Nordic Journal of Nursing Research

The aim of the study was to explore the association between leadership behaviour and burnout among nursing personnel in health care. Surveys were sent to a random sample of 900 nurses and nurse managers in various health care organizations around Finland. Of these, 660 nurses responded (73%), 627 of whom were accepted for the final analysis. Leadership behaviour was measured with Multifactor Leadership Questionnaire (MLQ) and burnout with Maslach Burnout Inventory-Human Services Survey (MBI-HSS). Correlations and one-way ANOVA were used for statistical analysis.

Nursing leadership is both positively and negatively associated with burnout among nursing personnel. Idealized influence, inspirational motivation, intellectual stimulation, individualized consideration and contingent reward were positively associated with personal accomplishment and negatively with emotional exhaustion and depersonalization. Active management-by-exception behaviour of the nurse manager may increase personal accomplishment. Passive management-by-exception and laissez-faire leadership were positively related to emotional exhaustion and depersonalization, while the connection to personal accomplishment was negative.

Active and future-oriented transformational leadership and rewarding subordinates seem to protect from burnout. On the other hand, passive leadership behaviour is an exposing factor for burnout among nursing personnel. The findings can be used in leadership education in the area of health care and to promote work well-being.

The shortage of specialist trained nurses in the operating theatre and psychiatric care is a problem in Swedish health care. There is a great need for recruitment since in both areas nurses have a high average age and few students register in these specialties at university. The reason for the low interest for these specialties is not clear. The purpose of the study was to investigate nurses' and nurse students' conceptions of the professional role of operating theatre and psychiatric care nurses. A qualitative approach with phenomenographic method was used. Twelve nurses and four nurse students were interviewed. Three categories of conceptions within each specialty emerged. Operating theatre nurses'professional role was perceived as: Dependent assistant, Responsible monitor and Fragmented nurse. Psychiatric nurses' professional role was perceived as: Empathetic agent, Conscious diplomat and Fragmented nurse. The informants had difficulties in understanding the professional role in both fields. One conclusion is that the theoretical and clinical training in basic nurse education play an important role for choosing specialist training as operating theatre nurse or psychiatric nurse.

The belief that medical errors can be avoided by using sanction and punishment implements a neglect of the importance of developing safety systems. The culture within the health services will be of vital importance if the successful prevention of medical errors is to be achieved.

This work based on four focus groups including 22 nurses from emergency wards in a hospital has given information how the organizational culture will affect the occurrence and reporting of medication errors. Individual perspective and personal responsibility is well incorporated and deeply rooted in the nursing culture, while understanding of the importance of systems and routines for patient safety in general may be improved. The understanding of incident reports as a preventive measure was underdeveloped. Self-reproach was a general response by the nurses if they had contributed to a medication error.

Criticism of the system is more adequate than criticism of individuals since self-reproach only create defensiveness and blaming. Incident reporting systems should be free from negative consequences for those who report. The health services would be improved by developing security systems and changing the culture from blame to safety.

This article aims to analyse family support as a care resource from a cultural perspective. The purpose of the study was to reflect on the cultural factors defining family support as a care resource among the Bena in the Tanzanian village of Ilembula. The data was collected through interviews, participant observation and personal working diaries. Sixty-one villagers were interviewed. The data was analysed using the inductive qualitative content analysis method.

The findings show that the culturally defined characteristics of family support among the Bena in the village of Ilembula were maintaining integrity, moral responsibility, role division, and being present; while the main actions taken by families to support their ill relatives were succour and comfort. The characteristics and activities of family support reflected the worldview of the Bena, their family-centred values, cultural beliefs and the lack of a social security system in Ilembula. The study proved that family support is a meaningful part of care, reflecting the Bena's world view and their cultural values beside their socio-cultural conditions. The results can be exploited in the practice and teaching of transcultural nursing.

The multicultural society has impacts on the nursing profession and multicultural aspects of education have impacts on international cooperation. Material from 10 years in a Nordic network with higher education institutions within nursing was analysed in order to develop cooperation, mobility, curriculum and research. Methods of benchmarking were used in analysing political documents, memorandum, descriptions of the departments, course programs and reports from teachers and students. The results indicated that the process from planning to realization was unclear, ambitions were higher than outcomes; experiences of mobility were mostly described in terms of personal experiences, enriching and useful, but relations to political goals or institutional strategies were invisible. Effects on academic subjects or competence were not reported, nor were they asked for. Weeklong courses with more participants were successful. However the research method implied new insights in the results; experiences became visible effects beyond an individual level exists, but they had to be named and asked for.

The development project began in 2001 at a college in Eastern Norway. The aim was to concretize and structure the guidance of student nurses in their first and third years of bachelor degree study by operationalizing and implementing relevant learning situations at nursing homes in a guidance model. The model was evaluated in order to determine whether the application of the model had clarified and improved the nursing home as a trainee site for student nurses. Students in their first year respectively third year of study (n=41 vs n=14), and fifty-five instructor nurses participated in the evaluation after the trainee period.

A questionnaire was distributed to the participants which focused on the impact of the guidance model.

The results indicate that the guidance model increases consciousness and appears to motivate students and instructor nurses in the first year to a higher degree than is the case with participants in their third year. The comments confirm that through the guidance model, students quickly discover the focus of learning at nursing homes. The students expressed wishes that the guidance model be used to a larger extent in situations in which student, teacher and instructor nurse together are reflecting over clinical situations.

The Chronic Kidney Disease (CKD) Diary is a carefully adjusted patient education material used within renal care in Sweden. It is designed to promote the patient's disease-related knowledge, involvement and self-care ability and to promote the cooperation between patient and nurse. This quality improvement study aimed at evaluating the benefit of the CKD Diary. Questionnaires were answered by patients with CKD and nurses within renal outpatient clinics. The results showed that the CKD Diary was to a great part used at home by the patients and their families. The patients as well as the nurses considered the CKD Diary as a useful tool to promote disease-related knowledge, involvement and self-care. Further the nurses found the CKD Diary helpful in promoting cooperation between patient and nurse and it was also adopted in group education sessions. It is recommended that a diary designed as the CKD Diary, i.e. well adjusted to the targeted patient group and with a structured introduction and follow-up could be an applicable tool to promote diseases-related knowledge, self-care, behavioural changes and collaboration in any chronic disease.

The article elucidates fundamental issues about phenomenological research on subjectivity and embodiment. Two main problems are discussed. The first deals with the relationship between empirical and philosophical knowledge inside phenomenological and qualitative research itself. The main argument that is outlined is that because phenomenology originally and mainly is a philosophy and not an empirical science or method, the empirical research that implements phenomenology should be research with a profound and explicit theoretical foundation. In the analyses of empirical and subjective phenomena like pain, the research should try to implement a dynamic and dialectic relationship between philosophy and empirical knowledge. This dialectic relationship ought to be reflected throughout the whole research process, and especially in the analyses and presentation of the research results.

The other and second issue raised in the article is on the relationship between phenomenology and other epistemologies. The article takes a pragmatic stand and argues that this relationship should be built on cooperation and that other epistemological traditions like the biomedical should be viewed as complementary and not opposite or contradictory to phenomenology. This is of crucial importance when it comes down to the question of understanding health science and implementing research on patient phenomena like pain and suffering etc.