Background: Chinese and global populations are aging, and more older people are living in nursing homes in China. However, there is a lack of research measuring nursing home residents' quality of life (QOL), and especially associations with nursing home types (publicly versus privately run). Therefore, this study aimed to determine the construct validity and internal consistency of the Chinese version of the life satisfaction questionnaire (LSQ-Chinese) and determine the associations between nursing home types (publicly versus privately run), residents' sociodemographic characteristics, and their QOL.

Methods: A cross-sectional survey measuring QOL among older people living in nursing homes was conducted (n = 419). Confirmatory factor analysis and Cronbach's alpha were used to assess the construct validity and reliability of the LSQ-Chinese. In addition, multivariate regression analysis was used to examine these associations.

Results: Confirmatory factor analysis indicated acceptable goodness-of-fit statistics for the seven-factor LSQ solution. All factors and the total scale had good internal consistency, with Cronbach's alpha values > 0.70. The two factors with the highest QOL scores (higher scores indicate a more desirable state) were "physical symptoms" and "socioeconomic situation," and those with the lowest QOL scores were "quality of close-friend relationships" and "quality of daily activities fun". Residents living in privately run nursing homes had higher LSQ scores overall and for all factors except "physical symptoms" and "sickness impact" compared with publicly run nursing homes. Multivariate analyses indicated that marital status, number of chronic diseases, education level, main source of income, and nursing home type significantly contributed to the variance in the total LSQ scores. The associated sociodemographic variables differed between the factors, and the variable publicly versus privately run was significant for five of the seven factors.

Conclusions: The LSQ is a suitable instrument for measuring the QOL of Chinese nursing home residents. The total LSQ score was higher among residents in privately run nursing homes than in publicly run ones. According to residents' needs, staff should work for person-centered activities, and facilitate residents' social interactions with friends, as both these aspects were scored relatively low.

Background: Changes in the everyday life and health of the significant others (SOs) of people living with stroke sequalae have been widely investigated. However, information regarding the frequency of the changes in daily life and the variables most associated with these perceived life changes is limited. Aims: To examine the extent to which SOs of persons with aphasia (PWAs) experience changes in everyday life and health after the stroke event and how they evaluate these changes and to identify which variables are associated with these perceived life changes. Methods & Procedures: A study-specific questionnaire about perceived changes in everyday life and health was completed by 173 SOs of PWAs living in Sweden (response rate 67.8%). The items concerned the SO’s working and financial situation, leisure time and social life, relationship with the PWA, household work and responsibility, and health and quality of life. Outcomes & Results: The everyday life and health of the SOs were greatly affected by the stroke event. The changes the SOs experienced were mainly appraised negatively. The relationships with the PWA and immediate family were least affected by the stroke. The perceived existence and severity of physical, cognitive, and language impairments of the PWA were the variables most strongly associated with the everyday life situation of the participants. The sex and age of the participants and the nature of the relationship with the PWA were only marginally associated with the experience of the situation. Conclusions: SOs’ perceptions of the PWA’s stroke-related disabilities and need for assistance may be a key factor in identifying SOs who may require support and guidance to help them cope with their new life situation.

Background

Nursing care should be respectful of and unrestricted by patients' age, ethnicity, gender, dis/abilities or social status, and such values should be taught to nursing students. Nursing teachers are crucial as role models, and their values are essential. In telephone nursing, only age, sex and ethnicity are known to the registered nurses, which can be challenging. The aim of this study was to explore awareness of discrimination and inequity in telephone nursing among nursing teachers.

Methods

A study specific survey was filled in by 135 nursing teachers from three universities in Sweden. The survey included short descriptions of 12 fictive persons who differed in age, ethnicity and sex and with questions about their estimated life situation. The teachers' estimations of life situation were ranked from lowest probability to highest probability. A 'good life index' was constructed and calculated for each fictive person. It included quality of life, power over one's own life and experience of discrimination.

Results

The results indicate that the nursing teachers were aware of how power and age, ethnicity and sex are related; that is, they were aware of discrimination and inequity in healthcare. The persons assessed to be most likely to lead a good life were males of Swedish origin, followed by females of Swedish origin. Persons with non-European origin were estimated to have the highest probability of experiencing discrimination.

Conclusions

The nursing teachers were aware of discrimination and inequity in healthcare. They were able to estimate a fictive person's life situation based on the limited knowledge of age, ethnicity and sex. This is important, as their values are pivotal in theoretical and practical nursing education.

Background

The shortage of registered nurses is a global concern. Motives to become registered nurses can be to help others, altruism, personal development and career security. Motives in combination with student expectations regarding the role are not explored.

Objective

To describe students' motives to become registered nurses and their expectations regarding their future profession.

Design

A longitudinal descriptive design with a qualitative approach was used to follow nursing students in the beginning, during and at the end of their education.

Participants and setting

A purposive sampling of a group with initially 75 students starting a three-year nursing program at a university in Sweden.

Methods

A study specific questionnaire with open-ended questions was used in the beginning, during and the end of the students' education. At data collection two and three, a copy of the earlier answers was attached. Data were analysed using manifest and latent content analysis.

Results

An important profession with career opportunities, interesting duties and team work were described. Students expected diversified duties, possibilities for development and work satisfaction. Increased concerns regarding their upcoming work life was described at the end of the education.

Conclusion

The students had a positive understanding of the profession and perceived their forthcoming role as interesting. The leading role of coordinating patient care was more comprehensive than expected. Supportive conditions and well planned transition periods could strengthen newly graduated nurses in their professional role and could be an important aspect in the future retention of RNs.

BACKGROUND: In most parts of the world, nursing historically has been considered an occupation for women. Gender stereotypes are associated with the nursing profession.

AIM: The aim was to describe and compare the self-reported competence in female and male nursing students. The students were also compared according to their different background college educations. The theoretical framework of hegemonic masculinity and femininity was used.

DESIGN: A cross-sectional design with a questionnaire was used at two points in time, 2012 and 2017.

METHODS: Nursing students completed a questionnaire on graduation from a three-year university nursing program from 12 universities/university colleges in Sweden. In total, 1,810 students were participating, 1577 female and 227 male students. The Nurse Professional Competence scale was used for data collection.

RESULTS: There were statistical significant differences in the self-reported competence between female and male students (t-tests and ANOVAs). These differences are in agreement with the patterns of hegemonic masculinity and femininity. Female students estimated their competence in giving value-based nursing care as higher than male did. Male students estimated their competence in development and leadership higher than female did.

CONCLUSION: The pattern of hegemonic masculinity and femininity could be identified. This indicates a difference in power between female and male students.

IMPACT: The study addresses the self-reported competence of female and male nursing students. The results indicated that male students possibly looked on themselves as superior to the female students. In order to change the image of nursing as a woman's work, the self-images should be discussed in nursing education as well as in college education. Women interested in development, research and leadership and men interested in nursing care and administration must feel that nursing is a suitable profession for them. The stereotypical image of nursing as a women's work is a barrier to nurses' professional development.

The quality of basic nursing bachelor programmes nationally and internationally must regularly be assessed to ensure that they fulfil requirements and are appropriate in relation to developments and changes in societies and healthcare systems. There is a need for instruments in helping to assess this. The aim of this study was to investigate whether the Nurse Professional Competence (NPC) Scale could serve as a tool to measure and detect possible differences between universities/university colleges regarding nursing students’ self-reported competence. Totally, 543 nursing students who had just completed their academic three-year nursing bachelor programmes at 10 universities/university colleges in Sweden participated in the study (response rate 71%). The students answered the NPC Scale with its 88 items constituting eight competence areas (CAs) and two overarching themes. The results from using the NPC Scale by the students were then compared between the 10 universities/university colleges. Significant mean score differences were found between the universities/university colleges on all CAs and on both themes. The highest mean score differences were found for the CAs ‘Medical and technical care’ and ‘Documentation and information technology’. The lowest mean score differences were found for the CAs ‘Value-based nursing care’ and ‘Leadership in and development of nursing’. It is concluded that the NPC Scale can serve as a useful tool in national and international assessments of nursing bachelor programmes.

OBJECTIVES: The need for assessment of possible drug-related signs and symptoms in older people with severe cognitive impairment has increased. In 2009, the PHASE-20 rating scale for identifying symptoms possibly related to medication was the first such scale to be found valid and reliable for use with elderly people. In this project, the aim was to develop and examine the psychometric properties and clinical utility of PHASE-Proxy, a similar scale for proxy use in assessing elderly people with cognitive impairment.

METHODS: Three expert groups revised PHASE-20 into a preliminary proxy version, which was then tested for inter-rater reliability, internal consistency, and content validity. Its clinical usefulness was investigated by pharmacist-led medication reviews. Group interviews and a study-specific questionnaire with nursing home staff were used to investigate the feasibility of use.

RESULTS: The PHASE-Proxy scale had satisfactory levels of inter-rater reliability (Spearman's rank correlation coefficient; rs = 0.8), and acceptable internal consistency (Cronbach's alpha coefficient; α = 0.73). The factor analysis resulted in a logical solution with seven factors, grouped into two dimensions: signs of emotional distress and signs of physical discomfort. The medication reviews, interviews, and questionnaires also found the proxy scale to be clinically useful, and feasible to use.

CONCLUSION: The PHASE-Proxy scale appears to be a valid instrument that enables proxies to reliably assess nursing home residents who cannot participate in the assessment, to identify possible drug-related signs and symptoms. It also appears to be clinically useful and feasible for use in this population.

BACKGROUND: Although Swedish legislation prescribes equity in healthcare, studies have reported inequalities, both in face-to-face encounters and in telephone nursing. Research has suggested that telephone nursing has the capability to increase equity in healthcare, as it is open to all and not limited by long distances. However, this requires an increased awareness of equity in healthcare among telephone nurses. The aim of this study was to explore and describe perceptions of equity in healthcare among Swedish telephone nurses who had participated in an educational intervention on equity in health, including which of the power constructs gender, ethnicity and age they commented upon most frequently. Further, the aim was to develop a conceptual model for obtaining equity in healthcare, based on the results of the empirical investigation.

METHOD: A qualitative method was used. Free text comments from questionnaires filled out by 133 telephone nurses before and after an educational intervention on equity in health, as well as individual interviews with five participants, were analyzed qualitatively. The number of comments related to inequity based on gender, ethnicity or age in the free text comments was counted descriptively.

RESULTS: Gender was the factor commented upon the least and ethnicity the most. Four concepts were found through the qualitative analysis: Denial, Defense, Openness, and Awareness. Some informants denied inequity in healthcare in general, and in telephone nursing in particular. Others acknowledged it, but argued that they had workplace routines that protected against it. There were also examples of an openness to the fact that inequity existed and a willingness to learn and prevent it, as well as an already high awareness of inequity in healthcare.

CONCLUSION: A conceptual model was developed in which the four concepts were divided into two qualitatively different blocks, with Denial and Defense on one side of a continuum and Openness and Awareness on the other. In order to reach equity in healthcare, action is also needed, and that concept was therefore added to the model. The result can be used as a starting point when developing educational interventions for healthcare personnel.

The aim was to compare coping strategies and quality of life (QoL) in patients with chronic heart failure (CHF) with such strategies and QOL in persons from two general Swedish populations as well as to investigate relationships between personal characteristics and coping strategies. Methods:A cross-sectional, comparative and correlational design was used to examine data from three sources. The patient group (n=124), defined using ICD-10, was selected consecutively from two hospitals in central Sweden. The population group (n=515) consisted of persons drawn randomly from the Swedish population. Data were collected with questionnaires in 2011; regarding QoL, Swedish population reference data from 1994 were used. Results: Overall, women used more coping strategies than men did. Compared to the general population data from SF-36, patients with CHF rated lower QoL. In the regression models, perceived low ‘efficiency in managing psychological aspects of daily life’ increased use of coping. Other personal characteristics related to increased use of coping strategies were higher education, lower age and unsatisfactory economic situation. Conclusion: Differences between the patients and the general Swedish population showed an unclear pattern for coping and a clear pattern for QoL. To deal with the psychological consequences of daily life, men with CHF and persons in the general Swedish population seemed to use both problem- and emotion-focused coping. 

OBJECTIVE: The overall aim of the present study was to explore awareness of inequity in healthcare and the intersection between different structures of power among nursing students. Another aim was to delineate the knowledge and use of Swedish Healthcare Direct in this group.

DESIGN: The study had a descriptive design with a quantitative approach.

PARTICIPANTS: The sample consisted of 157 nursing students from three universities in central Sweden.

METHODS: The students filled out a study specific questionnaire in class. The questionnaire consisted of short descriptions of twelve fictive persons who differed in gender, age, and ethnicity, with questions about their life situation. The mean was calculated for each assessed fictive person for every item. In the next step, the assessments were ranked from the lowest probability to the highest probability. A 'Good life-index' consisting of quality of life, power over own life, and experience of discrimination, was also calculated. Free text comments were analysed qualitatively.

RESULTS: People with Swedish names were assessed to have the highest probability of having a good life. Among those with Swedish names, the oldest woman was assessed as having the lowest probability of a good life. All students had knowledge about Swedish Healthcare Direct, but more female students had used the service compared to male students.

CONCLUSIONS: The results indicate that the nursing students had awareness of how power and gender, ethnicity and age, are related. Based on the free text comments, the questions and the intersectional perspective seemed to evoke some irritation which points to their sensitive nature. Therefore, the questionnaire could be used as a tool to start a discussion of equity in healthcare and in interventions where the aim is to raise awareness of inequality and intersectionality.