Clinical trials

28

Search and review clinical trials. Use filters to narrow results by trial status, phase, treatment, biological sex and sponsor.

Condition / disease
Location
Status: Recruiting

Hypnosis for Pain and Nausea Reduction in Scoliosis Surgery: An Interventional Study

This study evaluates whether preoperative hypnosis can reduce postoperative pain, nausea, and opioid use in adolescents undergoing scoliosis surgery. Participants aged 12-18 years will receive hypnosis training before surgery. Outcomes include pain scores, nausea severity, opioid consumption, and length of hospital stay. Results will be compared to a historical control group without hypnosis.

Participants needed: 30
Trial details
Age: 12-18Biological sex: AllType: InterventionalSponsor: St. Olavs HospitalUpdated: Oct 2, 2026Locations: 1
Eligibility criteria

Adolescents aged 12-18 years undergoing elective scoliosis surgery [+1]

Severe cognitive impairment [+2]

Status: Not yet recruiting

Ultrasound Assessment of Gluteal Muscle in Patients Receiving Depot Antipsychotics and Healthy Volunteers

This observational study will use ultrasound to assess the gluteal musculature in patients receiving depot antipsychotic medication and in healthy volunteers. The study aims to improve knowledge about anatomical conditions relevant to intramuscular depot injections.

Participants needed: 60
Trial details
Age: 18+Biological sex: AllType: ObservationalSponsor: St. Olavs HospitalUpdated: Sep 11, 2026
Eligibility criteria

adults receiving depot antipsychotic medication and able to provide informed con...

Acute infections at the injection site [+1]

Status: Recruiting

The Effect of Local Application of Tranexamic Acid Versus Placebo on Postoperative Complications in Plastic Surgery

Study objective: This is a study to investigate whether applying the drug tranexamic acid (TXA) onto a surgical wound surface may affect the incidence of surgical complications such as re-bleeding needing intervention, wound complications such as infection, wound rupture or seroma, or if it may increase the risk of blood clots. Eligible patients: Patients undergoing plastic surgical procedures with wounds that would normally receive application of TXA to reduce bleeding after surgery. Study intervention: Participants will receive a single local application of study drug onto their wound surfaces at the end of surgery. Study drug will be identical looking ampoules which contain either TXA or placebo (saline). Neither participants nor study personnel will know the contents of the ampoules.

Participants needed: 3,000
Trial details
Phase: Phase 4Age: 18+Biological sex: AllType: InterventionalSponsor: St. Olavs HospitalUpdated: Aug 14, 2026Locations: 11
Eligibility criteria

They are to undergo a surgical procedure within the field of plastic surgery whe... [+2]

Patients with known allergy to tranexamic acid.

Status: Recruiting

Exercise in Postconcussion Symptoms and Posttraumatic Headache

The goal of this clinical trial is to compare two models of delivery of guided exercise in patients with exercise intolerance after mild head injury. The main question it aims to answer is: • Is a program that includes elements of in-house exercise and follow-up sessions, and repeated treadmill testing, superior to a program with telephone-based follow-up only? Participants will undergo a treadmill test to determine eligibility for the study, and to determine at what intensity level their symptoms worsen (symptom threshold). Thereafter they will exercise 15-20 minutes, 3-5 times per week at 80-90% of the heart rate that was found to be the symptom threshold. One group will receive face-to-face folllow-up and repeated testing, one group will receive telephone-based follow-up only . Researchers will compare these two groups to see if closer follow-up is superior when it comes to recovery from exercise intolerance after 12 weeks of exercise.

Participants needed: 100
Trial details
Age: 18-65Biological sex: AllType: InterventionalSponsor: St. Olavs HospitalUpdated: Aug 11, 2026Locations: 1
Eligibility criteria

Age 18-65 years [+4]

More than 2 years since last injury. [+4]

Status: Recruiting

Pelvic Pain Electro-Acupuncture

The aim of the study is to investigate if a series of up to 9 treatment sessions of electroacupuncture can be used to alleviate pain in women with suspected endometriosis, scheduled for diagnostic laparoscopy

Participants needed: 38
Trial details
Age: 18-45Biological sex: FemaleType: InterventionalSponsor: St. Olavs HospitalUpdated: Jul 21, 2026Locations: 1
Eligibility criteria

Women aged 18-45 years referred for diagnostic laparoscopy with suspicion of end... [+3]

Pregnancy [+2]

Status: Recruiting

Testing a Functional Precision Medicine Approach to Select Chemotherapy for Metastatic Colorectal Cancer (COSENSE-1)

COSENSE-1 is an unblinded, phase II, single-armed, single center feasibility study for using a functional precision medicine platform to select oxaliplatin-based versus irinotecan-based chemotherapy regimens, for male and female participants aged 18 and older, with microsatellite stable (MSS)/proficient mismatch repair (pMMR) metastatic colorectal cancer (mCRC), that is incurable or not resectable with curative intent.

Participants needed: 148
Trial details
Phase: Phase 2Age: 18+Biological sex: AllType: InterventionalSponsor: St. Olavs HospitalUpdated: Jul 20, 2026Locations: 1
Eligibility criteria

Age 18 or older [+11]

Patient has metastatic MMR deficient/MSI adenocarcinoma [+20]

Status: Recruiting

The Norwegian Immunotherapy in Multiple Myeloma Study

The goal of this observational study is to study the effectiveness and complications of novel immunotherapies used in the treatment of multiple myeloma in routine care in Norway. The aim is to close knowledge gaps, generate evidence for future clinical trials and contribute to future consensus on how to monitor for adverse events, and what mitigation strategies should be implemented, so that we can increase patient survival and quality-of-life.

Participants needed: 400
Trial details
Age: 18+Biological sex: AllType: ObservationalSponsor: St. Olavs HospitalUpdated: Jul 20, 2026Locations: 23
Eligibility criteria

Participants age ≥ 18 years [+9]

None

Status: Recruiting

Initial Double Sequential External Defibrillation in Out of Hospital Cardiac Arrest

Double Sequential External Defibrillation (DSED) represents an alternative treatment of refractory ventricular fibrillation (rVF) in out-of-hospital cardiac arrest (OHCA). The procedure consists of two defibrillators that administer shocks at the same time. Currently, the procedure is not initiated before at least three failed attempts with one defibrillator. This can delay the potential benefits of establishing DSED earlier in the treatment. Studies have shown that early defibrillation is crucial for survival in OHCA patients, and in 2022, a clinical trial showed that survival in patients treated with DSED was higher compared to standard treatment. The effect of initiating OHCA treatment is unknown. The DUALDEFIB trial seeks to investigate if treating OHCA patients with DSED as an initial treatment will increase survival and provide improved neurological outcome.

Participants needed: 356
Trial details
Age: 18+Biological sex: AllType: InterventionalSponsor: St. Olavs HospitalUpdated: Jul 21, 2026Locations: 1
Eligibility criteria

Patients with out of hospital cardiac arrest presenting with a shockable rhythm

Age below 18 years [+3]

Status: Recruiting

Psychoeducational Course for Suicide Prevention

The plan is to include patients with a history of increased risk of suicide. In the aftermath of an episode of imminent suicide risk, patients will receive a psychoeducational course that entails information on different aspects of suicide-related topics, identifying triggers and detecting early warning signals for increased suicide risk. The course culminates in working on completing a individual safety plan to prevent an future increase in suicide risk. The course will incorporate both patients and their next of kin. The psychoeducational course will be compared to a control group where the patients receive one individual session with focus on a safety plan to evaluate the intervention. Both groups will receive treatment as usual (TAU) during both the acute phase and follow-up. The study will be conducted as a randomized controlled trial.

Participants needed: 80
Trial details
Age: 18-99Biological sex: AllType: InterventionalSponsor: St. Olavs HospitalUpdated: Jul 21, 2026Locations: 2
Eligibility criteria

Patients with a suicide attempt, suicidal behavior, or risk of suicidal behavior... [+1]

Not being sufficiently fluent in Norwegian to provide informed consent, valid re... [+5]

Status: Recruiting

Evaluation of a Digital Pre-therapy Patient Education Program (StartHjelp) in Outpatient Mental Health Care

Community mental health centers (CMHCs) face significant challenges in meeting the needs of individuals with mental health issues. For example, due to high demand, there are long waiting lists and low engagement rates. Innovative interventions are urgently needed to address these challenges to improve patient engagement, coping skills, and overall health outcomes. Educational and self-management interventions have shown promise in enhancing patient activation and treatment satisfaction in other contexts. They may therefore be potential solutions to reduce the identified challenges in the mental health service. To bridge these knowledge and practice gaps, this study aims to evaluate a digital pre-therapy patient education program tailored specifically for adults with mental disorders. This intervention aims to enhance treatment satisfaction, patient activation, knowledge, patient engagement, and overall mental health outcomes.

Participants needed: 170
Trial details
Age: 18-65Biological sex: AllType: InterventionalSponsor: St. Olavs HospitalUpdated: Jul 21, 2026Locations: 1
Eligibility criteria

Put on the waiting list for mental health outpatient treatment in the active stu... [+3]

In need of acute help

Status: Recruiting

Effects and Cost-effectiveness of e-Meistring - a Guided Internet-delivered Psychological Treatment

The goal of this observational multicentre study is to address the effectiveness and cost-effectiveness of providing a therapist guided internet based cognitive behavioural therapy (ICBT) for common mental disorders in a routine healthcare setting. Main research questions is 1) What is the effectiveness of guided internet based treatment for moderate depression, panic disorder and social anxiety disorder across clinics in routine care? 2) What is the cost-effectiveness of guided internet based treatment for moderate depression, panic disorder and social anxiety disorder across clinics? 3) Who benefits from guided internet-delivered treatment? 4) What are the predictors of drop-out from guided internet based treatment? 5) To what extent does user experiences of guided internet based treatment influence adherence and effectiveness? Participants will receive up to nine guided ICBT sessions (modules) and answer questionnaires covering symptoms severity, health related quality of life, work and social ability, user satisfaction and medication. All questionnaires are part of the standard patient follow up routines in the four treatment locations participating in the study. Analytical approach is to compare locations/clinics and subgroups of patients.

Participants needed: 800
Trial details
Age: 18+Biological sex: AllType: ObservationalSponsor: St. Olavs HospitalUpdated: Jul 21, 2026Locations: 4
Eligibility criteria

Not listed

Status: Recruiting

Gastrocnemius Tightness and Foot Pain in Children

Foot and leg pain among otherwise healthy children is a common reason for referral to our pediatric orthopaedics outpatient clinic. The pain is often intermittent and transient, but for some the pain is more dominating and has an impact on the child and families. Children grown and have normal anatomical variations such as in-toeing, out-toeing, hypermobility, flatfeet, knock knees etc. Assessing such normal variants is a major part of pediatric orthopaedic practice, and a common finding is a positive Silvferskiöld test, indicating gastrocnemius tightness. This is when dorsiflexion of the ankle is limited with extended knee, compared to flexed knee. We do not know if this is a more frequent finding among children with foot and leg pain. There is however evidence that adults with painful foot conditions often have gastrocnemius tightness. This project will investigate for gastrocnemius tightness in otherwise healthy children referred to our pediatric orthopaedic outpatient clinic with foot and leg pain, and compare results with a similar control group of children without pain. The aim is to investigate if there is an association, and how pain and tightness develops over time. The knowledge from this project will enable us to develop new treatment strategies to this patient group, where current evidence based recommendations are few.

Participants needed: 200
Trial details
Age: 4-16Biological sex: AllType: ObservationalSponsor: St. Olavs HospitalUpdated: Jul 21, 2026Locations: 1
Eligibility criteria

Otherwise healthy children referred to pediatric orthopaedic outpatient clinic w...

Status: Recruiting

Embolization for Meningioma

The natural course for meningioma suggests that a majority will grow over time. Treatment is usually indicated in growing or symptomatic meningiomas. Surgery is usually primary treatment, but there is a significant risk of adverse effects. Stereotactic radiotherapy is most often reserved to treat relapses after surgery, and except for surgery and radiotherapy there are no other established treatment methods. Endovascular embolization may be used in selected cases as a preoperative adjunct to reduce intraoperative bleeding. There is a need for more treatment options in patients with meningioma, both in uncomplicated, asymptomatic cases and in more complex cases. The aim of this study is to assess radiological and clinical results of therapeutic endovascular embolization for meningioma

Participants needed: 30
Trial details
Age: 18+Biological sex: AllType: InterventionalSponsor: St. Olavs HospitalUpdated: Jul 21, 2026Locations: 1
Eligibility criteria

Radiological diagnose of typical intracranial meningioma (homogenous contrast en... [+4]

Informed consent not possible (e.g. language barriers, aphasia, cognitive impair... [+13]

Status: Recruiting

Structured Physical Exercise in Short-term Inpatient Treatment of Substance Use Disorder

In 2017, structured physical exercise with high intensity was implemented as a part of the treatment program at St. Olav Hospital Clinic of Substance Use and Addiction Medicine. The objective of this study is to examine whether implementing structured physical exercise in the treatment program has implications for patients' physical and mental health and quality of life after completing a 3 month residential treatment program. The results of this study will benefit substance use disorder patients in the future, and may have an impact on further implementation of physical exercise in addiction treatment clinics both nationally and internationally.

Participants needed: 200
Trial details
Age: 18+Biological sex: AllType: ObservationalSponsor: St. Olavs HospitalUpdated: Jul 21, 2026Locations: 1
Eligibility criteria

Being an inpatient at the clinic

Status: Recruiting

Adjuvant Tranexamic Acid (TXA) Versus Surgery Alone for Adult Patients With Chronic Subdural Hematoma (CSDH)

This study is an open label randomized controlled trial. Patients with a symptomatic Chronic Subdural Hematoma (CSDH) confirmed on radiological imaging, planned for surgery, age over 18, free from other intracranial pathologies and no previous intracranial surgery, will be recruited at time of admission. Patients eligible for inclusion will be randomized to receive treatment with Tranexamic acid (TXA) as an adjunct to surgery or surgery alone. Surgical evacuation will be performed using a single or double burr hole and 24 hours postoperative drainage. The primary endpoint will be recurrent hematoma requiring repeat surgery within 90 days. Secondary outcomes will be modified Rankin Scale at 90 days, EQ-5D-5L, complications and adverse events, and 90-day mortality.

Participants needed: 274
Trial details
Phase: Phase 2, Phase 3Age: 18+Biological sex: AllType: InterventionalSponsor: St. Olavs HospitalUpdated: Jul 17, 2026Locations: 1
Eligibility criteria

Symptomatic chronic subdural hematoma confirmed on computer tomography (CT) or m... [+3]

Mechanical heart valve [+10]

Status: Recruiting

The Sleep Clinic Outcome and Practice Study

The goal of this clinical trial is to explore the outcome and practice treatment for sleep-wake disturbances in a Sleep Clinic. The main questions it aims to answer are: * What is the practice (timing and duration of treatment components) of sleep-wake disturbance treatment? * What is the treatment effect of sleep-wake disturbance treatment. Participants will receive treatment as usual by consultations with a trained psychiatrist or psychologist and will be asked to fill out self-reporting questionnaires and sleep diaries.

Participants needed: 3,400
Trial details
Age: 18+Biological sex: AllType: InterventionalSponsor: St. Olavs HospitalUpdated: Jul 20, 2026Locations: 1
Eligibility criteria

Referred to the Sleep Clinic at St. Olavs Hospital for an assessment of a sleep-... [+4]

Individuals working night shifts or that otherwise have external conditions that... [+4]

Status: Recruiting

Effect of Patient Education on Drinking Behaviour and Oral Hygiene in Patients Undergoing Bariatric Surgery

The background for the study is that many bariatric surgery patients struggle with their oral health after bariatric surgery. This is probably related to both physiological changes and changes in eating and drinking patterns. In addition, many have reduced oral health even before surgery, and a significant proportion also have dental treatment anxiety, which also affects their ability to seek dental treatment. In sum, this is probably a patient group that may be at risk of oral pathology. Participants in the study will be randomly allocated to different patient education programmes. The three interventions are: 1. customised information on a website 2. education delivered by a clinician 3. distribution of free samples relevant to dental hygiene The outcomes recorded are level of knowledge, drinking patterns, self-perceived oral health, and oral hygiene routines.

Participants needed: 300
Trial details
Age: 18+Biological sex: AllType: InterventionalSponsor: St. Olavs HospitalUpdated: Jul 20, 2026Locations: 1
Eligibility criteria

Eligible for bariatric surgery at a Norwegian hospital

Insufficient language skills [+1]

Status: Recruiting

Prophylactic Treatment With Atorvastatin for Chronic Migraine (ChronicStatinMig)

The main objective of this study is to see whether the favorable preventative effect of Atorvastatin 40mg per day in episodic migraine, that was found previously in three smaller randomized controlled cross-over studies, can be confirmed in a larger, multicenter, randomized controlled parallel group study. In addition it will be investigated whether 1) the favorable side effect profile, seen in previous studies, can be confirmed, and whether it is even better with the smaller dose, and 2) estimating the cost of Atorvastatin treatment, considering cost of medicine, cost of acute attack medicine, and cost of lost worktime.

Participants needed: 300
Trial details
Phase: Phase 2Age: 18-65Biological sex: AllType: InterventionalSponsor: St. Olavs HospitalUpdated: Jul 20, 2026Locations: 6
Eligibility criteria

Age 18 to 64 years [+7]

Pregnancy, planning to get pregnant, inability to use contraceptives (See inclus... [+11]

Status: Recruiting

The Effect of a Brief Educational Intervention for Adults With ADHD

This RCT-study proposes the evaluation of an intensive educational intervention tailored for adults with Attention Deficit Hyperactivity Disorder (ADHD) in community mental health centers (CMHCs). Given the prevalent challenges of prolonged waiting lists and low patient engagement in CMHCs, the research seeks to assess the efficacy of this intervention in enhancing patient engagement, self-efficacy, satisfaction with the information and overall health outcomes. The intervention, developed collaboratively with user representatives, combines a brief group-based educational sessions with standard clinical care. The primary hypotheses posit that this approach will lead to increased patient satisfaction with the treatment, patient self-efficacy, and activation compared to conventional treatment. Additionally, it aims to improve patients' satisfaction with information received. The study will employ a ITT analysis to assess the intervention's effects against usual treatment practices in outpatient settings. The anticipated outcome is a significant improvement in level of patient satisfaction, level of self-efficacy and level of satisfaction with the received information for patients with ADHD, potentially informing clinical practices and optimizing care for adults with ADHD.

Participants needed: 60
Trial details
Age: 18-65Biological sex: AllType: InterventionalSponsor: St. Olavs HospitalUpdated: Jul 20, 2026Locations: 1
Eligibility criteria

Confirmed ADHD-diagnosis [+2]

Unable to give informed consent [+3]

Status: Recruiting

Innovative Steroid Treatment to Reduce Asthma Development in Children After First-time Rhinovirus Induced Wheezing

The overall objective of the study is to determine the efficacy of corticosteroids in preventing recurrent wheezing and asthma in high-risk, first-time severe wheezing children with rhinovirus infection, stratified by rhinovirus genome load. The secondary objectives are to determine duration and severity of each acute episode with acute expiratory breathing difficulty, the number of episodes with acute expiratory breathing difficulty, degree of pulmonary hyperreactivity and quality of life within 24 months after study entry.

Participants needed: 280
Trial details
Phase: Phase 4Age: 3-23Biological sex: AllType: InterventionalSponsor: St. Olavs HospitalUpdated: Jul 20, 2026Locations: 8
Eligibility criteria

admitted to pediatric acute wards in the participating hospitals in Norway, Finl... [+4]

previous episodes with wheezing, defined as a history of acute breathing difficu... [+8]

Status: Recruiting

Fixation of Patellar Tendon Grafts in Anterior Cruciate Ligament Reconstruction. Endobutton vs Metal Interference Screws

In this randomized controlled trial the investigators will compare the results after primary anterior cruciate ligament (ACL) reconstruction using two different methods for femoral fixation of a bone-patellar tendon-bone (BPTB) autograft. Interference screws have been the standard method for fixing the femoral side of BPTB grafts; however, several pitfalls have been reported. Cortical fixation with the Endobutton CL BTB Fixation System has become available and the clinical results have been described as promising; however, no randomized controlled trials comparing these two femoral fixation methods have been conducted, and there is no published data that confirms that the bone block heals in the tunnel with the newer method. The aim of our study is to compare the outcome after primary ACL reconstruction with BPTB autografts using the Endobutton CL BTB or metal interference screw for femoral fixation.

Participants needed: 220
Trial details
Age: 18-55Biological sex: AllType: InterventionalSponsor: St. Olavs HospitalUpdated: Jul 20, 2026Locations: 2
Eligibility criteria

Primary reconstruction of ACL ruptures [+2]

Medical indication for using another graft than BPTB autograft (such as history... [+4]

Status: Recruiting

Prophylactic Treatment With Atorvastatin for Episodic Migraine.

The main objective of this study is to see whether the favorable preventative effect of Atorvastatin 40mg per day in episodic migraine, that was found previously in three smaller randomized controlled cross-over studies, can be confirmed in a larger, multicenter, randomized controlled parallel group study. In addition it will be investigated whether 1) there is an effect of a daily dose of 20mg Atorvastatin, 2) whether the favorable side effect profile, seen in previous studies, can be confirmed, and whether it is even better with the smaller dose, and 3) estimating the cost of Atorvastatin treatment, considering cost of medicine, cost of acute attack medicine, and cost of lost worktime.

Participants needed: 450
Trial details
Phase: Phase 2Age: 18-65Biological sex: AllType: InterventionalSponsor: St. Olavs HospitalUpdated: Jul 14, 2026Locations: 6
Eligibility criteria

Age 18 to 65 years. [+7]

Interval headache not distinguishable from migraine. [+16]

Status: Recruiting

Acute and Long-term Cardiovascular Toxicity After Modern Radiotherapy for Breast Cancer

In Europe, breast cancer is by far the most common form of cancer diagnosed in women today, accounting for 29% of all cases. The 5-year survival rate is approximately 90%. Surgery is usually combined with radiotherapy (RT), anthracyclines, aromatase inhibitors and/or trastuzumab (Herceptin) which all have improved the life expectancy and survival in breast cancer patients. Unfortunately, RT is associated with a broad spectrum of cardiovascular diseases, which includes coronary artery disease, valvular dysfunction, congestive heart failure and stroke, and is the most common non-malignancy cause of death. During the last two decades, RT regimens for breast cancer have changed and the doses of radiation to which the heart is exposed are now potentially lower due to new and improved RT techniques. However, there are no data on whether these new regimes decrease the risk of cardiovascular disease. In this study the incidence and prevalence of cardiovascular diseases will be estimated 8 and 15 years after both conventional and laser assisted breath controlled RT, and compared with cardiovascular diseases in the general female population. A further aim is to evaluate signs and prevalence of acute cardiotoxicity from RT with the use of cardiac magnetic resonance imaging, coronary fractional flow reserve, ECG and inflammatory and cardiac biomarkers and to investigate whether these signs can predict later cardiovascular disease. The importance of traditional cardiovascular risk factors (age, hypertension, hypercholesterolemia, smoking habits and physical activity, as registered before RT) will also be evaluated.

Participants needed: 1,600
Trial details
Age: 30-70Biological sex: FemaleType: ObservationalSponsor: St. Olavs HospitalUpdated: Jun 4, 2026Locations: 2
Eligibility criteria

diagnosis of breast cancer [+1]

Not willing to participate

Status: Recruiting

Group-based Stabilization and Skill Training for Patients With Lasting Posttraumatic Reactions in Mental Health Care

This study evaluates the addition of a group based stabilization and skill-training intervention to individual out-patient treatment for long lasting post-traumatic reactions. Half of the participants will receive the combined treatment while the other half will receive individual treatment as usual.

Participants needed: 160
Trial details
Age: 18-75Biological sex: AllType: InterventionalSponsor: St. Olavs HospitalUpdated: Apr 30, 2026Locations: 1
Eligibility criteria

Receiving treatment in ordinary out-patient clinics [+4]

Active psychotic symptoms. [+3]

Status: Recruiting

NeoDoppler: New Ultrasound Technology for Continuous Monitoring of Cerebral Circulation Pilot

Non-invasive tools for monitoring of course of disease are important and necessary in the treatment of pre-term/premature infants and sick neonates. For many years, the ultrasound group in Trondheim has been at the forefront in the development of new ultrasound technology for the diagnosis and monitoring of disease. Several methods previously developed in this research group are today widely used in hospitals around the world. In this project the investigators aim to test a new ultrasound technology that allows continuous monitoring of cerebral blood flow in sick neonates and pre-term children. This technology was CE-certified in October 2022, and in this project the investigators will test the CE-certified version with the newest available approved software.

Participants needed: 180
Trial details
Age: 0-12Biological sex: AllType: ObservationalSponsor: St. Olavs HospitalUpdated: Apr 23, 2026Locations: 1
Eligibility criteria

Open fontanelle [+3]

Caregivers not understanding/speaking Norwegian or English [+1]