceived lack of competence when transitioning from academia to clinical practice, which can lead to health problems or leaving the profession. Globally, creating healthy workplaces remains a challenge. The aim of this study, which had a salutogenic approach, was to explore health-promoting resources and workplace experiences among newly graduated healthcare and social work professionals.

Methods: This multicenter cross-sectional study included Swedish healthcare and social work professionals in their second year after graduation, recruited from six universities. Data were collected in March 2023 via a self-reported, web-based survey using validated instruments: the salutogenically oriented 13-item Sense of Coherence (SOC) Scale, the Salutogenic Health Indicator Scale (SHIS), and the 32-item Work Experience Measurement Scale (WEMS), along with questions on health, well-being, lifestyle and social factors at work, including three from the General Nordic Questionnaire (QPSNordic). Data were analyzed in SPSS 28 with nonparametric tests and Spearman correlations.

Results: A total of 115 newly graduated healthcare and social work professionals completed the questionnaire. The results indicated that those who expressed they were sure to stay in the profession reported a higher total WEMS score (p < 0.001), as well as higher scores in five out of six dimensions: supportive working conditions (p < 0.001), internal work experience (p < 0.001), autonomy (p < 0.001), time experience (p = 0.006), and management (p = 0.029). Participants who rated their well-being as good scored higher in supportive working conditions (p = 0.025) and the change process (p = 0.008). Those living with children reported higher internal work experience scores (p = 0.019).The results revealed positive and medium-strong to strong correlations between WEMS, SHIS, and SOC total scores. Specifically, there were medium-strong correlations between SHIS and SOC and two dimensions of WEMS: supportive working conditions and time experience, and between SHIS and the change process dimension.

Conclusions: This study highlights the importance of salutogenic resources in supporting newly graduated professionals. Factors such as supportive working conditions, autonomy, and internal work experience were linked to well-being and intention to stay in the profession. Understanding these factors can inform workplace interventions to promote retention and health in early career stages. © 2025. The Author(s).

Introduction: Knee pain increases the risk of developing chronic widespread pain (CWP) and knee osteoarthritis (KOA). The prevalence of CWP and KOA has increased, and there is a need for early prevention. Therefore, the aim was to examine the associations of health-related quality of life (HRQoL) and lifestyle habits with chronic pain at a two-year follow-up in individuals with knee pain. Methods: A two-year longitudinal cohort study including 251 individuals aged 30–60 years reporting knee pain at baseline. HRQoL was measured via the Short-Form General Health Survey (SF-36), and lifestyle habits included questions on overweight, physical activity, diet, alcohol and tobacco use. Pain was assessed with a pain mannequin. Differences in health status and lifestyle habits over time in groups with unchanged no chronic pain (NCP), transitioned to less and more pain, and unchanged CWP were analysed using Wilcoxon’s, McNemar’s and Friedman’s tests. Multinominal regression analysis was performed to study associations with reporting chronic pain at follow-up. Results: Reporting better HRQoL across various SF-36 concepts and normal weight at baseline was associated with reporting NCP after two years. A few changes were made regarding HRQoL and lifestyle habits over the course of two years, but an increase in general health was associated with transitioning to less pain. Conclusions: During primary care visits for knee pain with a combination of overweight or lower HRQoL, individuals should receive comprehensive attention to prevent the development of CWP. Future studies should investigate the associations further. © 2025 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.