Nordic Journal of Nursing Research

The study is based on the assumption that a group of nurses did not acknowledge and describe the advanced cancer patients perspective and suffering systematically in the nursing diagnosis.

The aim of this study was to identify and describe the typical structure of the potential and actual signs of suffering that 25 nurses within palliative care described in nursing diagnoses. CS. Peirce's semiotic and phenomenological grounded theory of signs was used to identify potential and actual signs within 76 nursing diagnosis. Giorgi's phenomenological method was used as the essential method to identify and describe the typical structure of the potential and actual signs that were described in the diagnoses. 8 diagnoses referred to the patients' suffering related to psychosocial and existential problems. 68 diagnoses were primarily influenced by the nurses' observations and explanations of the patients' organism, behaviour and symptoms.

This article is based on a literature study. The purpose of the article is to discuss Janice Morse' theory of suffering in a caring science perspective, and thereby contribute to increased understanding of suffering from both a nursing science and a caring science perspective. The interpretive framework includes Katie Eriksson's theory of suffering and the fundamental ontological assumptions forming the basis of the caring science perspective. The following research questions are posed with regard to the text: What are the most important elements of the theory? What is the theory's field? What is the theory's image of reality? A hermeneutic approach is used as method. The discussion illustrates differences between Morse and Eriksson's theories of suffering with regard to both content and structure. Morse has carried out an extensive scientific work on suffering in the contextual area, while Eriksson has her focus on the ontological area. Each in their own fashion gives us a unique contribution to the discussion and development of knowledge about the phenomenon of suffering.

Since the law of support and service for people with certain disabilities (LSS) was implemented 1994, the carers' role has changed from «taking care of» to «giving support to» people with intellectual disabilities/autism, but the requirements of knowledge hasn't been altered. In order to provide appropriate support, carers need both theoretical knowledge and experience of how people with intellectual disabilities understand their surrounding environment.

The purpose was to describe the knowledge and development of competence needed in caring for adults with intellectual disabilities/autism as viewed from a carer's perspective. Ten carers at different group dwellings in Sweden were interviewed. A qualitative content analysis was performed.

The result demonstrated two main categories: The carer's competence described personal qualities, theoretical knowledge, experience, communication abilities as well as co-working and problem solving abilities.

Possibilities of development of competence described interest and commitment, support and acknowledgement as well as organization and resources.

In conclusion, the carers' competence of creating a good life and a confident relationship between themselves and adults with intellectual disabilities/autism can be described as multifaceted with elements of tacit knowledge. To develop the individual competence, a personal interest, support and time for reflection is needed but not always offered.

When the emphasis in psychiatric care shifts to outpatient care and hospitalization becomes short-term; various individual alternatives are needed to support patients' coping at home and in open care. Post-ward outpatient services (PWOS) are available, but their role and significance in the psychiatric care system still need to be studied. The aim of this study was to describe and analyze the benefits of PWOS in adult psychiatric care. A phenomenographic approach was used. The data were gathered by interviewing patients and personnel in PWOS. As a result of the data analysis the four main categories were formulated: patient groups that benefit from PWOS; impacts to the patient; impacts to the nurses' work, and challenges for cooperation with community care. The findings show that seven different patient groups received care in PWOS. PWOS led the patient to manage at home and in community care and gave the nurses new kind of challenges and responsibility. Good cooperation with other agencies help patient to cope in community care.

Background Moving into a care home is a difficult undertaking, and frail older people need support if they are to participate in decisions related to the moving process.

Aim The aim of the present study on moving into a care home was to describe recently admitted older people's stated reasons for moving, as well as their experiences of participation in preparations and decisions. Furthermore, the aim was to study relatives' and home care managers ‘perceptions concerning the move and their own part in the moving process.

Methods Interviews were carried out with 13 older people who had moved into a care home, their relatives (n=10) and home care managers (n=10).

Findings The most frequently reported reasons for moving were insecurity and physical problems. Some older people and relatives felt the information was insufficient and three older people felt ‘left out’ with respect to their participation in the decision to move, but their home care managers were certain that they had participated.

Conclusions Satisfaction with admission was related to the older person's experience of participation in decision-making and achieving a feeling of power and control. The duty of home care managers and nurses is to encourage older people to participate actively in the moving process and to give them rich information.

Hospital-acquired infections are a serious problem and can be a threat to patient safety. The purpose of this study is to examine the thoughts and experiences of critical care nurses in regard to hospital-acquired infections and patient safety. This study uses a qualitative design based on focus group interviews. Inclusion criteria for the focus group panels were the following: nurses with advanced training in anesthesiology, intensive care or operating room nurses. The findings show that respect for hygiene protocols becomes reduced over time and this affects patient safety. A busy and stressful work environment can also be a problem when having to adhere to these protocols. They also pointed out the consequences of poor role models in that it was everyone's responsibility to adhere to hygiene protocols. Finally, the more experienced nurses had often not up-dated their education. In conclusion, critical care nurses have experienced that hospital-acquired infections and a decrease in patient safety can be result of poor hand hygiene, failure to comply with established protocols, poor role models and a busy and stressful environment. Thoughts and experiences of critical care nurses should be considered in clinical practices in order to reduce hospital-acquired infections and preserve patient safety.

The whole family is affected when a child is ill. Families facing the same illness stressors respond in different ways and have different needs for healthcare. However, assessing a family's needs is difficult. Few instruments for assessment of families' health related quality of life, when a child in the family has a chronic illness, exist. The purpose of this study was to translate The PedsQL™ Family Impact Module from English into Swedish and to test the instrument in clinical practise. This process was done in four steps. Two forwards, independently translations were compared and outlined in a first version. This version was backwards translated and compared with the original version and outlined in a second version. Five parents tested through face to face interviews the translated instrument. The questionnaire was field-tested in 103 parents to children with diabetes (aged 4–19), consecutively sampled when their child visited a children hospital in Sweden for their regular diabetes check. Internal consistency reliability alpha coefficient for the Swedish version of The PedsQL™ Family Impact Module (36 items) exceeded all scales the minimum reliability standard of 0.70. The instrument is suggested to be useful in quality improvement work and may be a help to identify families with chronic illness in need of support.

Malnutrition is a major problem among elderly at nursing homes. Overnight-fasting is defined as the time between the last mealtime at night and breakfast and was considered as long in this study when it exceeded eleven hours. The aim of the study was to map the overnight-fasting length, the frequency and rate of malnutrition and the health related quality of life in an elderly population living at a nursing home in western Sweden. The study was a quantitative descriptive study and was performed at a somatic department of a nursing home. The data was analysed using descriptive statistic. The result indicate a possible relation between the combination of manifest malnutrition as measured in this study, an overnight-fasting length exceeding 11 hours and low health related quality of life in old age. The study generated the hypothesis that health related quality of life among elderly persons living at nursing homes can increase if the over-night fasting length decrease under eleven hours. In addition there is a need for more knowledge concerning the elderly' own experience of long over-night fasting.

The purpose of the research was to evaluate the effect of a flexible approach to service use versus the established practice in a unit for schizophrenic patients. In particular, the study examined how changing two out of 11 beds from the conventional admissions approach to a user controlled admissions approach affected the experiences of patients and their support network (i.e. relatives, care-staff and the community mental health service). Data were collected by qualitative research interview from the first 18 patients and their support network that completed at least one year on the program. The results demonstrated:

The patients greatly valued the freedom and right to decide when a crisis arose and what help was relevant.

The results of this study support previous research on empowerment, demonstrating the viability of correcting the unequal distribution of power that occurs in patient admissions, without affecting the need for justifiable treatment.