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Aims: To describe nursing students' experiences of a TeamSTEPPS® longitudinal team training program and the application of teamwork skills in clinical practice. Design: A descriptive qualitative design. Methods: Overall, 22 nursing students participated in six online focus group interviews after attending a TeamSTEPPS® team training program from their first semester. The data were audio‐recorded, transcribed and analysed using inductive content analysis and reported following the COREQ guidelines. The focus group interviews took place in the students' fifth's semester. Results: The main category "Learning teamwork is not an event; it's a journey" emerged from 3 generic categories and 12 subcategories. The participants reported that grasping the relevance of team training and the use of teamwork skills takes time. Utilizing these skills improved their awareness of being a team member and facilitated learning. Conclusion: Team training raised the participants' awareness of teamwork as an essential component of being a professional nurse. Additionally, understanding the complexity of teamwork takes time. [ABSTRACT FROM AUTHOR]

The aim of this study was to describe experiences of everyday life as a relative of a person diagnosed with depression. A qualitative and descriptive design with a phenomenographic approach was chosen, and individual interviews with 24 relatives were carried out. Approval was given by the Regional Committee for Medical and Health Research Ethics, Norway (South East) ref 2010/126. The findings show the main category 'Living on the other person's terms', which may be expressed in terms of consideration for the next of kin, thus presenting a challenge and a need to be balanced against taking care of oneself. In addition, three descriptive categories emerged: 'Ambivalent relationship', 'Adjusting daily life' and 'Managing the situation'. In conclusion, the relatives of persons with depression may be in danger of developing their own health problems and in need for attention from health personnel. [ABSTRACT FROM AUTHOR]

Attention-deficit/hyperactivity disorder is one of the most common behavioural disorders diagnosed in children. Children who have this disorder have difficulties regarding regulation of their emotions, maintaining attention and impulse control. Parents may need guidance in creating structure and predictable boundaries. One of the personnel who meet these families is the public health nurse. The aim of this study was to explore the public health nurses role in relation to these families. A qualitative explorative design with a phenomenographic approach was used. Interviews were performed with 19 nurses, six in group and one individual. In the data analyses, three descriptive categories emerged: 'supporting the family-unit', which describes the nurses supervising the parents and the child in everyday challenges; 'understanding the child', which describes how the public health nurses use professional competence and choose the time and arena to observe the child and; 'collaborating multidisciplinary', which describes how the public health nurses define their own role and conceive their collaboration with other professionals. The public health nurse ( PHN)'s support for the parents and the entire family is important, and the PHN is the first encounter and trustful follower throughout the course of diagnosis and care. [ABSTRACT FROM AUTHOR]

ABSTRACT Aim To implement a simulation-based team training programme and to investigate intensive care nurses' evaluations of simulation used for team training. Background Simulation-based training is recommended to make health care professionals aware of and understand the importance of teamwork related to patient safety. Design The study was based on a questionnaire evaluation design. Methods A total of 63 registered nurses were recruited: 53 from seven intensive care units in four hospitals in one hospital trust and 10 from an intensive care postgraduate education programme. After conducting a simulation-based team training programme with two scenarios related to emergency situations in the intensive care, the participants evaluated each simulation activity with regard to: (i) outcome of satisfaction and self-confidence in learning, (ii) implementation of educational practice and (iii) simulation design/development. Result Intensive care nurses were highly satisfied with their simulation-based learning, and they were mostly in agreement with the statements about self-confidence in learning. They were generally positive in their evaluation of the implementation of the educational practice and the simulation design/development. Significant differences were found with regard to scenario roles, prior simulation experience and area of intensive care practice. Conclusion The study indicates a positive reception of a simulation-based programme with regard to team training in emergency situations in an intensive care unit. Relevance to clinical practice The findings may motivate and facilitate the use of simulation for team training to promote patient safety in intensive care and provide educators with support to develop and improve simulation-based training programmes. [ABSTRACT FROM AUTHOR]

Background: Chronic pain has an impact on the physical and social functioning of older people which in turn may worsen their health-related quality of life. Research with focus on prolonged extensive pain in the most elderly and how pain may interfere with their life situation is scarce. Aims: The aims were to describe and investigate pain from a multidimensional point of view (duration, location, psycho-social) and health-related quality of life as well as to compare sex and age groups in people aged 80 years and over. Methods: In this cross-sectional study, a total of 225 of 282 people responded to a questionnaire consisting of two instruments and background questions. The psycho-social dimension of pain was measured using the Multidimensional Pain Inventory-Swedish language version (MPI-S) with five scales: Pain Severity, Interference, Life Control, Affective Distress and Social Support. Health-related quality of life was measured using the Short Form Health Survey-12 (SF-12). Results: Median duration of pain was 9.0 years, and the mean number of pain locations was 2.04. The MPI-S scale Interference with a negative orientation had the highest mean score, while the mean score for Social Support was the highest for the scales with a positive orientation. The duration of pain was significantly greater for women, and those aged 80-85 years had higher pain severity than those aged ≥86. Participants with a lower health-related quality of life experienced significantly more severe pain, were more troubled with pain and had less control of their life. Conclusions: Older people with prolonged pain suffered from a low health-related quality of life. Pain interfered with their lives and contributed to diminished control in their daily lives. Nurses are essential for the identification and prevention of pain and should be aware of how pain affects older people's physical, mental and social health. [ABSTRACT FROM AUTHOR]

Scand J Caring Sci; 2013; 27; 99-107 Life-sharing experiences of relatives of persons with severe mental illness - a phenomenographic study Relatives of those suffering from severe mental illness experience multiple challenges and a complex life situation. The aim of this study was to describe life-sharing experiences from the perspective of relatives of someone with severe mental illness. A qualitative, descriptive study was performed, and interviews were carried out with eighteen relatives of persons with severe mental illness. A phenomenographic analysis, according to the steps described by Dahlgren and Fallsberg, was used to describe the relatives' conceptions of their situation. The findings show that the experiences of these relatives can be summarized in one main category: 'The art of balancing between multiple concerns'. Two descriptive categories emerged: 'Making choices on behalf of others and oneself' and 'Constantly struggling between opposing feelings and between reflections'. Relatives report that they have to manoeuvre between different ways to act and to prioritize between different wishes and needs. In addition, they face a wide range of strong feelings and they search for hope and meaning. Relatives of someone with severe mental illness have to balance multiple concerns, which induce ethical dilemmas. They felt love, compassion or sense of duty towards the mentally ill person. The changeable situation made it difficult for the relatives to establish a balance in their lives. To be able to prioritize some private time was important. Relatives need own support and sufficient follow-up of the mentally ill next of kin from the mental health services. [ABSTRACT FROM AUTHOR]

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

Aims. To study, within municipal care and county council care, (1) chief nurses’ and registered nurses’ perceptions of patient nutritional status assessment and nutritional assessment/screening tools, (2) registered nurses’ perceptions of documentation in relation to nutrition and advantages and disadvantages with a documentation model. Background. Chief nurses and registered nurses have a responsibility to identify malnourished patients and those at risk of malnutrition. Design and methods. In this descriptive study, 15 chief nurses in municipal care and 27 chief nurses in county council care were interviewed by telephone via a semi-structured interview guide. One hundred and thirty-one registered nurses (response rate 72%) from 14 municipalities and 28 hospital wards responded to the questionnaire, all in one county. Results. According to the majority of chief nurses and registered nurses, only certain patients were assessed, on admission and/or during the stay. Nutritional assessment/screening tools and nutritional guidelines were seldom used. Most of the registered nurses documented nausea/vomiting, ability to eat and drink, diarrhoea and difficulties in chewing and swallowing, while energy intake and body mass index were rarely documented. However, the majority documented their judgement about the patient's nutritional condition. The registered nurses perceived the VIPS model (Swedish nursing documentation model) as a guideline as well as a model obstructing the information exchange. Differences were found between nurses (chief nurses/registered nurses) in municipal care and county council care, but not between registered nurses and their chief nurses. Conclusions. All patients are not nutritionally assessed and important nutritional parameters are not documented. Nutritionally compromised patients may remain unidentified and not properly cared for. Relevance to clinical practice. Assessment and documentation of the patients’ nutritional status should be routinely performed in a more structured way in both municipal care and county council care. There is a need for increased nutritional nursing knowledge. [ABSTRACT FROM AUTHOR]

sandin bojö a.-k. ‘fia’, hall-lord m.-l., axelsson o., udén g. & wilde larsson B.(2004) Journal of Clinical Nursing 13, 75–83 Midwifery care: development of an instrument to measure quality based on the World Health Organization's classification of care in normal birth The aim of the study was to develop an instrument to measure midwifery care in relation to World Health Organization's classification of care in normal birth and to test the instrument for content validity and inter-rater reliability. The Delphi method was used for development of the instrument and to elicit evidence of content validity. Six experts from three different geographical regions in Sweden, representing clinically working midwives, lecturers in midwifery and obstetricians, participated in the first part of the study. The instrument was tested for inter-rater reliability in an exploratory study by two midwives and one of the authors. Data were analysed using percentage of agreement level and the Kappa coefficient. Five expert rounds were needed to reach consensus for content validity. The inter-rater reliability test showed high agreement levels (95.9, 94.2 and 95.7%) and good to very good Kappa coefficients (0.74–1.0). The final instrument consisted of 78 items divided into five sections: background (five items); practices which are demonstrably useful and should be encouraged (55 items); practices which are clearly harmful or ineffective and should be eliminated (five items); practices for which insufficient evidence exists to support a clear recommendation and which should be used with caution while further research clarifies the issue (four items); and finally practices which are frequently used inappropriately (nine items). The instrument can be used at a labour ward to measure documented care and quality of midwifery care. The results can be used to identify areas for improvements, to develop guidelines towards evidence-based care and to improve documentation. However, the present study should be regarded as an exploratory study and the feasibility of the instrument remains to be tested in empirical studies. [ABSTRACT FROM AUTHOR]

Chronic pain represents a major health problem among older people. The aims of the present study were to: (i) identify various profiles of pain and distress experiences among older patients; and (ii) compare whether background variables, sense of coherence, functional ability and experiences of interventions aimed at reducing pain and distress varied among the patient profiles. Interviews were carried out with 42 older patients. A cluster analysis yielded three clusters, each representing a different profile of patients. Case illustrations are provided for each profile. There were no differences between the clusters, regarding intensity and duration of pain. One profile, with subjects of advanced age, showed a decreased functional ability and favourable scores in most of the categories of pain and distress. Another profile of patients showed favourable mean scores in all categories. The third cluster of patients showed unfavourable scores in most categories of pain and distress. There appears to be a need to treat the three groups of patients in different ways in the caring situation. [ABSTRACT FROM AUTHOR]