Nordic Journal of Nursing Research

Abuse presents a serious threat to older peoples' health and quality of life. International studies estimate the rate to be 3–5% of the population over the age of 65 years as victims of abuse. Nurses in home and community care are well placed to identify older people suffering from abuse. The article focuses on the Indicators of Abuse Screen [IOA] and the Vulnerability to Abuse Screening Scale [VASS] and how appropriate these instruments are in practice. The IOA and the VASS have strengths and weaknesses in their ability to help nurses to detect abuse. The literature reviewed suggested that standardized instruments lack the capability to detect all the facets of the situation in which abuse occurs; therefore, their applicability in practice is problematic. On the other hand, awareness of indicators or signs related to the care recipient or the caregiver could help nurses to detect the occurrence of abuse amongst older people in home and community care, concomitant with nurses' professional knowledge and judgment.

In the focus of this article are the results from a study concerning teachers in multicultural classrooms in vocational education. In 2005, about 114.000 foreigners lived in Finland. The purpose of the study was to describe the teacher's everyday life in the multicultural classroom of vocational nursing education. The purpose was also to attain knowledge about the teachers' view of their own competence development.

The theoretical frame was based on theories concerning multicultural education.

The empirical material was collected during 2000 and 2001 through interviews, participating observations and a questionnaire. The results show that the teachers feel unprepared and unsure of their task regarding teaching of integrated groups. Consequently, the teachers wish to receive more knowledge in cultural matters. The analysis shows, however, that the need for knowledge is not as large as the need to transform the attitude of the teachers towards immigrant students. The teachers possessed a fairly good level of affective competence, but a need for developing the level of behavioural and cognitive competences was identified. All three areas of cultural competence are vital, in order to develop a multicultural educational institution.

The aim of the study was to describe the growth of bacteria on plain rings worn in contact with patients compared to other kinds of finger rings carried in the same kind of patient contact. Through a sterile procedure 100 plain rings and 52 non-plain rings were shaken in 5-ml sterile salt water (0.9% solution). The solution was transferred to agar and kept incubated at 35°C for 48 hours. The sample was 152 finger rings worn by 118 nursing staff in 15 units at one average-sized (400 beds) hospital. The findings showed significantly fewer bacteria on plain rings (median 3075 cfu, n=100) than on non-plain rings (median 134 250 cfu, n=52) (p=0.005, Mann-Whitney U, two-tailed test). Staphylococcus aureus were found only on two rings (both plain). Gramnegative rods were found on 11 (11.0%) of the plain rings, and on 16 (30.8%) of the non-plain rings (p= 0.002, Pearsons Chi-Square). Although the findings show that there are fewer bacteria on plain rings compared to non-plain rings, there is reason to believe that also plain rings may represent danger of infection.

Long-term sick-leave and primary health consultations for reasons of mental ill-health has increased dramatically in Sweden during the last years. The aim of this study was to get a deeper understanding of patients' experiences of meeting a psychiatric nurse in primary health care. The findings are based on qualitative interviews with 19 out-patients with depression, anxiety and worrying. The data were analysed using qualitative content analysis and showed three categories; Knowledge, Support, and Time and closeness. Knowledge was both general and personal which the nurse adapted to the individual patients needs, problems and recourses. Support was practical in e.g. promoting advances in daily life and referring to other health care professionals. Support was also emotional in providing opportunities to share thoughts and feelings with another human being. Time and closeness were both factual and experienced. To «get nursing time» was seen as an invitation to talk and think without disturbances in a peaceful and quiet environment nearby. Together these categories constituted the theme: «To get personal guidance». The psychiatric nurse vas described as a unique, experienced and competent person who paid attention to the informants' specific conditions and struggle for better health.

Massage of infants has been practiced globally and been advocated by health professionals. This article provides an overview of studies of its effect involving randomised controlled trials (RCT) and clinical controlled trials (CCT) published 1995–2005. A computer-aided search utilizing Cochrane Library, Medline and Cinahl was carried out in May 2006, the search words «infant massage» limited to clinical controlled trials (CCT) for infants aged 0–23 months being employed. The twenty articles satisfying the inclusion criteria were analysed. Results in six different areas are taken up: weight gain, analgesia, behavioural development and sleep patterns, parent-infant interaction, bone mineralization, and protection against infection. The major findings were that infant massage increased weight gain and provided protection against infections in both preterm and full term infants. Massage intervention appeared to improve behavioural development and sleep patterns. Infant massage was found to improve mother-infant interaction for mothers with postnatal depression and parental interaction with premature babies, its likewise improving bone mineralization in premature infants when combined with physical activity. Massage therapy was shown to provide analgesia and to sometimes help colicky infants. No harmful effects of infant massage were reported.

Self-harming inpatients are reported to be extremely challenging to deal with on psychiatric units, and the necessity to strengthen staff capacity towards these patients are emphasized in the literature. This article is based on a study which explored what challenges staff face when working with self-harming inpatients. The study was based on triangulation of data, methods and analysis. Challenges were found within the domains of understanding the patient, dealing with the patient on the unit, intervening during the process of self-harming and staff's own role-function (1). The challenges were interpreted within a theoretical framework which conceptualized self-harming as a four-dimensional phenomenon. In order to find how these dimensions of self-harming were involved in the challenges, the analysis was performed and validated through three steps in the analysing process; identification, correspondence and coherence. The relational dimension of self-harming was the most widespread in the challenges, followed by the functional dimension. The analysis confirms the complexity of self-harming and highlights the need to strengthen staff's relational capacity towards self-harming inpatients. The most complex challenge to deal with was the unpredictability of self-harming, followed by challenges relating to the contagion effect, the assessment of self-harming and focus in the relationship with the self-harming inpatient.

In April 2004, a group of nurses at Aarhus University Hospital, Skejby Sygehus promoted hand rubbing with alcohol as an intervention at the entire hospital. Sufficient hand hygiene is a strategy to prevent hospital acquired infections. Method: In total, we did four observations in 2004 and 2005 concerning hand hygiene. All staff groups were included. At the same time, we monitored the monthly incidence of hospital acquired septicaemia and the consumption of alcohol for hand disinfection. Results: Compliance for hand hygiene increased for the use of gloves (from 76% in 2004 to 80% in 2005) and for hand disinfection (from 58% in 2004 to 73% in 2005). Still the specified standards were not met. Compliance in observed doctors was at the end of 2004 and in 2005 lower than for nurses. The consumption of alcohol for hand disinfection increased with more than 90% between 2004 and 2005. The incidence of septicaemia did not change. Conclusion: The increase in compliance concerning hand hygiene and consumption of alcohol for hand disinfection did not seem to influence the rate of hospital acquired septicaemia. The compliance for hand disinfection in doctors seem to be low.

Medical advice does not necessarily concur with what the patient wants. Difference in opinion between the physician and the patient may be due to poor communication, but also different goals and views of health. This is a general problem. This article focuses on the basis for cooperation between doctor and patient with regard to use of anti-psychotic drugs. The question is whether the concept of compliance recognizes and takes in the complexity connected to use of anti-psychotic drugs. The concept of concordance, on the other hand, focuses consultation and cooperation. The question is whether this is feasible with regard to treatment of psychosis.

Compliance depends on what the patients actually thinks or believes about the medication regardless the opinions are in fact true or not. We argue that patient opinions and experience will be crucial in understanding how patients choose to act. Consequently, we need a concept that emphasizes treatment goals and intentions of the patients. This also necessitates a need to investigate patient attitudes about anti-psychotic drugs.