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Title. Stages of Change – Continuous Measure (URICA-E2): psychometrics of a Norwegian version. Aim. This paper is a report of research to translate the English version of the Stages of Change continuous measure questionnaire (URICA-E2) into Norwegian and to test the validity of the questionnaire and its usefulness in predicting behavioural change. Background. While the psychometric properties of the Stages of Change categorical measure have been tested extensively, evaluation of the psychometric properties of the continuous questionnaire has not been described elsewhere in the literature. Method. Cross-sectional data were collected with a convenience sample of 198 undergraduate nursing students in 2005 and 2006. The English version of URICA-E2 was translated into Norwegian according to standardized procedures. Findings. Principal components analysis clearly confirmed five of the dimensions of readiness to change (Precontemplation Non-Believers, Precontemplation Believers, Contemplation, Preparation and Maintenance), while the sixth dimension, Action, showed the lowest Eigenvalue (0·93). Findings from the cluster analysis indicate distinct profiles among the respondents in terms of readiness to change their exercise behaviour. Conclusion. The URICA-E2 was for the most part replicated from Reed’s original work. The result of the cluster analysis of the items associated with the factor ‘Action’ suggests that these do not adequately measure the factor. [ABSTRACT FROM AUTHOR]

Aim. This paper is a report of a study conducted to (1) compare means of the single items and the dimensions of the Caregiver Reaction Assessment among caregivers of frail older people and caregivers of cancer patients in the palliative phase; (2) examine gender differences for the scoring parameters in the Caregiver Reaction Assessment within each group and (3) examine the demographic variables' association with the caregiver groups' scores for the dimensions of the Caregiver Reaction Assessment. Background. Limited research has focused on the caregiver situation in the home-care setting among primary caregivers of frail older people, and caregivers of patients with cancer in the palliative phase. Methods. A convenience sample of 224 caregivers of frail older people, and 85 caregivers of patients with cancer in the palliative phase was recruited between 2002 and 2005. We used the Caregiver Reaction Assessment to collect the data. Results. The mean scores for the Caregiver Reaction Assessment dimensions showed statistically significant differences between the two groups of caregivers for the factors self-esteem, family support, finances and health. For caregivers of frail older people, we found statistically significant associations between several demographic variables and the Caregiver Reaction Assessment dimensions. For caregivers of patients with cancer in the palliative phase, age was the only demographic variable that was statistically significantly associated with the dimensions. Conclusion. Healthcare personnel should pay attention to how relatives experience their caregiver situation, and the Caregiver Reaction Assessment could be a valuable tool for gathering systematic data on this. [ABSTRACT FROM AUTHOR]

Title. Nursing students’ career preferences: a Norwegian study Aim. This paper is a report of a study to identify Norwegian undergraduate nursing students’ career preferences at the beginning and end of their nursing education programme, together with their reasons for these preferences. Background. International studies have shown that recruitment and retention of nurses in areas such as aged care and psychiatric nursing is difficult. It is important to know why some working areas are popular whilst others are not, so that nursing schools produce graduates who meet the needs of the community. Methods. All students starting their nursing education programme in 2001/2002 in five Norwegian university colleges were invited to complete questionnaires at the beginning and end of their nursing education programme. In phase 1, 620 of 782 commencing students completed questionnaires (response rate 79·2%). In their third year, phase 2, 473 questionnaires were distributed (response rate 82·6%, n = 386). The questionnaire included closed questions about career preferences and open-ended questions seeking the reasons for the preferences. Results. The study revealed changes in preferences between the beginning and the end of the nursing education programme. In phase 1, midwifery and paediatric nursing were ranked highest and in phase 2 working in medical/surgical ward, midwifery and psychiatric nursing were preferred. Working in aged care institutions remained unpopular throughout. Clinical experiences and professional challenges were often given as reasons for preferences. Conclusion. Nursing educators, clinical nurses and policymakers must reconsider their priorities and improve working conditions for nurses in aged care in order to meet society's need for nurses. [ABSTRACT FROM AUTHOR]

Short Report: Nursing education in Norway Aim. The aim of this paper is to describe nursing education in Norway and some essential questions and challenges regarding the undergraduate and newly graduated nurses' competencies and functionally preparedness. Background. The first formal training of nurses in Norway started in Oslo in 1886. Since then the education has changed considerably. As long as society is changing, and nurses are going to meet and adapt to societies needs, the education of nurses will also have to change continuously. The present general plan of nursing education has gone through a long process. The discussions have concerned the content of medical and natural science subjects, the practical part of the training and the relation between theory and practice. Challenges. There are challenges in nursing education in Norway today. We have seen that recruitment has decreased, and that nurses seek jobs where they are better paid. To increase the accessibility distance and part-time education has been established. The theory–practice gap will always exist. Therefore we should aim to prepare the students to minimize this gap in a way that they can combine training of nursing with training in improvement. The demand of a masters degree to be a nursing teacher has reduced the teachers' ability to keep up their practical skills. The government pays nursing teachers who want to practice as nurses for several months to maintain their salary level during that period. Conclusions. There are many possibilities to improve nursing education in Norway. We are on our way with highly qualified teachers and students, and we still have enough good applicants. The new general plan and new law for universities and university colleges offer great opportunities. However, the shortage of nurses is a great challenge for further quality improvement both in clinical practice and in education. [ABSTRACT FROM AUTHOR]

The ability to measure pain across diverse cultures is important for understanding the universal aspects of pain and expediting nursing intervention. The McGill Pain Questionnaire (MPQ) is the most valid and reliable single multidimensional pain instrument available for measuring pain. Although it has been translated in several languages, most efforts, including two Norwegian translations, have resulted in a variety of new versions, all lacking sufficient faithfulness to the original MPQ to allow qualitative or quantitative cross-cultural comparisons. There is a need for direct translations that maintain the original denotation, connotation and numerical value of the MPQ and thus provide a base for future cross-cultural studies of pain. This paper reports on the development and initial testing of a direct translation of the McGill Pain Questionnaire into Norwegian (NMPQ). The translation process involved three phases: translation, back-translation and consensual. In order to evaluate its performance and validity, the NMPQ was administered to a group of adult surgical patients at two different points in time during the postoperative period. The NMPQ was examined for its feasibility, its sensitivity in detecting decreases in intensity of pain postoperatively and for construct validity. A visual analogue scale was used to check for converging validity, and Spielberger's state anxiety scale was used to assess discriminate validity. The initial testing of the NMPQ with adult surgical patients suggests that the NMPQ is culturally acceptable, relevant, sensitive to fluctuations in pain and numerically consistent with the original MPQ. The moderate levels of validity attained lend considerable assurance to the instrument's readiness for use in cross-cultural studies of pain. [ABSTRACT FROM AUTHOR]

Title. Patterns of ‘balancing between hope and despair’ in the diagnostic phase: a grounded theory study of patients on a gastroenterology ward Aim. The aim of the study was to learn how patients going through the diagnostic phase experienced and handled their situation. Background. Many studies report about the stressful diagnostic phase; however, none has presented a conceptual theory where the concepts are sufficiently related to each other. The Theory of Preparative Waiting has previously been published as a descriptive grounded theory and describes the experience of a group of gastroenterology patients going through the diagnostic phase. Method. A classical grounded theory design was used, with data derived from 18 in-depth interviews with 15 patients in a gastroenterology ward at a Norwegian University Hospital. Interviews were conducted during 2002–2003. Findings. Participants’ main concern was found to be how they could prepare themselves for the concluding interview and life after diagnosis. The theoretical code of ‘balancing’ had four patterns; controlling pain, rational awaiting, denial, and accepting. These patterns of ‘balancing’ guided how participants used the categories of ‘Preparative Waiting Theory’‘seeking and giving information’, ‘interpreting clues’, ‘handling existential threats’ and ‘seeking respite’. Patterns were strategies, so one person could use more than one pattern. Conclusion. The diagnostic phase was a difficult time for the participants and the ‘Preparative Waiting Theory’ can assist nurses in assessing how patients prepare themselves differently for getting a diagnosis. All patients would find it helpful to be followed up by a designated contact person at the ward; however, patients using mostly the patterns of controlling pain and denial would benefit most from such support. [ABSTRACT FROM AUTHOR]

Background. The use of standardized questionnaires for measuring student satisfaction in higher education is motivated by theories predicting a close relationship between students' satisfaction and learning outcomes. The reliability and validity of the Course Experience Questionnaire as an indicator of teaching performance have been established by factor analysis in earlier studies from several countries. The Nursing Clinical Facilitators Questionnaire has been used for measuring satisfaction with clinical practice. Aims. The aims of this study were (1) to find out how satisfied nursing students in their last semester were with their clinical practice and the nursing programme as a whole, and (2) to measure the reliability and validity of the two standardized questionnaires. Methods. The data were collected using the two standard questionnaires, combined with some background items, in a survey design. Exploratory factor analysis was performed. Findings. A total of 276 nursing students from three university colleges in Western Norway answered the questionnaire in 1999/2000. The scores indicated slight overall dissatisfaction with the nursing programme, but general satisfaction with clinical practice. Furthermore, 70% of the students who expressed dissatisfaction with the quality of the nursing programme were nevertheless satisfied with clinical practice. The broad constituent structure of the Course Experience Questionnaire was replicated, with some deviation for the appropriate assessment scale. The Nursing Clinical Facilitators Questionnaire turned out to have two subscales, representing supportive and challenging behaviour, with satisfactory internal reliability. Conclusion. Annual evaluations using the two standardized questionnaires may result in greater focus being given to students' satisfaction with the nursing programmes and clinical practice in Norwegian nursing education departments. Comparative studies with the same instruments in other countries would also be of interest. [ABSTRACT FROM AUTHOR]

BACKGROUND: As the number of people diagnosed with cancer increases and the treatment of cancer changes and improves, the challenges and problems nurses experience in clinical practice are also changing. AIMS: To describe the problems that nurses in cancer care face in their day-to-day practice. Such information can be used to improve the quality of nursing care. DESIGN: A questionnaire was distributed to half of the members of the Norwegian Society of Nurses in Cancer Care (n = 464). Instrument. The survey questionnaire had previously been used in a Canadian study. The nurses were asked to consider 80 different areas relevant to cancer nursing and to indicate the extent to which each posed a problem for them in clinical practice. The sex, age and educational level of the nurses were also recorded, together with the work setting and number of years they had been employed in nursing. RESULTS: The response rate was 43% (199 of 464). The area the nurses experienced as being the greatest problem in their clinical practice was patients' anxiety. Problems connected with nutrition, the development of the cancer itself and grieving, and symptoms like nausea and vomiting and fatigue were also frequently rated as problems. The results also show some significant correlations between the rating of problems and variables such as work setting, years in practice and educational level. CONCLUSIONS: The present study shows that nurses in cancer care mainly experience psychological issues as problems in their clinical practice, which confirms previous research. The impact of work setting, years in clinical practice and education was surprisingly small. As the majority of nurses today will meet cancer patients during their professional careers, further research is needed in this area. [ABSTRACT FROM AUTHOR]

Twenty-one psychiatric inpatients who had thought about, expressed a wish to, or even attempted to commit suicide narrated their experiences of receiving treatment from physicians. The interview texts were transcribed and interpreted using a phenomenological-hermeneutic method inspired by the philosophy of Ricoeur. Two main themes and eight themes were found. Participating Approach: being with the patients, listening to patients without prejudice, trusting each other, respecting patients' integrity; and Observing Approach: leaving patients to themselves, listening to patients with prejudice, mistrusting each other, not respecting patients' integrity. These findings were interpreted in the light of the writings of Hegel, Buber and Cissna and Sieburg. The suicidal patients expressed their need for confirmation in their interaction with physicians, that is they needed to meet with respect and interest when staying in the hospital with suicidal thoughts or after suicidal attempts. [ABSTRACT FROM AUTHOR]

Following the analysis of about 150 hours of field observation on a critical care unit in Norway a theory was generated to explain the actual ethical decision-making process. This was grounded in the empirical reality of physicians, nurses and family. The core theme in this study was a delayed clarification in assessing the prognosis of accident victims with neurosurgical traumas. The physicians, nurses and family had to wait for the clinical picture to clarify, during which time there was an exchange and emergence of information. Exchanging information, a subprocess to delayed clarification, involved a continuous flow of collecting and dispersing information about the clinical status of the patient. The nurses engaged in two useful strategies: grading information to family when the patient prognosis was poor, and providing grieving strategies for themselves, colleagues and family members. The core variable, delayed clarification has three dimensions: clinical, psychological and ethical. The nurses participated in the decision-making process to discontinue treatment as passive participants, they did not engage in collegial deliberations with the physicians. Ethical dilemmas were end of life questions, resource allocations, and questions of justice and organ transplants. [ABSTRACT FROM AUTHOR]

Twenty-one psychiatric in-patients who had thought about, expressed the wish or even attempted to commit suicide narrated their experiences of receiving care from mental health nurses. The interview texts were transcribed and interpreted using a phenomenological-hermeneutic method, inspired by Ricoeur's philosophy. Two main themes with subthemes were found: Confirming: attending to patients' basic needs; seeing patient; having time for patient; being with patient; listening to patient without prejudice; being open to patient; accepting patient's feelings; communicating hope to patient; and Lack of confirming: overlooking patient's basic needs; not seeing patient; not having time for patient; leaving patient to herself or himself; listening to patient with prejudice; not being open to patient; denying patient her or his feelings; communicating hopelessness to patient. These findings were interpreted in the light of Hegel's philosophy of mutual recognition and confirmation. When relating episodes of good or bad nursing care suicidal patients emphasized their need for confirmation during their interaction with nurses when in hospital after suicide attempts. [ABSTRACT FROM AUTHOR]

Studies the patterns of recovery among heart surgery patients in Norway. Effects of heart recovery process on family functioning; Factors influencing the degree of experience stress; Increase of both on perceived ability and in actual performance of roles.