Little is known about the impact of lighting in rooms designated for critical conversations in counselling or policing contexts, such as therapy, clinical interviewing and police interviews. Lighting may affect bodily stress, discomfort, nervousness, anxiety, mood and self-disclosure. The aim of this study was to map and report research on how illumination affects people’s perception, mood and interaction in healthcare and policing contexts. A scoping review was conducted in which six databases were searched. Twelve studies were included: ten quantitative, one qualitative and one mixed method. The results were presented in two overarching categories: impact of lighting on communication and behaviour. The first category consisted of four sub-categories. The second main category depicted methods and experimental design. The findings indicate that this specific area remains relatively under-researched. The studies were mostly experimental and consisted of small samples. An improved understanding of lighting in contexts for critical and personal dialogue can support professionals, patients and organisations, not least in psychiatric healthcare and other socially vulnerable settings. In addition, our results may inform future design intervention studies and the configuration of rooms designated for conversational and policing environments where critical conversations are conducted.

Aim Children aged 0–18 years living with respiratory support represent a growing population worldwide. They have complex medical needs and rely on multidisciplinary care. Transportation is often challenging, and paediatric respiratory support teams are concentrated in a limited number of hospitals. As of 2024, Swedish paediatric long-term respiratory care facilities (PRCF) are centralised at four centres. We aimed to explore the relationship between travel distance from home to PRCF, healthcare utilisation and mortality before centralisation.

Methods A retrospective, population-based cohort study using data from the Swedish Quality Registry for Respiratory Failure (Swedevox) between 2015 and 2021. Multivariable linear regression models and survival analyses were applied to examine the associations between travel distance, healthcare utilisation and mortality.

Results A total of 596 children were included (mean age 5.4±5.1 years). Of these, 76% lived within 60 min of a PRCF (median 19 km, IQR 8–34), while 24% had travel times exceeding 60 min (median 171 km, IQR 105–268). No association was found between travel time to PRCF and healthcare utilisation or death before age 19. Children whose parents had 12+ years of education underwent more hospitalisations annually (R 0.29, 95% CI 0.01 to 0.57), and children in rural areas had fewer emergency visits (R −0.47, 95% CI 0.84 to −0.10).

Conclusions No associations were found between travel distance and healthcare utilisation or mortality among children with long-term respiratory support. Centralised PRCF may thus be feasible without compromising outcomes, but reforms should recognise possible unintended effects on children and families.

Background

Children aged 0–18 years who need long-term respiratory support rely on medical technology and comprehensive medical care. For this care to be provided at home, access to medical and social support and care is essential. In Sweden, the most notable form is personal care assistance (PCA), which is granted based on legislation and individual authority decisions. We aim to explore the impact of socioeconomic factors on the availability of PCAs in children on long-term respiratory support.

Methods

This was a retrospective, population-based cohort analysis of children living with respiratory support in the Swedish Quality Registry for Respiratory Failure (Swedevox) between 2015 and 2021, with crosslinked national registry data on socioeconomic factors and PCA. Associations between socioeconomic factors (country of origin, disposable household income, parents’ educational level and marital status) and having been granted PCA were analysed using multivariable regression models.

Results

Of the 600 included children (mean age 5.4 ± 5.1 years), 171 (29%) were granted PCA for a median 235 h/month (interquartile range 56–453). No associations were found between socioeconomic factors and the likelihood of children receiving PCA. Specifically, family income (tertile 2: OR 1.02, 95% CI 0.6–1.7; tertile 3: OR 0.89, 95% CI 0.5–1.5), parental education level (OR 1.08, 95% CI 0.7–1.6), parents’ marital status (OR 0.91, 95% CI 0.5–1.6), and country of origin (OR 1.33, 95% CI 0.9–2.0) were not associated with PCA receipt.

Conclusion

Among children on long-term respiratory support, 29% were granted PCA, which was not associated with their socioeconomic status. While this suggests that care is provided based on need, the low proportion of children granted PCA raises concerns about whether those judged ineligible receive adequate and equitable support.

Background 

It has become more common for patients with long-term diseases or receiving aggressive cancer treatments to need intensive care. Research about palliative care in the intensive care unit (ICU) largely focuses on decision-making in relation to end-of-life care and organ donation. Few studies examine the current evidence about how palliative care in its wider conceptualization is understood by intensive care health care professionals.

Objectives 

To synthesize the literature on ICU health care professionals' experiences and views of providing palliative care in the ICU.

Methods 

This was an integrative review where data were assessed and analyzed using Whittemore and Knafl's approach.

Results 

Four themes were identified in the synthesis: the meaning of palliative care, relationships with families, multidisciplinary working, and preparation for providing palliative care.

Discussion 

Our findings suggest there is variation in how palliative care in the ICU is conceptualized and interpreted. Intensive care unit professionals need enhanced competencies and training to develop their confidence in providing palliative care and improve role clarity. Such training should focus on serious illness conversations with patients/families and interdisciplinary teamwork. Integration of palliative consultants into the ICU could be further developed.

Purpose

Children living with respiratory support rely on medical technology, either fully or partially, throughout the day to meet their breathing requirements. Although children and young people living with respiratory support at home undergo long-term treatments and make extensive use of health and social care services, there is a notable absence of comprehensive outcome data on this group. The establishment of the first nationwide Course of DISease reported to the Swedish CPAP Oxygen and VEntilator RegistrY paediatrics cohort aims to investigate the disease trajectory, clinical and socioeconomic risk factors influencing incident illness, hospitalisation risk and mortality among children living with respiratory support.

Participants

Data on patients aged 0-18 years reported to the Swedish National Registry for Respiratory Failure and Sleep Apnoea (Swedevox) 1 January 2015 to 29 July 2021 were merged with seven quality or governmental registries, the National Quality Registry for Intensive Care, the National Medical Birth Register, the Swedish Cause of Death Registry, the Registry for Interventions under the Act on Support and Service to Certain Disabled Persons, the Swedish National Patient Registry and with socioeconomic data from Total Population Registry and Longitudinal Integrated Database for health insurance and labour market studies.

Findings to date

The cohort includes 716 children, 59% male, who began respiratory support at an average age of 6.4 years (SD 5.4). Among them, 28% use continuous positive airway pressure, 64% long-term mechanical ventilation (LTMV), 3% high-flow oxygen therapy (HFOT) and 5% other methods. Respiratory support is mostly used at night, but many LTMV (54%) and HFOT (81%) users need daytime aid. 77% of LTMV users rely on mask connection, differing from international data.

Future plans

Future projects include exploring the impact of socioeconomic factors on hospitalisation rates and mortality. The dataset is due for an update in 2026.

Purpose

This study aimed to examine how young people living with Home Mechanical Ventilation experience the transition from childhood to young adulthood in relation to everyday life, perceived health and transition into adult professional healthcare.

Methods

Nine young adults (three females and six males aged 18–31) were interviewed, and data was primary analysed using phenomenological hermeneutics. In the actual study, data was reworked using secondary analysis as described by Beck. Two interviewees were ventilated invasively and six non-invasively, and one was treated with continuous positive airway pressure (CPAP).

Results

The results are presented in two main categories. First; moving towards adulthood; and second, To handle changes in health and healthcare contacts. The study highlights the importance of ongoing social relations and being part of a socializing and physically active community. The transfer from paediatric to adult healthcare was solid and worked out well but was a process in which the participants struggled to find their own voice.

Conclusions

The transition into adulthood is a sensitive and challenging time for young people with HMV, but stable, close relationships and a well-organized transfer can enable this group to feel safe and able to find and use their own voice.

Purpose

An increasing number of children and young adults with complex medical conditions and respiratory failure are treated with home mechanical ventilation (HMV). The current study aimed to describe how young adults using HMV experience their everyday life with the ventilator, their physical impairments and their opportunities for an educational and professional career.

Materials and methods

Data were collected via narrative interviews with nine young HMV users (3 females and 6 males, aged 18–31 years) in their homes. Two were ventilated invasively, six were ventilated non-invasively and one was treated with continuous positive airway pressure (CPAP) via facemask. Data were analysed using a phenomenological hermeneutical method.

Result

A multi-professional team contributed to participants’ safety and ability to participate in society through higher education and professional work. A good and valuable life, mostly feeling healthy were experienced but also prejudice and stiffened social society structures.

Conclusion

The findings of this study prove the importance of having long-standing access to a competent and supportive available multi-professional healthcare team when living with a long-term complex condition. These teams provided well-functioning human and technological support in everyday lives.

Implications for Rehabilitation

· An increasing number of children and young adults are treated with home mechanical ventilation due to respiratory failure.

· The home mechanical ventilation treatment provided rest from breathing and improved sleep quality in such a way that work and higher studies could be managed.

· Longstanding access to a supportive multi-professional healthcare team provided feelings of being safe, which in turn boosted self-confidence in life and preparedness to meet new challenges.