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Aims and objectives: The purpose of this study was to examine the extent to which staffing adequacy predicts nursing teamwork, controlling for demographic and background variables. Background: Findings from former studies indicate that hospital, unit and staff characteristics may be related to nursing teamwork, such as type of hospital and unit, role, gender, age, work experience, type of shift worked, shift length, number of working hours per week, overtime and staffing adequacy. Teamwork as well as staffing is identified as significant contributors to patient and staff safety in hospitals. However, the contribution of staffing to the quality of nursing teamwork is scarcely studied. Design: This was a quantitative descriptive cross‐sectional study using the paper‐and‐pencil questionnaire Nursing Teamwork Survey‐Icelandic. Methods: The study was conducted in 27 inpatient units in eight hospitals in Iceland with a sample of 925 nursing staff members. Participants were 567 registered nurses, practical nurses, unit secretaries and nurse unit managers. The Strengthening the Reporting of Observational Studies in Epidemiology checklist was used for this paper. Results: When controlling for unit type, role, experience on current unit and intent to leave, perceived adequacy of staffing alone explains up to 10% of overall teamwork. Unit type, role, years of experience on current unit and perceived staffing adequacy correlated significantly with overall teamwork. Conclusions: The findings of this study indicate that unit and staff characteristics, including perceived adequacy of staffing, are associated with and explain the variability in nursing teamwork on inpatient hospital units. The findings of this study provide important information for clinical nurses, nurse managers, policymakers and instructors in health care. Relevance to clinical practice: The findings underline the importance of adequate staffing for nursing teamwork in inpatient hospital units. [ABSTRACT FROM AUTHOR]

Accessible summary What is known on the subject? Caregivers of adolescents with ADHD experience major difficulties as care providers and are in need of guidance and support., Adolescents with ADHD may develop oppositional and criminal behaviour. More than 50 % have the symptoms in adulthood, and up to one-fourth with severe emotional or antisocial difficulties., There is a lack of evidence of caregivers′ supporting intervention although caregiver groups have been found to contribute to better coping, decreased stress and improvements in ADHD symptoms., What does this paper add to existing knowledge? Primary caregivers of adolescents with ADHD experienced better quality of life after the Therapeutic Conversation Intervention., The intervention contributed to better social functioning among secondary caregivers., What are the implications for practice? The content of the Therapeutic Conversation Intervention is significant and highlights the utility of a combination of group and private sessions for caregivers of people with ADHD., The intervention can influence how services for families are organized, such that a Therapeutic Conversation Intervention could be offered on a regular basis., Abstract Introduction Caregivers of adolescents with Attention Deficit Hyperactivity Disorder are burdened with tasks and many suffer from distress. Adolescents with ADHD may develop antisocial behaviour and caregiver′s group can empower caregiver's supporting role. Aim/Question To evaluate the effectiveness of a Therapeutic Conversation Intervention on caregivers of adolescents with ADHD regarding strengthening the supportive role. Method The study utilized a quasi-experimental design. The participants ( n = 60) were caregivers of adolescents (13-17 years old) with ADHD. The intervention consisted in-group and parent sessions. The Calgary Family Model and the Family Illness Beliefs Model were used as theoretical frameworks. Results The study revealed significant differences in the improvement of quality of life; regarding primary caregiver ( PC) worry, daily activities, family relationships and collaboration post-intervention, as well emotional functioning at both post-intervention and follow-up. Secondary caregiver ( SC) social functioning was significantly improved at follow-up. Discussion The intervention proved to be beneficial to the caregivers and is filling a gap in much needed intervention. Implication for practice The results will expand health care professionals' knowledge of how to increase PC quality of life when supporting their adolescent with ADHD. This treatment information should improve service at health care centres/hospitals where adolescents with ADHD receive care. [ABSTRACT FROM AUTHOR]

The primary purpose of this exploratory, cross-sectional study was to determine the degree of agreement between parents' and adolescents' rating of adolescents' asthma-related quality of life (QOL). A secondary aim was to compare the degree of agreement between parent-adolescent dyads in two countries; 15 dyads each were recruited from Kentucky and Iceland. Both adolescent and adult participants completed separate paper surveys at the time of the adolescent's clinic appointment. The QOL instrument used (PedsQLTM 3.0 Asthma Module) contains the subscales of asthma symptoms, asthma treatment, worry, and communication. Parent-adolescent differences were determined using paired t-tests; associations were assessed with intraclass correlation coefficients (ICCs). Twosample t-tests investigated between-country differences in parent-child consistency in the assessment of the adolescent's asthma-related QOL. Adolescents rated their QOL higher than their parents did, but not significantly. The ICC of the QOL score for the 30 dyads was 0.39. The degree of agreement was high for asthma symptoms, but low for asthma treatment, worry, and communication. U.S. parents tended to underrate their child's QOL, while parents from Iceland overrated it (p = 0.007). Family-centered interventions may improve parents' understanding of how asthma affects QOL in adolescents, and such interventions may have to be tailored for cultural differences. [ABSTRACT FROM AUTHOR]

Background Since the implementation of the Icelandic Model for Primary Prevention of Substance Use in Iceland (IPM), substance use has decreased steadily among 14–16-year-old adolescents and primary prevention factors have improved. Although the IPM is being implemented in several other regions around the world, information documenting its effectiveness in other country contexts is lacking. This study assessed trends in substance use and primary prevention variables in three cities in Lithuania following the implementation of the IPM. Methods Data collected from repeated, comparative cross-sectional self-report surveys conducted among a total of 30 572 10th graders in the cities of Kaunas, Klaipeda and Vilnius, Lithuania, from 2006 to 2019, were analyzed. Cochran–Armitage test for linear trend and analysis of variance for linear trend was used to assess time-trends in prevalence of substance use and mean levels of primary prevention variables over time. Results Following the implementation of IPM rates of cigarette smoking and the use of alcohol, cannabis and amphetamine has decreased among 10th graders in Lithuania's three largest cities and simultaneously preventive variables targeted have improved. Similar to Iceland, primary prevention variables were related to substance use in the expected direction, with the exception of organized sports participation, which was not associated with less likelihood of alcohol, cannabis and amphetamine use. Conclusion Trends in substance use and primary prevention variables following the implementation of the IPM are similar in the three cities in Lithuania as in Iceland. Further research is needed to better understand the mechanisms underlying these trends. [ABSTRACT FROM AUTHOR]

Background The health, social and economic consequences of the severe acute respiratory syndrome coronavirus (SARS-CoV-2, henceforth COVID-19) pandemic have loomed large as every national government made decisions about how to respond. The 40 Health Systems, COVID-19 (40HS, C-19) study aimed to investigate relationships between governments' capacity to respond (CTR), their response stringency, scope of COVID-19 testing and COVID-19 outcomes. Methods Data over March and April 2020 were extracted for 40 national health systems on prepandemic government CTR (Global Competitiveness Index), stringency measures (Oxford COVID-19 Government Response Tracker Stringency Index), approach to COVID-19 testing and COVID-19 cases and deaths (Our-World-in-Data). Multidimensional scaling (MDS) and cluster analysis were applied to examine latent dimensions and visualize country similarities and dissimilarities. Outcomes were tested using multivariate and one-way analyses of variances and Kruskal–Wallis H tests. Results The MDS model found three dimensions explaining 91% of the variance and cluster analysis identified five national groupings. There was no association between national governments' prepandemic CTR and the adoption of early stringent public health measures or approach to COVID-19 testing. Two national clusters applied early stringency measures and reported significantly lower cumulative deaths. The best performing national cluster (comprising Australia, South Korea, Iceland and Taiwan) adopted relatively early stringency measures but broader testing earlier than others, which was associated with a change in disease trajectory and the lowest COVID-19 death rates. Two clusters (one with high CTR and one low) both adopted late stringency measures and narrow testing and performed least well in COVID-19 outcomes. Conclusion Early stringency measures and intrinsic national capacities to deal with a pandemic are insufficient. Extended stringency measures, important in the short term, are not economically sustainable. Broad-based testing is key to managing COVID-19. [ABSTRACT FROM AUTHOR]

This study sought to address the need for systematic, quantitative cross-cultural comparisons to extend our knowledge of the interplay between cultural backgrounds and human behaviors. Specifically, in this study, we compared young adult Danish, Icelandic, Polish, and American grandchildren's reports of received affection from their grandparents. The participants (N = 606) completed the Grandchildren's Received Affection Scale. Results of a multivariate analysis of variance (MANOVA) revealed significant cultural differences in grandchildren's reports of received affection from their grandparents. Thus, this study extends our understanding of how communicative behaviors differ across cultures; it is also indicative of practical, methodological, and empirical implications. [ABSTRACT FROM AUTHOR]

Aims and objectives To identify the contribution of hospital, unit, staff characteristics, staffing adequacy and teamwork to missed nursing care in Iceland hospitals. Background A recently identified quality indicator for nursing care and patient safety is missed nursing care defined as any standard, required nursing care omitted or significantly delayed, indicating an error of omission. Former studies point to contributing factors to missed nursing care regarding hospital, unit and staff characteristics, perceptions of staffing adequacy as well as nursing teamwork, displayed in the Missed Nursing Care Model. Design This was a quantitative cross-sectional survey study. Methods The samples were all registered nurses and practical nurses (n = 864) working on 27 medical, surgical and intensive care inpatient units in eight hospitals throughout Iceland. Response rate was 69·3%. Data were collected in March-April 2012 using the combined MISSCARE Survey-Icelandic and the Nursing Teamwork Survey-Icelandic. Descriptive, correlational and regression statistics were used for data analysis. Results Missed nursing care was significantly related to hospital and unit type, participants' age and role and their perception of adequate staffing and level of teamwork. The multiple regression testing of Model 1 indicated unit type, role, age and staffing adequacy to predict 16% of the variance in missed nursing care. Controlling for unit type, role, age and perceptions of staffing adequacy, the multiple regression testing of Model 2 showed that nursing teamwork predicted an additional 14% of the variance in missed nursing care. Conclusions The results shed light on the correlates and predictors of missed nursing care in hospitals. This study gives direction as to the development of strategies for decreasing missed nursing care, including ensuring appropriate staffing levels and enhanced teamwork. Relevance to clinical practice By identifying contributing factors to missed nursing care, appropriate interventions can be developed and tested. [ABSTRACT FROM AUTHOR]

The purpose of the study was to examine received and expected knowledge of patients with knee/hip arthroplasty in seven European countries. The goal was to obtain information for developing empowering patient education. The data were collected (during 2009-2012) from patients (n = 943) with hip/knee arthroplasty prior to scheduled preoperative education and before discharge with the Received Knowledge of hospital patient scale (RKhp) and Expected Knowledge of hospital patient scale (EKhp). Patients’ knowledge expectations were high but the level of received knowledge did not correspond to expectations. The difference between received and expected knowledge was higher in Greece and Sweden compared with Finland (p < .0001, p < .0001), Spain (p < .0001, p = .001), and Lithuania (p = .005, p = .003), respectively. Patients’ knowledge expectations are important in tailoring patient education. To achieve high standards in the future, scientific research collaboration on empowering patient education is needed between European countries. [ABSTRACT FROM AUTHOR]

Ageing population entails a growing international problem of osteoarthritis. Best practices for education of these patients are lacking. This study focused on empowering education in Northern ( Finland, Iceland, Lithuania and Sweden) and Southern Europe ( Cyprus, Greece and Spain). The aim was to analyse associations between expected knowledge and background factors. The data were collected from European arthroplasty patients with the Knowledge Expectations of hospital patients- scale, (KEhp- scale), including bio-physiological, functional, experiential, ethical, social and financial dimensions. Patients had essential bio-physiological and functional knowledge expectations. Women expected more than men, employed less than retired, unemployed or who worked at home. Generally, patients in Northern countries expected more than in Southern countries. However, highest expectations were found in Sweden and Greece, lowest in Spain and Cyprus. There are differences in knowledge expectations based on patients' backgrounds. Development of common standards in European patient education needs further research. [ABSTRACT FROM AUTHOR]

This article describes psychometric testing of an Icelandic adaptation of the Adult Reading History Questionnaire (ARHQ), designed to detect a history of reading difficulties indicative of dyslexia. Tested in a large and diverse sample of 2,187 adults, the Icelandic adaptation demonstrated internal consistency reliability (Cronbach’s alpha = .92) and test–retest reliability (r = .93). Validity was established by comparing scores of adults who as children received ICD-10 diagnoses of specific reading disorder (F81.0; n = 419) to those of adults defined as nondyslexics (n = 679). ROC curve analysis resulted in an area under the curve of .92 (95% CI = .90, .93, p < .001) and a cutoff score of .43 with sensitivity of 84.5% and specificity of 83.7%. An exploratory factor analysis (n = 2,187) suggested three subscales, Dyslexia Symptoms, Current Reading, and Memory, the mean scores of which differed significantly among diagnosed dyslexics, relatives of dyslexics, and population controls. Our results support the applicability of the ARHQ in Icelandic as a self-report screening tool for adult dyslexia in Iceland. [ABSTRACT FROM PUBLISHER]

Aims and objectives To describe the possible differences between knowledge expectations and received knowledge of patients undergoing elective knee arthroplasty in Iceland, Sweden and Finland and also to determine the relationship between such a difference and both background factors and patient satisfaction with care. Background Knee arthroplasty is a fast-growing and a successful treatment for patients with osteoarthritis. Patient education can improve surgery outcomes, but it remains unknown what knowledge patients expect to receive and actually acquire during the perioperative period and what factors are related to that experience. Design Descriptive, prospective survey. Methods In total, 290 patients answered questionnaires about their expectations (Knowledge Expectations of hospital patients - scale) before surgery and about received knowledge (Received Knowledge of hospital patients - scale) and satisfaction with hospital care (Patient Satisfaction Scale) at discharge. Sociodemographics, clinical information, accessibility to knowledge from healthcare providers (Access to Knowledge Scale), and preferences for information and behavioural control (Krantz Health Opinion Survey) were collected as background data. Results Patients' knowledge expectations were higher (mean 3·6, SD 0·4) than their perception of received knowledge (mean 3·0, SD 0·7). Multiple linear regression analysis showed that access to knowledge, information preferences and work experience within health- or social care explained 33% ( R²) of the variation in the difference between received and expected knowledge. Patients reported high satisfaction with their care except regarding how their family was involved. Conclusion Patients undergoing knee arthroplasty receive less knowledge than they expect, and individual factors and communication with healthcare providers during hospitalisation are related to their experience. The content of patient education and family involvement should be considered in future care. Relevance to clinical practice The results strengthen the knowledge base on the educational needs of knee arthroplasty patients and can be used to develop and test new interventions. [ABSTRACT FROM AUTHOR]

Accessible summary The purpose of this research was to assess psychological distress among university female students and identify their mental health service needs., Rates of elevated symptoms of depression and anxiety among university women students was 22.5% and 21.2%, respectively, which is similar to women of the same age in the general population. The mean level of depressive symptoms was however lower among the female students., Results showed that little less than one-third of psychologically distressed women students had received professional help, and only 1.4% had received mental health counselling from nurses., Most of the distressed female students experienced mild to moderate levels of depressive and anxiety symptoms, which indicates a need for prevention or early intervention measures., This need is a challenge for nurses working in the primary care sector, including the educational system. They are in a unique position to screen for psychological distress and provide or initiate preventive services or early interventions, including outreach programmes within schools where most young people are reachable., Abstract Psychological distress among university students, especially young women, is of increasing concern. This study focuses on the prevalence of psychological distress among female university students and their need for mental health services. The analysis is based on two cross-sectional surveys, an internet survey among women students attending the University of Iceland in the spring of 2007, and a postal survey of Icelandic female adults conducted in the Fall of 2006. Psychological distress was measured with the Symptom Checklist-90 Depression and Anxiety subscales. The prevalence of above-threshold depression and anxiety among the university women students was 22.5% and 21.2% respectively. Results showed that the mean depression score was significantly lower among the students than among women of the same age in the general population. However, little less than one-third of students with elevated distress levels received any professional help. Only 1.4% of the distressed students received mental help care from nurses. The high proportion of distressed female students not receiving professional help is a challenge to the primary health-care system and the nursing profession. This also raises questions about the adequacy of the current system of health-care delivery and the potential advantages of on-campus health services, in closer proximity to the students. [ABSTRACT FROM AUTHOR]

Aims and objectives To measure the benefit of a short-family therapeutic conversation ( STC) intervention in an acute paediatric unit. Background Studies of children with bronchiolitis caused by respiratory syncytial virus ( RSV) have shown that this virus may have an impact on their respiratory system in the form of a wheezing disorder, asthma and even allergy during their childhood. Studies of the parents of these children indicate that they experience distress, vulnerability and anxiety through the illness period and therefore need support from healthcare professionals. However, little is known about what intervention is of most benefit for these parents. Design Quasi-experimental. Method Data were collected from a convenience sample from February throughout April 2009 at an acute unit at a children's hospital in Iceland. Parents of infants diagnosed with bronchiolitis caused by RSV were invited to attend. In total, there are 41 participants: 21 in the intervention group ( n = 21) and 20 in the control group ( n = 20). Parents in both groups answered questionnaires about perceived support and family expressive functioning both before the intervention and on an average of 11 days after the intervention. Results The main findings showed that mothers in the intervention group perceive significantly higher support after the intervention compared with the control group. The findings also showed a significant difference between the genders (mothers and fathers) in the intervention group. The mothers perceived higher cognitive support than the fathers. Conclusions Despite the often chaotic environment in an acute care setting, the research findings give paediatric nurses reason to conclude that a STC intervention benefits mothers of infants with bronchiolitis caused by RSV. Relevance to clinical practice A STC intervention offered by a nurse within an acute paediatric unit can support families in handling the illness experience. [ABSTRACT FROM AUTHOR]

Primary objectives: To assess long-term effects of early traumatic brain injury (TBI) on mental health, cognition, behaviour and adjustment and to identify prognostic factors. Methods and procedures: A 1-year nationwide cohort of all 0-19 year old Icelandic children and adolescents diagnosed with TBI in 1992-1993 ( n = 550) received a questionnaire with clinical outcome scales and questions on TBI and socio-economic status (SES) by mail ∼16 years post-injury. A control group ( n = 1232), newly selected from the National Registry, received the same questionnaire. Non-respondents answered a shorter version by telephone. Overall participation was 67%. Main outcomes and results: Medically confirmed and self-reported TBI was reflected in worse outcome. Force of impact, number and severity of TBIs predicted poorer results. Parental SES and demographic factors had limited effects. Not reporting early, medically confirmed TBI did not exclude cognitive sequelae. In self-reported disability, absence of evaluation for compensation was not linked to outcome. Conclusions: Clinical outcome was consistent with late complaints attributed to early TBI. TBI-related variables had greater prognostic value than other factors. Self-reporting of TBI sustained very early in life needs supplementary information from parents and medical records. More consistency in compensation evaluations following paediatric TBI is indicated. [ABSTRACT FROM AUTHOR]

Purpose: Studies on iron status in infancy and early childhood have shown contradicting results concerning prolonged breast-feeding and cow's milk intake. The aim of the present study was to investigate associations between iron status among one-year-olds and feeding, with focus on the type of milk. Methods: Randomly selected healthy infants were prospectively investigated until 1 year of age in two cohorts born 1995-1996 ( n = 114) and 2005 ( n = 140). Information on birth data, feeding and growth until 12 months and iron status at 12 months was collected. Data from the two cohorts were pooled and the infants categorized into three groups according to their predominant milk consumption at 9 months of age, that is, breast milk, cow's milk or follow-on formula. Results: The prevalence of iron deficiency was highest in the cow's milk group and lowest in the follow-on formula group. According to a linear model, adjusted for gender, birth weight and exclusive breast-feeding duration, cow's milk consumption was negatively associated with serum ferritin (SF) and formula positively, but breast milk not. Predicted SF (μg/l) = 11.652(intercept) − 5.362(boy) + 0.005 × birth weight (g) + 2.826(exclusively breastfed ≥ 4 months) + 0.027 × formula (ml) − 0.022 × cow's milk (ml) + 0.005 × breast milk (ml). Correction for other dietary factors did not change these results. Conclusion: In this pooled analysis, cow's milk intake in late infancy associated negatively, and follow-on formula positively, with iron status. Prolonged partial breast-feeding does not seem to be of importance for iron status. Fortified food seems to improve iron status in late infancy. [ABSTRACT FROM AUTHOR]

A study of a brief cognitive behavioral group therapy intervention for psychologically distressed Icelandic female university students was conducted using a pre-post test quasi-experimental design with intervention and control group conditions. Students were randomly allocated to control and intervention group conditions ( n = 30). The intervention group received four sessions of cognitive behavioral group therapy, delivered by two advanced practice psychiatric nurses. Assessment of distress included self-reported depression and anxiety symptoms. Students in the intervention group experienced significantly lower levels of depression and anxiety symptoms compared to the control group post-test providing preliminary evidence concerning intervention effectiveness for Icelandic students. [ABSTRACT FROM AUTHOR]

Thome M. & Arnardottir S.B. (2013) Evaluation of a family nursing intervention for distressed pregnant women and their partners: a single group before and after study. Journal of Advanced Nursing 69(4), 805-816. doi: 10.1111/j.1365-2648.2012.06063.x Abstract Aim. To report a study of the effects of an antenatal family nursing intervention for emotionally distressed women and their partners. Background. High levels of depressive symptoms and anxiety are common in pregnant women, and their partners are likely to suffer from a higher degree of these symptoms than those of non-distressed women. Maternal anxiety and depressive symptoms influence the development of the foetus and child negatively. Distress-reducing interventions for couples are scarce. Design. The design was a pre- and post-test single group quasi-experiment. Methods. All women distressed during the last two trimesters of pregnancy were referred by midwives to a family nursing home-visiting service in a primary care setting in Iceland. They were invited to participate in the study from November 2007-September 2009. The final sample was 39 couples. Assessment of distress was through self-reporting of depressive symptoms and anxiety, self-esteem, and dyadic adjustment. The couple received four home visits that were guided by the Calgary Family Nursing Model. Results. Women experienced a higher degree of distress than men before the intervention. Couple's distress was interrelated, and improvement was significant on all indicators after the intervention. Conclusion. Healthcare professionals who care for distressed expectant women should attend to their partners' mental health status. The Calgary Family Nursing Model is an appropriate guide for nursing care of distressed prospective couples in a primary care setting. [ABSTRACT FROM AUTHOR]

Background: The risk factors for febrile, respiratory, and gastrointestinal illnesses in preschool children at day care centres have not been adequately identified and may differ between countries. Methods: In this repeated cross-sectional and longitudinal study of children at day care centres, we analyzed various potential risk factors for infectious illnesses using a mixed effect hierarchical Poisson regression model. The results of the analyses and the incidence rates of these illnesses are reported herein. Results: The study lasted 2.5 y (2000-2003) and was divided into five 6-month periods (seasons). Nine hundred and seventeen children participated, and their mean age within each season was 3.6-4.1 y. The only consistent risk factors identified were young age and winter season. No consistent risk factors at the day care centres (facilities or hygiene practices) were identified. The incidences of the febrile, respiratory, and gastrointestinal illnesses varied significantly between seasons (winter/summer) and between age groups. Conclusions: Risk factors of infectious illnesses are difficult to identify and because they may vary between countries, international recommendations on expensive intervention strategies are not justifiable. Rates of respiratory illnesses in Icelandic preschool children appear higher than in other countries, but rates of gastrointestinal illnesses lower. [ABSTRACT FROM AUTHOR]

Early identification of prodromal signs of acute deterioration of patients is essential in high quality care. Rigorous monitoring of patients is facilitated by risk assessment tools, e.g. the Modified Early Warning Score (MEWS). The purpose of the study was to estimate the accuracy of nursing documentation according to parameters that comprise MEWS in patients prior to emergency admission to the intensive care unit (ICU). The research design was retrospective and descriptive. Data was collected from medical records of in-patients who presented as emergency admission to two ICUs at a university hospital between 1 October and 31 December 2006. Data was collected from 65 patients' records over the 3-month period. Most admissions occurred between the hours of 8 a.m. and 4 p.m. Respiratory failure was the primary reason for admission, followed by septic shock. Respiratory rate was documented for 14% of patients ( n = 9) prior to ICU admission, which was the least documented observation. Urine output and fluid balance were documented for 40% of the patients, level of consciousness in 48% of patients ( n = 31), temperature for 69% ( n = 45) and oxygen saturation for 80% of the patients ( n = 53). Respiratory failure was the primary cause of emergency admission of in-patients to the ICUs with respiratory rate the least documented vital sign. Nursing documentation according to the MEWS was insufficient. Nurses need to be alerted to the necessity of documenting early signs of deterioration of patients, particularly the respiratory rate. With better monitoring and documentation of physiological parameters, emergency admission to the ICU might be avoided. [ABSTRACT FROM AUTHOR]

Evaluate the usefulness of the role of clinical nurse specialists and the content of their work by mapping their activities. The clinical work of advanced practice nursing differs in different countries, and a clear picture is lacking on what exactly advanced practice nurses do. Prospective exploratory study. The setting of the study was the largest hospital in Iceland where over half of the country's active nursing workforce are employed, including the only clinical nurse specialists. Of 19 clinical nurse specialists working at the hospital, 15 participated. Data were collected over seven days with a structured activity diary that lists 65 activities, classified into six roles and three domains. In 17 instances, the 'role activities' and 'domain activities' overlap and form 17 categories of practice. The clinical nurse specialists coded their activities at 15-minutes interval and could code up to four activities simultaneously. Daily, the clinical nurse specialists evaluated their clinical nurse specialist background. The roles that occupied the greatest proportion of the clinical nurse specialists' time were education, expert practice and 'other' activities, while the smallest proportions were in counselling, research and practice development. The domain they worked in most was the institutional domain, followed by the client/family domain and the clinical outcome management domain. All of the clinical nurse specialists reported working on two activities simultaneously, 11 of them on three activities and six on four activities. They self-assessed their background as clinical nurse specialists as being very useful. The activity diary is a useful tool for assessing the content of practice. Clinical nurse specialists spend too much time on activities related to the institution. Nurse managers are advised to provide clinical nurse specialists with ample time to develop the direct practice role in the client/family domain. The development of advanced nursing practice requires that clinical nurse specialists take an active and visible part in direct patient care. [ABSTRACT FROM AUTHOR]

The aim of this study was to develop and test an educational and support nursing intervention in Iceland to help families assist with the recovery of relatives with eating disorders. Studies indicate that if families receive adequate help in the recovery process of a relative with an eating disorder, the prognosis is better. The study is a pre-post design. The intervention was based on the Calgary Family Intervention Model. An educational and support intervention, which lasted for 3 weeks, was provided for 21 family members of individuals with eating disorders. The patients had been diagnosed with anorexia nervosa, bulimia nervosa or an eating disorder not otherwise specified. Participants were divided into three groups. The main findings revealed a significant improvement according to the scales used for measuring understanding in the level of expressed emotion questionnaire and for measuring eating behaviour, concern with weight and food, and denial of the problem in the anorectic behaviour observation scale. The participants' responses to the research questions about their satisfaction with the educational and support intervention were positive. The study indicates that an educational and support intervention can prove beneficial for families and patients with eating disorders. [ABSTRACT FROM AUTHOR]

Background. Family members of cancer patient's have multiple needs, many of which are not adequately met. Unmet needs may affect psychological distress and quality of life (QOL). The purpose of this study was to assess needs and unmet needs, QOL, symptoms of anxiety and depression, and the relationship between those variables in a large sample of family members of cancer patients in different phases of illness. Material and methods. Of 332 family members invited to participate, 330 accepted and 223 (67%) completed a cross-sectional, descriptive study. Data was collected with the Family Inventory of Needs (FIN), Quality of Life Scale (QOLS) and the Hospital Anxiety and Depression Scale (HADS). Results. Of 20 needs assessed the mean (SD) number of important needs and unmet needs was 16.4 ± 4.3 and 6.2 ± 5.6, respectively. Twelve important needs were unmet in 40-56% of the sample. The mean number of unmet needs was significantly higher among women than men, other relatives than spouses, younger family members, those currently working and those of patients with metastatic cancer. QOL was similar to what has been reported for healthy populations and cancer caregivers in advanced stages. The prevalence of symptoms of anxiety and depression was high (20-40%). Anxiety scores were higher among women than men and both anxiety and depression scores were highest during years 1-5 compared to the first year and more than five years post diagnosis. There was a positive relationship between number of important needs and QOL, and between needs met and QOL. Additionally, there was a significant relationship between anxiety and unmet needs. Finally, there was a significant relationship between QOL and symptoms of anxiety and depression. Conclusion. The results support the importance of screening needs and psychological distress among family members of cancer patients in all phases of illness. [ABSTRACT FROM AUTHOR]

To evaluate cultural differences in sociodemographic factors, illness severity and parents' perception of their adolescent's quality of life for Icelandic and USA families of adolescents with asthma; and to determine predictors of parent-rated quality of life. Asthma is known to have an impact on the quality of life of affected adolescents and their families, but few studies have addressed parents' perception of their adolescent's health-related quality of life. Cross-sectional exploratory study. The study involved families of adolescents with asthma included 15 from Iceland and 15 from USA, recruited from paediatric practices. Parent and adolescent participants completed questionnaires; this study is based on the parent responses. Data were collected from January-May 2006. While parents from Iceland and USA were similar in demographic characteristics, parents from Iceland rated their children's health-related quality of life (PedsQL 3.0, ) more positively than did USA parents, even though Icelandic parents were more likely than their USA counterparts to report that their adolescent's asthma is severe. Significant predictors of parent-rated quality of life included location (higher scores for Icelandic parents), gender (higher scores for parents of boys), exposure to second hand smoke in the home (higher scores for those not exposed) and frequency of troublesome wheezing (higher scores for lower frequency). Quality of life has been acknowledged as an essential health outcome measure. Even though gender difference was not found in asthma severity, parents of boys perceived their adolescent's quality of life as more positive compared with parents of girls. It might be helpful for Icelandic and USA families to integrate into care delivery models, cultural differences in parent-rated quality of life. Asthma management interventions may improve quality of life for adolescents with asthma by reducing symptoms. Interventions promoting smoke-free homes and enhanced self-monitoring to prevent exacerbations may improve quality of life. [ABSTRACT FROM AUTHOR]

This study addresses development of a content-valid cross-Nordic version of the Housing Enabler and investigation of its inter-rater reliability when used in occupational therapy rating situations, involving occupational therapists, clients, and their home environments. The instrument was translated from the original Swedish version of the Housing Enabler, and adapted according to accessibility norms and guidelines for housing design in Sweden, Denmark, Finland, and Iceland. This iterative process involved occupational therapists, architects, building engineers, and professional translators, resulting in the Nordic Housing Enabler. For reliability testing, the sampling strategy and data collection procedures used were the same in all countries. Twenty voluntary occupational therapists, pair-wise but independently of each other, collected data from 106 cases by means of the Nordic Housing Enabler. Inter-rater reliability was calculated by means of percentage agreement and kappa statistics. Overall good percentage agreement for the personal and environmental components of the instrument was shown, indicating that the instrument was sufficiently reliable for application in practice and research in the Nordic context. The varying kappa results highlight the need for further study in order to understand the influence of prevalence more profoundly, which should be kept in mind when interpreting the results. [ABSTRACT FROM AUTHOR]

Wind profile and eddy-correlation data obtained at two sites on a melting glacier surface in Iceland during the summer of 1996 are presented. Throughout the experiment the surface roughness increased rapidly from smooth to very rough, with the largest roughness element height obtained being about 1.7 m. In a layer close to the rough surface we find that the wind speed profiles were disturbed showing horizontal inhomogeneities as in a roughness sublayer. Its height was approximately two times the height of the main roughness elements (h) at both sites throughout the experiment. From the wind profiles and eddy-correlation data we calculated corrections for the displaced zero plane as a function of time and compared these with results obtained from a drag partitioning model. In general, the agreement was reasonable considering the ranges of uncertainty but the results indicate that the increasing horizontal anisotropy of the surface probably limits the use of the model. The values obtained for the roughness lengths are in good agreement with those calculated from a simple linear model, i.e., z$\_0$/h = 0.5λ with λ the frontal area index. Above the roughness sublayer the wind profiles, normalised standard deviations of wind speed, and the balance of the turbulence kinetic energy budget behaved as over an ideal homogeneous surface thereby confirming similarity of the flow. [ABSTRACT FROM AUTHOR]