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Since 1998, the National Prevalence Measurement of Care Problems (LPZ) has annually measured the prevalence, prevention and treatment of a number of care problems in many health care organisations. These problems include pressure ulcers, incontinence, intertrigo, malnutrition, falls and the use of restraints. This article describes trends in the prevalence of these problems during the past few years and the preventive and treatment measures taken for clients residing in psychogeriatric and/or somatic wards of nursing homes. The results show that the prevalence of these care problems has declined in general. Nevertheless, the individual interventions (preventive measures and treatment) have not really changed in recent years. It is concluded that the extra attention paid to these care problems might already have had a positive effect on their prevalence. This must be further investigated. In any case, extra follow-up steps need to be taken to bring about a further decline. The article describes which steps the project group has already taken in this respect.

The number of patients with heart failure is growing. To optimize care for these patients in hospital and at home, a supportive-educative intervention is developed. The intervention is guided by a standard nursing care plan which is developed from literature, existing standard nursing care plans, and interviews with nurses. A case study is used to explain and illustrate the intervention and to review the importance of the standard nursing care plan.

In this article the results of explorative research into the validity and reliability of a Dutch version of the Bradenscale are described. The Bradenscale is a risk assessment tool for measuring the risk of developing pressure sores. With a prospective longitudinal design the Bradenscale has been investigated in a hospital and a community setting in Belgium and the Netherlands. Results of the research in hospital indicate a fair to moderate agreement with respect to interraterreliability and a reasonable amount of predictive validity. In the community care setting interraterreliability indicates slight to fair agreement while predictive validity could not be established due to several reasons. Further research into the Bradenscale is recommended considering the limited research population in both studies and the results in community care.

The primary question in this survey was: Is it possible for a panel of experts, by means of existing measurement scales, to weigh and rank criteria in order to get a more refined judgement of quality. For this purpose 134 criteria were presented to a panel of experts using the Delphi-method. In two Delphi-rounds the panel selected 28 most important and 18 least important criteria by means of the VAS and the Coombsscale. This resulted in a selection of 34% of the original number of 134 criteria. The results proved it to be possible, to rank and weigh criteria by means of the VAS and Coombsscale in a Delphi-survey. If it is desired that a numerical value be attributed to criteria which differ little on a notional continuum, the Coombsscale appears to be most suitable. The VAS is not adequate in reaching 70% consensus in regarding least important criteria in a group of existing criteria.

The aim of the study was to investigate the correlation between complexity of nursing care and the level of competence of the nurse. In the study the actual level of competence and the desired level of competence has been distinguished. In total, 105 patients participated in the study. Complexity of care correlates with desired level of competence, but hardly with the actual level of competence. The correlation between complexity and level of competence is higher for new patients than for patients who were receiving care already.

The Abu-Saad Pediatric Pain Assessment Tool consists of 30 word descriptors in the sensory, affective and evaluative domains as well as a 10 cm scale that measures present and worst pain experienced by the child. In the first phase of the study an inventory was carried out of pain word descriptors used by hospitalized Dutch children. In the second phase, these word descriptors were given an intensity value on the 10 cm scale by 355 children. An alpha reliability coefficient of 0.83 supported instrument homogeneity. Factor analysis (N - 355) was used to investigate construct validity. A three-factor solution was carried out to evaluate the validity of the three dimensions of pain. Factor 1 consisted of items in the affective and evaluative domains and factors 2 and 3 items from the sensory domain. Ultimately a two-factor solution provided the most intelligible conceptual pattern with the least loss of information. Conceptual composition and discussion of these factors are described and elaborated.

This article reports on a qualitative study, that explored factors influencing nurses' pain assessment and interventions with children. Although many factors appear to influence decision-making processes, nurses seem to attach more weight to some factors than to others. For example, medical diagnosis and the intensity with which the child expresses its pain are used as determining factors for the decision to administer analgesics. In this article the results of the study, their relationship to information reported in the literature as well as their implications for practice and research are further elaborated and discussed.

In nursing literature no consensus exists on the phenomenon 'counseling'. A literature search of the concept 'counseling' makes clear that it is possible to distinguish two dimensions of the concept 'counseling', namely 'range' and 'intensity' of counseling. These two dimensions are the starting point of this study. The main purpose of this study is to gain insight in the range and intensity of the counseling given by district nurses and district assistant nurses. This article aims to discover how often psychosocial nursing problems are recognized and how often nursing interventions are executed by nurses, and with how many patients this was done. The research is designed as a secondary analysis. We used data collected by Wiersma et al. (1991). The results confirm earlier research but also offer new points of view. The study confirms that counseling is an essential aspect of district nursing. Some (significant) differences were discovered between district nurses and district assistant nurses in the psychosocial care that was given. Factors like level of education, patient population and organization will probably explain the differences between the two professional groups. This aspect of the study needs further inquiry.

In clinical practice professional nurses appear to make different judgments regarding particular nursing situations. Assuming that it is desirable that nurses, confronted with the same situation, make the same decisions, it is important to gain insight into the way decisions are made. The purpose of this literature review is to summarize what is already known about decision-making in nursing. It appears that most of the texts on decision-making in nursing are based on a general model on decision-making: the information-processing model. Factors influencing decision-making processes are discussed. Finally, an overview is given of research on decision-making in nursing.