bluuebunny/crossref_metadata_2025 huggingface dataset:
The Use of and Need for Patient Classification Systems in Swedish Neonatal Care
Authors: Almeida Rosimary T. , Persson Jan
Published: March 2013

Patient Classification Systems (PCSs) comprise a large group of instruments which describe the condition of a patient regarding severity of disease, severity of illness, risk factors, intensity of nursing care, costs, and so on. They are advocated as an essential ingredient in outcome assessment, but the application of PCSs extends beyond research activities. The aim of this study was to investigate the use of and need for PCSs in Swedish neonatal care units as well as the need for evaluation and improvement of the systems already in use. A survey of 44 units revealed a low level of experience in the use of these systems. Among the 20 units using PCSs, only a few applied standard systems and 11 units pointed out the need for improving these systems. In addition, a second study, based on participant observation and interviews, indicated some potential applications of PCS in a specific unit, such as standard criteria for referring mothers and newborns, staff allocation, staff education and training, standard criteria for parent information, and prognostic systems for medical decision support. Evaluation and adaptation of the existing systems, which are generally developed outside the country, are necessary before they can become a tool for quality assurance, if a national programme for quality of neonatal care is to be established in Sweden.
Assessment Instrument for Problem‐focused Coping
Authors: Tollén Anita , Ahlström Gerd
Published: March 2013

A new self‐report instrument, the Assessment Instrument of Problem‐focused Coping (APC) developed from qualitative interviews, is described. This instrument provides knowledge of the patients' own competence in coping with activities of daily living (ADL), the patients' own assessment of what they experience as problems, and the extent to which they are satisfied with their ADL. The purpose of the study was to test the reliability of the instrument with regard to intra‐rater reliability and internal consistency. The study group comprised 40 patients with muscular weakness and other symptoms relating to the postpolio syndrome. The result showed an acceptable internal consistency (alpha 0.70), which confirms the construct validity of the instrument. The test‐retest showed that the stability over a period of time varied from low to high for a total of 28 items. At the same time, it is evident that the instrument does not achieve the aim of being a good evaluation instrument, because the stability over a period of time was unsatisfactory. The test‐retest should be repeated with a larger test group in future research projects.
The View of Caring among Patients and Personnel
Authors: Lövgren Gunvor , Sandman P.‐O. , Engström Birgitta , Norberg Astrid , Eriksson Sture
Published: March 2013

All patients in hospital care and primary health care in the county of Västerbotten, Sweden (n = 5158) were asked to express their level of satisfaction with the quality of care. The study was carried out on one specific day. All personnel on duty that day (n = 2824) were also included and asked to give their interpretations of their patients' experiences. A questionnaire containing positive and negative statements concerning both the relationship and the task aspects of care was used. The results showed that the youngest and oldest patients expressed the highest degree of satisfaction, while young and middle‐aged patients expressed a more restrained view. The least satisfactory aspects concerned the opportunities to express criticism and the possibilities of receiving information about access to help outside the health care organization. The personnel's responses agreed with those of the patients, but fewer personnel thought that their patients were satisfied than was in fact the case.
Review of Finnish Nursing Research from 1958 to 1995
Authors: Suominen Tarja , Leino‐Kilpi Helena
Published: March 2013

This article provides a review of Finnish nursing research between 1958 and 1995. It is based on an analysis of the articles published in the Finnish Yearbook of Nursing from 1958–1988, in Nursing Science (Hoitotiede) from 1989–1995 as well as all licentiate and doctoral theses in nursing. The overview describes the content, sources of information and level of analysis in the works concerned.
Fall Injuries among Elderly Persons Living at Home
Authors: Johansson Berit
Published: March 2013

Falls and their consequences are a major health problem for elderly people. The aim of this study is to describe and analyse registered fall injuries in people 65 years and older, living in their own homes, during one year. In a local health care district, injuries of such severity as to require the attention of a doctor were registered. A form designed according to the National Swedish Board of Health and Welfare classification for registration of accident injuries was used. The computer program Epiinfo was used for processing and analysis. One thousand six hundred and thirty‐nine fall injuries among elderly people living at home were registered. The women accounted for 70%. The injuries occurred mostly at home or in the home area during daytime and in connection with daily routines. Fractures accounted for 46.4% of the injuries. Of the victims, 44.4% needed to make only one visit to a doctor. Additional visits and admission to hospital were more common among the women. The study reveals that most of those injured were women, and that the falls occurred during their daily routines. Registration of this kind tells nothing about the persons and the circumstances behind the accidents. In order to gain deeper knowledge, complementary investigations are necessary.
Staff's Experiences with Patients' Assaults in a Norwegian Psychiatric University Hospital
Authors: Wynn Rolf , Bratlid Trond
Published: March 2013

This pilot study addressed the problem of patients' assaults on staff at a Norwegian psychiatric university hospital. The questionnaire‐based study had a retrospective design, and involved a random sample of staff (n = 85). It revealed that 100% of the nursing staff and 60.9% of the therapists (doctors, psychologists, and social workers) had been physically assaulted by patients at least once during their careers at the hospital. Most of the assaults did not result in sick leave, and could as such be classified as not serious. There were no significant differences in the number of assaults on male and female staff or between staff in the emergency, intermediary, rehabilitation and psycho‐geriatric wards. The staff responded that they believed male patients were more violent and threatening than female patients, although a majority had been assaulted more frequently by female than by male patients. Assault was the reason most frequently given for physically restraining patients, and most of the staff did not believe that physically restraining patients reduced their chances of recovery. The study suggests that patients' assaults on staff in Norwegian psychiatric hospitals is an important problem, which needs further attention.
Refinement of the Questionnaire ‘Quality of Care from the Patient's Perspective’ using Structural Equation Modelling
Authors: Larsson Gerry , Larsson Bodil Wilde , Munck Ingrid M. E.
Published: March 2013

In 1994, the questionnaire ‘Quality of Care from the Patient's Perspective’ (QPP) was developed using a conventional factor analytical approach (Wilde et al. 1994). The items and conceptual framework of this questionnaire were derived from a theoretical model, which, in turn, was developed from qualitative patient interviews, using a grounded theory method of analysis (Wilde et al. 1993). The aims of this study were to develop further the dimensionality of the QPP using structural equation modelling combined with advances in factor analysis modelling, and to refine the instrument. This comparatively new methodology extracts more information out of questionnaire data and is considered to be superior to traditional scaling methods. The sample consisted of 611 somatic inpatients from four departments at a Swedish hospital. Data collected with the QPP were explored with the new tool tracing the dimensions postulated in the theoretical model underlying the QPP. A nested factor model was developed fulfilling statistical criteria for adjustment between model and data. The model consists of a general factor and 16 subordinate factors. Most of the original QPP scales were reproduced with the new statistical technique. However, some content changes were made which appear to bring the QPP scales closer to patients' meaning representations of the area. Some changes were also made to the response format, changes which appear to strengthen the psychometric properties of the instrument. The refined QPP will hopefully contribute to a more differentiated picture of quality of care when applied in the field. All scales, items, and response formats of the revised QPP are presented in an appendix.
The Opinions of District Nurses regarding the Knowledge, Management and Documentation of Patients with Chronic Pain
Authors: Törnkvist Lena , Gardulf Ann , Strender Lars‐Erik
Published: March 2013

This is the first of two studies investigating district nurses' opinions regarding the knowledge, management and nursing documentation of patients with chronic pain conditions, before and after the introduction of ‘pain advisers’ in one health care region in Stockholm. Seventy (97%) district nurses at 12 selected primary health care centres (PHCCs) answered a questionnaire. The study showed that 85% of the district nurses met patients with chronic pain conditions at least once a week. None of the 12 PHCCs had any written information/policies on pain control. Many district nurses did not perform any individual analysis of the patients' pain and very few used any tool, such as VAS, to assess or evaluate the patients' pain. The district nurses reported insufficient pain documentation. A number of district nurses were dissatisfied with the present management of patients with chronic pain at their PHCCs, their own knowledge of pain control, their own preparedness to meet these patients, their own follow‐ups and their own documentation. The study also showed that the district nurses' attitudes to pain and pain control varied, depending on how satisfied they were with their own management of patients with chronic pain conditions.
Lift/Transfer and Technical Aids for Persons with Severe Acquired Brain Injury
Authors: Edlund Carola Klint , Harms‐Ringdahl Karin , Seiger Åke
Published: March 2013

A questionnaire about assistive devices for lift and transfer was distributed to all individuals evaluated at the Solberga Project outpatient service unit, a regional centre for long‐term follow‐up of severely brain injured persons in the Greater Stockholm area. The target group was 60 severely brain injured adults, of whom 57 (30 women and 27 men) answered a questionnaire created by one of the authors. The causes of injury in the study population were trauma (n = 27), cerebrovascular accident (n = 19), anoxia (n = 10) and other (n = 1). Thirty‐two persons were quadriplegic after the injury and 21 were hemiplegic. More than half (33/57) reported problems with all five defined lift and transfer situations. Most (42/44) reported problems getting in and out of their wheelchairs. Technical aids were seldom used; 24 persons did not use any aids at all. The most commonly used aid was an adjustable bed. Most of the technical aids were used when the individual also had personal assistance. The persons who managed lift and transfer by themselves used few aids. It is reasonable to assume that severely brain injured individuals would be involved in more activities if they used technical aids more readily.
Touching by Skilled Nurses in Elderly Nursing Care
Authors: Routasalo Pirkko , Isola Arja
Published: March 2013

The frequency of touching in nursing care situations increases with patients who are in poor condition. Patients in long‐term care often require help from nurses in all their daily activities. Touching is also an important form of communication in situations where the individual is no longer capable of reciprocal verbal communication. In this study, 10 nursing care situations were video recorded in a long‐term care institution. The patients needed much help and had problems with verbal communication. Data analysis was inspired by Ricoeur's philosophy (1976) and involved three steps: naive understanding, structural analysis and comprehensive understanding. The findings show that each nurse—patient pair had its own distinct patterns of interaction that had taken shape over the years. Some nurses stood very close to their patients and frequently hugged, patted and stroked them; others remained at a greater physical distance and did not touch their patients more than was necessary to perform their tasks. In spite of their different patterns, all the nurses were highly competent and skilful in their jobs.
Quality in Child Healthcare
Authors: Jansson Annkristin , Isacsson Åke , Kornfält Ragnhild , Lindholm Lars H.
Published: March 2013

In child health promotion (CHP) programmes it is the public health nurse who is responsible for most of the work. However, the perspectives of the family and the staff must be identified in order to get a comprehensive picture of significant quality factors in child healthcare. One aim of this study was to assess the views of mothers and public health nurses concerning a CHP programme and the first home visit to parents of newborn children. Other aims were to compare mothers' and nurses' views of CHP programmes in relation to age, experience, structure of organization and urbanization, and mothers' views in relation to social position, health of the children, primi‐ or multipara, country of birth and urbanization. Two national postal questionnaires, one sent to the mothers (850), the other to public health nurses (291), yielded data for analysis. Both mothers' and public health nurses' views of what constitutes good child healthcare were found to concur with the official goals of child health promotion. Important quality indicators were said to be: kind treatment, competence, time, support, an all‐round view, the individual perspective, and home visits to primipara parents.
Parenthood as talked about in Swedish Ante‐ and Postnatal Midwifery Consultations
Authors: Olsson Pia , Jansson Lilian , Norberg Astrid
Published: March 2013

In order to explore the manner in which parenthood was discussed in midwifery consultations, 58 video‐recorded consultations were analysed. A content analysis revealed a variety of topics concerning conversation on parenthood—topics of an intimate nature and discussions from a societal perspective. Parenthood was not of primary importance in visits, which were mostly directed by the midwives. A phenomenological hermeneutic analysis of the meaning of being a mother revealed a complex and difficult situation of being both needed and dependent. The meaning of being a father revealed a struggle between distancing from and closeness to the child. The mate relationship was indicated as important and under strain. The metaphor of the ‘spiders web’, where the mother is the spider with the child mostly on her back, the father entering the web on her terms, summarizes the understanding. The results from this study could provide a basis for reflection on the status of the topic of parenthood, on the meaning of being a mother and a father disclosed in the consultations, and ultimately on the organization of ante‐ and postnatal midwifery care.
The Norwegian Version of the Quality of Life Scale (QOLS‐N)
Authors: Wahl Astrid , Burckhardt Carol , Wiklund Ingela , Hanestad Berit Rokne
Published: March 2013

The aim of this study was to adapt, validate, and test for reliability the Quality of Life Scale in Norwegian (QOLS‐N) for patients suffering from psoriasis. Two hundred and eighty‐two patients with psoriasis were included in the study. Self‐reported health was measured using the SF‐36. Disease severity was also measured in 95 patients using the Psoriasis Area and Severity Index (PASI). The reliability of the QOLS‐N was computed using the internal consistency reliability (Cronbach's alpha) and the test‐retest reliability test. Face and content validity and construct discriminant ability of the QOLS‐N were assessed. The results indicated that the QOLS‐N has highly satisfactory rates of test‐retest reliability (r = 0.83) and internal consistency reliability (alpha 0.86). As expected, the QOLS‐N had a lower correlation with physical health (r = 0.24, p < 0.000) and self‐reported symptoms (r = −0.20, p < 0.001), and a higher correlation with mental health (r = 0.52, p < 0.000). The correlation with disease severity was not significant (−0.06). The results reported in the present paper are in accordance with those derived in other validation studies. The QOLS‐N seems to be a reliable and valid measure of global quality of life in patients suffering from psoriasis.
Patient‐perceived Quality of Life after Coronary Bypass Surgery
Authors: Anderson Gunilla , Feleke Elehu , Perski Aleksander
Published: March 2013

In an interview conducted one year after coronary bypass surgery (CABG), 115 patients (92 males, 23 females) were asked to discuss their present quality of life, problems related to the operation and their reactions to the supportive care following the operation. The main purpose of this study was to assess whether the patients' own presentation of these questions revealed information not elucidated through a standard questionnaire which included the Nottingham Health Profile and other questions on physical, emotional and social well‐being. About one quarter of the interviewed patients expressed dissatisfaction concerning their present quality of life, information which corresponded well with the findings in the questionnaires. Reported limitation in physical activity did not, however, match exercise test findings. The interviews alone revealed additional information concerning well‐being. Most important were problems with wound healing and difficulties describing and interpreting pain and other discomfort in the thoracic area. Several patients also expressed dissatisfaction with the postoperative supportive care. We conclude that there is a need for a complementary approach to estimate quality of life, and that this could be included in an extended nursing care program designed to meet the varying needs of patients after CABG.
Structure and Content in Norwegian Nursing Care Documentation
Authors: Stokke Torbjørg Aa. , Kalfoss Mary H.
Published: March 2013

In 1994, the Norwegian Board of Health (NBH) published recommendations for nursing care documentation. The two‐fold purpose of the present study was to see if 5 wards in 2 Norwegian hospitals fulfilled the proposed NBH recommendations and guidelines regarding documentation, and to evaluate them in terms of the proposed structure and key words of the VIPS model. Results showed that all nursing records (n = 55) had an admission assessment. A nursing care plan was present in 62% of the records. Nursing goals were lacking in the remaining 38%, diagnosis and planned interventions were absent in 18%, and 45% of the diagnoses lacked information concerning patient progress or outcome. The nursing care plans were updated in only 40% of the records and discharge notes were present in 35%, confirming that NBH recommendations were not met in this sample. The key words of the VIPS model covered all information present in the records, and high interrater reliability was obtained for the majority of key words categorized by two independent researchers. It is suggested that the VIPS model components and key words can contribute to a reliable and uniform model for nursing care documentation and enhance comprehensive and systematic documentation, which is presently lacking in Norwegian records.
Cancer Patients who Prefer to Die at Home
Authors: Sørbye Liv Wergeland
Published: March 2013

This article presents a descriptive study based on quantitative and qualitative methods. We wished to determine factors that promote or restrict home deaths. The Norwegian Central Bureau of Statistics released non‐identifiable data for the time period 1990–1994 for all municipalities in Norway. Relevant health and social data from the Norwegian Social Science Data Service for the 24 municipalities, which had more than 20% or less than 10% of the cancer patients dying in their own homes, were analysed. Key persons in the home care teams were interviewed. There were few occurrences of home deaths in municipalities with a local hospital, good capacity in nursing homes or a larger percentage of one‐person households. Indicators for several occurrences of home deaths were openness, good co‐operation with physicians, and a stable, flexible staff. In addition, the patient had to have a strong desire to die at home. Finally, the employees had to be professionally confident and willing to go beyond the prescribed shift hours.
Changes in Quality of Life after Rehabilitation for Patients with Progressive Neurological Disorders
Authors: Nordeson Astrid , Engström Birgitta , Norberg Astrid
Published: March 2013

The aim was to study whether patients with progressive neurological disorders experienced a changed quality of life at the end of a rehabilitation period and 3–4 months after their return home. Forty‐one and 37 patients respectively filled in a self‐administered questionnaire Quality of Life: Status and Change (QLsc). There was a significant difference between the two occasions for responses regarding the items ‘My bodily health has become’, ‘My well‐being has become’ and ‘I am able to maintain a good pace and lead an active life’. The alternatives ‘rather good’ to ‘much better’ were chosen more often at the end of the rehabilitation period than after 3–4 months. There were also differences between respondents who had been to the rehabilitation centre for the first time and those who had recurrent visits, regarding the items: ‘My bodily health has become’, ‘My well‐being has become’ and ‘My whole life is’. The alternative neither/nor was rated fairly evenly on both response occasions. The study probably indicates that the recurrent rehabilitation periods at the centre have an effect. When the respondents respond to items with a global focus, they seem to indicate experiences of a higher QOL.
To See or Not to See
Authors: Öresland Stina , Jakobsson Annika , Segesten Kerstin
Published: March 2013

In order to examine the perceptions of sex equality among medical doctors (MDs) and registered nurses (RNs), a survey was conducted in a Swedish University Hospital in May 1995. A questionnaire was sent to 475 MDs and RNs of three different age groups. The results showed that women tend to have similar opinions irrespective of occupation and age, which differed significantly from those of men. Men believed that equality in general exists in the hospital, while women think the values and conditions in the workplace mainly benefit men. No evidence was found to indicate a change in the sex hierarchy within the health care system. Rather, the status quo will be maintained and gender stereotypes reinforced from one generation to the next.
Early Planning of Care and Rehabilitation after Amputation for Vascular Disease by Means of Katz Index of Activities of Daily Living
Authors: Hermodsson Ylva , Ekdahl Charlotte
Published: March 2013

The aim of the study was to investigate whether the Swedish version of the Katz Index of ADL (Activities of Daily Living), on days 5–7 after amputation for vascular disease, had predictive value regarding length of hospital stay, discharge to the patient's own home or death within 1 month. Patients who had recently undergone primary unilateral trans‐tibial amputation, living in their own homes before the amputation, were included. Fifty‐two patients with a median age of 78 years (60–92) were assessed with the Katz Index of ADL. Results revealed that of the 10 (20%) patients discharged to their own homes within 1 month, only 2 belonged to grades A‐C, that is, were independent in the majority of functions in personal ADL. Within 6 months 62% were discharged to their own homes. Eighty‐four percent of the patients in grades D‐G, i.e. most dependent on others, were still at the hospital or dead 1 month post‐operatively. All the patients who belonged to grades A‐F survived the first month post‐operatively. The Katz Index of ADL had predictive value regarding early outcome in terms of length of hospital stay, discharge to the patient's own home or death within 1 month, and positive predictive value regarding survival the first month post‐operatively.
Staff and Administration Perspectives in a One‐year Geriatric Rehabilitation Developmental Process
Authors: Iwarsson Susanne , Nygren Carita , Isacsson Åke , Dehlin Ove
Published: March 2013

A health care reform for senior citizens took effect in 1992 in Sweden. Shortcomings as regards geriatric rehabilitation were identified and, in 1995, governmental grants were assigned to local developmental projects. The aim of this study was to report the staff and administration perspectives in a geriatric rehabilitation developmental process over a 1‐year period. In all, 782 staff and 45 administration respondents took part. The investigation was based on questionnaires and series of interviews. Significant positive changes with respect to collaboration between the authorities involved were demonstrated at the administrative level, while the most positive results at staff level concerned competence development in the group of employees without college education. A positive process as regards geriatric rehabilitation has started in the study district, indicating that governmental grants assigned for the stimulation of developmental activities are beneficial. Official goals for geriatric rehabilitation, points of departure for the organization of rehabilitation services and the content of general and specialized rehabilitation programmes are pinpointed as some of the areas deserving further attention.
Experience of Musculoskeletal Pain
Authors: Soares Joaquim J. F. , Grossi Giorgio
Published: March 2013

We explored differences regarding several psychosocial constructs (e.g. coping with pain) between immigrant (n = 140) and Swedish (n = 446) patients seeking treatment for pain at health and physiotherapy centres. A cross‐sectional study design was used. The findings showed that, compared with Swedes, immigrants more often relied on benefits for their support and were more concerned with their financial situation. They also had longer periods of sick‐leave. In addition, immigrants felt more disabled, reported more job strain and relied more on passive coping strategies for pain. Finally, they were more emotionally distressed, as they showed more symptoms of burnout, anxiety, depression and post‐traumatic stress reactions, and lower self‐confidence. Multivariate analyses performed separately for immigrant and Swedish patients showed differential patterns of associations between sociodemographic variables, financial strain, emotional distress, perceived disability, passive coping and job strain. We conclude that immigrant patients live under more strained psychosocial conditions and experience a deeper impact of pain than do their Swedish counterparts.
Towards a Theory of Interrupted Feelings
Authors: Kristoffersen Kjell , Mustard Gerald W.
Published: March 2013

The purpose of this study is to identify central aspects of feelings in relation to the experience of being a brother or sister of someone who suffers from schizophrenia. The study makes use of a hermeneutical method for the collection of data as well as for the systemising and interpretation of data. The participants in the study were 16 siblings of persons with diagnosed schizophrenia. In total 80 interviews were done, with an average length of 50 min. A theory of interrupted feelings was developed within the tension between empirical data and preunderstanding. Mixed feelings of grief, hope, anger, guilt and shame are interrupted by four interrelated factors: ambiguous loss, the fluctuating nature of the illness, an inner prohibition of feelings and the tendency of others to invalidate the feelings. The interruption may lead to a lonely and painful experience which is difficult both to process for oneself and to share with others.
Patients' Satisfaction with the Care given by District Nurses at Home and at Primary Health Care Centres
Authors: Törnkvist Lena , Gardulf Ann , Strender Lars‐Erik
Published: March 2013

The main purpose of this study was to investigate patients' satisfaction with the care given by the district nurses at home and at the primary health care centres in one area of Greater Stockholm. The questionnaire entitled ‘Quality of Care from the Patient's Perspective’ (QPP) was used. A total of 168 adult, home‐care (HC) and 264 outpatient clinic (OC) patients answered this questionnaire. Maximum median scores were reported for most items designed to measure the four following dimensions: ‘medical‐technical’ competence of the district nurses; ‘physical‐technical’ conditions of the care organization; ‘identity orientation’ in the attitudes and actions of the district nurses and the ‘socio‐cultural’ atmosphere of the care organization; and the perceived accessibility of nursing care. Some areas were identified as being in need of improvement, for example, pain alleviation, safety of the patients' home environment, the possibility of the patients participating in the decision‐making process, the feeling that the care is not based on the patients' desires and needs, and the possibility of always meeting the same district nurse. Differences between HC and OC patients and between sub‐groups were found regarding demographic characteristics and self‐rated, physical health and psychological well‐being. HC and OC patients with poor, self‐rated, physical health were identified as being likely to be dissatisfied with the care.
Between Suffering and Redemption
Authors: Käppeli Silvia
Published: March 2013

The aim of this research was to study the potential influence and significance of Jewish and Christian patients' religion on their coping with cancer. After intensive methodological experimentation, the Interpretive Biography‐approach, an inductive unstructured research method was applied to collect and analyse the data. In this way 100 Jewish and Christian patients were interviewed. Document analysis was performed when patients' diaries were available. Comparative analysis of the patients' stories made possible the identification of a number of religious motives from which the patients drew meaning to explain their suffering. The findings show that Jewish and Christian patients utilize the same religious motives. The relevance of this research for nurses lies in the finding that, for many patients, their religiousness has great potential as a resource and it should therefore be supported by nurses.
Beliefs concerning Dietary Practices during Pregnancy and Lactation
Authors: Ahlqvist Margary , Wirfält Elisabet
Published: March 2013

Growing multiculturalism in Sweden challenges health professionals to provide safe and culturally meaningful care. Differences between the health—disease explanatory models of lay persons and health professionals may lead to communication problems, which ultimately could affect health outcomes. The aim of this study was to explore cultural beliefs about food and health during pregnancy and lactation. Increased knowledge and understanding among health professionals on such issues should facilitate culturally congruent nutrition counselling. Individual interviews were performed among first‐generation Iranian female immigrants in the county of Stockholm. The interviews followed a set of predefined key questions. Content analysis of interview transcripts followed a grounded theory approach. Five major categories emerged, which referred to ‘hot‐cold’ values, foetal attributes, satisfaction of cravings, survival of the mother, and quantity and quality of breast milk. ‘Mother's diet provides strength that sustains life’ emerged as the most relevant core concept. This study demonstrated maternal strength to be important for a successful pregnancy outcome and lactation. Displacement of food items caused by migration in combination with a strong adherence to Iranian health beliefs could potentially cause food choices with detrimental health effects.
Self‐care Behaviour of Patients with Heart Failure
Authors: Jaarsma Tiny , Abu‐Saad Huda Huijer , Dracup Kathleen , Halfens Ruud
Published: March 2013

Heart failure‐related self‐care behaviour is important to optimize outcomes for patients with heart failure. Such behaviours include adherence to medication, diet and exercise, but self‐care also refers to such things as seeking assistance when symptoms occur, and daily weighing. The study aim was to describe heart failure‐related self‐care behaviour, to test the effect of education and support on self‐care behaviour and to discuss limitations. Data were collected from 128 heart failure patients during their hospital stay and at 1‐, 3‐ and 9‐month follow‐ups. Concepts from Orem's general theory of nursing were used to describe heart failure‐related self‐care behaviour and its limitations. The effects of intensive systematized and planned education from a nurse in hospital and at home were evaluated in an experimental design. Results showed that education enhanced self‐care behaviour significantly at 1 and 3 months after discharge. Despite intensive education and support, patients did not manifest all self‐care behaviours that might be expected. Patients in both the intervention and control groups described limitations in knowledge, judgement/decision‐making and skills. It can be concluded that supportive‐educative intervention is effective in enhancing heart failure‐related self‐care behaviour early after discharge. To optimize such intervention, more emphasis must be placed on behavioural strategies (e.g. self‐medication), social support (e.g. from family members) and reinforcement (e.g. home visits).
Factors Influencing Job Satisfaction Among Swedish Occupational Therapists in Psychiatric Care
Authors: Eklund Mona , Hallberg Ingalill Rahm
Published: March 2013

This study examined job satisfaction among occupational therapists in Swedish psychiatric care, and investigated how clinical supervision, organizational aspects and demographic characteristics contributed to job satisfaction. We received 332 returned questionnaires, corresponding to a response rate of 66.9%. Job satisfaction factors that emerged were: general satisfaction with work, communication and co‐operation among team members, managerial feedback, the patients' influence on care and the relatives' influence on care. The respondents rated their general satisfaction, co‐operation and communication as high. They were least satisfied with the relatives' influence on care. We found few relationships between other factors and job satisfaction, but, for example, satisfaction with the patients' influence on care was higher among occupational therapists working in outpatient care than among those working in hospital wards. Furthermore, having supervision was positively associated with co‐operation and communication. This study revealed a fairly satisfactory situation, possibly thanks to social support, advantageous care‐planning strategies and supervision. However, managerial staff must be aware that measures need to be taken continuously to counteract detrimental forces. The study pointed to a need for further research that relates occupational therapists' job satisfaction with issues such as support, control and individual need for growth.
Importance of the Midwife in the First‐time Mother's Experience of Childbirth
Authors: Tarkka Marja‐Terttu , Paunonen Marita , Laippala Pekka
Published: March 2013

The aim of this study was to examine factors related to how the first‐time mother experiences childbirth. The data were collected by questionnaire in a sample of 326 first‐time mothers in Tampere University hospital in Finland. The multivariate method used was a stepwise regression analysis. The most important predictors for the nature of the childbirth experience were the characteristics of the midwife, such as empathy, friendliness, tenderness, calmness and lack of hurry; the attitude of the child's father toward the pregnancy; the duration of delivery; and the mother's age and marital status. The more positive the experience the mother had of the attending midwife caring for her, the more positively she experienced childbirth. The positive attitude of the child's father toward the pregnancy and a short duration of delivery were also predictors for a positive childbirth experience. Young and unmarried mothers also had more positive experiences of childbirth. On the basis of the research results, we can state that positive childbirth experiences of first‐time mothers are enhanced by the positive characteristics and professional skills of the attending midwife, positive attitude of the spouse/child's father toward the pregnancy, and a short duration of delivery.
Evaluation of Nursing Documentation
Authors: Nilsson Ulla‐Beth , Willman Ania
Published: March 2013

In this article we describe the results of a comparative study focusing on the evaluation of nursing documentation before and after an educational intervention. An additional aim is to report the results of a comparison between quality measurements of nursing documentation using the examination instruments NoGA© and Cat‐ch‐ing© and, against this background, to recommend an instrument for future examinations. The educational intervention was directed towards nurses at Helsingborg hospital/health care district. The intervention, which comprised supervision, group sessions, lectures and field trips, covered a period of two years and was built on a learning model. In all, the data material examined included 515 nursing records collected from 52 units. The study reports on a comparison of the examination results from four different clinics for the years 1994 and 1997. The results show a statistically significant difference between the four clinics before the intervention, a difference that disappeared after the intervention. Furthermore, the results show a statistically significant improvement in documentation after the intervention. For future examinations, it is recommended that the examination instrument Cat‐ch‐ing© should be used and that methods for examination of the content of the documentation must be developed.
Reliability and Validity of a Swedish Version of Kogan's Old People Scale
Authors: Söderhamn Olle , Gustavsson Siw Merit , Lindencrona Catharina
Published: March 2013

Standardized and well‐tested instruments are needed in order to study attitudes toward old people. One scale that has been widely used is Kogan's Old People scale. A Swedish version of the scale has been available since 1987. The aim of this study was to test this Swedish version of the scale for reliability and validity, in a sample consisting of students and different health‐care professionals. A convenience sample of 319 individuals in western Sweden took part in the study, and data were collected by means of a questionnaire that included the scale. Reliability was assessed as homogeneity and validity as construct validity. All but 4 of the 34 items were found to have significant item‐total correlations. The Cronbach's alpha coefficient for the total scale was 0.79. Some evidence of construct validity was found in a three‐factor solution, which explained 30% of the variances. Strong evidence of construct validity was shown in the scale's capability to differentiate between individuals who rather preferred to work with old people (p < 0.005) than with young clients. Convergent validity, as a form of construct validity, was also supported for the scale.
Changes in the Importance of Quality of Life Domains After Cancer Diagnosis
Authors: Rustøen Tone , Wahl Astrid , Burchardt Carol
Published: March 2013

The aim of this study was to describe what domains in quality of life were considered most or least important by patients with newly diagnosed cancer and in what way the domains of importance changed during a 9‐month period. We also analysed the impact of selected demographic variables on the important domains. The Ferrans' and Powers' Quality of Life Index was used to measure quality of life. As this index consists of one section measuring the importance of various domains of life, information about changing standards was available. The study sample consisted of 131 adult patients recently diagnosed with different cancers. The whole sample filled in the questionnaire once, while part of the sample (n = 41) filled it in four times during a 9‐month period. Items related to family matters were rated as most important, while faith in God was reported to be of least importance. The patients fluctuated somewhat in terms of what was most important to them during the study period. Overall, the most unstable items tended to be less important over time. In addition, results showed significant differences in the importance of quality of life domains according to gender, age, educational level and cohabitation.
Professional Skills and Frame of Work Organization in Managing Borderline Personality Disorder
Authors: Bergman Bodil , Eckerdal Annsofi
Published: March 2013

Caregivers' experiences and beliefs of working with borderline personality disorder (BPD) in a psychiatric organization were investigated using a qualitative analysis of 29 in‐depth interviews. The analysis identified eight characteristics, which were organized in two core concepts. The first of these core concepts, professional skills of mental health work, comprised the categories of empathy for persons with BPD, interest in treating the disorder, feelings of professional frustration and need for a common outlook. The second core concept, frame of work organization, that is categories common to the organization, included ambivalence between the professions of the caregivers, the need for structure in organizing the work, forms of emotional support to the caregivers and the need for a shared philosophy of care. A tentative model was proposed to illustrate the effects of these factors on the type and outcome of work that interact with the care of the patient. It is concluded that ambivalence in the division of labour may be a critical hindrance to the development of cooperation in the care of BPD patients. It is suggested that a shared common philosophy will support corresponding ethical standards by individual practitioners for the benefit of patient outcome.
Behaviour Modification Group‐treatment of Children with Recurrent Lower Urinary Tract Infections
Authors: Lindstrom Torill Christine , Baerheim Anders , Flataas Anne Sjursen
Published: March 2013

It has long been recognized that infrequent micturition and incomplete emptying of the bladder in children represent important factors in the causation of incontinence during the day, and of urinary tract infections (UTI). Behaviour modification is well documented, both as an individual‐and a group intervention. The purpose of our study was to develop a programme for group intervention with children, with the aim of improving the children's micturition habits and thereby changing the frequency of wettings, the amount of residual urine, and the UTI frequency. The children responded quickly to the intervention. The amount of residual urine was unaffected, but there are methodological problems in measuring this. There were, however, significant reductions in incontinence and UTI, although there was a tendency to relapse of incontinence over time, probably because of lack of continued follow‐up. It is tentatively concluded that the described behavioural intervention seemed effective in improving children's micturition habits, thereby changing the frequency of wettings, and the frequency of urinary tract infections. The treatment seems to be suitable for nursing intervention, either within a hospital setting, or on an outpatient, primary care basis.
DIVIDEND POLICY: BALANCING SHAREHOLDERS' AND CREDITORS' INTERESTS
Authors: Shao Liang , Kwok Chuck C.Y. , Guedhami Omrane
Published: March 2013

Dividend policies provide an opportune setting to examine how firms simultaneously manage the diverging interests of shareholders and creditors. Dividends ease shareholders' concerns about expropriation by insiders while exacerbating creditors' concerns about expropriation by shareholders. Firm insiders should set dividend policies to minimize the agency costs of equity and debt. Using a sample of 39 countries for 1991–2010, we find strong evidence that dividends are more positively sensitive to creditor (shareholder) rights when shareholders (creditors) are adequately protected. Our research emphasizes the importance of accounting for the interactions between both agency relationships when studying corporate policies.
Limit Order Book and Commonality in Liquidity
Authors: Kang Wenjin , Zhang Huiping
Published: March 2013

We show that the liquidity provided by an individual stock's limit order book comoves significantly with the market aggregate limit order book liquidity. A closer look at the inside and outside liquidity provided by different parts of limit order book suggests that inside liquidity is mainly influenced by market volatility, while idiosyncratic volatility has a larger impact on outside liquidity. Hence, limit order book inside liquidity exhibits higher commonality than outside liquidity. We also show that the comovement between the stock‐level and market‐aggregate limit order book liquidity measures is related to the commonality in the overall stock market liquidity.
Earnings Smoothing, Cash Flow Volatility, and CEO Cash Bonus
Authors: Das Somnath , Hong Keejae , Kim Kyonghee
Published: March 2013

Prior studies generally relate managers’ decisions to smooth earnings to their desire to maximize their overall compensation and to smooth their consumption. However, earnings smoothing could also be driven by the firm's expected benefits from reporting a smooth earnings stream. Our paper provides empirical support for the latter explanation of earnings smoothing. Specifically, we find that while CEO bonus on average increases with earnings smoothing, the increase is larger when the firm's cash flow volatility is higher. Further, CEO bonus is shielded from the negative effects of lower earnings arising from the need to report a smoother earnings stream.
Relationships between Financial Sectors’ CDS Spreads and Other Gauges of Risk: Did the Great Recession Change Them?
Authors: Hammoudeh Shawkat , Bhar Ramaprasad , Liu Tengdong
Published: March 2013

The objectives are to discern how the three financial sectors’ credit default swap (CDS) spreads interrelate to each other and with three other risks in terms of possible contagion, competition, interdependence and independence relations under the full sample and two subperiods: the 2007 Great Recession and the 2009 Recovery, and to assess the impact of QE1 on those risks in the second subperiod. The results indicate that the own and cross‐effects among the CDSs and the other risk measures are significant and mixed, but all in all contagion is dominant. The system has become less stable and less adjusting to the equilibrium in the first subperiod. QE1 in the second period decreases risks but increases inflationary expectations.