Nordic Journal of Nursing Research

Fever is a symtom of a disease which has caused people inconvenience since ancient times. The view upon fever, what it is and how to treat it, has been changing from time to time. Today there is at debate whether fever is friend or foe. Patients in an intensive care unit almost always has an increased body temperature. The Intensiv e Care Unit (ICU)-staff look upon fever as a natural response to an infection but they have different opinions about what treatment should be used. The purpose of this study was to investigate what was written about fever and compare to the knowledge and nursing care among nurses working in a specific ICU. Thirtysix questionnaires was distributed and 28 were answered. We have found that the nurses, among themselves, have different ways of caring for the feverish patient. Administration of antipyretics, fluids, nutrition and furthermore cooling and warming measures differs between nursing and literature. Particularly concerning the cooling measures nurses take without previous administration of antipyretics. This is something that the literature definitely dissuades from because of the risk of initiating a chill and perhaps rise the temperature instead. We can also conclude that the nurses do not describe their patients feverish conditions in similar words which can lead to misunderstandings. Finding a similar language in nursing documentation is therefore essential.

The aim is to describe the basic process of psychiatric nursing in a hospital environment and to produce a practical theory of psychiatric nursing by the grounded theory method. The data were collected by means of observation and interviews and analysed simultaneously, so that the preliminary results and experience gained in the field shaped the data collection process. The data were subjected to continuous comparison analysis and classified into categories by open coding. The basic process was identified by means of axial coding and theoretical memos. The selective coding consisted of related categories grouped around a core category. The basic process of psychiatric nursing involves the patient's needs for care, the helping methods available and the objectives of care. The patient needs help because of his/her inability to manage in daily life, and the role of nursing is to help the patient to manage. The basis of psychiatric nursing lies in caring for the needs of the patient by employing various helping methods. Patient management consisted of three categories, each subsuming three subcategories. Examination of the content of these led to the identification of different types of psychiatric nursing, labelled as confirming, educating and catalytic. The results suggest that collaborative methods in psychiatric nursing enable and support the patient's participation in his/her care and show that both nurses and patients consider collaboration a good helping method, although requiring a change in attitudes and activities for both the nurse and the patient. In spite of changes in psychiatric nursing, there has been no essential development, as most of the care provided is still normative and traditional and the patient is a passive recipient.

Urinary incontinence (UI) is a disability caused by an impairment, which can lead to a handicap of importance for nursing care. This means that UI is not only a practical-medical concern but also a socio-economic problem. The purpose of the study was to determine the prevalence of UI among 65 year-olds in a Swedish Health Care District and to compare gender differences concerning medical history and psychosocial consequences. In a Primary Health Care District, a questionnaire pertaining to UI was mailed to all women and men 65 years of age (N=458). A total of 91% (n=419) was sufficient for data analysis, which was performed by descriptive and inferential statistics. It was found that 28% (n=61) of the women and 9% (n=21) of the men were afflicted with UI. Women reported significantly more urge incontinence (p<.05) as well as stress incontinence (p<.05). Information from the health service about UI had been given to 46% (n=28) of the women and 33% (n=7) of the men. The strongest reason reported, both in women (42%, n=26) and men (40%, n=8), for not seeking help from the health service was that UI was a normal condition for people of their age. Most of the women had to urinate at least twice per night (42%) compared to once per night (44%) for the men. It is important to establish a UI clinic at every main Primary Health Care Centre which builds on nursing care and whose aim is to inform the general public that UI is a common problem, that it leads to psychosocial consequences, and that the health service can offer active rehabilitation interventions.

Before a general, nursing documentation model was implemented in one health care region of the Stockholm County Council the opinions which district nurses and nurses at the primary health care centres (PHCCs) had of nursing documentation were investigated. 164 nurses (94%) at all the 22 PHCCs within the region answered a questionnaire in October, 1995. The study showed that the nurses in general were dissatisfied with their own, as well as with their colleagues, nursing documentation. The lack of a common, patient-record model for nursing documentation was concidered the greatest obstacle, followed by lack of time and lack of knowledge. Most of the nurses believed that patient records which clearly included all parts of the nursing process would promote patient care. However, according to the nurses themselves, less than one-fifth of them recorded nursing history and nursing outcomes for all or most of their patients. One-third of the nurses reported that documented planned nursing interventions, about one-fourth nursing status and about half of them implemented nursing interventions for all or most of their patients. The nurses said that nursing diagnoses, goals and epicrises were rarely documented. There was no significant correlation between the nurses' ages and their opinions of nursing documentation. Nurses who had completed their education after 1985 were more positive to further education in nursing documentation and to computerised patient records, and confirmed more than others that patient records which included the entire nursing process model would promote patient care. Nurses who worked only at PHCCs care. Nurses who worked only at PHCCs were more satisfied with their own documentation as well as with that at their centres and were more positive to computer support than district nurses. Nurses at PHCCs were less in favour of education in nursing documentation, compared with nurses working in home health care and child care. The nurses who were not satisfied with their own nursing documentation were not satisfied with their colleagues' documentation either, but they were positive to further nursing education. More than others, they were of the opinion that better patient care follows from patient records which include the entire nursing process model. The study shows the need for education and continuous support aimed at nurses within the primary health care system regarding nursing documentation.

In this paper experiences from a project to improve nursing documentation in a medium size Scandinavian acute care hospital are presented. The project has followed an action research approach to ensure close cooperation in a coordinated fashion over a period of time. In the paper it is explained that structural changes are not enough to ensure higher quality in the nursing documentation. A broader perspective on clinical practice is therefore presented in order to reflect the complexity of clinical practice and varying documentation needs.

The central issue in this article is religious communication in two district hospital units in Norway, one surgical and one psychiatric. The objective was to get an understanding of patient's and staff's experience of the role of religion in the daily life at the hospitals. Methods used were participant observation and qualitative interviews. Religious communication is not an ordinary part of daily conversation, neither between patients and staff nor within the respective groups. If religion becomes a subject, it is after the initiative of a patient. This initiative of the patient and the religious freedom of choice seem to be important norms for the staff. Patients want an offer, both written and verbal, so that they may choose what they want to utilize.

The aim of this paper is to demonstrate that the VIPS-model, a model for nursing documentation, can be used as a tool and as a structure for analyzing and categorizing literature and emprical data. The usefulness of the model is demonstrated with data from a study concerning nursing interventions to prevent decubitus.

The purpose of this study was to find criteria characteristic for patients in need of care and social services. The criteria should serve as a guideline for patients and staff to facilitate care planning before discharge. The sample consisted of 49 patients, born before 1925, in need of emergency inpatient treatment, admitted to medical — or orthopaedic wards. Data of the patient's self care needs were collected by interviews, assessment of self care status and need of treatment. The patients could be divided into three groups depending on type of discharge. Group A (n=27) discharged home, group B (n=7) discharged to geriatric clinic and group C (n=15) discharged and in need of further care and social services. Criteria indicating the patients further assistance from the community were in group C (medical — and orthopaedic wards) deficit in daily living activities and locomotion. Group B had an increased need of support from the physiotherapist and the occupational therapist, in locomotion as well as daily living activities The physician's assessment showed that the criteria behind the decision “no further medical treatment appropriate” and “ready for discharge” were not related to medical impairment but to lack of self care, need of care, rehabilitation and social services.

The purpose of this study was to describe nursing practice in war zones and skills nurses had acquired through their work. A descriptive design was used. The sample included 39 nurses who had worked in different areas of conflict around the world for two Norwegian humanitarian organizations. A questionnaire was designed to collect both quantitative and qualitative data. The results seem to indicate that the nurses were well prepared for this particular work. The nursing practice consisted of nursing victims of war and supervision / teaching of local nurses. The nurses had positive experiences from their work. The nurses acquired personal and professional skills from their work in war zones, but the results seem to indicate that their Norwegian employers just to a certain degree took advantage of these skills.