Search

Scand J Caring Sci; 2011; 25; 828-833 Cross-cultural Validation of the Pediatric Quality of Life Inventory™ 4.0 (PedsQL™) generic core scale into Arabic Language Background: A range of scales is available to measure health-related quality of life. Recently, established quality of life scales have been translated for use in a wide range of Western and non-Western cultures. One of the most widely used health-related quality of life scales for use with children is the PedsQL™ 4.0. In this paper, we describe the process of translating this scale into Arabic and establishing its reliability and validity. Aim: This paper has three aims: first, to explain the process of translating the PedsQL™ (4.0) self- and proxy-reports for the ages 8-12 and 13-18, from English into Arabic; second, to assess the reliability of the new Arabic version of the scale and third, to assess its validity. Method: The scale was translated from English to Arabic and back-translated to ensure accuracy. The Arabic version was administered to healthy children and those with cancer and a range of chronic illnesses in Jordan. Statistical methods were used to test the psychometric properties (reliability and validity) of the Arabic version of the PedsQL™ (4.0) and its ability to discriminate between children in the above groups. Results: Cronbach's alpha coefficients for child self- and parent proxy-reports exceeded 0.7 for the total scores, health summary scores and psychological health summary scores. Testing for discriminant validity showed that the healthy (control) group had a higher health-related quality of life than children and young people with cancer and chronic illness. The children with chronic illnesses had the lowest scores for physical, emotional and school functioning. Conclusion: Initial testing of the Arabic version of the PedsQL™ (4.0) suggests that the scale has satisfactory psychometric properties. [ABSTRACT FROM AUTHOR]

Scand J Caring Sci; 2011; 25; 510-516 Oral health-related quality of life in older Swedish people with pain problems Objectives: The aim of the present paper was to explore the oral health-related quality of life in old Swedish people with pain problems, with special reference to demography, socio-economic factors, health, and general health-related quality of life. Method: Individuals ≥80 years (n = 186) who earlier reported pain problems answered two multi-item instruments on oral health-related quality of life (Oral Health Impact Profile, OHIP-14) and general health-related quality of life (Short Form Health Survey, SF-12), respectively. Socio-demographic and health questions were also inquired. Results: Both the oral and general health-related quality of life were rated very low. Two thirds (67.2%) reported at least one of the aspects in the OHIP-14 fairly often, very often or all the time. The mean additive score of the OHIP-14 was 14.6 (SD 10.5). The mean value of the physical component scale (PCS) of SF-12 was 25.9 (SD 6.2) and of the mental component scale (MCS) 44.1 (SD 11.5). The OHIP-14 was consistently and significantly correlated with self-rated general and oral health, chewing ability and MCS. The associations between self-rated general and oral health in relation to the OHIP-14 were independent of possible confounders: OR 3.63 (95% CI 1.58-8.32) and OR 2.68 (95% CI 1.44-4.99), respectively. Conclusion: Old people with pain problems experienced very low oral and general health-related quality of life. Personnel caring for the oldest with pain problems should be aware that oral health problems can contribute to a low quality of life and that oral care should be included in the general care. [ABSTRACT FROM AUTHOR]

Scand J Caring Sci; 2010; 24; 38-45 The objectives of this article are to present a measurement instrument for virtues, and to examine the link between virtues and health. The instrument was tested by the occupational health care at a large Finnish pulp and paper manufacturer and was shown to be consistent, valid and reliable. In developing the scale, we had two samples of employees and used factor analysis and partial least squares modelling (PLS) on both samples. Factor analysis showed that pride is the most important virtue, followed by love and generosity. In the PLS analysis, we found virtues to significantly reduce the number of sick days. In addition, we found significant relationships between virtues and fatigue, depression and happiness. Virtuous behaviour decreased sick leave and depression. The virtues had a positive influence on happiness and on improvement in one's health. The results show that by taking into account virtues in working life, companies can significantly improve their employees' well-being. The measurement instrument helps broaden the traditional view on health and is meant to be used by health care professionals in their daily practice. By addressing a person's physical, mental and virtual well-being, health care practitioners can take care of employees on a broader level than before. [ABSTRACT FROM AUTHOR]

Background: In this study, we investigate how socio‐demographic characteristics (age, gender and education) and informal care relationship characteristics (e.g., time spent on care, number of informal caregivers, professional care) are linked with informal care burden during the COVID‐19 pandemic. In addition, we expect this burden to differ by personality characteristics, degree of resilience, and—in this specific context—perceived the COVID‐19 threat. Method: We used the fifth wave of a longitudinal study to identify 258 informal caregivers. These online survey data came from a five‐wave longitudinal study in Flanders, Belgium that ran from April 2020 to April 2021. Data were representative of the adult population by age and gender. Analyses include t‐tests, ANOVA, SEM and binomial logistic regression. Results: We found that the informal care burden was strongly linked with a socio‐economic gradient, time investment changes in care since the start of the pandemic, and whether there was more than one informal caregiver. Personality traits such as agreeableness and openness to experience, and the perceived threat of COVID‐19 were also related to care burden. Conclusions: During the pandemic, informal caregivers were put under extra considerable pressure: restrictive government measures sometimes led to the temporary suspension of some or all professional care for persons with care needs, which may have resulted in a growing psychosocial burden. We recommend that, in the future, the focus should be on supporting the mental wellbeing and social participation of caregivers along with measures to protect caregivers and their relatives from COVID‐19. Support structures for informal caregivers should be kept running during crises now and in the future, but it is also important to adopt a case‐by‐case basis to consider support for informal caregivers. [ABSTRACT FROM AUTHOR]

Background: A culture of shared leadership is widespread among palliative care teams based on a commitment to valuing and including all people equally. As compassion is a core value for end‐of‐life care work, compassionate leadership may be the best way to lead in palliative care. Aims: The aims of this study were twofold: (1) to adapt and validate the Compassionate Leadership Self‐reported Scale in a sample of palliative care professionals; and (2) to study the relation between compassionate leadership and associated concepts of self‐compassion, awareness and self‐care. Methods: A cross‐sectional survey of 296 Spanish end‐of‐life care professionals was conducted. Analyses included descriptive statistics, a confirmatory factor analysis (CFA) with four‐correlated factors, reliability estimates and a structural model. Results: Results suggested there were medium to high levels of compassionate leadership in the sample. The CFA showed an adequate overall fit: χ2(98) = 277.595 (p < 0.001); CFI = 0.986; SRMR = 0.047; RMSEA = 0.088 [0.076, 0.100]. Reliability estimates for four subscales of compassionate leadership (attending, understanding, empathising and helping) were also adequate, ranging from 0.72 to 0.96. Finally, the structural model predicting compassionate leadership suggested that the dimensions of attending and understanding were most highly related to positive self‐compassion and awareness; empathising, to self‐care and awareness; and helping, to positive self‐compassion and self‐care. Conclusion: The Compassionate Leadership Scale has adequate psychometric properties when used to assess compassionate leadership in the context of end‐of‐life care. Our results indicate that self‐compassion, awareness and self‐care are important correlates of such compassionate leadership. [ABSTRACT FROM AUTHOR]

Background: Consistent practice, an agreed clinical practice based on evidence, has been considered as a base for effective provision of quality and safety of care. As a result, patients have an equal quality of care regardless of the organisation or worker. However, despite the international guidelines, pressure ulcer prevention practices vary in long‐term older people care. Aim: To develop, implement and evaluate the impact of renewed, consistent practice for pressure ulcer prevention, in long‐term older people care. Design: A quasi‐experimental intervention study. Methods: Two long‐term older people care facilities chosen with convenience sampling were randomly allocated to intervention or comparison group. Registered and practical nurses, in total 141/112, participated in the study. The renewed consistent practice based on international guidelines for pressure ulcer prevention was developed and implemented using the Operational Model for Evidence‐Based Practices (OMEBP). Frequencies and agreement of PU prevention practices in line with international guidelines in the care facilities were measured using the PUPreP instrument. Results: In the intervention facility, improvement in line with international guidelines was seen in the frequency of PU prevention practices in risk assessment, nutrition, pressure‐relieving devices and documentation. Furthermore, improvement was seen in the intervention facility in all six areas of agreement on practices. Conclusions: The results of this study support the implementation of PU prevention guidelines in long‐term older people care (LOPC) and more widely in healthcare settings for older people to promote consistent practice, and safety and equal quality of care. [ABSTRACT FROM AUTHOR]

Background: Trust is widely acknowledged as the main component of relationships between patients and nurses. Aims: Considering the importance of building trust in the patient–nurse relationship especially in vulnerable patients such as patients undergoing haemodialysis, this study was carried out to assess the trust of these patients towards nurses in the haemodialysis unit and to explore its relationship with some characteristics of the patients. Methods: In this cross‐sectional study, a total of 180 patients undergoing maintenance haemodialysis were selected using random sampling method. Data were collected by trust in nurses (TNS) scale. The collected data were analysed by SPSS (ver.21) software using anova, independent t‐test and Pearson's correlation coefficient. Results: The mean score of patients' trust in nurses was 23.82, showing a high level of trust towards nurses. The lowest score (with a mean score of 4.17) was related to the providing of accurate information by nurses about the disease. Pearson's correlation coefficient indicated a positive significant relationship between the age and patient's trust (r = 0.17, p > 0.05), and there was a negative relationship between the mean score of trust and the mean of interdialytic weight gain (r = 0.57, p > 0.05). Conclusions: Although the patient trust towards nurses was high in this study, there were some deficiencies in certain items especially in the provision of information and education to the patients. Education of specialised courses for nurses and empowering them to provide a high quality care to the patients on dialysis could help to increase the patents' trust. [ABSTRACT FROM AUTHOR]

Aims: The short version of the Perinatal Grief Scale (PGS) has 33 items of Likert type whose answers vary from 1 (strongly agree) to 5 (strongly disagree), and is used to assess the grief after perinatal loss and to identify women at major need of specific support. This is the first attempt to validate an Italian version of PGS. Materials and methods: The English version of PGS by Potvin et al. was translated into Italian by a professional mother tongue English translator. The survey was administered at 3 different times (translated Italian version; original English version after 10 days; and same Italian version after other 10 days) to 16 Italian/English bilingual women who had experienced a perinatal loss. The reproducibility among the three administrations and concordance were assessed using Cronbach's alpha and Cohen's kappa, respectively. Results: Considering the PGS, median score ranged from 74.5 (58.5–94.5) to 78 (64–95), with no significant difference among the three questionnaire administrations (p = 0.616). No significant difference emerged among the three administered questionnaires for subscales (p = 0.095, 0.410 and 0.410 for 'active grief' AG, 'difficulty in coping' DC and 'despair' D scores, respectively). Concordance varied from good to very good among all questionnaire administrations. Conclusions: This Italian version of the PGS can be used by clinicians to assess Italian women's responses to stillbirth and perinatal loss, as well as by researchers for research purposes. [ABSTRACT FROM AUTHOR]

Introduction: Acute lymphoblastic leukaemia (ALL) is one of the most common neoplasms in children, that is. 3,000 new cases are diagnosed in the USA each year. The assessment of the quality of life (QoL) by the patient is the important indicator of the effects of treatment by the means of physical, psychical and social functioning. Aim: The aim of the study was to evaluate the QoL of children treated for ALL and the stress levels of their parents. Additionally, the impact of the most common symptoms on perceived QoL was analysed. Material and methods: Seventy‐four patients with ALL (mean age 9.03) were enrolled in the study. The questionnaire of Paediatric Quality of Life (PedsQL) and the medical records as the source of the socio‐clinical data were applied in this study. Results: In QoL assessment, the social functioning reached the highest score (67.57 ± 21.33), and physical functioning – the lowest score (51.1 ± 25.59). The analysis of the symptoms showed that the most intensive were stress (7.19 ± 2.71), fatigue and weakness (5.19 ± 2.76). In Spearman's rank correlation analysis the depressed mood, fatigue and weakness were significant negative predictors influencing QoL in all the domains of PedsQoL. In the linear regression analysis only the depressed mood was the significant independent determinant of the decreased QoL in the majority of the domains of PedsQoL, respectively: the general QoL (β = −0.314; p = 0.002); psychosocial functioning (β = −3.44; p < 0.01); role functioning (β = −3.18; p = 0.004); social functioning (β = −3.5; p = 0.007) and emotional functioning (β = −3.012; p = 0.002). Conclusions: Quality of life of children with ALL is decreased and of the lowest value in the range of physical health. The factors negatively influencing the QoL are depressed mood, fatigue and weakness. The significant independent determinant of the decreased QoL is children's depressed mood. [ABSTRACT FROM AUTHOR]

Background: Medication‐related errors are common in elderly care. Most are detected during the preparation and administration stages of the medication process. Nursing staff have a key role in preventing errors, and it is based on adherence to guidelines. Aim: The aim was to determine nursing staff's self‐assessments of how they adherence to guidelines on safe medication preparation, administration and asepsis in the medication process in long‐term elderly care and to identify factors affecting this adherence. Method: Cross‐sectional study was conducted by total sampling at the communal long‐term elderly care wards of one healthcare district in Finland in November 2016. Data were collected from nursing staff by using a previously developed web‐based questionnaire. The response rate was 39.4% (n = 492). Results: One‐third of the nurses stated that they do not always follow guidelines when preparing medication, and around a half deviate from them occasionally, when administering medication. The most serious deviation on preparation stage was crushing of sustained release and enteric‐coated tablets and mixing of crushed tablets together. On administration stage, the deviation of guidelines of giving medicine in recommended time or in relation to food was common. Associations were detected between the adherence to guidelines and the nurses' experience about the adequacy of their knowledge of pharmacology and infection control, and their skill at performing medication calculations. Conclusion: Deviation from guidelines often causes an error. There is a need to review the teaching of pharmacology, infection control and medication calculations during undergraduate and continuing education. In addition, nursing staff must be reminded about the ethical aspects of safe medication processes and the appropriate attitudes to these processes. Nurses must understand why it is important to follow guidelines when preparing and administering medications, in order to avoid errors. [ABSTRACT FROM AUTHOR]

Background: First‐line managers are links between an organizations' administration and the workforce. They transmit information from higher managers to workers and vice versa. Their management skills and especially their interaction with staff are a key point in successful management. Aim: To describe how first‐line managers realized appreciative management in their everyday management practice in health and social care. Method: A quantitative descriptive study was conducted by means of an electronic survey among social and healthcare managers in Finland. Results: Based on the self‐evaluations of the managers, appreciative management is well realized. The most recognition was given to equality and the least to appreciative know‐how. Connections were seen between appreciative management and gender, education, education level and managers with higher education, and those with fewer work units below them tended to have a better realization of appreciative management. Conclusion: The education level of first‐line nurse managers is meaningful when realizing appreciative management in social and healthcare settings. Implications for nursing management: More advanced education levels of first‐line managers help to promote appreciative management in social and health care, together with the amount of work units (meaning outpatient and inpatient wards). A first‐line manager is responsible for the needs of their workforce and needs to be critically assessed so that they might have more time for managing in an appreciative way. Appreciative management should be given increased focus when educating nurse managers. [ABSTRACT FROM AUTHOR]

Background: Family violence (FV) is a prevalent health issue around the world and health care services have an important role in both recognizing and treating the consequences of violence. However, FV experiences among health care professionals themselves have not been investigated much. We also lack specific knowledge on the associations between FV and mental health. Aim: The purpose of the study was to investigate the prevalence and effects of FV in a sample of Finnish health care professionals. In addition to analysing direct connections between different types of FV and mental health, the mediating effect of sleep quality was also taken into account. Methods: The study followed a cross‐sectional design. The sample comprised 1952 health care professionals from Central Finland, who participated in a survey measuring their health and well‐being. The dependent variables were perceived sleep quality and mental health as measured by depressive symptoms and the mental health continuum short form (MHC‐SF) questionnaire. Data were analysed using cross‐tabulations, anova and structural equation modelling. Results: Thirty‐eight per cent of the participants reported experiencing FV. The most common forms of abuse were 'psychological FV only' and 'psychological & physical abuse'. Participants with FV experiences scored significantly worse on depressive symptoms (p < 0.001), MHC‐SF classification (p = 0.008), sleep quality (p = 0.001) and emotional (p < 0.001), social (p < 0.001), and psychological (p = 0.008) well‐being. The mediation analyses indicated that the harmfulness of FV was at least partially explained by impaired sleep quality. Conclusion: The results indicate that FV experiences are common among Finnish health care professionals and that they can significantly affect their mental health. FV should thus be taken to account in seeking to promote the occupational well‐being of health care professionals. The results also suggest that the harmfulness of FV might be mediated by sleep quality. This finding prompts the need for further investigation and FV‐related interventions. [ABSTRACT FROM AUTHOR]

Background: Implementing family system nursing in clinical settings is on the rise. However, little is known about the impact of graduate school education as well as continuing education in family systems nursing (FSN) on nurses' perceptions of their family nursing practice. Aims: To evaluate the level of nursing education, having taken a continuing hospital educational course in family system nursing (FN‐ETI programme), and the impact of job characteristics on nurses' perceptions of their family nursing practice skills. Design and Methods: Participants were 436 nurses with either a BSc degree or graduate degree in nursing. The Job Demand, Control and Support model guided the study (R. Karasek and T. Theorell, 1992, Healthy Work: Stress, Productivity, and the Reconstruction of Working Life, Basic Books, New York, NY). Scores for the characteristics of job demands and job control were created to categorise participants into four job types: high strain (high demand, low control), passive (low demand, low control), low strain (low demand, high control) and active (high demand, high control). Results: Nurses with a graduate education who had taken the FN‐ETI programme scored significantly higher on the Family Nursing Practice Scale than nurses with an undergraduate education. Nurses who were characterised as low strain or active scored significantly higher on the Family Nursing Practice Scale than the nurses who were characterised as high strain. Further, the interaction of education by job type was significant regarding family nursing practice skills. Hierarchical regression revealed 25% of the variance in family nursing practice skills was explained by job control, family policy on the unit, graduate education and employment on the following divisions: Maternal‐Child, Emergency, Mental Health or Internal Medicine. Conclusion: Graduate education plus continuing education in FSN can offer nurses increased job opportunities more control over one's work as well as increased skills working with families in clinical settings. [ABSTRACT FROM AUTHOR]

Rationale: Previous studies have shown that children may take on higher extents of caring activities if their parents are affected by severe illness or disability, especially when their parents lack access to formal and informal care. Aims and objectives: This study examined the extent and nature of caring activities done by patients’ children; differences in caring activities between different types of parental illness; factors associated with caring activities. Design: An explorative cross‐sectional multicentre study. Methods: Parents as patients in specialised healthcare services, and their children, were recruited from five health trusts in Norway. The sample included 246 children aged 8–17 years and their 238 parents with severe physical illness (neurological disease or cancer) (n = 135), mental illness (n = 75) or substance abuse (n = 28). Main outcome measure: Multidimensional Assessment of Caring Activities (MACA‐YC18). Results: A large number of children with ill parents are performing various caring activities. Increased caring activities among children due to their parent's illness were confirmed by their parents, especially with regard to personal care. We found no significant differences in the extent of caring activities between illness types, but there were some differences in the nature of these activities. Factors significantly associated with the extent and nature of caring activities were as follows: better social skills and higher external locus of control among the children; and poorer physical parental health. Parent's access to home‐based services was limited. Study limitations: In recruitment of participants for the study, a sampling bias may have occurred. Conclusion: To promote coping and to prevent inappropriate or extensive caring activities among children with ill parents, there is a need for increased access to flexible home‐based services adapted to the type of parental illness. [ABSTRACT FROM AUTHOR]

Patient‐centred care and user involvement in healthcare services are much emphasised globally. This study was the first step in a multicentre research project in Finland to improve service users' and carers' opportunities to be more involved in mental health services. The aim of the study was to assess attitudes of professionals towards service user involvement. The data were collected via an online questionnaire from 1069 mental health professionals in four hospital districts. Altogether, 351 professionals responded. Data were analysed using appropriate statistical methods. According to the results, attitudes of healthcare professionals were more positive towards service users' involvement in their own treatment than in other levels of services. There were also differences in gender, age groups, working places and experiences in the attitudes of professionals concerning service users' involvement in their own treatment. These should be taken into account in the future when planning education for mental health professionals. In spite of governmental guidance on service user involvement and the growing body of knowledge of the benefits associated with it, change in attitudes towards user involvement is slow. Special attention should be paid to the attitudes of professionals working in inpatient care and of those with less working experience. [ABSTRACT FROM AUTHOR]

Background: Among the various complementary therapies for patients with dementia (PwD), cognitive stimulation therapy (CST) and reminiscence therapy (RT) are frequently used to improve cognitive function and quality of life. However, no studies have examined the use of complementary therapies applied to different types of behavioural and psychological symptoms of dementia in PwD. Aims: The purpose of this study was to investigate the distinctive effects of CST and RT on cognitive function and quality of life for PwD with three types of behavioural problems – the dispute, return and dissociate types. Methods: A quasi‐experimental design was employed. A total of PwD residing in 10 long‐term care institutions participated in the study and were divided into three groups. The CST and RT groups received 50‐minute sessions of intervention therapy once a week for 10 continuous weeks, and the control group participated in regular activities. The pretest (week 1), post‐test (week 12) and follow‐up (week 24) data were collected using the Mini–Mental State Examination and Quality of Life–Alzheimer's Disease. Two‐way analysis of variance was used for data analysis. Results: The results of our study revealed CST and RT interventions had positive effects on cognition and quality of life of PwD. For short‐term effects on cognitive function, CST was the most positive intervention for the dispute type. With regard to short‐term effects on quality of life, CST was greater than RT for PwD. For follow‐up effects, CST and RT may have potentially sustained effects. Conclusion: This study suggests that CST and RT could be applied to improve the cognitive function and quality of life for PwD, as well as contribute to the effectiveness of nonpharmacological approaches to PwD with certain types of behavioural problems. [ABSTRACT FROM AUTHOR]

Background Understanding children's views of illness and health is vital to a child-centred approach in patient education and care. Paediatric healthcare providers should incorporate children's views of health and illness to enable children and their families to participate in self-management plans and achieve better health outcomes. However, there is limited scientific knowledge regarding the views of children with specific diseases. Method This comparative study investigated whether and in what ways the experience of having different chronic diseases influenced children's views of being ill and healthy. The participants were 82 children aged 8-13 years diagnosed with a chronic disease (31 had asthma, 27 had diabetes and 24 had cancer). A group of 81 healthy children participated as a comparison group. The 'draw-and-write' technique was used to collect the children's views, and the data were analysed using a previously validated coding system (inter-rater agreement of 93%) and subsequently quantified for the examination of any differences in relation to illness. Results Statistically significant differences were found in all dimensions of the children's conceptions of health and illness according to whether they had a chronic condition (effect sizes calculated with Cohen's d ranged from 0.35 to 1.22). Globally, the chronically ill children expressed a narrower definition of being healthy and ill than their healthy peers. Moreover, the comparison among the children with asthma, diabetes and cancer showed differences that seemed to reflect their specific experiences with their type of chronic disease and the associated treatments (effect sizes calculated with Eta-squared ranged from 0.07 to 0.25). Conclusions This study's findings can be used to guide education and clinical services tailored to ill children suffering from different chronic conditions. [ABSTRACT FROM AUTHOR]

Rationale and objectives Suffering through infective endocarditis ( IE) can drastically alter a person's physical appearance, and body image-related concerns have been reported by patients. The extent and severity of the phenomenon has not previously been explored, as no quantitative measure has been validated in this patient population. The purpose of this study was thus to assess the validity, reliability and responsiveness of the Danish Body Image Quality of Life Inventory ( BIQLI- DA) on patients treated for IE. Methods We evaluated the psychometric properties of the BIQLI- DA on data obtained in the CopenHeart IE trial, which is a randomised clinical trial evaluating the effects of comprehensive cardiac rehabilitation for patients treated for IE. We administered the BIQLI- DA as part of data collection at baseline and 6 months. We examined the psychometric properties through correlations to other measures, including body mass index, Medical Outcome Short Form 36 and Hospital Anxiety and Depression Scale. In addition, we examined internal consistency on item and scale level and performed anova group-by-time interaction to test for responsiveness. Results and study limitation Participants were seventy patients with a mean age of 58 years and of which 83% were men. Results indicated convergent construct validity by confirming hypothesised associations to potentially related constructs. The BIQLI- DA was found to be highly internally consistent with a Cronbach's alpha of 0.96. Instrument responsiveness was indicated by a significant group-by-time interaction. Support for the validity of the BIQLI- DA might have been strengthened by a larger sample with more women. A more optimal design for testing responsiveness would possibly have allowed for clearer conclusions. Conclusions The BIQLI- DA may be applicable in healthcare research as it seems to be valid, reliable and responsive; however, evidence should be strengthened through further exploration of instrument performance, particularly regarding responsiveness. [ABSTRACT FROM AUTHOR]

Aim Nutrition is important for pressure ulcer prevention. This randomised control pilot study assessed the feasibility of conducting a larger trial to test the effectiveness of a patient-centred intervention for improving the dietary intakes of patients at risk of pressure ulcer in hospital. Methods A 3-day intervention targeting patients at risk of pressure ulcer was developed, based on three main foundations: patient education, patient participation and guided goal setting. The intervention was piloted in three wards in a metropolitan hospital in Queensland, Australia. Participants were randomised into control or intervention groups and had their oral intakes monitored. A subset of intervention patients was interviewed on their perceptions of the intervention. Feasibility was tested against three criteria: ≥75% recruitment; ≥80% retention; and ≥80% intervention fidelity. Secondary outcomes related to effects on energy and protein intakes. Results Eighty patients participated in the study and 66 were included in final analysis. The recruitment rate was 82%, retention rate was 88%, and 100% of intervention patients received the intervention. Patients viewed the intervention as motivating and met significantly more of their estimated energy and protein requirements over time. Conclusion This pilot study indicates that the intervention is feasible and acceptable by patients at risk of pressure ulcer. A larger trial is needed to confirm the effectiveness of the intervention in the clinical setting. [ABSTRACT FROM AUTHOR]

Objectives Previous studies suggest that not only education but also personal aspects such as experience of working as a registered nurse ( RN) and age can influence competence. The objective was to explore the educational and self-rated competence of RNs and their duties within the care of older people. Methods A cross-sectional descriptive design was used. All RNs in two counties in Sweden were asked to complete a written questionnaire: a study specific questionnaire with educational and work related questions using the Nurse Competence Scale. The response rate was 61% (n 344). Results Higher self-rated satisfaction with own professional competence was related to older age, more years after nursing education and possessing at least one postgraduate education in specialist nursing. Educational needs were related to younger age and fewer years since nursing graduation. Education within elder care, including education about drugs was rated the most urgently needed area of education. The most frequently reported tasks were found in the domain helping role, whereas ensuring quality was less present in their daily work. Conclusions Educational level, age and years of experience had an impact on RNs' self-perceived competence, which is in accordance with previous descriptions of the concept competence. It seems imperative that RNs working in care of the old and with the demands placed on them are given the opportunity to take a postgraduate specialist education in order to gain a competence level in their desired area of work. It is also important that RNs working in care of the old get tailored education in line with the requirements the organisation places on them. [ABSTRACT FROM AUTHOR]

Rationale People have a fundamental right to know about care and services within health care. This right is also important for persons with memory disorders ( Pw MD) and their significant others ( SO) for empowering them to manage with difficult situations at home and in institution. Aim This study explores the self-assessed level of received knowledge about care and services of the SOs of Pw MDs and the understandability of that knowledge. Methods This study employed an exploratory and correlational survey design in multisite settings for older people. Data were collected in Finland in 2010-2011 from the SOs of Pw MDs (N = 304, n = 264, response rate 87%) using questionnaires, including the Knowledge of Care and Services for Persons with Memory Disorders; the level of knowledge and the understandability of the knowledge were assessed using visual analogue scale ( VAS 0-100). Data were analysed statistically using descriptive statistics, independent samples t-test, one-way analysis of variance and Pearson's correlations coefficients. Results The self-assessed level of received knowledge of SOs about care and services was low (mean 47.7 ± 25.3 out of 100), with the highest level seen in medication (54.5 ± 31.1) and memory disorder as a disease (54.3 ± 30.3) and the lowest level in the services provided at home for Pw MDs (45 ± 30.6) and generally for SOs (38.5 ± 31.7). SOs assessed the received knowledge as being understandable to a moderate degree (53.7 ± 25.5). Conclusion More knowledge could be delivered to Pw MDs to manage in their homes and especially to SOs to take care of Pw MDs. New educational solutions could be created aimed at improving the understandability of the knowledge. [ABSTRACT FROM AUTHOR]

Portugal is impacted by the rapid growth of the aging population, which has significant implications for its health care system. However, nurses have received little education focusing on the unique and complex care needs of older adults. This gap in the nurses′ education has an enormous impact in their knowledge and attitudes and affects the quality of nursing care provided to older adults. A cross-sectional study was conducted among 1068 Portuguese nurses in five hospitals (northern and central region) with the following purposes: (i) explore the knowledge and attitudes of nurses about four common geriatric syndromes (pressure ulcer, incontinence, restraint use and sleep disturbance) in Portuguese hospitals; and (ii) evaluate the influence of demographic, professional and nurses' perception about hospital educational support, geriatric knowledge, and burden of caring for older adults upon geriatric nursing knowledge and attitudes. The mean knowledge and attitudes scores were 0.41 ± 0.15 and 0.40 ± 0.21, respectively (the maximum score was 1). Knowledge of nurses in Portuguese hospitals about the four geriatric syndromes (pressure ulcers, sleep disturbance, urinary incontinence and restraint use) was found inadequate. The nurses' attitudes towards caring for hospitalized older adults were generally negative. Nurses who work in academic hospitals demonstrated significantly more knowledge than nurses in hospital centers. The attitudes of nurses were significantly associated with the hospital and unit type, region, hospital educational support, staff knowledge, and perceived burden of caring for older adults. The study findings support the need for improving nurses' knowledge and attitudes towards hospitalized older adults and implementing evidence-based guidelines in their practice. [ABSTRACT FROM AUTHOR]

Background and aim When a child is diagnosed with type 1 diabetes, it is a complex and challenging situation for the whole family. The management of the disease places substantial demands on the family and they need to change their daily life. The short- and long-term impact on the family has rarely been described; therefore, the aim of this study was to describe and compare the disease impact on parents and children in terms of health-related quality of life ( HRQOL) at diagnosis and 1 year subsequent to the child's diagnosis with type 1 diabetes. A further aim was to describe and compare the parents' satisfaction with the care received. Method Sixty-nine children and their parents were included. Parents independently filled in the Peds QL™ Family Impact Module and the Peds QL™ Health Care Satisfaction Generic Module. The Peds QL™ 3.0 Diabetes Module was filled in by parents and children over the age of 5. Results Mothers reported a lower HRQOL than fathers both at the time of diagnosis (p = 0.003) and 1 year later (p = 0.041). For diabetes-specific HRQOL, children aged 5-7 years and their parents reported more worry than children and parents in older age groups (p = 0.037). Children aged 8-12 and 13-18 years reported a higher treatment adherence than mothers (p = 0.011 and p = 0.039, respectively); no differences were found between children and fathers. Both parents expressed overall satisfaction with the child's health care. Conclusion The family is affected during the first year after their child is diagnosed with type 1 diabetes. Both parents and the youngest children estimated a high degree of worry. The diabetes team needs to be aware of this and to take it into consideration. [ABSTRACT FROM AUTHOR]

Chronic stress is among the most common diagnoses in Sweden, most commonly in the form of exhaustion syndrome ( ICD-10 classification - F43.8). The majority of patients with this syndrome also have disturbed breathing (hyperventilation). The aim of this study was to investigate the association between hyperventilation and exhaustion syndrome. Thirty patients with exhaustion syndrome and 14 healthy subjects were evaluated with the Nijmegen Symptom Questionnaire ( NQ). The participants completed questionnaires about exhaustion, mental state, sleep disturbance, pain and quality of life. The evaluation was repeated 4 weeks later, after half of the patients and healthy subjects had engaged in a therapy method called ' Grounding', a physical exercise inspired by African dance. The patients reported significantly higher levels of hyperventilation as compared to the healthy subjects. All patients' average score on NQ was 26.57 ± 10.98, while that of the healthy subjects was 15.14 ± 7.89 ( t = −3.48, df = 42, p < 0.001). The NQ scores correlated strongly with two measures of exhaustion ( Karolinska Exhaustion Scale KES r = 0.772, p < 0.01; Shirom Melamed Burnout Measure SMBM r = 0.565, p < 0.01), mental status [Hospital Anxiety and Depression Score (HADS) depression r = 0.414, p < 0.01; HADS anxiety r = 0.627, p < 0.01], sleep disturbances ( r = −0.514, p < 0.01), pain ( r = −.370, p < 0.05) and poor well-being ( Medical Outcomes Survey Short Form 36 questionnaire- SR Health r = −0.529, p < 0.05). In the logistic regression analysis, the variance in the scores from NQ were explained to a high degree ( R2 = 0.752) by scores in KES and HADS. The brief Grounding training contributed to a near significant reduction in hyperventilation ( F = 2.521, p < 0.124) and to significant reductions in exhaustion scores and scores of depression and anxiety. The conclusion is that hyperventilation is common in exhaustion syndrome patients and that it can be reduced by systematic physical therapy such as Grounding. [ABSTRACT FROM AUTHOR]

Aims To describe and compare the perceived social provision for a group reporting never feeling lonely with that of a group reporting feeling lonely and to explore the meaning of loneliness. Subjects Participants (N = 101) were recruited from geriatric wards. Inclusion criteria were as follows: aged 65 years or more, the absence of dementia, one or more chronic physical disorders and plans to be discharged from the hospital to their home. The mean age was 81.3 years (range: 65-96 years), 68% were women, and 66% lived alone. Measures Assessments of social provisions and loneliness were collected by a subjective report using the Social Provision Scale ( SPS), and the Montgomery-Aasberg Depression Rating Scale ( MADRS) was used to assess depression. The participants were also asked whether they felt lonely and were then asked to describe the meaning of loneliness if they had indicated feeling lonely. Narratives were then condensed by the participants into short sentences. Results Seventy-five per cent of the participants reported feeling lonely, of these 54% were living alone, and 18% identified with depression. Three subscales of SPS scores were significantly lower in the lonely group: attachment (p < 0.001), a sense of reliable alliance (p = 0.001) and the obtaining of guidance (p = 0.01). The overall view of the experience of loneliness was dominated by emptiness and negative emotions. The following themes were identified: Emotions were dominated by sadness, anxiety and restlessness, anger and guilt. Relationships were dominated by being left alone, being confined and feeling useless. Existential dimensions were characterised by emptiness, endless boredom, isolation and the potential for change. Conclusion The study shows that loneliness is prevalent among older people suffering from chronic physical illness and confirms the complexity of the concept. A mixed-methods design contributed to nuanced and detailed information about the meaning of loneliness. [ABSTRACT FROM AUTHOR]

Aim This article investigates attitudes towards and awareness of research and use of research findings among primary healthcare nurses, determinants of attitudes and evaluation of psychometric properties of an instrument measuring nurses' attitudes. Background The production of new knowledge is ongoing and the amount of research of relevance for health care has increased, but there remains a gap between what is known and what is done in practice. To enhance evidence-based practice and patient safety, the use of research findings needs to be encouraged and promoted. Method An explanatory study using a cross-sectional survey was conducted in 2005-2006. The survey included items about background data and the instrument attitudes towards and awareness of research and development in nursing. 1054 nurses participated in the study. Factor analyses and Cronbach's alpha were used to evaluate internal structure and internal consistency of the instrument. Result The nurses generally held positive attitudes towards research. Although most of the nurses reported using research in practice, 37% claimed that they never or rarely used research findings. Half of the respondents perceived they had the ability to analyse scientific reports/articles. This ability and research use were significant determinants of attitudes. Factor analysis of the scale resulted in a three-factor solution, which differs from the seven-factor structure previously identified by the originators of the instrument. Conclusion Our results support the view that implementation of research is a complex process involving several factors. The different factor structure identified suggests that further work is needed on this instrument. [ABSTRACT FROM AUTHOR]

Check Your Health was constructed as four-two-sided vertical thermometers (0-100) measuring physical and emotional health, social well-being and quality of life today and before onset of diabetes. Burden of diabetes was calculated as the difference between the two scores (today and before onset of diabetes). The aim was to examine concurrent and discriminant validity and reliability of Check Your Health in a convenience sample of 180 people with diabetes, who visited the diabetes clinic during a 3-month period. A randomly selected subsample of 43 of the 180 patients responded to the questionnaire twice (test-retest). Besides Check Your Health, three additional questionnaires were mailed to the patients, the EVGFP scale ( EVGFP stands for Excellent-Very good-Good-Fair-Poor health) for measuring concurrent validity, the Diabetes Empowerment Scale ( Swe- DES-23) and an attitude measure, Semantic Differential in Diabetes ( SDD) for calculation of discriminant validity. There was significant agreement between Check Your Health and the five EVGFP health groups. The instrument discriminated well between patients with and without late diabetic complications. The measure on burden of diabetes showed that the higher the burden of diabetes, the lower the quality of life. The same pattern was found for both Swe- DES 23 and SDD; the higher the burden, the lower the sense of empowerment and the lower the burden, the more positive the attitudes towards diabetes. Check Your Health showed good stability (0.88-0.68). The results indicate that Check Your Health can be used as an acceptable and sufficiently accurate method for detecting health distress in people with diabetes. [ABSTRACT FROM AUTHOR]

Background: The concept of nursing power has not been extensively reported in the nursing literature. Power is an extremely abstract concept, making it difficult to define and study. However, when defined as the capacity to achieve goals, power becomes a significant resource in nursing. Aims: The aim of this study was to describe how nursing professionals perceive the level of nursing group power in public healthcare organizations. Additionally, the connections between the background variables and nursing group power were analysed. Methods: The participants in the study consisted of 289 Finnish nurses working in the specialist healthcare sector in Finland. The Sieloff-King Assessment of Group Outcome Attainment within Organizations© (SKAGOAO) instrument was utilized to assess the level of nursing group power within the selected organizations. Findings: According to the present study, nursing professionals rated the outcome attainment (mean, 1.93), as well as goals/outcome competency (mean, 2.24), as very good. The position of nursing (mean, 2.55) as part of the healthcare service system was considered fairly respected. The role of nursing (mean, 2.54) was also considered to be at a good level. As regards to the actualization of power or outcome attainment capacity, respondents gave the lowest ratings to controlling the effects of environmental forces (mean, 2.75), resources (mean, 3.48), communication competency (mean, 3.00) and group supervisor's outcome attainment competency (mean, 2.87). Age, education, type of employment and work experience had an impact on how nursing group power was perceived. Conclusions: The results of the present study indicated that the nurses perceived the lowest levels of group power in relation to the subscales of controlling the effects of environmental forces, resources, communication competency and group supervisor's outcome attainment competency. [ABSTRACT FROM AUTHOR]

Scand J Caring Sci; 2013; 27; 77-83 Longitudinal assessment of distress and quality of life in the early stages of breast cancer treatment Abstract Background: During breast cancer treatment, a decline in quality of life and the patient's psychological well-being is observed. The purpose of this study was to assess levels of quality of life and psychological distress during breast cancer treatment. Methods: Utilizing a longitudinal design, patients with breast cancer were assessed at three time-points during treatment. The within-subject analysis of variance was conducted to compare subscales of quality of life. Linear regression analyses were utilized to determine the contribution of psychological distress to the quality of life at each time assessment. Results: Significant differences between the assessment times on the physical subscale (p < 0.001), socio-family (p < 0.01) and emotional well-being (p < 0.001) were showed. Specific domain-related breast cancer and psychological distress (p < 0.05) were significant during the assessment period. No difference was found on the total quality of life score within the three points of reference for treatment. The regression analysis revealed that after treatment, psychological distress showed a higher percentage of variance of the quality of life (62.6%) compared to other treatment time-points. Conclusions: Significant changes to the quality of life and psychological distress subscales are seen during breast cancer treatment. The degree to which psychological distress affected quality of life varied over the illness continuum. Health professionals should pay attention to the variability of the emotional support and care needs of patients with cancer at different times of treatment. [ABSTRACT FROM AUTHOR]

Scand J Caring Sci; 2012; 26; 505-512 All professionals are equal but some professionals are more equal than others? Dominance, status and efficiency in Swedish interprofessional teams This study explored status differences in interprofessional teams and their link with efficiency. In total, 62 teams (423 individuals) from occupational health-care, psychiatry, rehabilitation and school health-care responded to a questionnaire. Fifty-four of those teams (360 individuals) also participated in an observation session simulating problem-solving team meetings. Data were reduced to a number of indexes: self-assessed/perceived equality, functional influence and efficiency; and observed verbal dominance/activity and problem-solving capacity. Perceived status differences within the teams appeared moderate, irrespective of professional belonging. With respect to verbal dominance during meetings, however, the findings revealed a hierarchy with psychologists, physicians and social workers at the top together with special education teachers. No relationship was found between self-assessed efficiency and actual problem-solving nor between observed verbal activity and problem-solving. The findings suggest that different problems may demand different prerequisites to be solved effectively: successful solving of simple convergent problems correlated negatively with equality, whereas functional influence was a predictor of success with respect to divergent, complex problem-solving. The findings raise questions about leadership and procedures during team meetings. [ABSTRACT FROM AUTHOR]

Scand J Caring Sci; 2012; 26; 372-380 Patient satisfaction as an outcome of individualised nursing care Background: The association between individualised nursing care and patient satisfaction has been previously found. However, there is a lack of studies examining this association between individualised care and patient satisfaction in a cross-cultural study. Aims: This study examines the association between individualised care and patient satisfaction in a sample of general surgical patients from five European countries. Methods: A cross-sectional design and survey method were used to collect data from general surgical patients (N = 1315, response rate 78%) in 72 inpatient wards in 26 general acute hospitals' in 2009 using self-completed questionnaires the Individualised Care Scale and the Patient Satisfaction Scale. Data were analysed using descriptive statistics, Pearson correlation coefficients and multiple stepwise regression analyses. Results: Surgical patients reported that the care they received was only moderately individualised overall, but individuality was taken into account well in patients' clinical situation and decisional control over care. Patients were satisfied with their care, mostly with the technical aspects of care and least with the information given. There were between-country differences in patients' perceptions of individuality in care and patient satisfaction. A positive correlation between the level of individualised care received and patient satisfaction was found, confirming that individualised nursing care delivery influences patients' satisfaction with care and demonstrating that this quality of care indicator might be able to be used as a predictor of patient satisfaction, one outcome of care. Conclusion: The findings of this study strengthen previous results and further reporting the existence of a relationship and the positive correlation between individualised care and patient satisfaction. The results can inform administrative decisions and policy on introducing nursing approaches to care that would increase patient satisfaction. [ABSTRACT FROM AUTHOR]

Scand J Caring Sci; 2011; 25; 499-509 Fathering in the first few months Becoming a parent is a major event in life. Pregnancy is a time when both physical and emotional changes affect the lives of expectant parents as they prepare for parenthood. The aim of this study was to focus on fathers during and shortly after pregnancy. A prospective longitudinal study was conducted in all hospital prenatal clinics in the county council of Västernorrland, Sweden. Participating were 827 partners of women who had been pregnant and given birth during the period of June 2007 to June 2008. Data were collected using three questionnaires. Regression analysis showed that fathers who were most concerned about their new role were those that were university educated, first-time fathers, and those with financial worries. Support from the midwife or others close to the father did not impact fathers' thoughts about the difficulties of being a parent during pregnancy, but lack of support from the partners after the birth increased fathers' concern. This study suggests that more research is needed on fathers' own needs for support in parenting. [ABSTRACT FROM AUTHOR]

Scand J Caring Sci; 2011; 25; 220-226 To assess what was documented by Registered Nurses regarding diabetes care in a Swedish municipality's home nursing service; to what extent diabetes-related nursing actions were planned for, performed and evaluated according to the goals of metabolic control, treatment and prevention of complications. Cross-sectional study. Registered Nurses' documentation of patients with diabetes mellitus (n = 172). Number of recorded different nursing actions planned, performed and evaluated. The overall standard of records was insufficient. Evaluation of blood glucose levels and metabolic control was documented in 61% of the records; weight was documented in 4% of the records. Blood pressure was recorded in 10%. Ongoing foot ulcers were documented in 21%. Patient education or actions to prevent foot ulcers was not recorded. Tablet and insulin administration were well recorded. The nursing process was not followed. Updated medicine lists were missing in many files, this might have resulted in an underestimation of the number of included records. The Registered Nurses are responsible for a vulnerable patient group suffering from multi-organ disease unable to maintain their own diabetes self-care. Insufficient documentation may lead to impaired quality of care. We suggest that improved documentation routines include a structure of planning, performing and evaluation of metabolic control (blood glucose measurements, Hba1c, weight and nutrition status), complications (regular blood pressure measurements, protective foot care) and education of health care assistants in assisted diabetes self-care. [ABSTRACT FROM AUTHOR]

Scand J Caring Sci; 2011; 25; 383-393 There is no systematic identification of parents with excessive alcohol use who have a child admitted to hospital. Children in families with excessive alcohol issues form a high risk group as substantial alcohol consumption has a damaging influence on a child emotionally, cognitively, socially and physically. Alcohol consumption is a sensitive issue, and health staff needs knowledge, qualifications and adequate training in communicating with parents about this taboo. During 1 year, screening and brief intervention (SBI) was accomplished, including health staff conducting dialogues with parents of a hospitalized child using motivational interviewing (MI) and screening for risky alcohol behaviour by Cut down, Annoyance from others, feel Guilty, Early-morning Craving (CAGE)-C. Data were analysed by descriptive statistics, and relationships were tested with a statistical significance level of 0.05, using SPSS (version 16.0). Motivational dialogues with 779 parents were conducted by 43 staff members, and 11% of the parents were screened positive for risky alcohol behaviour. Drinking alcohol 4 days a week or more and drinking alcohol outside mealtimes were main risk factors. Parents' gender was the strongest predictor of screening positive and OR was 6.8 for men (CI 4.03-11.74) compared to women, p < 0.0001. An OR of 1.2 for parents' age (CI 1.02-1.42) indicates the risk of screening positive increases with age, p = 0.027. Brief intervention using CAGE-C and MI has proven successful in mapping parents' alcohol consumption patterns and in identifying parents with risky alcohol consumption habits. Health staff is able to manage health promotion and prevention when having the right competences and when being supervised. [ABSTRACT FROM AUTHOR]

Scand J Caring Sci; 2011; 25; 365-372 The purpose of this study was to describe mental health among adult Swedish patients with cystic fibrosis (CF) and to study if mental health and the salutogene factor sense of coherence (SOC) intercorrelate with good medical status. Women and men were compared. The patient group (n = 59) attended the Stockholm CF Center. Mental health was measured with the General Health Questionnaire (GHQ-28) and the salutogenesis by SOC-3. Medical status included forced vital capacity and forced expiratory volume in 1 second in per cent of predicted as well as Body Mass Index. The differences within and between groups were tested with t-tests and the relations between the variables were described by Spearman's correlation coefficient. The patients had on the whole good mental health, but the group with a risk of mental ill-health (n = 19) experienced life as difficult to manage, meaningless and hard to understand compared to the group with a small risk of mental ill-health (n = 40). Women at risk of mental ill-health (n = 10) experienced difficulties in managing life to a greater extent than women with a small risk of mental ill-health (n = 16). Men at risk of mental ill-health (n = 9) found life hard to understand. Mental health and SOC did not correlate significantly with the medical status of the CF patients. The conclusion was that there were comparably few problems of mental health among the patients with CF. The problems that were found were not related to the seriousness of their CF. Women had a more complex pattern of problems in mental health and SOC than men had. [ABSTRACT FROM AUTHOR]

Scand J Caring Sci; 2011; 25; 269-276 Families who experience a chronic complex of socio-economic and psychosocial problems are hard to reach with mainstream care. Evidence exists that the core of this problem is a problematic interaction between this type of family and current systems of care and services. To improve access to problem families, an assertive outreach intervention was implemented into the field of preventive child health care, the Netherlands. The study aimed to provide a more detailed insight into characteristics of the target group. Although there is consensus about some general features of hard to reach problem families, little is known about their specific characteristics because empirical studies among this group are rarely conducted. Especially, the problems of the children is shed insufficient light on. The studied population consisted of families included in the assertive outreach intervention delivered during one year ( N = 116). To assess psychosocial adjustment of the children, the Strengths and Difficulties Questionnaire was filled in by the parents. Furthermore, a Dutch questionnaire on family functioning was completed by professional carers. Descriptive data were calculated. The findings show that by using the assertive outreach intervention, programme staff came into contact with families characterised by a considerably higher than average proportion of single parents and unemployed households receiving social benefits. The families faced a high level of risk and a wide range of severe and multiple difficulties, including a lack of basic child care, an inadequate social network and poor parenting. Children in these families were also facing a number of risks. The proportion of psychosocial problems was well above the (inter)national average. The findings reveal the problem areas of unreached families and a need to improve the access to care for these families. [ABSTRACT FROM AUTHOR]

Scand J Caring Sci; 2011; 25; 235-242 The aim of this study was to gain an understanding of the concept of receiving care, from the perspective of the general public, nursing students and graduate nurses. The need for, and acceptance of care can occur at many different times during a human life and is sometimes necessary for survival. Experiences of receiving care are often retained as a tacit and subconscious awareness and knowledge. It is reasonable to expect that perceptions of receiving care can differ depending on different situation and experiences. Data were gathered by a questionnaire containing an open-ended question, which were presented to and answered by the general public, nursing students and graduate nurses. Content analysis was used to analyse the question posed. Having analysed the data, one main theme could be identified; being of value despite any potential disadvantages which include both edifying and not very edifying aspects. This study demonstrates that if one is in need of receiving care, there are not many choices available. Those requiring care must accept the situation and be prepared to leave themselves in the hands of caregivers. Receiving care highlights the human mode of being, which includes experiences of being exposed, which in turn motivates a seeking for valued and appreciated mutual interactions within the caring process. Within current nursing practice, our findings confirm the necessity of nurses to be fully aware of the importance of mutuality when giving care to patients. It is essential that modern nursing education continuously review the many complex aspects involved in the giving of, and receiving care. [ABSTRACT FROM AUTHOR]

Scand J Caring Sci; 2011; 25; 373-382 The aim of this study is to investigate the experiences of health care personnel of a bereavement follow-up intervention for grieving parents and of the ways to develop it. The intervention included three components: a support package for grieving parents, peer supporters' and health care personnel's contact with parents. The sample included 29 health professionals. Data were collected via open-format questionnaires and telephone interviews from health care personnel. Content analysis was used as a means of data analysis. The support package for grieving parents was considered important and versatile. Health care personnel perceived the intervention and its viability as mostly good. Parents' willingness to receive support, health care personnel's good resources and organizational preconditions were important for the follow-up contact. The intervention clarified the policy related to supporting grieving parents. It was enabled by a good attitude, shift arrangements and co-worker support. However, the implementation was considered difficult because of scarce resources. Parental support engendered negative feelings in health care personnel and they desired systematic supervision to deal with these. Follow-up care of grieving parents is a demanding task. Continuous education about bereavement follow-up care and systematic supervision to health care personnel is needed. Family-focused care in supporting grieving families after leaving from hospital should be increased. Inter-organizational cooperation in supporting parents is important and feasible. [ABSTRACT FROM AUTHOR]

Scand J Caring Sci; 2011; 25; 394-403 A Danish study compared three different outpatient settings for persons with rheumatoid arthritis (RA). All participants completed a short course before random allocation to one of three groups. A third of the patients continued with planned medical consultations. A third was allocated to a shared care setting with no planned consultations. The final third was allocated for planned nursing consultations every 3 months. Little knowledge exists of patients' experiences at different outpatient settings. (1) To explore the patients' experiences of participation in the course and one of the three different outpatient settings and (2) to explore whether some of these experiences can explain possible changes in self-efficacy beliefs. In total six focus group interviews were carried out with 33 participants from the three settings. The interviews and the analysis were inspired by phenomenological philosophy. On the short course the participants felt understood, gained new insights and some changed behaviours after attendance. Important themes in experiences from the three outpatient settings were: (1) continuity and relationships with health professionals, (2) a need for others to take control, and (3) contact with health professionals. The nursing consultations were experienced as less factual and less authoritarian than the medical consultations. The participants in the shared care setting had a lack of confidence in the GP's competence to manage their RA. However, they felt responsible for taking action in case of a flare up. The study provided opportunities to enhance the participants' self-efficacy beliefs. When planning follow-up care, the focus needs to be on continuity, the interpersonal relationship and easy access to health professionals with thorough knowledge of RA. A short course and consultations with nurses and hospital doctors can enhance patients' self-efficacy and thereby strengthen their confidence to assess and manage their own disease. [ABSTRACT FROM AUTHOR]

Scand J Caring Sci; 2011; 25; 243-252 Research has shown that families experience poor involvement in needs assessment of older people while little is known about municipal care managers' views of family participation. The aim was to explore how municipal care managers view families' participation in and influence on needs assessment of older people receiving public home help. Individual interviews (n = 26) were conducted with care managers (n = 5) about their previously conducted needs assessments (n = 5-6). As a complement, a focus group interview with care managers (n = 9) from nine different municipalities was conducted. All interviews were analysed using a qualitative content analysis. The results revealed the overarching category, 'Having to establish boundaries towards family influence and at the same time use them as a resource', which encompassed five principal categories. How family participation was viewed and handled during the needs assessment process seemed determined by the way care managers set boundaries for their professional responsibility. Their views revealed both distancing and strengthening attitudes. The distancing attitude dominated, in particular towards family members who were not perceived as having any legal rights to be considered, even though their participation was an important resource. To follow legislation and municipal guidelines of allocation of public home help to avoid reprimands caused a need for self-protection. The care managers seemed pressed by demands from organizations and families, and in this competition, the family lost out. Adherence to organizational developed patterns of handling legislation and guidelines were prioritized. Because family members often are older and assist in providing care, family participation in the needs assessment of older help recipients needs further societal support. [ABSTRACT FROM AUTHOR]

Scand J Caring Sci; 2011; 25; 317-324 About 10% of newborn babies have infantile colic which means that they cry more than 3 hours per day. The baby's crying risks disturbing the early parent-child interaction. This study aimed to illuminate the meaning of being a parent of a baby with infantile colic. An inductive qualitative interview study. Twenty-three parents (12 mothers and 11 fathers) seeking help for infantile colic at a Child Health Clinic in south Sweden, having verified in a diary their babies' crying to more than 3 hours/day, were individually interviewed between March 2006 and April 2007. Parents were selected to ensure variation in age and gender and if they were first-time parents. Parent's narratives were analysed using a phenomenological hermeneutic method. The main theme found was 'Colic overshadows everything'. Tired and worried parents experienced living in an inferno. Both fathers and mothers suffered with their babies, felt powerless and overwhelmed by strong feelings and neglected their other needs. To get through this period, parents used various strategies to ease their baby's pain. Parents forced themselves not to lose control, to keep a stiff upper lip and generally to bear up. Sharing the burden was important. In spite of the suffering, they also felt hope, happiness and gratitude that they had a healthy baby. The results were reflected upon in relation to systems theory, attachment theory and a theory of interpersonal aspects of nursing. It is an important task for professionals to empower parents and help them to endure the colic period and to gain higher self-esteem as parents. By listening to the parents' stories they can better understand their situation, offer support and increase self-efficacy. [ABSTRACT FROM AUTHOR]

Scand J Caring Sci; 2011; 25; 62-69 Type 2 diabetes (T2D) can be prevented through lifestyle changes. Regular exercise for more than 4 hours per week, combined with weight loss and changes in dietary habits reduces the incidence of T2D. The aim of this study was to describe motivators and barriers to exercise among adults with a high risk of T2D. Altogether, 74 subjects participated in a study on the Effectiveness and Feasibility of Activating Counseling Methods and Videoconferences in Dietary Group Counseling of Subjects with high risk of T2D. The qualitative data were gathered from video-recorded group counselling sessions and were analysed using content analysis. Enjoyment from exercise, social relationships related to exercise, encouragement from others, benefits to health, and the aim of weight control motivated subjects to exercise. The wish to join people with an active lifestyle, admiration of active friends and willingness to serve as an example for children reflected why exercise was an important value in life. The barriers to exercise were weather/season, health problems, lack of time, work-related factors and lack of interest. Adults with high risk of T2D experienced many individually meaningful motivators. They experienced few barriers to exercise and highlighted the motivators. Thus, we present that they had a positive attitude towards increasing exercise during participation to counselling. The results can be used when developing counselling methods because they provide concrete content for counselling discussion such as importance of work-related factors, family exercise, time management skills and social support for regular exercise. [ABSTRACT FROM AUTHOR]

Scand J Caring Sci; 2011; 25; 151-159 In this study, a qualitative design based on a thematic analysis approach was employed to explore the comprehension and experiences of Iranian nursing students regarding evaluation process in both classroom and clinical setting. After utilising purposeful sampling to choose 13 bachelor's degree nursing students, semi-structured interviews were held for data gathering. During the data analysis, three main themes emerged: 'definition of evaluation process', 'unfair evaluation' and 'ideal evaluation'. The second theme consisted of two sub-themes: 'problematic process' and 'unexpected outcome'. Our study findings showed a gap between what Iranian nursing students depicted as a fair and equitable evaluation and what they experienced during their academic career. There is a need to bring a change to process of evaluation to increase the feeling of fairness and justice regarding evaluation among nursing students. The findings can be helpful for international nurse instructors to be exposed to the unheard perspectives of nursing students and reconsider the weaknesses of evaluation process conducted by them. [ABSTRACT FROM AUTHOR]

Scand J Caring Sci; 2011; 25; 143-150 Pain is the most common symptom following laparoscopic cholecystectomy (LC) and might delay discharge from hospital after day surgery. A patient's ability to manage stressful situations can be assessed by the sense of coherence (SOC) and has been proposed to predict health. The aim of this study was to investigate predictors of average pain the first postoperative week after LC, and predictors of changes in perceived health, with special reference to individual coping resources measured by the Sense of Coherence Scale. Furthermore, a test-re-test was performed on SOC to evaluate the stability in the context of LC surgery. Seventy-three patients completed questionnaires about SOC, health status, pain, anxiety, symptom occurrence and symptom distress preoperatively, postoperative day 1-7 and after 1 and 6 months following LC. By multiple regression, 23% of the variability in pain intensity could be explained by the variables age, SOC and education. Age was the strongest predictor. Further, 19% of the change in health between day 7 and 1 month could be explained by the two variables symptom distress the first postoperative day and SOC. The test-re-test of SOC had a correlation coefficient ( r) of 0.55. Forty-six patients (63%) remained within ± 10% of their preoperative SOC score at 6 months, 11 patients (15%) decreased and 16 patients (22%) increased their SOC values. SOC was found to be a significant but weak predictor of pain intensity the first week after LC. Furthermore, patients scoring low SOC values experienced a delay in their health improvement. SOC was more unstable over time than previously suggested. Further, interventional studies are needed to clarify if SOC might be a clinically useful measure to identify vulnerable patients undergoing LC surgery. [ABSTRACT FROM AUTHOR]

Scand J Caring Sci; 2011; 25; 45-52 One of the job characteristics of geriatric care is the long-term relationship of the employees to the elderly people they are interacting with. However, these relationships are characterised by the fact that despite of the care provided by the employees, the patients experience physical suffering during the relationship, which often ends with their deaths. Although that is to be expected in this profession, it can be interpreted as personal failure and may be a reason why employees in geriatric care feel exhausted and perceive strain and stress in the job. The objective of this study was to explore the influence of career success perceptions on geriatric care staffs' coping and work-related behaviour. Data were collected in 2008 in a German geriatric care facility using the standardised psychometric questionnaire 'AVEM' (Occupational Stress and Coping Inventory) as well as a previously developed ranking of career success dimensions in geriatric care. The 69 employees, who participated were of various age groups, had different work experience and were working in distinct areas of expertise. The results show that men experience higher success at work and have more career ambitions than women. Differences in age with regard to success perception at work could not be identified. However, there is an influence of the intensity of contact between patient and employees on the perception of career success. Also, a correlation between the career success dimension happiness in the job and work experience could be verified. The current results show no impact of subjective career success dimensions on work-related coping behaviour. At the same time, the results point to differences in the relevance of subjective career success dimensions regarding the demographics of employees in geriatric care. Thus, demographics may be considered as health resources and can have positive health impacts for employees in caring-professions. [ABSTRACT FROM AUTHOR]

Scand J Caring Sci; 2010; 24; 86-92 The aim of this study was to complete a thorough psychometric evaluation of the 'RS-nl', a Dutch adaptation of the Wagnild and Young Resilience Scale. All of the 25 items of the original RS were retained, but a 4-point rather than a 7-point response was used and one item was reworded by removal of the negation. Psychometric analyses on 3265 healthy participants revealed a significant positive association between age and the total resilience score, confirming the findings with the Swedish version by Lundman et al. To a lesser extent, associations between education and the subscale 'Personal Competence' and between gender and the subscale 'Acceptance of Self and Life' was found. There was, however, no strong evidence for a five factor structure reflecting the five characteristics described by Wagnild and Young, mainly because of high secondary loadings. Therefore, in accordance with the 25-item RS, a two factor model (creating the subscales 'Personal Competence' and 'Acceptance of Self and Life') was maintained. The RS-nl seems to be a valid and useful screening instrument to detect persons at risk, who could benefit from closer and prolonged psychological help. [ABSTRACT FROM AUTHOR]

Scand J Caring Sci; 2010; 24; 56-61 The care dependency scale (CDS) aims at determining nursing care needs in a holistic way, at providing standardized and meaningful descriptions of the type and intensity of nursing care needs and the degree of independence. Assessment results support appropriate care planning for individuals and they provide epidemiological data about care dependency. Although the CDS is used worldwide in various healthcare settings, data quality in the home care setting has not been examined yet. The interrater reliability and agreement of CDS scores were investigated within two large prevalence surveys of care problems in the Netherlands in the home care setting. Three hundred and thirty-five (year 2007) and 337 (year 2008) home care clients were independently assessed twice by trained nurses. Intraclass correlation coefficients [ICC(1,1)] for CDS sum scores were 0.94 (95% CI: 0.92-0.95) and 0.93 (95% CI: 0.92-0.95), and corresponding standard errors of measurement were 3.2 and 3.3. The items mobility, day/night pattern and learning ability contained the largest amounts of measurement error and the lowest interrater reliability. Results indicate that CDS sum scores are reproducible estimates characterizing the care dependency in the home care setting. Interrater agreement is too low to make clinical decisions on individual level. [ABSTRACT FROM AUTHOR]

Scand J Caring Sci; 2010; 24; 62-66 The importance of this study lies in the availability of psychometrically sound assessment instruments, which are of critical importance for the study of patient's care dependency and the provision of care to these patients. The aim of this study was to identify the psychometric properties of the Care Dependency Scale (CDS) by analyzing data gathered in Poland. The Polish research instrument was a translation of the original Dutch CDS. Psychometric evaluations were carried out based on a convenience sample of 216 older patients. A high alpha coefficient of 0.98 was obtained. Subsequent inter-rater and test-retest reliability revealed Kappa values between 0.82-0.97 and 0.64-0.86, respectively. Factor analysis (principal component analysis) confirmed the one-factor model reported in earlier studies. The analysis of the scale showed that the instrument is promising to be used in elderly care in Poland. The Polish version of the CDS permits comparison with results from earlier studies using this instrument. [ABSTRACT FROM AUTHOR]

Scand J Caring Sci; 2010; 24; 638-647 Intimate partner violence (IPV) is seen as a serious health risk factor for women with significant acute and long-term health consequences and it affects women from all ethnic and socioeconomic groups. Knowledge of these consequences of IPV may help emergency department (ED) professionals to identify these women and provide them with appropriate care, including information on a variety of community services, and refer those women to such services if necessary. The study aimed to describe the frequency of ED visits by women exposed to physical intimate partner violence as estimated by ED professionals (nurses, practical nurses, emergency medical technicians) and identification of acute IPV. In this study 'partner' is defined as a woman's husband, former husband, current or former cohabitant or partner. This design was used as part of a larger, descriptive, cross-sectional multi-centre and multi-method study. Data were collected from 28 EDs in 13 Finnish hospital districts. Altogether 488 questionnaires were returned, which yielded a response rate of 51%. The data were analysed using descriptive statistics and quantitative content analysis. Findings showed that 48% (n = 231) of the ED professionals reported that they encountered women in IPV relationships at least once a month. Over one-fifth of the ED professionals reported having repeatedly encountered the same women visiting the ED for IPV related injuries. Over half of the participants reported having problems 'often' or 'now and then' when identifying women exposed to IPV. Those with training on IPV estimated that they had identified women exposed to IPV more often. To conclude, the research suggests that improvement of identification of acute IPV requires that training be arranged and jointly agreed written procedures for handling IPV be introduced. [ABSTRACT FROM AUTHOR]

Scand J Caring Sci; 2010; 24; 734-745 During hospitalization patients need support from nursing staff. To improve the delivery of support during hospitalization, it is necessary to know more about how patient background factors and organizational factors are associated with patients` perceived access to support. This study describes hospital patients' perceived access to emotional and informational support from nursing staff. A further concern is with the associations of patient background factors (e.g. age, education, mode of admission) and various organizational factors (e.g. nurse to bed ratio, skill mix) with support. A quantitative research approach was applied. The data were collected from patients (n = 731) at a Finnish university hospital using a specially developed scale. The sample of hospital patients was drawn from the population by stratified random sampling. In addition, data were retrieved from the hospital's electronic database. During their stay in hospital, patients felt they received more emotional than informational support. Outpatients and elective inpatients reported receiving more support than inpatients and emergency patients. Having a named nurse was also positively associated with access to support. Staffing levels showed a positive association with patient access to support. On the other hand, the availability of support deteriorated when the number of emergency inpatients and the unit workload increased. Steps are needed to improve the provision of informational support to nursing care patients and to assess the methods of support provision. Patient support can also be improved by adopting the named nurse system. There is a significant association between organizational factors and patient access to support, which warrants further investigation. [ABSTRACT FROM AUTHOR]