The purpose of this study was to describe degree projects on a bachelor level in nursing where peer review was used as quality assurance. Two student groups, 45 nursing students and seven registered nurses, participated. This case study describes quality assurance through collaboration between examiners. The results are focused on students´, supervisors´ and examiners` experiences during the degree process from the examiners perspective. Time disposal and criteria for a passing grade constituted factors associated with obstacles for students as well for supervisors and examiners. Peer review between two universities created opportunities for increasing awareness and validation of the quality of degree project and increased reliability for the examiner’s assessment. The study highlighted the need for collaboration between supervisors and examiners throughout the work process with student’s degree project. A model of group supervision e.g. with eight students, two supervisors and one examiner with regularly utilisation of peer-review for quality assurance is a further development to reach quality assurance in a degree project.
One method to ensure that nursing students are better prepared for their future professional role can be to offer them process-oriented group supervision. The aim of this prospective, longitudinal pilot study was to evaluate the effects of a process-oriented group supervision programme (PGSP) comprising educational, supportive and developmental areas based on reports by nursing students undergoing a 3-year nursing education. The students (N=61) evaluated their experiences of the PGSP by means of a questionnaire, which they filled in after each study year. An independent t-test was conducted to compare the educational, supportive, and developmental areas after the first (2002), second (2003) and third year (2004) as well as over the whole 3-year study period. The result showed no significant difference in scores in the educational area. However, there was a significant increase in the supportive area (p=.03) over the 3-year period, which was especially noticeable during the first year (p=.013). There was also an increase in the developmental area over the 3-year period (p=.021) as well as during the first year (p=.024). Thus, PGSP seems to develop nursing students in their professional identity and personal growth. However, as this was a pilot study, a research implication is to perform a large-scale study over a longer period of time.
A central part of the nursing profession is the supervision in clinical practice of nursing students and a consequence of this is that the nurse needs to be prepared and have sufficient knowledge to support student's learning process. The aim of this study was to gain a deeper understanding of nurses' experiences of the supervision of nursing students in clinical practice. Fifteen nurses with experience of being supervisor were interviewed and the data material was analyzed with a Grounded Theory approach. The results comprise a core category “supervision was perceived as developing and stimulation” and four categories; to have sufficient with time, to have a working co-operation, to have sufficient knowledge and to get confirmation. These categories formed a conceptual model explaining the nurse’s experiences of the process of supervision and their needs of time, co-operation, knowledge and confirmation if the supervision should be perceived as developing and stimulating. More research needs to be conducted to expand the perspective on how supervision education and opportunities for reflection during the clinical education contribute to the student's learning process.
Background: A more complex and knowledge-based society has resulted in increasing specialization and greater demands on employees in the fields of practice. At Gjøvik University College, a new supervision model was tested for nursing students in practice. The main elements were: daily supervisors were given increased responsibility for assessing the students, while at the same time participating in three group counseling meetings. A portfolio contained the student’s work requirements. A weekly reflection hour was formalized. Purpose: The purpose was to elucidate how the supervision model influenced the student’s learning situation. Method: The SVIP model was evaluated by the use of focus group interviews. The data were analyzed using qualitative content analysis. Findings: Three categories: structure, inclusion and self-confidence describe the students’ need for clear guidelines and objectives, as well as their need to be included and to be seen. Conclusion: Various aspects of clinical practice, including daily supervision are important for student learning. Counseling meetings where the supervisor role is recognized and developed through the tutor, and daily supervisor sharing of experiences and knowledge, should permeate the cooperation.
Background: Pain is a symptom that affects quality of life negatively for many people. As a person gets older, the symptoms will increase and more than 50 % of the elderly in the municipal health care is expected to have some sort of pain. This makes pain management a key question.
Aim: The aim of this study was to describe what nurses perceive affect pain management for older people.
Method: The study is based on interviews with 18 nurses from two municipalities in Sweden. The method used was qualitative content analysis.
Results: Four categories affecting pain management were revealed: Proficiency, communication, organization and treatment strategies. Within each category three to four sub-categories were formed, such as medicine and older, documentation, work environment and pharmacological treatment. Several variations were revealed within each sub- categories. The results showed possibilities for good pain relief but the lack of tailored pain assessment tools, communication and treatment strategies tailored for older patients in pain made it difficult. The emerging theme was an unstructured organization makes it difficult to provide good pain relief.
Conclusion: If evidence-based pain management strategies including pain assessment tools adapted in municipal health were developed, more patients should receive adequate pain treatment.
Psychosocial difficulties in patients after a cardiac event is well-known concept yet no systematic or routine assessment with focus on their psychosocial condition with regard to coping, social support and sense of coherence is established. Accordingly the aim of this pilot study was to develop and test the psychometric properties of a short-form questionnaire regarding patients’ psychosocial condition after a cardiac event to be used in every day clinical practice. This pilot study, which had a methodological design, used selected sample of 30 participants to answer a questionnaire built on 37 items in order to determine face, content and construct validity and homogeneity reliability. Five factors built on 18 items emerged, all with good values for the psychometric tests chosen, and labelled according to their theoretical belongings: closeness, belongingness, availability, concordance and outlook. This short-form questionnaire measuring the psychosocial condition after a cardiac event useful in every day clinical practice seems appropriate but needs further psychometric development carried out in large scale studies with regard to cultural-socio-demographics and diagnoses.
Tertiary prevention comprising treatment, care and rehabilitation of patients with heart disease is an important task for nurses and other health care professionals. This is achieved through a combination of medico-physical and psychosocial interventions, related to the male or female patient's personal, expressed problems and the personnel's know ledge. Therefore, the aim of this literature study was to highlight the comprehensiveness of the cardiac rehabilitation concept from a Nordic perspective and with focus on psychosocial gender differences. The Nordic examples of cardiac rehabilitation programmes, involving a multidisciplinary team and comprising health education, physical exercise and stress management, include no specific efforts for women. However, the efficacy of out-patient programmes is still poorly documented and there is a need to increase the attendance of eligible patients, particularly women, in these programmes. There are differences between the genders concerning the need for support from personnel and laymen in order to better reach patient's compliance. Taking the psychosocial characteristics specific to women into account, could be the first step towards increased attendance rates for women as well as reaching the proximal and distal targets with regards to cardiac rehabilitation.
In society of today there are great demands on young women concerning education, work and social life and also concerning health and beauty expectations. The aim of this study was to compare 26-year old Swedish women studied at intervals of twenty years concerning stress in daily life and self-rated health. The participants in 2002 (n=386) answered the same questionnaire that was used twenty years ago in a prospective population study (n=85). The result showed no difference in self-rated health between the two groups. However, women in 2002 reported more stress and health complaints such as exhaustion, sleep disorders, restlessness and difficulty concentration. They also reported low energy level and bad appetite. This discomfort must be interpreted with caution and not necessarily as ill health. However, it is important to take the experience of stress in daily life and the increase in health complaints into consideration even if women today rate their health as good in order to avoid lasting imbalance and thereby future diseases.
Aim: To explore district nurses' experiences of information received from the employer and communicated to patients in the context of the pandemic A(H1N1).
Background: Dissemination of oral and written information in pandemics is essential to limit the spread of infection and public concern. Information is channeled via various authorities and health care centers, where district nurses often provide information directly to patients.
Method: Transcribed semi structured interviews with 21 district nurses in Region Skåne were analyzed using qualitative content analysis.
Results: The district nurses experienced shortfalls in the information communicated from the employer and that the relevant information was often preceded by public media. This made it problematic to provide information concerning pandemic A(H1N1) in a professional manner, as well as to mediate safety and credibility. During the pandemic the district nurses simultaneously sought information from websites, popular science magazines and other public media. The nurses did however express an understanding of the difficulty in this unique situation and have a positive outlook on the use of the intranet for dissemination of information.
Conclusion: It is important that district nurses receive prompt and precise information from their employer in a pandemic to facilitate the patients' information needs in credible manner.
To date, consolation has not been clearly defined in nursing science. The purpose of this study was to identify the phenomenon of consolation from the perspective of practising nurses. Data from interviews with 21 nurses were analysed by means of the grounded theory approach. Consolation comprised supportive consolation, avoiding consolation, insufficient consolation and inaccessible consolation, which were integrated into the nurses’ professional approach and personal outlook. More basic research is required in order to illuminate the meaning of the phenomenon of consolation with focus on supportive consolation as well as the non-consolation phenomenon comprising the so-called avoiding, insufficient and inaccessible consolation. In order for nurses to be able to prescribe, carry out and evaluate consoling care which alleviates patient suffering, there is a need for further knowledge of what constitutes and does not constitute consolation.
To date, consolation has not been clearly defined in nursing science. The purpose of this study was to identify the phenomenon of consolation from the perspective of practising nurses. Data from interviews with 21 nurses were analysed by means of the grounded theory approach. Consolation comprised supportive consolation, avoiding consolation, insufficient consolation and inaccessible consolation, which were integrated into the nurses’professional approach and personal outlook. More basic research is required in order to illuminate the meaning of the phenomenon of consolation with focus on supportive consolation as well as the non-consolation phenomenon comprising the so-called avoiding, insufficient and inaccessible consolation. In order for nurses to be able to prescribe, carry out and evaluate consoling care which alleviates patient suffering, there is a need for further knowledge of what constitutes and does not constitute consolation.
The aim of this study was to evaluate professional development and promotion as well as whether the new competence was requested after completion of a one-year master programme (MP) in Cardiovascular (CV) nursing. In Sweden the first one-year MP within the CV area took place between 2003 and 2005 at Halmstad University with a follow-up in 2007. The sample consisted of seventeen former students who had completed the MP. A questionnaire was developed comprising twenty items grouped into three main sections. Most of the nurses stated that their knowledge was requested and that they had developed their professional attitude, skills and knowledge. Seven of the nurses had a new position and five of them had advanced in terms of leadership. In three cases, the master exam was critical for the employers’ decision. Six of the nurses who had a new post had obtained an increase in salary. In conclusion, the MP led to increased competence as well as improved career prospects. Information about the MP should be available at clinics, and collaboration between clinical practice and education is necessary in order to ensure relevant use of master educated nurses’ competence.
Theoretically, one part of supervision is the direct object i.e. what can be learnt, another part is the indirect object aiming at how the learning process is constituted and influenced by both the doctoral student and his/her supervisor. Emphasising both the what and the how object of learning as well as their interrelationship may be an important factor for the development of the role of supervisor in research. The aim of this study was to describe supervision of doctoral students from the perspective of a research supervisor. Interview data were analysed in accordance with content analysis. The result showed that research supervision had a latent content of awareness of underlying structures and the preconditions for learning that became visible through self-appraisal, orientation towards a goal, in the interaction and the performance of an art. Awareness was a cornerstone in research supervision that enabled both the what and the how aspect of learning.
No studies have examined the level of preparedness of CCU nurses to deal with cardiac patients’ death issues. Accordingly, the aim of this pilot study was to explore and describe CCU nurses’ outlook on their own as well as their patients’ thoughts about death. A pilot study was conducted in 2005 at a University Hospital in southern Sweden. The 63 (93%) nurses answered a newly established 18-item questionnaire regarding their own and their patients’ thoughts about death. Descriptive statistics revealed that 90% of nurses believed that patients often thought about death. Regarding their outlook on death issues, 41% were aware of their personal standpoint, 63% were clear about their plan of action, 34% showed openness towards their patients and 26% expressed educational adequacy. These low figures pertaining to both personal and professional awareness indicate a lack of knowledge and competence. Clinical implications are the provision of various forums at CCUs on this subject and the creation of awareness at all levels of nursing education. Research implications are to further develop the instrument and implement an intervention at the CCU of how to care for dying cardiac patients in a professional manner.
Nursing is a profession involving mental strain. Sick-rates among nurses are increasing. Positive working conditions are essential in order to prevent the negative effects of work-related stress. The aim of this study was to describe how clinical group supervision can promote mental health among nurses. Data was collected by means of semi-structured interviews with 12 nurses having attended clinical supervision for 1,5 year. The material was analysed using a qualitative method with reference to phenomenography. The analysis resulted in three qualitatively different descriptive categories: 1. To reflect; to talk and work with emotions. 2. To feel support; to feel strengthened personally and professionally. 3. To have control; to delimit and cope with stress. The result shows that clinical supervision has an impact when it comes to preventing negative effects of work-related stress. Karasek-Theorell´s ”demand-control-support-model” confirms the conception that clinical group supervision has a protective and supporting effect on nurses’ mental health. The consensus of opinion is that clinical group supervision prevents the negative effects of work-related stress. Further research is therefore needed to investigate if there is a connection between clinical group supervision and sick-rates among nurses.
Aim: The aim was to identify how nurses perceive the performance of pain management and the use of guidelines for pain management.
Background: Pain is one of the most common symptoms of illness for which people request health care. Patients in pain ought to be treated quickly and adequately in order to avoid developing a chronic state. Guidelines for effective pain relief are not always implemented in clinical practice.
Method: A questionnaire regarding factors relevant to pain management and guidelines were designed.
Findings: Of the 219 nurses who were invited, 111 (50.7%) answered the questionnaire. Thirty-one nurses responded that they used guidelines and they administered additional analgesics significantly more often when breakthrough pain occurred compared to nurses responding not using guidelines. Pain assessment is not always performed, 44 nurses agreed completely or partly that pain assessment is performed only when pain in the patient has become a problem. Forty-two nurses agreed completely or partly that there are routines in their department for treating patients with difficult pain issues. The nurses highlighted the importance of collaborating in team and having pain treatment routines.
Conclusion: Pain management was perceived to be performed non-systematically and not always adapted to the individual. Guidelines were not always used.
The aim of this study was to describe nurses' experiences of factors enhancing professional development trough process-oriented group super- vision, one year after completed nursing education. The objective of process-oriented group supervision in nursing care is to support students’ development of their ability to manage complex care situations. The attitude of the supervisor and the students’ willingness to reflect on them- selves have been described as playing key roles in process-oriented group supervision during nursing education. The link to nursing science has also been described as significant by several researchers, but some supervisors are not using nursing science as a foundation in group supervision for nurses. The analysis was completed using a qualitative content analysis method based on interviews with 18 nurses resulting in the general theme “Process oriented pedagogy” which is presented in three categories: Supervisor’s character, Pedagogical strategy and Reflective communication. The findings suggest that the supervisor's personal qualities in combination with an inspiring structure are impor- tant to promote the participants’ reflective communication during the group supervision sessions. Reflective communication supports the students’ development towards a deeper professional knowledge. Further research should focus on the use of nursing science as a foundation in clinical process-oriented group supervision.