Aim: To explore the long-term learning process in movement awareness development supported by a video-based learning model.

Participants: Eleven undergraduate nursing students.

Method: The students participated in learning sessions comprising video modelling, video feedback and reflective enquiry with a focus on inter-personal interaction. Each student participated in three individual video sessions during a four-month period. Three individual interviews were carried out, the last one 12–18 months after the final session. Visual, verbal and written material were collected from the video sessions, individual interviews and diaries, and interpreted within a hermeneutical approach.

Results: The learning process was described in three themes: motivation for change, exploring alternative perspectives and movement changes through challenges.

Conclusions: The video-based learning model implies a challenging experience on a personal level that supports motivation and a deep approach to learning. It adds a powerful base for reflection, which encourages student-centred active learning. The facilitator’s reflective approach is essential to allow the student to explore her/his own movement, in contrast to delivering instructions. The learning model may be valuable in the physiotherapist’s clinical work in facilitating patients’ movement awareness in the process of movement improvements.

Health care staff and students have a great risk of developing musculoskeletal symptoms. One cause of this is heavy load-related work activities such as manual handling, in which the quality of individual work technique may play a major role. Preventive interventions and well-defined educational strategies to support movement awareness and long-lasting movement changes need to be developed. The aim of the present study was to explore nursing students’ experiences of a newly developed interactive learning model for movement awareness. The learning model, which is based on a life-world perspective with focus on inter-personal interaction, has been used with eleven undergraduate students from the second and final year. Each student participated in three individual video-sessions with a facilitator. Two individual interviews were carried out with each student during the learning process and one interview 12-18 months after the last session. The interviews were audio-recorded and transcribed verbatim and a phenomenological hermeneutic method inspired by Paul Ricoeur and described by Lindseth & Norberg was used to interpret the interviews and diary notes. The interpretation resulted in three key themes and nine sub-themes. The key themes were; Obtaining better preconditions for bodily awareness, Experiencing changes in one’s own movement and Experiencing challenges in the learning process. The interactive learning model entails a powerful and challenging experience that develops movement awareness. The experience of meaningfulness and usefulness emerges increasingly and alternates with a feeling of discomfort. The learning model may contribute to the body of knowledge of well-defined educational strategies in movement awareness and learning in for example preventive interventions and ergonomic education. It may also be valuable in other practical learning situations where movement awareness is required.

Nursing education should prepare students for a lifelong professional career including managing clinical physical demands. Musculoskeletal symptoms, such as bodily pain, have been reported among nurses and nursing students but less is known about the impact of symptoms in daily activities. The aim was to explore the prevalence of self-reported musculoskeletal symptoms and their impact on general physical activity among nursing students. This cross-sectional study was based on a questionnaire to all undergraduate nursing students at one university. The prevalence of symptoms and physical impact during past 3 and 12 months was calculated for each study year. Odds ratio was analysed with logistic regression. Of 348 students 224 responded, 84% women, mean age 24.6 years (range 20-46). Of those 143 (64%) reporting symptoms during the past 12 months, 91 (64%) reported impact on physical activities. Most commonly reported were everyday activities such as transportations and prolonged sitting. The odds ratio for reporting symptoms was 1.8 for year 2 (95% CI: 0.9-3.5), and 4.7 for year 3 (95% CI: 2.1-10.7). The prevalence of musculoskeletal symptoms was high among nursing students and higher the final study year and not only resulted in discomfort but had an impact on the students' general physical activities.

The aim of this study is to describe an interactive model developed for movement awareness in a practical learning situation and to explore the use of video-based digital feedback and reflective enquiry in this model among nursing students. Sixteen students participated in individual interactive video sessions with a facilitator, who encouraged the students to reflect upon their own movements. Qualitative analysis showed that movement patterns were visualized, and that movement awareness and self-analysis were gradually developed. Encountering one’s own movement and reflecting on one’s own experiences appear to support motivation for movement changes.

Adults with ADHD experience a wide range of difficulties in daily life, and RNs and other healthcare professionals need to know how to support them. The aim was to conduct a systematic review of which selfcare strategies adults with ADHD use and need in order to manage daily life. A literature review based on the PRISMA model was performed, and seven articles with a qualitative design were found. Data were analyzed with thematic analysis. The analysis generated one major theme Enabling ways to manage the consequences of disability in daily life based on three subthemes; Establishing ways of acting to help yourself, Finding encouraging and helping relationships, and Using external aids for managing daily life. Professionals may benefit from knowing about these selfcare strategies when meeting people with ADHD.

The aim of this study was to develop a classic grounded theory about people who have psychiatric disabilities and live in ordinary housing with housing support. Interviews and observations during the interviews were analyzed, and secondary analyses of data from previous studies were performed. The impossible mission in everyday life emerged as the main concern and mastering everyday life as the pattern of behavior through which they deal with this concern. Mastering everyday life can be seen as a process, which involves identifying, organizing, tackling, challenging and boosting. Before the process is started, avoiding is used to deal with the main concern. The community support worker, providing housing support, constitutes an important facilitator during the process, and the continuity of housing support is a prerequisite for the process to succeed. If the process mastering everyday life is interrupted by, for example, changes in housing support, the strategy of avoiding is used.

The aim of this study was to develop a grounded theory about people with psychiatric disabilities, living in supported housing. Interviews as well as observations during the interviews were analyzed together with secondary analyses of quantitative and qualitative material from previous studies. Being deprived of self-determination emerged as the main concern for residents in supported housing and striving for meaning emerged as the pattern of behavior through which this group resolves their main concern. Striving for meaning involves living in the present, striving for self-determination, strengthening self-esteem, emotional processing and resting from the present. The strategies facilitate each other and are used singly, together simultaneously, or alternately. If they are successful, a meaning in the present is perceived. If all the strategies fail repeatedly, escaping from the present is used in order to deal with being deprived of self-determination. The implications of the findings suggest prioritizing a reduction of the institutional nature of the social and physical environment, and to support the residents' self-determination.

The aim of this study was to investigate the degree of satisfaction with housing and housing support for people with psychiatric disabilities in Sweden. A total of 370 residents, in supported housing and in ordinary housing with housing support, completed a new questionnaire and reported a high degree of overall satisfaction, but many of them wanted to move somewhere else. Differences were found between the two different types of housing concerning satisfaction with housing support, social life and available choices. Security and privacy, as well as other's influence on the choice of residential area and dwelling proved to be important predictors for satisfaction.

The aim of this study was to investigate the reliability and validity of a questionnaire for studying satisfaction with housing and housing support for people with psychiatric disabilities. Most items were gathered from English language questionnaires. These were translated and adapted to a Swedish context and items concerning housing support were added. Two studies were conducted. The first, a test-retest reliability analysis, was performed in a pilot study with 53 participants; in the second study, which had 370 participants, a five factor solution with good internal consistency emerged. Further development of the questionnaire is discussed.

The major aim of the present study was to explore what people with psychiatric disabilities, living in two different types of housing, consider to be the best and the worst in their housing situation. A secondary aim was to explore to what extent additional questions to a questionnaire with a free-response format can provide complementary information to the previous knowledge in the field. The content analysis revealed that the physical attributes were of great significance for the residents in ordinary housing, while both psychosocial aspects and physical attributes were important for those living in supported housing. When providing good housing solutions for people with psychiatric disabilities, attention needs to be given to these aspects by politicians, policymakers as well as by nursing staff.

The main aim of the study was to investigate whether the three hypothesized subscales of Antonovsky's sense of coherence (SOC) scale: comprehensibility, meaningfulness and manageability, can be found when measuring SOC in a sample of patients with schizophrenia living in the community. A further aim was to study the relationship between SOC and psychopathology. The concept of SOC has been proposed to explain successful coping with life stressors. A total of 120 patients completed the SOC scale and the Brief Psychiatric Rating Scale (BPRS) was used to assess the psychopathology of the patients. The SOC scale was analysed by means of a factor analysis with a varimax rotation and the Spearman rank correlation test was used to test for associations between subscales, factors and psychiatric symptoms. A four-factor model presented the best solution and explained 48% of the total variation in SOC. The first factor, which included 12-items of the SOC scale, turned out to be the most salient factor explaining 29% of the total variation. All factors displayed some overlapping between items. Affective symptoms were negatively related to all the three subscales and the four factors of SOC, while positive symptoms were similarly related to two of the subscales and two of the factors while negative symptoms were not associated with any of the factors or subscales. The findings in this study corroborate those in studies with other patient groups and indicate that the theoretical framework of SOC should not be adopted uncritically. Furthermore, the use of the three subscales in the SOC scale in studies of patients with a severe mental illness is questioned and a further investigation of the relationship between SOC and psychopathology is proposed.

The aim of the present study is to address issues of construct validity and reliability of a revised short version of the COPES instrument to measure the psychosocial environment of supported housing facilities for persons with psychiatric disabilities. The results revealed that the division into subscales is not sufficiently reliable for use in measuring the psychosocial environment, although the three higher order dimensions can possibly be used for the descriptive and comparative purposes. A factor analysis based on the revised short version generated new factor solutions, differing from the COPES subscales, but with sufficient psychometric properties.

The main aim of the study was to describe and compare the patient and staff perceptions of the ward atmosphere of a maximum-security forensic psychiatric hospital in southern Sweden. The main instrument used, the Ward Atmosphere Scale (WAS), was administered to both patients and staff on the eight wards of the hospital, where there was a total of 82 beds. The hospital has a regional responsibility for maximum-security forensic psychiatric care in southern Sweden. Forty-eight per cent of the patients and 82% of the staff consented to participate in the study. The results of the study showed that the patients rated intermediate levels of all the 10 subscales of WAS with the lowest mean scores for Autonomy and Involvement and the highest mean scores for Programme Clarity and Order and Organization. The staff, however, rated a low level of Staff Control and high levels of Programme Clarity, Practical Orientation and Support. The staff and patient perceptions differed on eight of the 10 WAS subscales with only Personal Problem Orientation and Anger and Aggression being rated at similar levels. The results are considered in the light of the limited available literature in the field. Furthermore, the differences between the perceptions of the two groups as well as the clinical implications of these differences are discussed.

Background: The work of staff in supported housing facilities for people with psychiatric disabilities has most often been studied from the perspective of one of the two groups but not from both. The staff in these facilities generally come from differing professions, reflecting either the beliefs of the medical or social models of psychiatric care. 

Aim: The aim of the present study was thus to investigate the perceptions of residents and staff of the frequency and the importance of verbal and social interactions in supported housing facilities for people with psychiatric disabilities and to compare these perceptions. A further aim was to investigate whether differences in education background and other sociodemographic factors are reflected in the staff perceptions of these interactions.

Methods: One hundred and eleven residents living in supported housing facilities in Sweden and 223 staff completed the Verbal and Social Interaction Supported Housing questionnaire. 

Results: The results revealed significant differences between the perceptions of the residents and staff on all six categories of interactions, where the staff rated the frequency and importance higher than the residents, but also some similarities in terms of the relative order of the frequency of the categories of interactions. Both the residents and staff perceived that “To build a relationship with a supportive quality” as the most frequently occurring and most important category. The mean levels of importance for all the categories were higher than for the frequency according to both groups. No differences were found between the staff with a medical or social educational background. Similarly, no differences were found in staff perceptions between those with short experience and those with long experience. 

Conclusion: This study is the first survey of its kind and the results indicate the need for reducing the gap between the staff intentions and the residents’ preferences, which could form the basis for in-house training activities. 

A questionnaire to measure the verbal and social interactions between carers and residents in supported housing facilities for persons with psychiatric disabilities has been developed. It is an adaptation of a questionnaire originally used in a forensic psychiatric setting. The aim of the present study was thus to investigate the construct validity and the reliability of this new version of the Verbal and Social Interactions questionnaire for use in supported housing facilities (VSI-SH). Two hundred and twenty-three carers from municipal and privately run housing facilities completed the questionnaire. A factor analysis was performed, which resulted in six factors. The number of items was reduced from the original 47 to 30 in order to minimize factorial complexity and multiple loadings. The reliability was tested with Cronbach's alpha and good internal consistency for the questionnaire and five of the six factors was found. The resulting six factors and the items were compared to the conceptual model and four of the six factors corresponded well with the categories in this original theoretical model. The questionnaire can be a useful contribution to the study of interactions between carers and residents in supported housing facilities for persons with psychiatric disabilities.

Patients and staff in a forensic psychiatric setting were requested to name three distinguishing characteristics of the ward atmosphere. The manifest content analysis of the responses revealed the following categories: interpersonal relations and pre-conditions for interpersonal relations, organization, staff, treatment, daily activities, physical environment and feeling good and secure. The patients appeared to have a peripheral role as contributors to the ward atmosphere in the views of the respondents. The easily administered single question format provided valuable information about that intangible element of psychiatric settings – the ward atmosphere.

The residents' perspective of the quality of housing support for people with psychiatric disabilities living in congregate supported housing has been studied and a comparison has been made with the findings from those from a previous study in ordinary housing with outreach support. One-hundred and seventy-eight residents from 27 supported housing facilities in eight Swedish municipalities completed the Quality of Psychiatric Care-Housing (QPC-H) instrument. The highest quality ratings were found for: Secluded Environment, Encounter and Support, while Participation, Housing Specific and Secure Environment were rated at lower levels. Despite relatively high ratings, a majority of items did not attain the 80% cutoff point deemed as defining satisfactory quality of service. The residents in ordinary housing with outreach support rated higher levels for the majority of the QPC-H dimensions in comparison with those in supported housing. A conclusion is that the quality of care in supported housing facilities has a number of deficiencies that need to be addressed. Supported housing is generally rated as having a lower quality of care than in ordinary housing with outreach support. Suggestions for the content of staff training are made based on the results.

Students in nursing education do not need to have any experience of having worked in healthcare prior to entering the programme. A total of 123 students rated their perceived knowledge and degree of difficulty in performing supportive caring actions during the first semester of their nursing education. The study, which has a descriptive approach, has been carried out using the Verbal and Social Interaction for Nursing Students (VSI-NS) questionnaire that contains four factors: Inviting to talk about feeling and thoughts, Building a caring relationship, Encouraging social and practical aspects in daily life and Caring towards health and well-being. The results of the study showed that the nursing students rated a high level of knowledge about supportive caring actions, but that these could be difficult to perform. The only significant difference was between male and female nursing students, where the male nursing students considered that it was more difficult to create a caring relationship than their female counterparts.

Aims and objectivesTo identify perceived challenges related to self-management among recently diagnosed adults and those with longer experience of type 2 diabetes as a foundation for the future development of a person-centred information and communication technology service. BackgroundLearning self-management of type 2 diabetes includes mastering the skills required to complete complex emotional and physical tasks. A service developed with the participation of stakeholders may be an alternative way to meet rising needs for self-management. DesignQualitative descriptive design influenced by a participatory approach. MethodsMultistage focus group interviews among one group of recently diagnosed (3years, n=4) adults and one group with longer experience (5years, n=7) of type 2 diabetes. ResultsChallenges in self-management in everyday life with type 2 diabetes were identified: understanding; developing skills and abilities; and mobilising personal strengths. Both groups described challenges in understanding the causes of fluctuating blood glucose and in developing and mobilising skills for choosing healthful food and eating regularly. The recently diagnosed group was more challenged by learning to accept the diagnosis and becoming motivated to change habits while the experienced group was mainly challenged by issues about complications and medications. ConclusionAdults with diabetes have different needs for support during different phases of the disease. From a person-centred perspective, it would be desirable to meet individual needs for self-management on peoples' own terms through a technological service that could reach and connect to a large number of people. Relevance to clinical practiceDiabetes nurses need to address the knowledge needs of patients with diabetes and support them in developing self-management skills. Consistent with person-centred care, practitioners should also encourage patients' abilities to mobilise their own personal strengths to maintain self-management.

Purpose: The incidence of gestational diabetes among Chinese women is 4.3%. No study has previously been conducted about beliefs and health-related behavior among urban Chinese women with this disease. This article aims to explore beliefs about health and illness and health-related behavior among women in this group in a Chinese sociocultural context.

Design: A qualitative exploratory study was conducted and semistructured individual interviews (n = 15) were processed by content analysis.

Results: Beliefs about health and illness among these women were foremost attributed to the individual, social, and natural worlds. They feared the negative influence of gestational diabetes, but some of them believed in “letting nature take its course” and “living in the present.” Their care-seeking behavior varied between the professional, popular, and folk sectors. They sought a balance between following professionals’ advice and avoiding practical difficulties.

Conclusion: The beliefs and health-related behavior among them were influenced by Chinese culture, which can sometimes but not always reduce the effect of the disease.

Objective: This study explores beliefs about illnessand health and self-care behaviour among womenwith gestational diabetes living in a rural area of thesouth east of China.Design: A qualitative exploratory study using semistructuredinterviews and qualitative content analysis.

Setting: A hospital located in the outskirts of a city inthe south east of China.Participants: Seventeen women with gestational diabetesin 34–38th pregnant weeks.

Results: The beliefs about gestational diabetes amongthe women in the present study were found to be bidirectional.Some of them feared the illness and its negativeinfluence on health, while others believed that itwas not a severe illness and disbelieved the diagnosisof gestational diabetes. They related their illness andhealth to the individual, social and natural factors.They mainly sought help from the professional sector,but did not fully comply with the professionals’advice. Diet control and exercise were their main selfcaremeasures, but none of them self-monitored theirblood glucose. They demonstrated their misunderstandingabout diet control and self-monitoring ofblood glucose.

Conclusions: This study highlighted the serious lackof knowledge, lower level of risk awareness and poorself-care behaviour among women in this group.Health professionals were found to be the most importantsource of knowledge about gestational diabetesfor these women. The influence of Chinese culture was demonstrated. Gestational diabetes among thesewomen can most likely be improved by training thehealth professionals and by health education involvingindividuals, families and the rural communities.

Objective To explore the lived experience of women with gestational diabetes mellitus (GDM) living in China in order to add knowledge about how the Chinese women suffer from GDM. Design A qualitative interpretive interview study. Data were collected with a snowball sampling technique. Phenomenological hermeneutics was used as the analysis method based on Ricoeur's phenomenological hermeneutical interpretation theory. Setting The study was performed at the participants' work places, or at the obstetric clinics or wards at two provincial hospitals and one municipal hospital in the southeast of China. Participants Inclusion criteria were age >= 18 years, diagnosis of GDM without other pregnancy complications, in 34th gestational weeks-postpartum 4th weeks and speaking Mandarin Chinese without speech impediment. 62 women, who met the inclusion criteria, took part in the study. Results The lived experience of the women with GDM living in China was formulated into a main theme: 'longing for caring care'. The main theme was derived from four themes: being stricken by GDM, wishing to receive caring GDM care, being left alone to struggle with GDM and trying to adjust and adapt to life with GDM. Conclusion The eagerness for caring care in China was highlighted. The lack of caring care could be one of the possible reasons why the professional-patient relations were deteriorating in China. It could be useful for health providers and health policymakers to receive education and training about caring care. Using the health metaphor of balance and 'patient participation' and 'patient-centred' approaches may benefit women with GDM and thus improve the quality of care in China.

Objective: To explore the quality of gestational diabetes mellitus (GDM) care experienced by women in China and how it could be improved.

Methods: A qualitative study was conducted at a municipal hospital in south east China. Women who had been diagnosed with GDMat 34–38 weeks of pregnancy were enrolled during two periods;between May 1 and July 31, 2012, and between April 1 and July 31, 2013. Data regarding patient-perceived care quality were collected through semi-structured individual interviews and were analyzed by qualitative content analysis.

Results: The study enrolled 44 patients; the interviews recorded a lack of professional care resources for GDM, a lack of high-quality personalized care for women with GDM, and patients’ suggestions regarding how to improve GDM care.

Conclusion: The participants reported a lack of high-quality GDM care, describing the core problem as an imbalance between over-stretched hospitals and low-efficiency under-utilized primary healthcare centers. Clinical-practice reforms identified, particularly in primary healthcare settings, included improving services through increasing the number of health professionals and material resources to comply with diabetes guidelines, and incorporating a humanistic approach in the provision of care

Objective: To systematically review literature about the rehabilitative effects of traditional Chinese exercises (TCEs) on limb function among patients with stroke. Methods: Systematic review and meta-analysis of randomized controlled trials (RCTs). Twelve electronic databases were searched from their inceptions to February 2017, including PudMed, The Cochrane Library, Web of Science, EMBase, Science Direct, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, Allied and Complementary Medicine, Chinese Scientific Journal Database, China National Knowledge Infrastructure, Chinese Biomedical Literature Database and WanFang Data. RCTs were located to examine the rehabilitative effects of TCEs on limb function among stroke patients. Two authors independently screened the literature, extracted data and assessed the risk bias of the included studies. Methodological quality evaluation and meta-analysis of included studies was performed by using Cochrane Collaboration's tool (RevMan 5.3). Results: A total of 31 RCTs with 2349 participants were included. Results of meta-analysis showed that TCEs produced positive effects on limb motor function (random effects model, standardized mean difference [SMD] = 1.21, 95% confidence interval [CI] = 0.66 to 1.77, P < 0.01), balance function{Berg balance scale: (random effects model, SMD = 2.07, 95% CI = 1.52 to 2.62, P < 0.01), timed-up-and-go test: (fixed effects model, mean difference [MD] = - 1.77, 95% CI = -2.87 to -0.67, P < 0.01)}, activities of daily living (ADL) ability {Barthel Index scale: (random effects model, MD = 15.60, 95% CI = 7.57 to 23.63, P < 0.01), Modified Barthel Index scale: (random effects model, MD = 12.30, 95% CI = 7.48 to 17.12, P < 0.01)}, and neurological impairment (fixed effects model, MD = -2.57, 95% CI = -3.14 to -2.00, P < 0.01). After subgroup analysis and sensitivity analysis, the positive effects did not be affected by different types of TCEs and different lengths of intervention time. However, TCEs were no benefit to physical function on Short Physical Performance Battery and 2-min Step Test among stroke patients. Conclusion: Current evidence showed that TCEs produced positive effects on limb motor function, balance function, ADL ability and neurological impairment among stroke patients. More large-scale, highquality, multiple center RCTs are required to further verify above conclusions in the future. (C) 2017 Elsevier Ltd. All rights reserved.

BackgroundTo minimize the risk of perioperative hypothermia, it is recommended that healthcare professionals be familiar with heat conservation measures and use passive and active warming methods, in line with international guidelines. However, there is a low level of adherence perioperatively to the use of heat conservation measures. To understand why, there is a need to capture the nurse anesthetists' perspective. The aim is to describe nurse anesthetists' perceptions of heat conservation measures in connection with surgery.MethodsAn inductive descriptive design with a phenomenographic approach was chosen. A total of 19 nurse anesthetists participated and were interviewed. Data were analyzed according to Larsson and Holmstrom's phenomenographic seven-step model.ResultsSix ways of understanding the phenomenon heat conservation measures in connection with surgery were found: the preventive, the useable, the untenable, the caring, the adaptive, and the routine care approach. These approaches were related to each other in a flexible way, allowing for several to co-exist at the same time, depending on the situation.ConclusionsNurse anesthetists want to prevent the patients' heat loss and maintain normothermia, regardless of the type of surgery. This willingness, motivation, and intention enable the use of heat conservation measures. However, there are perceptions that have an impact, such as doubts and uncertainty, access, time and financial constraints, preconditions, routines or habits, and lack of availability of education/training. These barriers will require support from an organizational level to promote lifelong education and guidelines. As well as offer education at the nurse anesthetists' program.

Purpose

The aim of this study was to determine if nurse anesthetists (NAs) have access, knowledge, and adhere to recommended guidelines to maintain normal body temperature during the perioperative period.

Design

A descriptive survey design.

Methods

Questionnaires were sent to heads of the department (n = 56) and NAs in the operating departments in Sweden.

Finding

The level of access to the recommendations is high, but only one third of the operating departments have included the recommendations in their own local guidelines. The NAs' adherence was low, between 5% and 67%, and their knowledge levels were 57% to 60%.

Conclusions

A high level of knowledge, access, and adherence are important for the organization of operating departments to prevent barriers against implementation of new recommendations or guidelines. There are needs for education about patients' heat loss due to redistribution and clear recommendations.

Purpose: The aim was to describe patients' lived experience of warmth and coldness in connection with surgery.

Methods: A reflective lifeworld research (RLR) approach founded on phenomenology and the methodological principles of openness, flexibility, and bridling were used. The data consisted of 16 in-depth interviews with patients from four hospitals in Sweden.

Results: Warmth and coldness in connection with surgery means an expectation to maintain one ' s daily life temperature comfort. When patients' needs of temperature comfort is fulfilled it give a sense of well-being and calmness. Despite the body is covered there are feelings of vulnerability. When patients have the ability to change their own temperature comfort, they feel independent.

Conclusion: The individual feeling of temperature comfort could be affected or changed to discomfort during the perioperative context, and an intervention is required to avoid suffering due to the care. An ability to independently influence one ' s own temperature comfort can strengthen the patient, whereas the opposite entails suffering in silence. The phenomenon is also related to feelings of confidence about receiving the best care as well as being exposed and vulnerable. When the patient ' s need of comfortable temperature is met then feelings of security and sense of well-being emerged.

Patient education in mental health care is a conventional intervention to increase patients' knowledge about their illness and treatment. A provider-centered focus in patient education may put patients in a passive role, which can counteract their processes of recovery. There is an increasing emphasis on recovery-oriented practice, an approach that is aligned with the service user perspective, but little is known about healthcare staffs’ perspective on person-centered mental health care. A qualitative approach was used to describe staffs’ experiences of being group leaders in a person-centered health education intervention in municipal services for persons with a persistent mental illness. The analysis of staff experiences revealed three core categories: implications of division of responsibility between local authorities, awareness of facilitating factors of growth and the meaning of dialogue, forming the theme “Preconditions for person-centered care”. Further research is required to explore larger economic, political and social structures as a backdrop to person-centered mental health care, from the perspective of service users, families, health professionals and society at large.

The main focus of psychoeducative interventions for people with persistent mental illnesses have been on the reduction of noncompliance by providing information about symptoms of disease and its treatment. Social support and supporting group contexts have been described as essential for transforming personal strategies into action and the achievement of personal goals. A qualitative descriptive approach was used in order to explore experiences of a person-centered health education group intervention among persons with a persistent mental illness. The sample consisted of 13 persons with a persistent mental illness who had participated in the group intervention between the autumn 2008 and the autumn 2009. Participants expressed experiences of health processes in terms of stimulating content, development towards personal growth and group context with equality, when participating in the intervention. The findings of the actual study support further investigation on the topic of health promotion approaches emphasizing individual preferences throughout the process of psychoeducation. Further research regarding individual preferences and participation in decision-making processes related to issues of compliance among persons with a persistent mental illness are suggested.

Anorexia nervosa (AN) is a serious disease which is difficult to treat. Little is known about the recovery from AN, and therefore, this review's aim was to review and synthesise patients' experiences and perceptions of what is meaningful for recovery from anorexia nervosa while having contact with psychiatric care. Cinahl, PubMed, and PsycINFO were systematically searched, and 24 studies met the inclusion criteria and were included in the review. Three themes were identified: Being in a trustful and secure care relationship, Finding oneself again, and Being in an engaging and personal treatment. Efforts supporting staff learning and person-centred care should be emphasised and researched further.

Background: 

As part of preparation for a Swedish multicentre study, exploring sexual and married life in patients with myocardial infarction and their partners, a Swedish validated instrument was required. 

Aims:

The aim of this pilot study was to evaluate the validity and reliability of a Swedish version of the Watts Sexual Function Questionnaire (WSFQ) among persons with a heart disease.

Methods:

A convenience sample of 79 persons (47 men and 32 women) living with a heart disease was recruited from the members of the National Association of Heart and Lung Patients. They completed a Swedish version of the WSFQ on two occasions.

 Results:

Two separate factor analyses each revealed a two-factor structure on both occasions: “Sexual appetite” and “Sexual expectations ”with gender-neutral questions and “Sexual sensitiveness” and “Sexual ability” with gender-specific questions. Cronbach's alpha coefficients ranged from 0.48 to 0.86 and test – retest values for all but one question exceeded 0.70.

Conclusions:

The Swedish version of the WSFQ showed good validity and stability and acceptable internal homogeneity. Extended evaluations of the questionnaire are recommended.

Objective. To examine psychiatric patients' experience of mechanical restraints and to describe the care the patients received.

Background. All around the world, threats and violence perpetrated by patients in psychiatric emergency inpatient units are quite common and are a prevalent factor concerning the application of mechanical restraints, although psychiatric patients' experiences of mechanical restraints are still moderately unknown.

Method. A qualitative design with an inductive approach were used, based on interviews with patients who once been in restraints.

Results. This study resulted in an overbridging theme: Physical Presence, Instruction and Composed Behaviour Can Reduce Discontent and Trauma, including five categories. These findings implicated the following: information must be given in a calm and sensitive way, staff must be physically present during the whole procedure, and debriefing after the incident must be conducted.

Conclusions. When mechanical restraints were unavoidable, the presence of committed staff during mechanical restraint was important, demonstrating the significance of training acute psychiatric nurses correctly so that their presence is meaningful. Nurses in acute psychiatric settings should be required to be genuinely committed, aware of their actions, and fully present in coercive situations where patients are vulnerable.

Aim: The aim of this study was to develop and evaluate a self-report instrument measuring patients', family members', and staff's perceived support from light and color in the physical environment of an emergency department (ED)-the Light and Color Questionnaire (LCQ). Background: The physical care environment is an important part of a comprehensive caring approach in all levels of care not only for patients but also for family members and staff. However, no existing self-report questionnaire assessing the extent to which light and color are perceived as being supportive in the physical care environment from the users' perspective was found. Method: The LCQ was developed as part of a pre-post study in which an ED serving 125,000 people was refurbished and remodeled using evidence-based design. The LCQ consists of six items for light and five items for color and assesses awareness/orientation, safety/security, functional abilities, privacy, personal control, and stimulation. The study was carried out in four steps: constructions of items, assessment of face validity, data collection, and data analysis. Result/Conclusion: Psychometric evaluation of the two versions, LCQ-Patient/Family member and LCQ-Staff, showed satisfactory content and internal validity (>90%) and high internal consistency (Cronbach's coefficient alpha = .9) to support the use of the questionnaire for research and development purposes. Explorative factor analysis of a total of 600 questionnaire responses confirmed light and color as distinctive and independent dimensions creating perceptions of more or less supportiveness for respondents. The LCQ instrument may be useful for architects, administrators, and researchers of healthcare environments.

Aim: This study aimed to investigate the similarities and differences related to verbal and social interaction skills between nursing students attending universities in Sweden and China, two countries with different educational systems, during the students’ first semester.

Background: Nurses need a high level of interaction skills in order to interact effectively with patients and their families. Thus, practical nursing education focusing on clinical skills is essential.

Method: Students at one university in Sweden and two universities in China completed the Verbal and Social Interactions for Nursing Students (VSI-NS) questionnaire.

Results: The students perceived ‘Building a caring relationship’ and ‘Caring towards health and well-being’ as the most frequently occurring and important types of caring interactions. The students perceived that talking with a patient about his/her feelings and thoughts was the least frequently occurring and least important type of caring interaction.

Conclusion: The students appear to understand from the initial phase of their education that the caring relationship and the patients’ health and well-being will be the major focus of their role as nurses.

Background/aims The aim of the present study was to test the psychometric properties and dimensionality of the instrument Quality in Psychiatric Care - Daily Activities (QPC-DA) and to briefly describe the day centre attendees' perception of the quality at community-based day centre services. Methods A sample of 218 attendees from 14 community-based day centre services in seven municipalities in Sweden participated in the study. Results Confirmatory factor analysis revealed that the QPC-DA consists of six dimensions and has a factor structure that to a large extent corresponds to that found in other studies of quality in psychiatric care settings, such as inpatient, outpatient, forensic inpatient, and housing support for people with psychiatric disabilities. The internal consistency of the factors was satisfactory and thus the QPC-DA showed adequate psychometric properties. The attendees' ratings of quality of community-based day centre services were generally high. The highest rating was for the encounter dimension and the lowest for the participation and the secluded environment dimensions, indicating areas for improvement. Conclusion/significance The QPC-DA includes important aspects of the attendees' assessment of quality of community-based day centre services and offers a simple and inexpensive way to evaluate quality from their perspective.

BACKGROUND/AIMS: Community-based day centres in Sweden are well-established arenas for psychiatric rehabilitation, but little is known of the attendees' perception of the quality of the service provided. The aim of the study was thus to describe and investigate the quality of the services in community-based day centre for people with psychiatric disabilities.

METHODS: A sample of 218 attendees in 14 community-based day centre services in Sweden completed the Quality in Psychiatric Care - Daily Activities (QPC-DA).

RESULTS: The results showed that people with psychiatric disabilities perceived the quality of community-based day centre services as high. Most notably, quality of service was rated higher by those with lower educational level, had waited shorter time to attend the centre, and had better mental and physical health. However, particularly aspects of a secluded environment and participation (information) may be areas with potential for improvement.

CONCLUSION/SIGNIFICANCE: From an occupational science perspective, the results adhere to the importance of occupational balance, with periods of rest/privacy during the time at the centre.

Purpose – The purpose of this paper is to test the psychometric properties and dimensionality of the instrument Quality in Psychiatric Care-Housing (QPC-H) and briefly describe the residents’ perception of quality of housing support. Design/methodology/approach – A sample of 174 residents from 22 housing support services in nine Swedish municipalities participated in the study. Confirmatory factor analysis (CFA) revealed that the QPC-H consisted of six dimensions and had a factor structure largely corresponding to that found among other instruments in the Quality in Psychiatric Care (QPC) family of instruments. Findings – CFA revealed that the QPC-H consisted of six dimensions and had a factor structure largely corresponding to that found among other instruments in the QPC family of instruments. The internal consistency of the factors was acceptable except in the case of secure and secluded environment, probably due to few numbers of items. With this exception, the QPC-H shows adequate psychometric properties. Social implications – The residents’ ratings of quality of housing service were generally high; the highest rating was for secluded environment and the lowest for participation. This dimension would thus seem to indicate an important area for improvement. Originality/value – The QPC-H includes important aspects of residents’ assessment of quality of housing service and offers a simple and inexpensive way to evaluate housing support services from the residents’ perspective. © 2016, © Emerald Group Publishing Limited.

Objective To investigate the relationship between perceived mental health service provision and quality of life (QoL) as perceived by patients in psychiatric outpatient care.Methods A total of 373 adult patients registered at 15 psychiatric outpatient clinics in three regions in central and southern Sweden were included in the study. Survey data were collected using a questionnaire on mental health service provision, symptom severity, recovery, clinical diagnosis, sociodemographics (serving as independent variables) and QoL (serving as the dependent variable). Three aspects of mental health service provision were used: patients' perceived quality of care, perceived staff-patient interaction, and patient reported psychiatric treatments. Structural equation modelling was used to model the relationship among the variables.Results Variables in mental health service provision showed few direct associations with patients' perceived QoL. Instead, the associations of mental health service provision on QoL were mainly mediated through symptom severity and recovery. These relationships were retained after adjusting for sociodemographic variables and clinical diagnoses. The final model achieved excellent goodness of fit (chi 2 = 49.502, p = 0.230, RMSEA = 0.020, CFI = 0.997 and a SRMR = 0.024).Conclusion This study shows that mental health service provision is associated with patients' perceived QoL; however, this association is mostly indirect and mediated by reduced symptom severity and increased recovery. This finding can help inform the design of future interventions to enhance service provision to improve patients' QoL.

Background:The EQ-5D index often fails to detect the effect of ophthalmic diseases and sight loss. Investigating predictors of individual EQ-5D health dimensions might reveal the underlying reasons. The aim of this study was to investigate predictors of health dimension ratings obtained with the EQ-5D-3L from participants with impaired vision representing a spectrum of eye diseases.

Methods: Observational cross-sectional study with participants recruited at four public hospitals in Portugal. Outpatients with visual acuity of 0.30 logMAR(6/12) or worse in the better-seeing eye were invited to participate. Participants completed two instruments: the EQ-5D-3L (measures participants’ perceived health-related quality-of-life) and the Massof Activity Inventory (measures visual ability–ability to perform vision-related activities). This study used logistic regression models to identify factors associated with responses to the EQ-5D-3L.

Results: The study included 492 participants, mean age 63.4 years (range = 18–93), 50% females. The most common diagnosis was diabetic retinopathy (37%). The mean visual acuity in the better seeing eye was 0.65 logMAR (SD = 0.48) and the mean visual ability was 0.62 logits (SD = 2.04), the correlation between the two was r = − 0.511 (p < 0.001). Mobility and self-care were the health dimensions with the fewest problems (1% reported extreme problems), anxiety and depression the dimension with the most problems (24% reported extreme problems). ROC curve analysis showed that the EQ-5D index was a poor predictor of cases of vision impairment whilst visual ability given was a good predictor of cases of vision impairment. Visual ability was an independent predictor of the response for all dimensions, higher ability was always associated with a reduced odds of reporting problems. The odds of reporting problems were increased for females in 3 out of 5 dimensions. Comorbidities, visual acuity and age-category were predictors of the odds of reporting problems for one dimension each.

Conclusions: The odds of reporting problems for the five health dimensions of the EQ-5D-3L were strongly influenced by the ability to perform vision-related activities (visual ability). The EQ-5D index showed poor performance at detecting vision impairment. These findings are informative and relevant for the clinic and for research evaluating the impact of eye diseases and disease treatments in ophthalmology.

It  is  seldom  that  it  is  only  the  patient  who  is  affected  when  someone  is  admitted  to  compulsory  psychiatric  inpatient  care,  the  next  of  kin  is  usually  also  impacted.  The  aim  was  to  describe  the  lived  experiences  of  being  a  next  of  kin  to  a  woman  in  need  of  compulsory  psychiatric  inpatient  care.  Ten  next  of  kin  were  interviewed  and  the  material  was  analyzed  with  a  Reflective  Lifeworld  Research  approach.  The  results  show  loneliness  and  feelings  that  their  existence  has  collapsed.  An  emotional  duality  is  described  in  the  realization  that  the  care  is  needed  but  they  are  devastated  that  the  woman  is  there.  A  trust  exists,  but  it  changes  when  the  next  of  kin  are  no  longer  a  part  of  the  care  process.

AimTo determine the reliability of application of the RETTS© triage scale after an educational intervention using paper-based scenarios in emergency care education.BackgroundKnowledge about and education in triage are important factors in triagescale implementation. Presenting students with a large number of triage scenarios is a common part of triage education.MethodsIn this prospective cross-sectional study at two universities students undergoing education in emergency care used RETTS© to assess triage level in 46 paper-based scenarios.Results57 students in the study made 2590 final triage decisions. Fleiss Kappa for final triage was 0.411 which is in the lower range of moderate agreement. In 25 of 46 (53.4%) scenarios, final triage levels did not agree about whether the case was stable or unstable.Conclusion/ImplicationsApplication of the RETTS© triage scale after an educational intervention with paper-based simulation in emergency care education resulted in moderate agreement about the final levels of triage.

Syftet med denna studie har varit att belysa hur boende i kommunala bostäder med särskilt stöd, för personer med psykiska funktionshinder upplever de stödinsatser de erhåller från boendestödspersonal.

Målgruppen var personer med psykiska funktionshinder som har sitt boende ordnat i ett ordnat boende med boendestöd och bostad med särskilt stöd genom kommunal försorg, antingen enligt SoL eller enligt LSS.

Vid analysen av intervjuerna så framträder olika genomgående teman som belyser vad de boende upplever som stöd. Ett genomgående tema i analysen är känslan hos de boende av gemenskap med boendestödjarna och denna går som en röd tråd igenom det mesta av vad de boende talar om. Förutom gemenskapen så framträder olika teman som på olika sätt kan belysa det som påverkar det stöd som de boende upplever där ett av temana tycks företrädesvis beröra egenskaper hos boendestödspersonalen. Detta tema kan i sin tur delas upp i två subteman. Det ena subtemat belyser att boendestödjarna strävar efter ömsesidighet och respekt medan det andra subtemat belyser hur de försöker möta den boendes svårigheter. Vidare så framträder ett tema, i resultatet som helhet, och detta är de boendes upplevelser av på vilket sätt som stödpersonalens arbete/bemötande hjälper dem. Detta tema berörde flera av de boende spontant vid flera tillfällen under intervjuerna och inte bara i samband med att de fick den direkta frågan. Detta tema kan delas upp i två subteman där det ena belyser hur boendestödjarna kan skapa ordning då den boende mår dåligt, medan det andra subtemat belyser hur boendestödjarna tycks kunna bidra till att den boendes mer långsiktiga förmåga att hantera sitt liv kan öka. Ett annat tema förefaller beröra stöd med olika praktiska saker. Ytterligare ett tema som går att återfinna är mer inriktad på att känslan av struktur ger trygghet. Avslutningsvis belyses även vad de boende saknar eller tycker att de har extra behov av.

Rapporten är nr 5 (av 24st) i Boendeprojektet som är ett riktat projekt inom ramen för kansliet för Nationell psykiatrisamordning. Projektmedel beviljades av Socialstyrelsen år 2005 för ett uppdrag inom satsningen på psykiatri och socialt stöd och omsorg för personer med psykisk sjukdom och/eller psykiska funktionshinder. Projektet har letts av David Brunt, Institutionen för vårdvetenskap och socialt arbete, Växjö universitet.

Denna studie har avsett att kartlägga hur vanligt det är att olika vårdande/stödjande handlingar förekommer i kommunala stödboenden för personer med psykiska funktionshinder samt hur viktiga dessa handlingar anses vara utifrån boendes och personals perspektiv.

Målgruppen var personer med psykiska funktionshinder som har sitt boende ordnat i ett särskilt boende genom kommunal försorg, antingen enligt SoL eller enligt LSS, samt den boendestödspersonal som arbetar inom dessa stödboenden.

De sex olika kategorierna av vårdande/stödjande handlingar förekommer i olika grad, enligt de boendes svar. De två kategorierna av handlingar som är mest vanligt förekommande är Att skapa och vidmakthålla relationer och Stöd och uppmuntran. Reflekterande samtal är den minst vanligt förekommande kategorin. När det gäller de boendes syn på hur viktiga de olika kategorierna är så framträder i stort sett samma mönster dock är Socialt umgänge mer viktigt än Stöd och uppmuntran. Dessutom så skattas kategorierna Att skapa och vidmakthålla relationer och Socialt umgänge av de boende vara betydligt mer viktiga än de andra fyra kategorierna.

När vi tittar närmare på hur mönstret ser ut från personalens perspektiv så skiljer det sig i vissa delar från de boendes svar. Att skapa och vidmakthålla relationer följt av Stöd och uppmuntran är även enligt personalen de mest vanligt förekommande och de mest viktiga kategorierna av vårdande/stödjande handlingar. Däremot så anser personalen att de minst viktiga handlingarna är medvetandegörande samtal, visserligen tätt följt av Reflekterande samtal.

Det som är intressant att notera när man jämför de boendes med personalens svar så skattar de boende Socialt umgänge som något mer viktigt än vad personalen gör.

Rapporten är nr 7 (av 24st) i Boendeprojektet som är ett riktat projekt inom ramen för kansliet för Nationell psykiatrisamordning. Projektmedel beviljades av Socialstyrelsen år 2005 för ett uppdrag inom satsningen på psykiatri och socialt stöd och omsorg för personer med psykisk sjukdom och/eller psykiska funktionshinder. Projektet har letts av David Brunt, Institutionen för vårdvetenskap och socialt arbete, Växjö universitet.

Denna studie har avsett att kartlägga hur vanligt det är att olika vårdande/stödjande handlingar förekommer inom privata boendeformer (HVB-hem mm) för personer med psykiska funktionshinder samt hur viktiga dessa handlingar anses vara utifrån boendes och personals perspektiv.

Målgruppen var personer med psykiska funktionshinder som har sitt boende i en bostad som drivs av en privat entreprenör, HVB-hem mm samt den boendestödspersonal som arbetar inom dessa boenden.

Den kategori av stödinsatser som boende och personal anser vara mest vanligt förekommande och som upplevs mest viktig är att skapa och vidmakthålla relationer. Den näst mest vanligt förekommande och viktiga är stödjande och uppmuntrande samtal. Den minst vanligt förekommande kategorin är enligt såväl de boende som personalen reflekterande samtal. Kategorierna socialt umgänge och reflekterande samtal är de minst viktiga enligt de boende medan medvetandegörande samtal är den minst viktiga enligt personalen.

De viktigaste handlingarna, enligt de boende, är att personalen uppmuntrar dem när de gör något som är bra och att de står för vad de har sagt samt att de visar de boende att de är tillgängliga för dem. Dessutom så anger de boende att det är viktigt att personalen visar att de bryr sig och är ärliga men även att de uppmuntrar de boende att komma och prata när de har det besvärligt och att de hjälper de boende att se sina möjligheter. De handlingar som personalens svar visar är särskilt viktiga (förutom de handlingar som ingår i kategorin att skapa och vidmakthålla relationer) är att uppmuntra de boende när de gör något som är bra, att uppmuntra de boende att hålla god hygien, att komma och prata när de har det besvärligt men även att de pratar med de boende om de gör något olämpligt.

Den generella bilden som framträder i denna studie är att personalen kan antas ha en relativt god förmåga att se och försöka arbeta med det som de boende anser är viktigt. Däremot så finns mer påtagliga skillnader mellan de boendes och personalens skattningar beträffande hur ofta de olika kategorierna av handlingar förekommer. Detta tyder på att personalens budskap inte har nått fram, i önskvärd grad, när det gäller de vårdande/stödjande handlingarna. En mindre skillnad mellan dessa två gruppers skattningar kan vara ett tecken på att personalen uppfattar hur viktigt patienterna anser att dessa handlingar är och arbetar därför med dessa. En större skillnad kan vara ett tecken på att personalen har svårt att möta det som de boende anser viktigt eller att personalen arbetar mer med det som de själva anser är viktigt. Det sistnämnda kan vara ett tecken på att personalen arbetar med sådant de känner sig trygga med.

Rapporten är nr 8 (av 24st) i Boendeprojektet som är ett riktat projekt inom ramen för kansliet för Nationell psykiatrisamordning. Projektmedel beviljades av Socialstyrelsen år 2005 för ett uppdrag inom satsningen på psykiatri och socialt stöd och omsorg för personer med psykisk sjukdom och/eller psykiska funktionshinder. Projektet har letts av David Brunt, Institutionen för vårdvetenskap och socialt arbete, Växjö universitet

The Verbal and Social Interaction Nursing Students questionnaire (VSI-NS) has been created to measure the development of verbal, social and interactional skills of nursing students with patients, from their perspective in nursing care. The aim of the present study was to determine the construct validity and internal consistency reliability of the questionnaire. The study had a methodological and developmental design and was carried out in four steps: adjustment of the items, face validity, data collection and data analysis. The number of items was reduced from 48 to 31. The factor analysis of the final 31 items resulted in four quite distinct factors: “Inviting to talk about feelings and thoughts”, “Building a caring relationship”, “Encouraging social and practical aspects in daily life” and “Caring towards health and wellbeing”. The results showed satisfactory psychometric properties in terms of content validity, construct validity and the internal consistency reliability of the questionnaire.  It could be concluded that the original conceptual model could serve as a theoretical foundation to explain and understand nurses’ caring interactions with their patients.