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Accessible summary: What is known on the subject: Previous studies of interdisciplinarity and nursing responsibilities have mainly focused on outcomes such as patient safety, job satisfaction and organizational factors.Mental health nurses often describe role confusion in relation to other health professionals.Opportunities for interdisciplinary communication with other professionals may benefit health care. What the paper adds to existing knowledge: The current large‐scale study is the first to investigate whether mental health and SUD nurses' perceptions of their opportunities to accommodate patients' needs are related to interdisciplinarity in the treatment unit and a nursing role with clearly defined responsibilities.Strong interdisciplinarity was associated with greater perceived opportunities to accommodate patients' psychosocial, somatic, and economic and legal needs, while strictly defined nursing roles/responsibilities were related to weaker opportunities to do so. What are the implications of practice: The findings highlight the need to address how mental health and SUD nurses organize practice to meet patients' diverse needsInterdisciplinary teamwork could strengthen nurses' ability to address patient needsFinding the best possible balance of providing service in teams or individually could improve resource utilization at the same time as strengthening patient care, and making sure that the patients' various needs are met. Introduction: Nurses' roles in specialist mental health and substance use disorder (SUD) treatment services are multidimensional and complex. Their responsibility, autonomy and interdisciplinary collaboration may be of importance for their perceived opportunities to accommodate patients' health needs. Previous studies of interdisciplinarity and nursing responsibilities have mainly focused on outcomes such as patient safety, job satisfaction and organizational factors, and included relatively small samples. The studies have also mainly been conducted in other sectors than the mental health and SUD nursing sectors. Aim/Question: The aim of this study is to examine the associations between nurses' roles, interdisciplinarity and their perceived opportunities to accommodate patients' psychosocial, somatic and economic/legal needs. Method: A cross‐sectional web‐based questionnaire survey was conducted in a nationwide sample of Norwegian nurses in the mental health, SUD treatment and combined mental health and SUD treatment sectors. Of 5,501 contactable nurses (74% of the population), 1918 (35%) responded. Results: The results revealed that interdisciplinarity was significantly associated with greater perceived opportunity to accommodate patient needs, whereas strictly defined nursing roles/responsibilities were associated with less opportunity to accommodate these needs. Discussion/Implication for practice: Facilitation of interdisciplinary collaboration may improve quality of care for patients in mental health and SUD treatment services. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: Many carers report feeling unrecognized by professional healthcare teams.Carers often report difficulty accessing mental health services for relatives.Carers who are also mental health professionals may experience role conflict as found for General Practitioners. What this paper adds to existing knowledge?: Carers who are mental health professionals are often not recognized for their professional knowledge and face similar communication barriers as other carers.Difficulties for carers who are mental health professionals are concerned with information sharing, decision‐making and continuity of care. What are the implications for practice?: Opportunity for services to learn from the experiences of mental health professional and carers to develop better communication and shared decision‐making methods for carersCarers who are mental health professionals should be recognized by services for their dual role (and skills).Service development opportunity for training in supporting and engaging carers who are mental health professionals Introduction: Around 60% of carers of relatives with mental health problems report feeling unrecognized by professional health care, and many report a lack of engagement, shared decision‐making and information sharing. There is a paucity of research examining these issues for carers who are also mental health professionals. Aims: This was an exploratory study to (a) explore the extent of this role among health service staff, (b) gather an indication of the issues faced by carers when interacting with the health system and (c) test the feasibility of conducting research. Methods: Mental health professionals in mental health services completed an online survey that assessed the frequency, content and satisfaction of the experiences of carers. Results: The sample comprised 453 mental health professionals (74% female), 52% being carers. Half of carers reported having therapist contact, and 25% were satisfied with the contact. Negative experiences were related to Information, Decision‐making and Continuity of care. Discussion: There was a high frequency of mental health professionals who were carers. The majority were dissatisfied, and this was primarily in relation to communication with services. Implications for practice: Improving information sharing through training of staff and identification of the system barriers is likely to enhance experiences for service users and families. [ABSTRACT FROM AUTHOR]

Aim To validate the European Health Literacy Survey Questionnaire ( HLS- EU-Q47) in people with type 2 diabetes mellitus. Background The HLS- EU-Q47 latent variable is outlined in a framework with four cognitive domains integrated in three health domains, implying 12 theoretically defined subscales. Valid and reliable health literacy measurers are crucial to effectively adapt health communication and education to individuals and groups of patients. Design Cross-sectional study applying confirmatory latent trait analyses. Methods Using a paper-and-pencil self-administered approach, 388 adults responded in March 2015. The data were analysed using the Rasch methodology and confirmatory factor analysis. Results Response violation (response dependency) and trait violation (multidimensionality) of local independence were identified. Fitting the 'multidimensional random coefficients multinomial logit' model, 1-, 3- and 12-dimensional Rasch models were applied and compared. Poor model fit and differential item functioning were present in some items, and several subscales suffered from poor targeting and low reliability. Despite multidimensional data, we did not observe any unordered response categories. Conclusion Interpreting the domains as distinct but related latent dimensions, the data fit a 12-dimensional Rasch model and a 12-factor confirmatory factor model best. Therefore, the analyses did not support the estimation of one overall 'health literacy score.' To support the plausibility of claims based on the HLS- EU score(s), we suggest: removing the health care aspect to reduce the magnitude of multidimensionality; rejecting redundant items to avoid response dependency; adding 'harder' items and applying a six-point rating scale to improve subscale targeting and reliability; and revising items to improve model fit and avoid bias owing to person factors. [ABSTRACT FROM AUTHOR]

Aims and objectives To investigate what differences exist in nurses' communications with each other as opposed to their communications with members of other healthcare professions. Background Difficulties have been reported related to the introduction of interdisciplinary collaboration in hospitals even when their efficacy has been demonstrated. Design This paper is a report of a project that was a cross-sectional survey design. Method Nurses and assistant nurses received questionnaires that examined two different components of interdisciplinary collaboration. Using the psychometric method known as Systematizing Person-Group Relations to gather data and for analysis, the method aims to investigate the dominant aspects of the particular work environment by identifying key characteristics of interdisciplinary collaboration. Results The respondents reported significant differences in six of the 12 factors; high scores on caring, acceptance, engagement and empathy characterised communication with members of their own professional group as low scores on the same factors characterised communication with other healthcare professions. Conclusion Findings in this study suggests that nurses behave in a more loyal, accepting and critical manner when communicating with each other than they do when communicating with members of other healthcare professions. Nurses are more influenced by behaviours characterised by assertiveness and resignation in their communication with members of other healthcare professions. The findings indicate that nurse's experience mixed emotions and behaviours that influence their communications with healthcare personnel from other professions. Relevance to clinical practice Nurses often hold key positions on interdisciplinary collaboration; therefore, they must develop the communicative skills required in this position to be able to improve the quality of patient care in hospitals, related to nurses' experiences and skills. [ABSTRACT FROM AUTHOR]

hatlevik i.k.r. (2011) The theory-practice relationship: reflective skills and theoretical knowledge as key factors in bridging the gap between theory and practice in initial nursing education. Journal of Advanced Nursing 68(4), 868-877. Abstract Aim. This paper is a report of a correlational study of the relations of nursing students' acquired reflective skills, practical skills and theoretical knowledge on their perception of coherence between theory and practice. Background. Reflection is considered a key factor in bridging the gap between theory and practice. However, it is not evident whether reflective skills are primarily generic in nature or whether they develop from a theoretical knowledge base or the acquisition of practical skills. Method. This study is a secondary analysis of existing data. The data are part of a student survey that was conducted among third-year nursing students in Norway during the spring of 2007. A total of 446 nursing students participated in this study and the response rate was 71%. Structural equation modelling analyses were performed. Findings. The results indicate that students' perception of coherence between theory and practice during initial nursing education is directly influenced by reflective skills and theoretical knowledge. The results also reveal that reflective skills have mediating effects and that practical skills have a fully mediated and theoretical knowledge a partially mediated influence on students' perception of coherence. Conclusion. The findings imply that helping students perceive coherence between theory and practice in nursing education, developing students' reflective skills and strengthening the theoretical components of the initial nursing education programme might be beneficial. The results suggest that reflective thinking is not merely a generic skill but rather a skill that depends on the acquisition of relevant professional knowledge and experience. [ABSTRACT FROM AUTHOR]

Aims: To gain a comprehensive understanding of nurses' infection control practices, antibiotics stewardship attitudes and self‐efficacy when caring for patients with multidrug‐resistant bacterial infections in a hospital setting. Background: Multidrug‐resistant bacteria cause a substantial health burden by complicating infections and prolonging hospital stays. Attitudes and self‐efficacy can inform professional behaviour. Nurses' attitudes and self‐efficacy concerning multidrug‐resistant bacteria, infection prevention and control and antibiotic stewardship are vital in keeping patients safe. Design: A descriptive and convergent mixed‐methods design involving quantitative and qualitative approaches was used. Methods: Two hundred and seventeen nurses working in clinical practice at seven different hospital wards (i.e., general medicine, surgical, haematological and oncology) at a Norwegian university hospital were invited to participate. Data were collected in February and March 2020 via two questionnaires: the Multidrug‐Resistant Bacteria Attitude Questionnaire and the General Perceived Self‐Efficacy Scale (n = 131) and four focus group interviews (n = 22). The data were analysed using descriptive statistics and systematic text condensation. Results: Most nurses showed moderate knowledge, adequate behavioural intentions towards infection prevention and antibiotic stewardship, and high self‐efficacy. However, they reported negative emotions towards their knowledge level and negative emotions towards nursing care. The nurses appeared uncertain about their professional influence and role in antibiotic stewardship practices. Organisational and relational challenges and ambivalent perceptions of nurses' role were potential explanations. Conclusion: Nurses report moderate attitudes and high self‐efficacy when caring for patients with multidrug‐resistant bacterial infections. This study suggests that nurses experience organisational and relational factors in their work environment that challenge their attitudes towards infection prevention and control and antibiotic stewardship practices. Measures that strengthen their knowledge and emotional response underpin correct infection prevention and control behaviour. A role clarification is needed for antibiotic stewardship. No Patient or Public Contribution. Relevance to clinical practice: Measures to increase attitudes towards infection prevention and control, antibiotic stewardship and multidrug resistance is recommended. Measures should be taken to overcome organisational challenges. A clarification of the nurses' role in antibiotic stewardship is needed. [ABSTRACT FROM AUTHOR]

Aims and Objectives: To investigate the association between perceived nurse–patient interaction and quality‐of‐life among nursing home residents, adjusted for loneliness, anxiety and depression. Background: Symptoms of anxiety and depression are known to residents of nursing homes along with cognitive impairment, physical inactivity and low quality‐of‐life. Anxiety, depression and loneliness are found detrimental to NH residents' quality‐of‐life. The nurse–patient relationship is important for patient's well‐being, both in terms of illness and symptom management. Design: Cross‐sectional design. Methods: Data were collected in 2017 and 2018 from 188 residents in 27 nursing homes resided in two large urban municipalities in Middle and Western Norway. The inclusion criteria were: (1) local authority's decision of long‐term NH care; (2) residential stay 3 months or longer; (3) informed consent competency recognised by responsible doctor and nurse; (4) capable of being interviewed, and (5) aged 65 years or older. This article is executed in accordance with STROBE statement. Results: Adjusting for age, sex, anxiety, depression and loneliness, perceived nurse–patient interaction was statistically significant to quality‐of‐life. While anxiety and depression showed insignificant estimates, loneliness demonstrated a significant relation with quality‐of‐life. Nurse–patient interaction and loneliness explained together 25% of the variation in quality‐of‐life. Conclusion: This study suggests that loneliness is frequent as well as more detrimental to quality‐of‐life among nursing home residents compared to anxiety and depression. Furthermore, the present results show that the nurse–patient interaction represents an essential health‐promoting resource for Quality‐of‐life in this population. Relevance to clinical practice: Staff nurses need to exercise their awareness of loneliness to meet residents' needs. Nursing educations should provide knowledge about nurse–patient interaction, and students as well as staff nurses in NHs should be trained, for instance by simulation, to use the nurse–patient interaction as a health‐promoting resource. Finally, loneliness represents a bigger challenge than depression and anxiety; accordingly, building nurses that are capable of meeting patients' needs and facilitate care that counteracts loneliness is highly warranted [ABSTRACT FROM AUTHOR]

Aims and Objectives: To explore the longitudinal experiences using an application named remote home care for remote palliative care among patients with cancer living at home. Background: Introducing welfare technology in home‐based care for patients with cancer in the palliative phase is internationally suggested as a measure to remotely support palliative care needs. However, little is known about the experiences of patients utilising welfare technology applications to receive home‐based care from healthcare professionals in a community care context. Although living with cancer in the palliative phase often presents rapidly changing ailments, emotions and challenges with patients' needs changing accordingly, no studies exploring the longitudinal experiences of patients were found. Design: A qualitative study with a longitudinal, exploratory design. Methods: Data were collected through individual interviews with 11 patients over 16 weeks. The data were analysed using qualitative content analysis. The COREQ checklist guided the reporting of the study. Results: Three themes were identified: (1) potential to facilitate self‐governance of life‐limiting illness in daily life, (2) need for interpersonal relationships and connections, and (3) experiences of increased responsibility and unclear utility of the Remote Home Care. Conclusion: The results showed that remote home care facilitated patients' daily routines, symptom control and improved illness‐management at home. Interpersonal relationships with healthcare professionals were considered pivotal for satisfactory follow‐up. Infrastructural glitches regarding data access, information sharing and lack of continuous adjustments of the application represented major challenges, with the potential to impose a burden on patients with cancer in the palliative phase. Relevance to Clinical Practice: By exploring the experiences of patients in palliative care over time as the disease progresses, this study provides constructive insights for the design and development of welfare technology applications and optimal care strategies. Patient or Public Contribution: The remote home care was developed by interdisciplinary healthcare professionals. [ABSTRACT FROM AUTHOR]

Aim and objectives: Describe patients' and family members' perceptions of family support from nurses and other mental healthcare professionals, and quality of care in community mental healthcare service. Further, compare the perceptions of patients and family members. Background: While patients value family involvement, family members feel unprepared and lack the necessary skills to be supportive. Since healthcare professionals predominantly focus on patients, they may fail to understand the complex needs of families. Family perceived support and quality of community mental health care may vary across patients and family members. Design and methods: Cross‐sectional study with patients suffering from mental illness and family members in community mental healthcare services in Norway. Altogether 86 participants, of whom 33 patients and 33 family members had a family relationship—paired samples. Participants filled in the translated version of the Iceland Family Perceived Support Questionnaire (FPSQ‐N) and Quality in Psychiatric Care—Community Out‐Patient (QPC‐COP) and Community Out‐Patient Next of Kin (QPC‐COPNK). STROBE checklist was used. Results: Family members scored family perceived support and quality of community mental health care lower than patients. Family members feel the loss of support. Patient and family members found the Patient—healthcare professionals' relationship to be of high quality, while family members gave low score to being respected and invited to take part in care by nurses and other mental healthcare professionals. Conclusion: Family members' unmet need of support highlights the need for nurses and other community mental healthcare professionals to assess complex family needs and to intervene. Barriers to collaboration exist, and family members need to be respected and invited into community mental health care. Relevance to clinical practice: Contributes knowledge of how to meet the family's needs and provides a basis for further care and treatment development in similar contexts nationally and internationally. [ABSTRACT FROM AUTHOR]

senneseth m., alsaker k. & natvig g.k. (2012) Health-related quality of life and post-traumatic stress disorder symptoms in accident and emergency attenders suffering from psychosocial crises: a longitudinal study. Journal of Advanced Nursing 68(2), 402-413. Abstract Aims. This paper is a report of a study of health-related quality of life and post-traumatic stress disorder symptoms in patients attending an Accident and Emergency department because of psychosocial crises. Background. Psychosocial crises are commonplace globally, but there is little knowledge about patients attending Accident and Emergency departments because of psychosocial crises. Methods. Data were collected at an Accident and Emergency department in Norway from September 2008 to June 2009. A total of 99 adults participated in the baseline study and 41 of these participated at 2 months follow-up. The Short Form-36 Health Survey and the Post Traumatic Symptom Scale were used to obtain data. Findings. Participants reported significantly lower scores in all health-related quality of life domains at baseline compared with the general Norwegian population. The mental health score was two standard deviations below the norm. Health-related quality of life scores were improved and post-traumatic stress disorder symptoms were reduced after 2 months. High levels of post-traumatic stress disorder symptoms were reported by 78% of the participants at baseline and 59% at follow-up. Participants with high levels of post-traumatic stress disorder symptoms at follow-up also reported low health-related quality of life scores. Conclusion. This study suggests a need for an acute psychosocial intervention and an opportunity to receive follow-up support at Accident and Emergency departments. [ABSTRACT FROM AUTHOR]

Rokstad AMM, Engedal K, Edvardsson D, Selbæk G. International Journal of Nursing Practice 2012; 18: 99-105 Psychometric evaluation of the Norwegian version of the Person-centred Care Assessment Tool The Person-centred Care Assessment Tool (P-CAT) was developed as a self-reporting assessment scale for staff ratings of the person-centredness of their nursing practice. This study investigates the psychometric properties of P-CAT in a sample of staff working in residential units for older people. Descriptive characteristics were calculated for each item and an independent-sample t-test was used to compare ratings from different groups. Internal consistency and reliability were examined using the Cronbach's alpha coefficient. Exploratory factor analysis was used to evaluate construct validity. Test-retest reliability was examined by means of intra-class correlation and the Pearson correlation coefficient. The mean score of P-CAT was 45.3 (standard deviation 7.8). Cronbach's alpha was 0.83. The factor analysis resulted in a two-component solution organizing the items into two subscales. There were significant differences between ordinary care units and special-care units and between various occupational groups, indicating a discriminating ability of the tool. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Advanced Nursing (John Wiley & Sons, Inc.) is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Advanced Nursing (John Wiley & Sons, Inc.) is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aims and objectives: (a) To describe and analyse advanced practice nursing students' self‐assessment of their clinical competence and need for further training and (b) to analyse the possible predictive variables in their self‐assessment. Background: The self‐assessment of clinical competence in nursing education is important for identifying professional development and educational needs to improve patient care. Design: A cross‐sectional survey following STROBE guidelines was used. Methods: Ninety‐nine students from three universities/university colleges in Norway participated in the study, and data were collected using a revised version of the Professional Nurse Self‐Assessment Scale II. Descriptive, correlation and regression analyses were performed. Results: The students gave the highest self‐assessment ratings for their clinical competence in taking full responsibility and for their need for further training in medication effects and interactions. Although the students gave themselves low ratings for the use of electronic devices, they assessed their need for further training in this area as average. Clinical work experience as a registered nurse and previous higher education level were not significant predictors of clinical competence nor the need for further training. Conclusion: The findings indicate that self‐assessment is appropriate for students in advanced practice nursing programmes. This study implies that programmes in advanced practice nursing need to familiarise students with the possibilities of information technology. It questions the entry requirement that stipulates that prospective students must have several years of clinical work experience as registered nurses before entering advanced practice nursing programmes. These programmes need to communicate that competencies other than direct clinical practice are also needed for students' future roles. Relevance to clinical practice: The study contributes to the exploration of how students self‐assess own clinical competence and need for further training in advanced practice nursing programmes. Further research should evaluate the development of clinical competence. [ABSTRACT FROM AUTHOR]

Aims and objectives: To examine the association between registered nurses' (referred to as "nurses" for brevity) shifts of 12 hr or more and presence of continuing educational programmes; ability to discuss patient care with other nurses; assignments that foster continuity of care; and patient care information being lost during handovers. Background: The introduction of long shifts (i.e., shifts of 12 hr or more) remains controversial. While there are claims of efficiency, studies have shown long shifts to be associated with adverse effects on quality of care. Efficiency claims are predicated on the assumption that long shifts reduce overlaps between shifts; these overlaps are believed to be unproductive and dangerous. However, there are potentially valuable educational and communication activities that occur during these overlaps. Design: Cross‐sectional survey of 31,627 nurses within 487 hospitals in 12 European countries. Methods: The associations were measured through generalised linear mixed models. The study methods were compliant with the STROBE checklist. Results: When nurses worked shifts of 12 hr or more, they were less likely to report having continuing educational programmes; and time to discuss patient care with other nurses, compared to nurses working 8 hr or less. Nurses working shifts of 12 hr or more were less likely to report assignments that foster continuity of care, albeit the association was not significant. Similarly, working long shifts was associated with reports of patient care information being lost during handovers, although association was not significant. Conclusion: Working shifts of 12 hr or more is associated with reduced educational activities and fewer opportunities to discuss patient care, with potential negative consequences for safe and effective care. Relevance to clinical practice: Implementation of long shifts should be questioned, as reduced opportunity to discuss care or participate in educational activities may jeopardise the quality and safety of care for patients. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Advanced Nursing (John Wiley & Sons, Inc.) is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Advanced Nursing (John Wiley & Sons, Inc.) is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aims and objectives: To assess Norwegian advanced geriatric nurses' (AGNs) use of their knowledge and skills, and factors that may influence AGNs' opportunities to use their knowledge and skills to reach their full potential. Background: Despite the need for nurses with advanced knowledge and skill in the care of older adults, the introduction of new advanced nursing roles has been challenging. Countries in the process of establishing advanced roles need to monitor and identify possible implementation issues. Design: A cross‐sectional descriptive survey. Methods: We invited the total population of AGNs in Norway (n = 26) and some of their colleagues (n = 465) to answer an online questionnaire. Twenty‐three (88.5%) of the AGNs and 195 (42.0%) of the invited colleagues completed and submitted the questionnaires. The data were analysed with descriptive statistics. STROBE guidelines were used in reporting this study. Results: Of the AGNs, 16 (69.6%) used their knowledge and skills to their full potential when providing direct care. However, a minority used their knowledge and skills to their full potential when proving indirect care (n = 11, 47.8%), teaching/supervision (n = 11, 47.8%) and coordination (n = 5, 21.8%). A total of 47 (24.1%) colleagues experienced the AGNs' scope of practice as completely clear, and 52 (26.6%) collaborated with the AGNs several times a week. Of the colleagues, 131 (67.2%) considered the AGNs' role and scope of practice contributed positively to a high degree to health service for older adults. Conclusion: The results indicate the need for greater focus on organisational adjustment for the AGNs to utilise their knowledge and skills to their full potential. Relevance to clinical practice: There is a need for greater focus on organisational adjustment to integrate AGNs at the workplace, as complete integration may improve the AGNs' use of their knowledge and skills. [ABSTRACT FROM AUTHOR]

Aims and objectives: To gather insight in conditions important to an understanding of undocumented migrants' life situations and more specifically to explore undocumented migrants' quality of life and how we can understand the various domains of quality of life related to demographics, living conditions, migration history and inflicted burden. Background: Undocumented migrants suffer from economic hardship and acculturative stress, limited psychological and social support and at the same time restricted access to health care and social welfare. Design: An exploratory mixed methods design using primarily quantitative data with a qualitative component was implemented. Methods: Sociodemographic data on 90 undocumented migrants were collected, and self‐report questionnaires on quality of life and psychological distress were completed, supplemented by qualitative data obtained through interviews and additional qualitative questions. The STROBE checklist for cross‐sectional studies was used for reporting this study. Results: Quality of life in our group of undocumented migrants was poor. Leaving their home country because of war or persecution, hunger, having experienced abuse, homelessness and higher age were statistically significantly associated with poorer quality of life. Having membership in a local association and having a partner were statistically significantly associated with better quality of life. Qualitative data indicate that marginal living conditions, fear of death and suffering and conditions associated with dependency were the main components comprising the burden to our respondents, reflecting their precarious juridical status as undocumented migrants. Conclusion: Our respondents' poor quality of life was related to the complex interplay between possible exposures to traumatic experiences before and during flight and post‐migration traumatisation in relation to our respondents' experiences of economic, social and acculturative hardship in Norway. Relevance to Clinical Practice: Responses called for to improve undocumented migrants' quality of life and eliminate barriers to their health care appeal more to nurses as a professional group and to those in positions of authority than each individual nurse on duty. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Advanced Nursing (John Wiley & Sons, Inc.) is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Advanced Nursing (John Wiley & Sons, Inc.) is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract: Aims: To examine changes and explanatory variables for changes in health‐related quality of life in patients treated with long‐term mechanical ventilation over a 6‐year period. Background: Long‐term mechanical ventilation is a treatment for individuals with chronic hypercapnic respiratory failure, primarily caused by neuromuscular diseases, obesity hypoventilation syndrome, chronic obstructive pulmonary and restrictive thoracic diseases. Studies on long‐term outcome on health‐related quality of life and factors influencing it are lacking. Design: Prospective cohort study. Methods: Data were collected from the Norwegian Long‐Term‐Mechanical‐Ventilation Registry and from patient‐reported questionnaire in 2008 and 2014. Health‐related quality of life was measured by the Severe Respiratory Insufficiency questionnaire, containing 49 items and seven subdomains. Linear mixed effects models were used to measure changes and identify factors for changes. Results: After 6 years, 60 patients were still participating, out of 127 at baseline. Health‐related quality of life improved significantly in the total score and in four subdomains of the questionnaire. Satisfaction with training in long‐term mechanical ventilation was an explanatory variable for improved ‘psychological well‐being’ and follow‐up for improvement of ‘anxiety’. Side effects of the treatment like facial soreness were associated with the total score. High age and high forced vital capacity were related to lower ‘physical function’ and improved ‘social functioning’, respectively. Conclusion: Long‐term mechanical ventilation over 6 years improved health‐related quality of life in most patients. Patient training, follow‐up and reduction of side effects, largely delivered by trained nurses, contribute to achieve the main goal of the treatment—improved health‐related quality of life. [ABSTRACT FROM AUTHOR]

Aims and objectives: To gain insight into how people suffering from depression experience and manage life. Background: Depression is the leading cause of incapacitation and constitutes the second largest healthcare burden worldwide, causing considerable discomfort for depression sufferers and their significant others. Depression must be understood against the backdrop of a person’s context as well as biological, psychological and social factors. While various studies have been conducted on the process of depression, only a few studies have examined its existential aspects. Design: A classical grounded theory methodology employing open and selective coding was used to identify the participants’ main concern and the strategies they used to handle it. Method: Data were collected in 2015–2016 during 18 in-depth interviews with people with current or former moderate depression. The data were analysed through constant comparisons until the grounded theory emerged. Results/findings: The main concern of the participants was Longing for belonging, and they handled their depression through a process named Risking existence. The process comprised four phases: (i) Ungraspable processing; (ii) Giving clues; (iii) Daring dependence; and (iv) Courage to be. The process of risking existence was accompanied from beginning to end by three essentials: to hope, to endure and shame. Conclusion: Working in mental health care involves encountering the pain, suffering and despair that humans endure. This challenges nurses to go beyond the symptoms and to listen for their meaning to each individual person. Relevance to clinical practice: The grounded theory of risking existence provides a model by which nurses can orient themselves when working with people who are depressed. Each phase describes different strategies that patients use that can help the nurse recognise what is going on, thus enabling him or her to understand and guide his or her patients. [ABSTRACT FROM AUTHOR]

Aims and objectives To explore school nurses' experiences with and attitudes towards working with young people with mental health problem in the school health services. Background Worldwide, 10%-20% of children and adolescents are affected by mental health problems. When these occur during youth, they constitute a considerable burden and are one of the main causes of disability among adolescents. School nurses are at the forefront of care for children and adolescents, identifying pupils struggling with physical, mental, psychosocial or emotional issues. Design A qualitative, explorative study was performed based on open-ended questions in a cross-sectional study of 284 school nurses in Norway. Inclusion criteria were as follows: working as a school nurse in the school health services with children and adolescents between the ages of 11-18 years. A qualitative inductive content analysis was conducted. Results Three generic categories emerged: perception of their role and experiences with mental health: the school nurses acknowledge their important role in work with adolescents focusing on their mental health. Perception of their professional competence: the school nurses described a lack of confidence and unmet training needs concerning mental health problems. Experiences with collaboration: the school nurses requested more knowledge about inter- and multidisciplinary cooperation regarding follow-up of pupils with mental health problems. Conclusions The school nurses lacked knowledge and confidence in respect of working with children and adolescents suffering from mental health problems. This may be a barrier to giving pupils adequate aid. Relevance to clinical practice Nurses need to acquire more knowledge about mental health problems among children and adolescents as this is a growing public health issue. Educational programmes for school nurses need to be revised to achieve this. [ABSTRACT FROM AUTHOR]

Aims and objectives To explore changes in illness perception and health-related quality of life in patients with coronary heart disease following percutaneous coronary intervention from the time when patients were discharged from hospital and five months later and to investigate association between illness perception and physical and mental health-related quality of life at five-month follow-up. Background Illness perception is known to influence patients' motivation to engage in preventive behaviour. Design Prospective and comparative with two measurement points: at discharge from hospital (time 1) and five months later (time 2). Methods Two self-administered questionnaires were used as follows: the Illness Perception Questionnaire-Revised measured illness perception and the Short Form Health Survey ( SF-36) measured physical and mental health-related quality of life. The sample consisted of patients with coronary heart disease admitted to University Hospital between November 2011-April 2012. Results A total of 69 questionnaires were returned for both measurement times. Most responders were male (71%), mean age was 68·9 (SD 10·3) years. Health-related quality of life increased over time, and illness perception changed; five months after discharge, participants were more aware that the disease was chronic and could worsen suddenly, and they perceived that the disease had less of a consequence on their lives compared to when they were staying in the hospital. Associations between increased personal control, changeability of the disease, perceptions of less of a consequence of the disease on daily life and increased health-related quality of life were demonstrated at time 2. Conclusion Perceptions of personal control, changeability and consequences of the disease should be assessed and discussed with cardiac patients, as these illness perceptions are related to physical and mental health-related quality of life. Relevance to clinical practice Increased understanding of consequences of the disease, personal control and perceived changeability of the illness affects health-related quality of life; these are factors that nurses in clinical practice can influence and thereby improve patients' outcomes. [ABSTRACT FROM AUTHOR]

Aims and objectives The aim of this study was to investigate if quality of life improved in chronic heart failure patients with Cheyne-Stokes respiration treated with adaptive servo-ventilation in nurse-led heart failure clinic. Background Cheyne-Stokes respiration is associated with decreased quality of life in patients with chronic heart failure. Adaptive servo-ventilation is introduced to treat this sleep-disordered breathing. Design Randomised, controlled design. Methods Fifty-one patients (ranging from 53-84 years), New York Heart Association III- IV and/or left ventricular ejection fraction ≤40% and Cheyne-Stokes respiration were randomised to an intervention group who received adaptive servo-ventilation or a control group. Minnesota Living with Heart Failure Questionnaire was used to assess quality of life at randomisation and after three months. Both groups were followed in the nurse-led heart failure clinic. Result Adaptive servo ventilation improved quality of life-scores both in a per protocol analysis and in an intention to treat analysis. Twenty-one patients dropped out of the study, nine in the control and 12 in the intervention group. Conclusion Use of adaptive servo-ventilation improved quality of life in chronic heart failure patients with Cheyne-Stokes respiration. However, the drop-out rate was high. Relevance to clinical practice Chronic heart failure patients come regularly to the nurse-led heart failure clinic. The heart failure nurses' competency has to include knowledge of equipment to provide support and continuity of care to the patients. [ABSTRACT FROM AUTHOR]

Aims and objectives To examine the relationship between leisure-time physical activity, health-related quality of life and sense of coherence in women after an acute myocardial infarction, and further to investigate whether these aspects were associated with age. Background Physical activity and health-related quality of life are vital aspects for patients after an acute myocardial infarction. Design Cross-sectional. Method All eligible women diagnosed with acute myocardial infarction received a postal questionnaire two to three months after hospital discharge, and 142 women were included. To measure health-related quality of life and sense of coherence, The MacNew Heart disease questionnaire and the Sense of coherence-13 scale was used. Results Respondents reporting at least one type of physical activity had significantly higher health-related quality of life as compared to respondents reporting no kind of physical activity. Respondents reporting physical activity for at least 30 minutes twice a week had significantly higher health-related quality of life scores than respondents being active less than twice a week. A weak association was found between physical activity level and sense of coherence. Reduction in physical activity after the acute myocardial infarction was associated with reduced health-related quality of life and sense of coherence. Sense of coherence was significantly associated with age, as respondents 75 years and older had significantly higher scores than respondents younger than 75 years. Conclusions Physical activity, even at a low level, is significantly associated with increased health-related quality of life and to some extent to sense of coherence. Relevance to clinical practice Tailoring women after an acute myocardial infarction about lifestyle changes must include knowledge about the benefits of leisure-time physical activity, and that even a small amount of activity is associated with a better health-related quality of life. The utmost important assignment is to motivate the women for regular physical activity in their leisure-time. Older women need special attention. [ABSTRACT FROM AUTHOR]

Aims and objectives To explore undocumented migrants' mental healthcare needs and more specifically to explore how undocumented adults living in Norway perceive psychological distress, to gather insight on their living conditions and to explore associated living condition risk factors. Background Undocumented migrants are defined both nationally and internationally as an especially vulnerable group with regard to their health status, living conditions and barriers to access to health care and social welfare. Design An exploratory mixed-methods design using primarily quantitative data with a qualitative component was implemented. Methods Socio-demographic data on 90 undocumented migrants were obtained, and self-report questionnaire on psychological distress was completed, supplemented by qualitative data obtained through interviews. Results The level of psychological distress was extremely high in our group of undocumented migrants. Leaving their home country because of war or persecution, economic strain, homelessness, hunger and having experienced abuse was significantly positively associated with psychological distress. Contrary to what was predicted, having family and work was not significantly associated with the reduction of psychological distress. Additional qualitative data indicate that having family entails great responsibilities and work implies exploitation to such an extent that any potential positive influence this has on mental health, such as a sense of belonging and a reasonable standard of living, is outweighed. Conclusions The high level of psychological distress indicates a need of additional diagnostic evaluation and mental health care. The living conditions were so marginal that their day-to-day existence was threatened. Relevance to clinical practice We recognised a need for an interdisciplinary and dynamic approach to mental health care. Undocumented migrants are in need of a minimum of psychological and material support assuring basic needs such as shelter and appropriate food and access to health care and social welfare. [ABSTRACT FROM AUTHOR]

Aims and objectives A description and comparison of sexual activity and function in relation to various gynaecological cancer diagnoses, treatment modalities, age groups, psychological distress and health-related quality of life. Background Various forms of gynaecological cancer have the potential to negatively influence sexual functioning, but there are few studies that describe and compare sexual activity and functioning according to diagnosis. Design A descriptive cross-sectional study. Methods The study includes 129 women from an intervention study. The questionnaires addressed sexuality, psychological distress, health-related quality of life and demographics. Disease and treatment characteristics were extracted from medical records. Results Close to two-thirds of the women were sexually active. However, 54% of the sexually active women reported that they were not satisfied or little satisfied with their sexual activity. About half of the women reported dryness in the vagina, and 41% reported pain and discomfort during penetration. There were no significant differences concerning pleasure and discomfort related to treatment modality, diagnoses or FIGO stage. Conclusion Health personnel should make a priority of sexuality throughout a patient's cancer treatment and in the follow-up, as sexuality is a vital part of a good life. Relevance to clinical practice Since the patients experience relatively low satisfaction with their sexual activity and many report pain during penetration, health personnel need to be sensitive to the woman, her questions, and her needs. Of importance are also the personnel's ability to communicate and their expertise in diagnosing and treating difficulties relating to sexuality. [ABSTRACT FROM AUTHOR]

Aims and objectives To compare the prevalence and severity of pain in men and women during the first year following cardiac surgery and to examine the predictors of persistent postoperative pain 12 months post surgery. Background Persistent pain has been documented after cardiac surgery, with limited evidence for differences between men and women. Design Prospective cohort study of patients in a randomised controlled trial ( N = 416, 23% women) following cardiac surgery. Methods Secondary data analysis of data collected prior to surgery, across postoperative days 1-4, at two weeks, and at one, three, six and 12 months post surgery. The main outcome was worst pain intensity (Brief Pain Inventory-Short Form). Results Twenty-nine percent (97/339) of patients reported persistent postoperative pain at rest at 12 months that was worse in intensity and interference for women than for men. For both sexes, a more severe co-morbidity profile, lower education and postoperative pain at rest at one month post surgery were associated with an increased probability for persistent postoperative pain at 12 months. Women with more concerns about communicating pain and a lower intake of analgesics in the hospital had an increased probability of pain at 12 months. Conclusion Sex differences in pain are present up to one year following cardiac surgery. Strategies for sex-targeted pain education and management pre- and post-surgery may lead to better pain outcomes. Relevance to clinical practice These results suggest that informing patients (particularly women) about the benefits of analgesic use following cardiac surgery may result in less pain over the first year post discharge. [ABSTRACT FROM AUTHOR]

Aims and objectives To evaluate the test-retest stability in assessments of perceived symptom intensity on the Edmonton Symptom Assessment System-revised and the European Organization for Research and Treatment of Cancer, Quality of Life Questionnaire Core 15 Palliative. The possible interchangeability between the instruments and the patients' experiences of completing the instruments were also studied. Background The two instruments assess the same symptoms, but the symptom intensity is assessed on 11-point numerical scales on the Edmonton Symptom Assessment System-revised and on four-point verbal descriptive scales on the European Organization for Research and Treatment of Cancer, Quality of Life Questionnaire Core 15 Palliative. Both instruments are commonly used; however, uncertainty exists about which instrument should be recommended and about the interchangeability of the instruments. Design This study used a test-retest design with inter-scale comparisons. Methods Data from 54 patients with cancer who were receiving palliative care in an oncology outpatient clinic were self-reported by the patients in the clinic, at home and when patients returned to the clinic. Results The assessments on the European Organization for Research and Treatment of Cancer, Quality of Life Questionnaire Core 15 Palliative verbal rating scales showed a higher level of test-retest stability than the assessments on the Edmonton Symptom Assessment System-revised numerical scoring scales, indicating higher reliability. The correspondence between the verbal categories and the numerical scores of symptom intensity were low because different verbal categories were used by patients who assessed the same numerical score. Conclusions The test-retest stability in the assessments was higher on the European Organization for Research and Treatment of Cancer, Quality of Life Questionnaire Core 15 Palliative and the results show that assessments on the two instruments could not be used interchangeably. Therefore, the symptom instrument chosen must be specified and unchanged within a patient to improve efficacy in clinical practice. Relevance to clinical practice The Edmonton Symptom Assessment System-revised or the European Organization for Research and Treatment of Cancer, Quality of Life Questionnaire Core 15 Palliative can be used for initial assessments of patients, but should not be compared or used interchangeably. It is vitally important to have individual follow-up for all patients who score an instrument. [ABSTRACT FROM AUTHOR]

Aims and objectives To assess the content validity and reliability of the Person-centred Climate Questionnaire-Patient version in long-term care facilities, to describe residents' perceptions of the extent to which their ward climate was person-centred and to explore whether person-centredness was associated with facility and resident characteristics, such as facility and ward size, having a sensory garden and having a primary caregiver. Background The importance of the physical environment to persons with dementia has been investigated. However, research is lacking regarding the extent to which mentally lucid residents experience their physical and psycho-social ward climate as person-centred and the factors influencing their experience. Design Cross-sectional survey design. Methods The Person-centred Climate Questionnaire-Patient version was translated into Norwegian with forward and backward translation. The content validity index for scales was assessed. The Person-centred Climate Questionnaire -Patient version was completed by 145 mentally lucid residents in 17 Norwegian long-term care facilities. Reliability was assessed by Cronbach's α and item-total correlations. Test-retest reliability was assessed by paired samples t-test and Spearman's correlation. To explore differences based on facility and resident characteristics, independent-samples t-test and one-way anova were used. Results The content validity index for scales was satisfactory. The Person-centred Climate Questionnaire-Patient version was internally consistent and had satisfactory test-retest reliability. The climate was experienced as highly person-centred. No significant differences were found, except that residents in larger facilities experienced the climate as more person-centred in relation to everyday activities (subscale 2) than residents in smaller facilities. Conclusion The Norwegian version of the Person-centred Climate Questionnaire-Patient version can be regarded as reliable in a long-term care facility context. Perceived degree of person-centredness was not associated with facility or resident characteristics, such as the number of residents, having a sensory garden or knowing that one has a primary caregiver. Relevance to clinical practice A person-centred climate can be attained in different kinds of long-term care facilities. [ABSTRACT FROM AUTHOR]

Aims and objectives To examine the prevalence of cancer-related fatigue in women treated for various types of gynaecological cancers and, for these cancers, to assess fatigue in relation to distress, health-related quality of life, demography and treatment characteristics. Background Advances in treatment of cancer have improved the likelihood of survival. Consequently, there are a growing number of patients who become survivors after cancer and who face side effects even years after treatment. One of the most frequently reported side effects across all types and stages of the disease is cancer-related fatigue. Design A descriptive cross-sectional study. Methods One hundred and twenty women treated for gynaecological cancers who were participants in an intervention study were included. Fatigue, psychological distress, health-related QoL and demographics were assessed by questionnaires. Disease and treatment characteristics were extracted from medical records. Results Cancer-related fatigue was reported in 53% of the women treated for gynaecological cancers, with a higher proportion in the group of cervical cancer, followed by ovarian cancer. Younger participants reported fatigue more frequently than older participants. When adjusting for age, the type of cancer a woman experiences was shown to have little impact on her risk of experiencing fatigue. The participants with fatigue reported higher levels of anxiety and depression than participants without fatigue. There was a relationship between fatigue and quality of life as measured by SF-36 domains. Conclusion The findings underscore the importance of screening for fatigue, patient education and symptom management. This should be included in a standard procedure during treatment and follow-up. Both somatic and psychological aspects of fatigue should be emphasised. Relevance to clinical practice The findings imply the need for health personnel to have focus on fatigue during the entire cancer trajectory of women after gynaecological cancers, as well as the need for screening, information, guidance and symptom management. [ABSTRACT FROM AUTHOR]

Aim To investigate how undergraduate nursing students' perceived professional qualifications and job values relate to their choice of clinical field after graduation, particularly about employment in care of older people and psychiatric fields. Background In the light of greater demand for highly qualified nurses, it is important to understand how professional qualifications and job values relate to career choices. Design A quantitative longitudinal study of 290 undergraduate nursing students based on a questionnaire survey and register data. Methods Data were analysed by multinomial logistic regression analyses. The questionnaire was distributed to all undergraduate nursing students during the final semester of study at two university colleges in Norway ( N = 411) to collect the students' perceived professional qualifications and job values (2001). Register data on clinical fields after graduation (2002-2006) were merged into the survey data in 2008 (Statistics Norway). Results The tendency among undergraduate nursing students to choose care of older people rather than general hospital care after graduation increases as their score on altruism decreases, but is not correlated with their score on theoretical knowledge. The tendency to choose psychiatric fields rather than general hospital care increases with an increasing score on perceived practical skills and decreases with an increasing score on perceived theoretical knowledge. Conclusion The choice of clinical field after graduation correlates with undergraduate nursing students' perceived professional qualifications and job values. [ABSTRACT FROM AUTHOR]

Aim This study investigated how prosocial motivation reported by nursing students in their final year of academic studies relates to career commitment and job involvement three years after graduation. Background Most studies investigating nurses' prosocial motivation for choosing the nursing profession examine only their prosocial motivation for entering nursing training; they do not investigate whether this motivation is associated with job involvement or commitment to the profession. Design A longitudinal survey design was used. Method The present longitudinal study included 160 nurses. In their final academic year of spring 2007, the nurses received a questionnaire about their motivation for entering nursing. Three years after graduation, spring 2010, they received another questionnaire about their level of job involvement and career commitment. Results The results showed that prosocial motivation measured in their last academic year was related to career commitment three years after graduation, but unrelated to job involvement. Conclusion The results indicated that prosocial motivation is important in identifying with the profession but not necessarily for personal involvement in the job. The study gives important knowledge on how a commonly reported motivation for entering nursing relates to the nurses' attitudes about their work life. [ABSTRACT FROM AUTHOR]

Aims and objectives To investigate the experiences of home care nurses with electronic messaging (e-messaging) and to determine how it influenced their communication with general practitioners. Background Nurses in home care services must collaborate with general practitioners to care for homebound patients. Studies have shown that communication and collaboration are often constrained because they are organised separately and are dispersed. The use of information and communication technology is expected to support communication and to be a tool for increased patient safety and higher-quality care. Design Cross-sectional study with group comparisons Methods The data were collected with a mailed questionnaire that was answered by home care nurses ( n = 425) who had implemented e-messaging and by home care nurses in a comparison group who had not implemented e-messaging ( n = 364). The data were analysed using descriptive analyses, chi-square test, Mann-Whitney U-test and multilevel analysis. Results The home care nurses who used e-messages reported to a greater extent that they had communication procedures with general practitioners compared to what the home care nurses in the comparison group reported. The implementation of e-messaging did not result in timelier communication or differences between the two groups in the use of nonelectronic communication, except for a lower use of faxes in the e-messaging group. However, the home care nurses who used e-messaging reported more frequent contacts with general practitioners. Conclusion The results demonstrate that even if e-messaging was implemented, the home care nurses and the general practitioners continued to use nonelectronic communication methods. Relevance to clinical practice E-messaging did not replace but rather complemented the communication methods and thereby transformed clinical communication and collaboration. This should be considered when planning and implementing new information technology in primary care. [ABSTRACT FROM AUTHOR]

Aims and objectives To assess patients' symptoms, quality of life and satisfaction with information three to four years after radical prostatectomy, radical external beam radiotherapy and postoperative radiotherapy and to analyse differences between treatment groups and the relationship between disease-specific, health-related and overall quality of life and satisfaction with information. Background Radical prostate cancer treatments are associated with changes in quality of life. Differences between patients undergoing different treatments in symptoms and quality of life have been reported, but there are limited long-term data comparing radical prostatectomy with radical external beam radiotherapy and postoperative radiotherapy. Design A cross-sectional survey design was used. Methods The study sample included 143 men treated with radical prostatectomy and/or radical external beam radiotherapy. Quality of life was measured using the 12-item Short Form Health Survey and the 50-item Expanded Prostate Cancer Index Composite Instrument. Questions assessing overall Quality of life and satisfaction with information were included. Descriptive statistics and interference statistical methods were applied to analyse the data. Results Radical external beam radiotherapy was associated with less urinary incontinence and better urinary function. There were no differences between the groups for disease-specific quality of life sum scores. Sexual quality of life was reported very low in all groups. Disease-specific quality of life and health-related quality of life were associated with overall quality of life. Patients having undergone surgery were more satisfied with information, and there was a positive correlation between quality of life and patient satisfaction. Conclusion Pretreatment information and patient education lead to better quality of life and satisfaction. This study indicates a need for structured, pretreatment information and follow-up for all men going through radical prostate cancer treatment. Relevance to clinical practice Long-term quality of life effects should be considered when planning follow-up and information for men after radical prostate cancer treatment. Structured and organised information/education may increase preparedness for symptoms and bother after the treatment, improve symptom management strategies and result in improved quality of life. [ABSTRACT FROM AUTHOR]

Aims and objectives To explore students' opinions of the learning environment during clinical placement in settings outside traditional hospital settings. Background Clinical placement experiences may influence positively on nursing students attitudes towards the clinical setting in question. Most studies exploring the quality of clinical placements have targeted students' experience in hospital settings. The number of studies exploring students' experiences of the learning environment in healthcare settings outside of the hospital venue does not match the growing importance of such settings in the delivery of health care, nor the growing number of nurses needed in these venues. Design A survey design was used. Method The Clinical Learning Environment Inventory was administered to two cohorts of undergraduate nursing students ( n = 184) after clinical placement in mental health care, home care and nursing home care. Results Nursing students' overall contentment with the learning environment was quite similar across all three placement areas. Students in mental health care had significantly higher scores on the subscale individualisation, and older students had significantly higher scores on the total scale. Compared with other studies where the Clinical Learning Environment Inventory has been used, the students' total scores in this study are similar or higher than scores in studies including students from hospital settings. Conclusion Results from this study negate the negative views on clinical placements outside the hospital setting, especially those related to placements in nursing homes and mental healthcare settings. Relevance to clinical practice Students' experience of the learning environment during placements in mental health care, home care and nursing homes indicates the relevance of clinical education in settings outside the hospital setting. [ABSTRACT FROM AUTHOR]

Aims To investigate the extent to which perceived support from healthcare professionals and shock anxiety is related to device acceptance among implantable cardioverter defibrillator recipients. Background Device acceptance can be influenced by several factors, one of which is shock anxiety associated with poor device acceptance. Reduced shock anxiety, as well as increased device acceptance, has been reported after psycho-educational programmes. As healthcare professionals appear to play a significant role in providing support and education during regular follow-up visits, they may constitute an important social support system that could be another factor influencing device acceptance. However, little is known about the relationship between perceived support from healthcare professionals and device acceptance among recipients. Design A cross-sectional survey design. Methods A sample comprising implantable cardioverter defibrillator recipients completed questionnaires assessing perceived support from healthcare professionals, shock anxiety and device acceptance. Demographic and clinical data were collected by self-report and from medical records in September-October 2010. Results The descriptive results indicated that approximately 85% of the recipients experienced high device acceptance. Regression analysis demonstrated that constructive support from healthcare professionals was positively associated with device acceptance and moderated the negative relationship between shock anxiety and device acceptance. Non -constructive support and shock anxiety had a negative statistical association with device acceptance. Conclusions Healthcare professionals may represent a valuable constructive support system that can enhance device acceptance among implantable cardioverter defibrillator recipients, partly by preventing shock anxiety from leading to poor device acceptance. Non-constructive communication on the part of healthcare professionals could hinder device acceptance. [ABSTRACT FROM AUTHOR]

Aims and objectives To investigate the associations between meaning-in-life and physical, emotional, functional and social well-being in a cognitively intact nursing-home population. Background Meaning-in-life is understood as an influential psychological variable that promotes health and well-being; meaning-in-life has been found to be a mediating variable in both psychological and physical health. Design and methods The study employed a cross-sectional design. Data were collected in 2008 and 2009 using the purpose-in-life test and the FACT-G quality-of-life questionnaire. A total of 250 cognitively intact nursing-home patients who met the inclusion criteria were approached and 202 attended. The hypothesised relationships between meaning and multidimensional well-being were tested by means of structural equation modelling. Results The structural equation modelling model fit well with the present data, showing significant direct relationships between meaning-in-life and emotional and functional well-being, and a significant mediated influence of meaning on social and physical well-being. Conclusion Meaning-in-life is associated with all dimensions of well-being and likely plays an important role in both emotional and physical well-being. Relevance to clinical practice Facilitating patients' perceived meaning-in-life might help ease emotional distress and physical symptoms, thus fostering well-being in cognitively intact nursing-home patients. Therefore, advancing staff nurses' competence in facilitating meaningful involvement, connectedness, nurse-patient interaction and symptom management is important for care quality and global well-being in nursing homes. [ABSTRACT FROM AUTHOR]

Aims and objectives To assess the effects of introducing a systematic approach to pain and sedation management in the ICU. Background Identification of ICU patients' analgesic and sedative needs decreases the risk of complications and the hospital length of stay. Several studies have reported a lack of systematic assessment. Design and methods Three assessment tools were implemented in two Norwegian ICUs in a prospective two-site study ( April- July 2009). Frequency of pain and sedation documentation, the number of days when a sedation level was prescribed, and the amount of analgesics and sedatives used were documented for 958 ICU days in 139 mechanically ventilated patients. Fifty-five ICU nurses completed a questionnaire on the effects of the assessment tools before and after implementation. Results Patients assessed by the tools had a documented pain score 2·5 times daily and a sedation score three times daily. A sedation level was prescribed for 70% of the total patient days. A documented match between prescribed and reported sedation level was achieved for 27% of the days. Combinations of continuous analgesia and sedation were prescribed with wide therapeutic ranges. Significant improvements were seen in the units' assessment and documentation routines scored by the nurses after the implementation of the tools. Conclusion Although the tools were well accepted, they were not used as frequently as recommended. The proportion of missing written prescriptions and documentation of sedation levels most likely reflects the nurses' and physicians' poorly defined intentions for the prescribed treatment. The tools applied helped nurses to focus on significant signs and symptoms. Relevance to clinical practice Without well-organised pain treatment and sedation, the risk of oversedation is always present. Our results show that the implementation of tools contributes to a systematic approach of the assessment and treatment of pain and sedation in intensive care. [ABSTRACT FROM AUTHOR]

Aims and objectives To investigate the prevalence of physical and emotional symptoms and the associations between symptoms and meaning-in-life in a cognitively intact nursing-home population. Background Meaning has been found to be a strong individual predictor of successful ageing and life satisfaction as well as an important psychological variable that promotes well-being. Meaning serves as a mediating variable in both psychological and physical health. Design and methods The study employed a cross-sectional design. Data were collected in 2008 and 2009 using the QLQ-C15- PAL quality-of-life questionnaire, the purpose-in-life test and the Hospital Anxiety and Depression Scale. A total of 250 cognitively intact nursing-home patients who met the inclusion criteria were approached and 202 attended. Results The prevalence of symptoms was fairly high, with fatigue (57%), pain (49%), constipation (43%) and dyspnoea (41%) as the most frequent physical symptoms, while 30% were depressed and 12% had anxiety. Significant correlations between meaning-in-life and symptom severity were displayed. Conclusions The level of symptom severity among cognitively intact nursing-home patients is high, requiring highly competent staff nurses. Meaning-in-life might be an important resource in relation to a patient's physical and emotional health and global well-being. Relevance to clinical practice Facilitating patients' meaning-in-life might help reducing symptom severity and fostering quality of life in cognitively intact nursing-home patients. However, advancing staff nurses' competence in palliative care, symptom management and nurse-patient interaction is important for care quality and quality if life in nursing homes. [ABSTRACT FROM AUTHOR]

Aims and objectives To investigate the long-term effect of a nurse-led hospital-based patient education programme combining group and individual education for patients with chronic inflammatory polyarthritis. Background Patient education interventions have shown short-term effects, but few studies have investigated whether the effects are sustained for a longer period. Design Randomised controlled trial. Methods Patients with rheumatoid arthritis, psoriatic arthritis and unspecified polyarthritis were randomised to the intervention group ( n = 71) or a waiting list ( n = 70). Primary outcomes were as follows: Global Well-Being and the Arthritis Self-Efficacy Other Symptoms Subscale. Secondary outcomes were as follows: patient activation, physical and psychological health status, patients' educational needs and a Disease Activity Score ( DAS28-3). Results The intervention group had a statistically significant higher global well-being than the controls after 12 months, mean change score 8·2 (95% CI, 1·6-14·8; p-value = 0·015), but not in the Arthritis Self-Efficacy Other Symptoms Subscale, mean change score 2·6 (95% CI, −1·8 to 7·1; p-value = 0·245). Within each group, analyses showed a statistically significant improvement in DAS28-3, mean change -0·3 (95% CI, −0·5 to −0·1; p-value = 0·001), in the intervention group from baseline to 12 months, but not in the controls. The controls had a statistically significant deterioration in the Arthritis Self-Efficacy Other Symptoms Subscale, mean change −5·0 (95% CI, −8·6 to −1·3; p-value = 0·008), Arthritis Impact Measurement Scales - 2 Social, mean change 0·3 (95% CI, 0·1-0·5; p-value = 0·008), and Hospital Anxiety and Depression Scale total, mean change 1·4 (95% CI, 0·3-2·5; p-value = 0·013). Conclusion A combination of group and individual patient education has a long-term effect on patients' global well-being. Relevance to clinical practice Nurses should consider whether a combination of group and individual patient education for patients with chronic inflammatory polyarthritis is an alternative in their clinical practice. This combination is less time-consuming for the patients, and it includes the benefit of group learning in addition to focusing on patient's individual educational needs. [ABSTRACT FROM AUTHOR]

Aims and objectives To investigate (1) the extent to which shock anxiety and perceived support from healthcare professionals are related to post-traumatic stress disease ( PTSD) symptoms and (2) the extent to which perceived support from healthcare professionals moderates the relationship between shock anxiety and PTSD symptoms in implantable cardioverter defibrillator recipients. An additional aim was to describe the level of PTSD symptoms and perceptions of support from healthcare professionals. Background Studies examining PTSD symptoms among implantable cardioverter defibrillator recipients are still sparse. In addition, little is known about how perceived support from healthcare professionals is related to PTSD symptoms. Design Cross-sectional survey design. Methods Recipients ( n = 167) with implantable cardioverter defibrillator attending an outpatient device clinic completed questionnaires assessing shock anxiety, PTSD symptoms and perceived support from healthcare professionals. Results The results indicated that between ten and 15% of the recipients experienced moderate to severe symptoms of PTSD. Although a majority perceived constructive support from healthcare professionals, 12% perceived nonconstructive support. Regression analysis demonstrated that shock anxiety and perceived nonconstructive support from healthcare professionals had a statistically significant (p < 0·01) association with PTSD symptoms. Moreover, the results suggest that associations between shock anxiety and PTSD symptoms were significantly (p < 0·01) moderated by perceived nonconstructive support from healthcare professionals. Young age, short time since implantation and secondary prevention indication were also significantly associated with PTSD symptoms. Conclusions The results indicate that nonconstructive support from healthcare professionals can increase the tendency to develop PTSD symptoms, particularly in those who experience shock anxiety. Relevance to clinical practice Healthcare professionals should pay more attention to the way in which they communicate information to the recipients during follow-up visits. Clinically based strategies and interventions targeting shock anxiety and PTSD symptoms should be carried out. [ABSTRACT FROM AUTHOR]

Aims and objectives To develop, empirical test, and validate an instrument measuring patient participation in surgical treatment decision-making from healthcare professionals' perspective. Background Since the advent of New Public Management in many Western countries, patient participation in healthcare decision-making has been considered to be a best practice. A common notion is that well-educated and well-informed public want to choose their own treatments and providers and want to ask questions about the quality of their health services. Design Survey. Methods A self-report-measuring instrument was designed and administered to 620 healthcare professionals. Items were developed, validated and tested by 451 nurses and physicians working in six surgical wards in a University Hospital in Norway. Results A 16-item scale with the following four dimensions was developed: information dissemination, formulation of options, integration of information and control. Factor analysis procedures and reliability testing were performed. A one-way, between-groups analysis of variance was conducted to compare doctors' and nurses' opinions on four dimensions of patient participation in surgical treatment decision-making. Conclusions This article shows that patient participation in surgical treatment decision-making can be measured by a 16-item scale and four distinct dimensions. The analysis demonstrated a reasonable level of construct validity and reliability. Nurses and physicians have a positive attitude towards patient participation overall, but the two groups differ in the extent to which they accept the idea of patient participation in treatment decision-making. Relevance to clinical practice The instrument can be a tool for managers and healthcare professionals in the implementation of patient participation in clinical practice. Data from the instrument can be useful to identify health services being provided and what areas that could strengthen patient participation. [ABSTRACT FROM AUTHOR]

Aim To investigate the associations between nurse-patient interaction and meaning-in-life in a nursing home population. Background Meaning has been found to be a strong individual predictor of successful ageing and life satisfaction as well as an important psychological variable that promotes well-being. Meaning seems to serve as a mediating variable in both psychological and physical health. Connecting and communicating with others have been seen to facilitate meaning-in-life among older individuals. Design Cross-sectional descriptive study. Methods The data were collected in 2008-2009 using the Nurse-Patient Interaction Scale and the Purpose-in-Life test. A total of 250 cognitively intact nursing home patients met the inclusion criteria and 202 (81%) participated. A structural equation model of the hypothesized relationship between nurse-patient interaction and meaning was tested by means of LISREL 8.8. Findings The structural equation model fit well with the data. A significant direct relationship between nurse-patient interaction and meaning-in-life in cognitively intact nursing home patients was displayed. Conclusion Nurse-patient interaction significantly relates to meaning and purpose-in-life among cognitively intact nursing home patients and might be an important resource in relation to the patient's mental health and global well-being. High-quality nurse-patient interaction and in-house activities aiming to increase patients' meaning might increase psychological and physical health, well-being and psycho-spiritual functioning in this vulnerable population. [ABSTRACT FROM AUTHOR]

Aims and objectives. To evaluate physical functioning in a nurse-led integrated physiotherapy and Cognitive Behavioural Therapy (CBT) approach in treatment of people suffering from chronic pain. Background. Inter-professional working and physical activity supervision is described as important components of successful rehabilitation and is often included in approaches to chronic pain. Design. A quasi-experimental nonrandomised controlled design was used. Method. A consecutive sample of 117 outpatients from a rehabilitation unit at a university hospital was included in this intervention study. The effects of an 8-week multidisciplinary programme, including 6 and 12 month follow-up, was examined with measures including health-related quality of life (HRQL), pain perception, pain stages of change and physical functioning. To broaden our understanding qualitative data from three physiotherapists involved were collected. Results. Improvements in physical functioning status during the programme were positively related to improvements in stages of change, pain interference (PI) and severity (PS) and HRQL. Qualitative data support these findings. Conclusions. Findings suggest that our pain management intervention, that includes physical activity designed to help patients to live a healthier life, can have a clinically assessable impact on reducing PI and PS, improving physical functioning and HRQL. Relevance to clinical practice. Training in CBT approaches and inter-professional working in chronic pain may extend the skills of nurses and physiotherapists to improve physical functioning among a group of patients for whom traditional medicine has little to offer. [ABSTRACT FROM AUTHOR]

Aim and objectives. To measure health-related quality of life, anxiety and depression ahead of mammography screening and to assess any differences in health-related quality of life compared to reference population. Background. The study of health-related quality of life among attendees prior to mammography screening has received little attention, and increased knowledge is needed to better understand the overall health benefits of participation. Design. A two-group cross-sectional comparative study was performed. Methods. The samples comprised 4,249 attendees to mammography screening and a comparison group of 943 women. We used the SF-36 Health Survey to assess health-related quality of life. Linear regression was used to study any differences between the groups with adjustment for age, level of education, occupation, having children and smoking status. Other normative data were also used. Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale. Results. Attendees scored statistically significant higher on the SF-36 than the comparison group but were in line with normative data. Attendees had anxiety mean 4 ·1 and depression mean 2 ·6. Conclusions. The majority of the attendees have a high health-related quality of life, low anxiety and depression ahead of screening. Anxiety and depression were less than shown in normative data from Norway. Despite a high health-related quality of life, low anxiety and depression among the majority, healthcare workers should pay special attention to the few women who are anxious and depressed, and have a lower health-related quality of life. Omitted from mammography screening may be women who are unemployed, have lower socioeconomic status, are anxious and are depressed. Further research should be performed with non-attendees and subgroups to improve the screening programme. Relevance to clinical practice. It is important to identify which patients have the greatest need for support and caring in an organised mammography screening and who may be overlooked. [ABSTRACT FROM AUTHOR]

kouwenhoven s.e., kirkevold m., engedal k. & kim h.s. (2011) 'Living a life in shades of grey': experiencing depressive symptoms in the acute phase after stroke. Journal of Advanced Nursing 68(6), 1726-1737. Abstract Aim. The aim of the present study was to describe the lived experience of stroke survivors suffering from depressive symptoms in the acute phase; addressing the following questions: (a) what is the nature of depression as experienced by post-stroke patients in the acute phase? (b) what is it like to live with depression within the first weeks following stroke? Background. Post-stroke depression occurs in at least one quarter of stroke survivors and is linked to poorer outcomes. Method. This qualitative study is methodologically grounded in hermeneutic phenomenology, influenced by van Manen and Ricoeur. A descriptive, qualitative design was used applying in-depth interviews as the method of data collection with nine participants. The data collection took place in 2008. Results. The material revealed two main themes that generate the feeling and description of 'living a life in shades of grey': (a) being trapped and (b) losing oneself. 'Shades of grey' could be understood as being confined in a new life-world and losing oneself as the person one knew. Conclusion. The participants confirmed suffering from depressive symptoms, but depression was not seen as meaningful on its own. They related their experiences of post-stroke depression in the acute phase to the losses they experienced. Nurses ought to take into account the depth of the life changes that stroke survivors may experience. There is a need for continued empirical research on how nurses may help and support stroke survivors dealing with depressive symptoms in the acute phase after stroke and how depressive symptoms develop over time. [ABSTRACT FROM AUTHOR]

dysvik e., kvaløy j.t. & natvig g.k. (2011) The effectiveness of an improved multidisciplinary pain management programme: a 6- and 12-month follow-up study. Journal of Advanced Nursing 68(5), 1061-1072. Abstract Aim. This article is a report of a Norwegian-revised study on the effectiveness of a follow-up multidisciplinary management programme for chronic pain to investigate the change processes associated with treatment. Background. Substantial evidence supports the use of Cognitive Behavioural Therapy approaches to chronic pain. As relapse is often reported, follow-up sessions should be included. Methods. A follow-up quasi-experimental design was performed, and a previous control group was used. The study initially included 117 participants, and 104 of the sample completed the 6- and 12-month follow-up programme. The 6-month follow-up consisted of therapeutic dialogue and education combined with physical activity. At the 12-month follow-up, a telephonic consultation was conducted. The data collection period was between September 2006 and January 2008. The statistical and clinical significance were considered. Results. Findings suggest that this follow-up programme can potentially maintain the positive results of the basic programme in terms of reduced pain perception, improved health-related quality of life, and movement towards self-management. Conclusion. These results are consistent with the ultimate goal of Cognitive Behavioural Therapy approaches, which is to help patients with chronic pain to cope more effectively and to improve their health-related quality of life and functioning. To maintain treatment improvements and advance nursing, there is a clear need for research that tests the efficacy of follow-up interventions that are designed to prevent drop out and relapse. [ABSTRACT FROM AUTHOR]