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BACKGROUND: Among individuals diagnosed with the chronic neurologic disease, multiple sclerosis (MS), a majority suffers from fatigue, which strongly influences their every-day-life. The aim of this study was to investigate work capacity and health-related quality of life (HRQoL) in a group of MS patients and also to investigate if work capacity and HRQoL could be predicted by background factors, fatigue, heat sensitivity, cognitive dysfunction, emotional distress or degree of disability. METHODS: A descriptive, cross-sectional, designed survey was undertaken A questionnaire was sent to 323 individuals diagnosed with MS, aged between 20 and 65 years, with physical disability on the expanded disability status score (EDSS) in the interval 0 ≥ EDSS ≤ 6.5, living in Östergötland county in eastern Sweden. Questions on background factors, occupation and work, together with the health-related quality of life short form instrument (SF-36), the fatigue severity scale (FSS), the perceived deficit questionnaire (PDQ) and the hospital anxiety depression scale (HAD) were posed. Associations between variables were analyzed using Pearson's and Spearman's correlations. Differences between groups were tested using the Chi-square test, the Mann Whitney U-test, and the Student's t-test. Predictive factors were analyzed using multiple linear and multiple logistic regression analysis. RESULTS: Of those who completed the questionnaire (n = 257, 79.6%), 59.8% were working. Work capacity was found significantly more among men (p < 0.005), those with a higher level of education (p < 0.001), those reporting less fatigue (p < 0.001), and those having no heat sensitivity (p = 0.004). For work capacity, significant predictors were low physical disability (EDSS), low fatigue, higher level of education, male sex and lower age. Those with work capacity showed significantly higher HRQoL than those who had no work capacity (p < 0.001). Levels of fatigue, cognition and emotional distress

Aim To describe the development and evaluation of a model for a national clinical final examination in the bachelor nursing education. Background After the transfer of nursing education to the academy, concerns have been raised among nurses, nurse leaders, lecturers and researchers about the nursing students’ clinical competence at the entrance to professional life. Methods During 2003 to 2005, a collaborative project was carried out between four universities and adjunctive health-care areas supplying clinical placements in Sweden. A two-part examination was agreed upon comprising a written theoretical test and a bedside test. An assessment tool for the bedside test was created. Nursing students, nurses and clinical lecturers participated voluntarily in the evaluation. Results The model was highly appreciated, and its relevance, usability, and validity were considered quite good for the assessment of nursing students’ clinical competence at the final stage of their education. Several deficiencies were revealed, which led to further development of the model. Conclusions and implications for nursing management The development and first evaluation of the model proved encouraging for further use, but it needs further evaluation. Involvement of nursing managers is necessary in order to satisfy new demands on competence and staffing of clinical nurses.

Objective: The purpose of this study was to translate and test the psychometric properties of the Norwegian language version of the Risk Assessment Pressure Sore (RAPS) scale. Background: Risk assessment scales for pressure ulcer (PU) prevention have become an aspect of quality improvement in healthcare, but their effectiveness depends on the reliability and validity of the scale. Methods: A convenience sample of 481 residents in 15 nursing homes in rural Norway was included between January and June 2007. The English-language version of the RAPS scale was translated into Norwegian, and this scale was used to collect the data, including a skin examination. The number of PUs and grades were documented. Reliability was assessed in a small group of 26 residents and construct validity in the total study group. Results: Equivalence between two assessments regarding total scores of the RAPS scale was reflected in an intraclass correlation coefficient (ICC) of 0.95. Construct validity was supported, and the RAPS scale could define groups with expected low and high scores. Further evidence of construct validity was shown in a confirmatory factor analysis. Conclusion: The Norwegian version of the RAPS scale has shown sufficient psychometric properties to be considered a reliable and valid scale for identifying risk of PUs among nursing home residents. However, further testing is needed.

Few studies have appeared in the health care literature on the meaning of transition into retirement and later life. However, this predictable-involuntary transition may influence personal health and well-being, and studying it from a self-care perspective could be useful. The aim of this study was to illuminate aspects of self-care in a group of middle-aged individuals in relation to their anticipated transition into retirement in the Nordic welfare context. A total of 13 individuals, aged 55 to 65 years, were randomly chosen from the total number of inhabitants in three municipalities in mid-west Sweden. Conversational interviews took place, during which the informants shared important events in their lives that had occurred from early childhood until the present time, together with thoughts about their anticipated future developmental transition into later life. The interviews were tape recorded and transcribed verbatim. After content analyses and interpretation, a comprehensive picture of the phenomenon was revealed. The results showed that there were opportunities, expectations, wishes, concerns, and worries related to the transition into retirement and old age among informants from both rural and urban municipalities. Self-care, in connection with this, depended on motivating and demotivating factors. Autonomy and mature dependence seemed to be positive driving forces for reaching a successful transition into later life. Supporting autonomy should be a way of facilitating the transition into retirement and later life., Äldres liv och villkor

The aim of this study was to investigate the construct validity of the Moral Development Scale for Professionals (MDSP) using structural equation modeling. The instrument is a 12-item self-report instrument, developed in the Scandinavian cultural context and based on Kohlberg's theory. A hypothesized simplex structure model underlying the MDSP was tested through structural equation modeling. Validity was also tested as the proportion of respondents older than 20 years that reached the highest moral level, which according to the theory should be small. A convenience sample of 339 nursing students with a mean age of 25.3 years participated. Results confirmed the simplex model structure, indicating that MDSP reflects a moral construct empirically organized from low to high. A minority of respondents >20 years of age (13.5%) scored more than 80% on the highest moral level. The findings support the construct validity of the MDSP and the stages and levels in Kohlberg's theory

Background: Many individuals diagnosed with Multiple Sclerosis (MS) are sensitive to increased body temperature, which has been recognized as correlating with the symptom of fatigue. The need to explore this association has been highlighted. The aim of this study was to investigate the occurrence of heat sensitivity and its relations to disease course, disability, common MS-related symptoms and ongoing immunosuppressive treatments among individuals 65 years of age or younger diagnosed with MS.Methods: A cross-sectional designed survey was undertaken. A questionnaire was sent to MS-patients with an Expanded Disability Status Score (EDSS) in the interval of 0-6.5 and who were between 20 and 65 years of age, living in an eastern region of Sweden (n = 334). Besides occurrence of heat sensitivity (Yes/No) and corresponding questions, the Fatigue Severity Scale (FSS), the MS-related symptom checklist and the Perceived Deficit Questionnaire (PDQ) were included. Data were analysed in relation to data level using Chi-square, Mann Whitney U-test, and Student's t-test. Pearson's and Spearman's correlations were calculated. In the logistic regression analyses (enter) dichotomized MS-symptoms were used as dependent variables, and EDSS, disease-course, time since onset, heat-sensitivity, age and sex (female/male) were independent variables. In the linear regression analyses, enter, mean FSS and summarized PDQ were entered as dependent variables and EDSS, disease-course, time since onset, heat sensitivity, age and sex (female/male) were independent variables.Results: Of the responding patients (n = 256), 58% reported heat sensitivity. The regression analyses revealed heat sensitivity as a significant factor relating not only to fatigue (p < 0.001), but also to several other common MS symptoms such as pain (p < 0.001), concentration difficulties (p < 0.001), and urination urgency (p = 0.009).Conclusions: Heat sensitivity in MS patients is a key symptom that is highly corre

Introduction:Pain in connection with needles is a major reason to children’s anxiety and fear. Parents have a unique competence and knowledge about their children’s experiences and reactions that should be regarded as important in health care. Purpose: The purpose of this study was to describe a group of parents' perceptions of the factors that influence their children's experience in relation to venepuncture. Method: Qualitative interviews were conducted with 11 parents. The interviews were based on the question “What factors influence your child's experience in relation to venepuncture?”. The data were analysed through manifest and latent content analysis. Results: The manifest analysis resulted in five categories: Children's experience of fear and stress, The parent's behaviour, Information and preparation, Distraction and Staff expertise. The latent content analysis led to the theme: Adapting the peripheral venepuncture for the individual child is both the responsibility of the parents and the health care professionals. Conclusions: Parents have specific knowledge of the child they wish to convey to the nursing staff. They also want to work in collaboration with staff to minimize the child's anxiety and fear. Parents should be seen as a resource in the child’s health care.

Introduction:There may be different attitudes towards the transition into retirement and old age pensioner life among people who are relatively close to get into their third age. This phenomenon has not been widely studied in the nursing literature. Since this predictable-involuntary transition may have influences on personal health and well-being, it should be meaningful to study it in a self-care perspective. The aim of this study was to illuminate aspects of self-care in a group of middle-aged individuals in relation to their anticipated transition into retirement in the Nordic welfare context. Methods and Materials:A qualitative design was used in this study. A total number of 13 individuals, 55–65 years of age, were randomly chosen from the total number of inhabitants in three municipalities in mid-west Sweden. The interviews were tape recorded and transcribed verbatim. After content analyses and interpretation, a comprehensive understanding of the phenomenon was revealed. Results: All informants viewed their lives in retrospective with positive feelings with respect to their childhood and youth. As grown up individuals, they saw family, friends and social relations as very important. No particular differences between the informants from the different municipalities were found, nor in relation to age, sex or profession. There were opportunities, expectations, wishes, concerns and worries related to the transition into old age pensioner life among the informants from both the rural and urban municipalities. Conclusion: Autonomy and mature dependence seem to be positive driving forces for reaching a successful transition into old age. Supporting autonomy should, therefore, be a way for facilitating the predictable-involuntary transition into retirement. Further studies about the retirement transition within a self-care perspective are needed. This study indicates that motivation, autonomy and mature dependence are important issues that should be focused in such, Special Issue: Fourth European Nursing Congress - Older Persons: the Future of Care (October 4-7 2010, Rotterdam, the Netherlands) Guest Editors: Cuno van Merwijk & Johan Lambregts : Parallel Session J

In this pilot study a faces pain scale (FPS) and the ColouredAnalogue Scale (CAS) were evaluated. The FPS consists of six faces corresponding to a numeric scale of 0 to 10, and the CAS is a modified visual analogue scale from 0 to 10. The aims were to examine if FPS and CAS were considered as equal, valid and applicable in measuring pain in children in an emergency room. To assess concurrent validity, 62 children in an emergency room were asked to mark their current pain on both self-report scales. When construct validity was assessed, a subgroup of children (n=19) was asked to score their pain before and after administered analgesics. All children were asked which scale they preferred. There were no significant differences in the scores between the scales. The correlation between them was 0.64 for children >8 years of age and 0.66 for children 4.5–7 years (p<0.05). Median scores after analgesic administration decreased from 5.8 to 4.2 with CAS (p<0.001) and from 6 to 4 with FPS (p<0.001). Children >8 years preferred CAS, while younger children preferred FPS (p<0.05). Both scales showed concurrent and construct validity in this study group of untrained children in an emergency room.