Background: Stress in the intimate relationship is found to worsen the prognosis in women suffering from myocardial infarction (MI). Little is known about how male spouses experience the intimate relationship.

Aim: This study aimed to explore and describe the experience of men’s intimate relationships in connection to and after their female partner’s first MI.

Methods: An explorative and qualitative design was used. Interviews were conducted with 16 men having a partner who the year before had suffered a first MI. The data were analysed with qualitative content analysis.

Results: Three themes emerged: masculine image challenged; life takes another direction; and life remains unchanged. The men were forced to deal with an altered image of themselves as men, and as sexual beings. They were hesitant to approach their spouse in the same way as before the MI because they viewed her to be more fragile. The event also caused them to consider their own lifestyle, changing towards healthier dietary and exercise habits.

Conclusions: After their spouse’s MI, men experienced a challenge to their masculine image. They viewed their spouse as being more fragile, which led the men to be gentler in sexual intimacy and more hesitant to invite sexual activity. This knowledge about how male spouses experience the intimate relationship could be helpful for health personnel in hospitals and primary care when they interact with couples where the woman suffers from cardiac disease or other chronic disorders.

Aim.

This study aimed to explore and describe women’s experience of intimate relationships in connection to and after their partner’s first myocardial infarction.

Background.

Support from partners is important for recovery, but little is known about partners’ experience of intimate relationships after myocardial infarction.

Design.

The study used an explorative, qualitative design.

Methods.

The first author interviewed 20 women having a partner who had suffered a first myocardial infarction during the preceding year. Qualitative content analysis was used to analyse the data.

Findings.

Three themes emerged: ‘limited life space’, ‘sense of life lost’ and ‘another dimension of life’. The women described how their self-assumed responsibility led to a more stifling and limited life. Their sense of life lost was described in terms of deficits and feeling the loss. The women also described experiencing another dimension of life characterised by three subthemes: ‘uncertainty of life’, ‘certain of relationship’ and ‘share life more’.

Conclusions.

The partners’ myocardial infarction had an impact on the interviewees’ intimate relationships; they suffered a major loss and missed their ‘former’ partner, both emotionally and sexually. They struggled with the new asymmetry in their intimate relationship and felt compelled to adapt to their partners’ lack of sexual desire or function. Also, their partner controlled them, which lead towards a stifling, more limited life space.

Relevance to clinical practice.

Caregivers in hospital and primary care settings could apply the findings in their efforts to help couples recover or maintain intimate relationships following myocardial infarction.

Background: Sexual health and sexual activity are important elements of an individual’s well-being. For couples, this topic is often affected after a myocardial infarction (MI). It has become increasingly clear that, after an MI, patients are insufficiently educated on how to resume normal sexual activity. However, sufficient data on the general knowledge that patients and partners have about sexual activity and MI are lacking.

Objective: The aims of this study were to explore and compare patients’ and partners’ sexual knowledge 1 month after a first MI and 1 year after the event and to compare whether the individual knowledge had changed over time. A second aim was to investigate whether patients and their partners report receiving information about sexual health and sexual activity from healthcare professionals during the first year after the event and how this information was perceived.

Subjects and Methods: This descriptive, comparative survey study enrolled participants from 13 Swedish hospitals in 2007-2009. A total of 115 patients with a first MI and their partners answered the Sex After MI Knowledge Test questionnaire 1 month after the MI and 1 year after the event. Correct responses generated a maximum score of 75.

Results: Only 41% of patients and 31% of partners stated that they had received information on sex and relationships at the 1 year follow-up. The patients scored 51±10 on the Sex After MI Knowledge Test at inclusion into the study, compared with the 52±10 score for the partners. At the 1-year follow-up, the patients’ knowledge had significantly increased to a score of 55±7, but the partners’ knowledge did not significantly change (53±10).

Conclusions: First MI patients and their partners reported receiving limited information about sexual issues during the cardiac rehabilitation and had limited knowledge about sexual health and sexual activity.

Objectives: To study the relationship between coping strategies and nausea during emetogenic pelvic-abdominal radiotherapy, and to describe the patients’ rationales for their expectations regarding nausea. Methods: Patients (n = 200: 84% women, mean age 64 years, 69% had gynecological, 27% colorectal, and 4% had other malignances) longitudinally participated during pelvic-abdominal radiotherapy. We measured adopted coping strategies using the Mental Adjustment to Cancer scale and the patients’ rationales for their expectations regarding nausea at baseline. The patients registered nausea and vomiting daily during the radiotherapy period (mean 36 + Standard Deviation 10 days). Results: Patients who experienced nausea (n = 128, 64%) during the radiotherapy period graded a lower score on “Fighting Spirit” (median, md, score 51, P = .031) and a higher score on “anxious preoccupation” (md 18, P = .040) compared to patients who did not experience nausea (n = 72, 36%), md 54 and md 17. More of the patients for whom “Helpless-Hopeless” represented the most predominant response experienced nausea (100%) or vomited (56%) compared to patients adopting “Fighting Spirit”: 62% experienced nausea (P = .011) and 20% vomited (P = .014). Only four (6%) of the nausea-free patients had expected themselves to be at increased risk for nausea. Of the patients who became nauseous, 22 (17%) patients had expected themselves to be at increased risk for nausea (P = .017), based on previous experience. Conclusion: Patients adopting maladaptive coping strategies or patients expecting nausea based on previous experiences, were more likely to experience nausea than other patients when undergoing emetogenic pelvic-abdominal radiotherapy. Cancer care professionals may identify patients adopting maladaptive coping strategies or having high nausea expectations by applying the MAC scale and self-assessment of expected nausea risk and guide these patients to adopt adaptive coping strategies and strengthen their expectations on successful prevention of nausea.Trial registration number: Clinicaltrials.gov: NCT00621660.

Aims and objectives. To describe the partners’ experiences of living with a person with chronic illness and how they manage everyday life.

Background. The number of partners providing informal care for their chronically ill spouse is rising, and they describe their daily life as demanding.

Design. A descriptive design with a qualitative approach was used.   

Methods. A purposive sample of 16 partners with a chronically ill spouse were interviewed. The interviews were recorded, transcribed, and analyzed using qualitative content analysis.

Results Four main themes were identified: ‘Living with challenges caused by the spouse's disease,’ ‘Seeking support for living with the spouse’s illness,’ ‘Appreciating the good parts of life’ and ‘Adapting to constant changes and an uncertain future.’ The participants rated their health as rather good and had great confidence in their own ability to cope with daily life. Their experiences of support from formal care providers varied; they expressed the need for more assistance from the health care sector.

Conclusions. The partners experienced many challenges in everyday life when providing informal care for their chronically ill spouse. This affected both their physical and psychological health, as they had limited time for themselves. The partners seemed to receive more support from their informal network than from formal care providers. In handling daily life, the partners balanced demands and resources to identify possibilities to move forward and find meaning in life.

Relevance to clinical practice. Formal care providers must acknowledge partners' needs, develop evidence-based assessment guidelines, and provide efficient support to partners with a chronically ill spouse. 

During the last ten years, the inclusion of education in health information systems has assumed an important role in graduate programs for health professionals. More recently, attention has focused on undergraduate programs. Throughout the world schools of nursing, organisations and associations are addressing the issue of educational offerings in nursing informatics. This paper reports on the status of nursing informatics at undergraduate level. Nurse academics from Gavle and Lund in Sweden, and from Melbourne and Sydney in Australia, took part in a survey of the respective nursing courses. The purpose of the study was to identify and describe examples of types of nursing informatics courses in Australia and Sweden A convenient sample of academics were approached and interviewed The results of the survey illustrate, in the schools surveyed, the slow emergence of nursing informatics into nursing curricula.

Background: Common mental disorders (CMDs) are currently a major cause of long-term sick leave, with women being the most affected.Objective: Using the Theory of Planned Behaviour (TPB), we aimed to describe the development and psychometric evaluation of a new questionnaire to measure women's beliefs about return to work (RTW) after long-term sick leave for CMDs.Methods: Data were collected in central Sweden from women on long-term sick leave(2–24 months) for CMDs. The questionnaire was developed by conducting an elicitation study with 20 women and included direct and indirect measures. Subsequently, 282 women participated in a psychometric evaluation and 35 of them in a test-retest procedure. Psychometric properties were evaluated by determining reliability (internal consistency [Cronbach’s alpha] and test-retest stability [intraclasscorrelation coefficient]), construct validity (exploratory factor analysis) and content validity. Results: The development resulted in 60 questionnaire items. Content validity assessment showed that the women overall found it easy to complete the questionnaire. Reliability analyses showed satisfactory results for direct and indirect measures, with a few exceptions. Factor analyses of the indirect scales showed that items were generally in line with the TPB, but that items related to life as a whole/personal life and items related to work separated into two different factors. Conclusions: The questionnaire, called the RTW Beliefs Questionnaire, showed promising results and can among women with CMDs considered useful, especially scales for direct measures. This questionnaire gives the opportunity to identify new potential predictors for RTW.

Background and aim

Common mental disorders are common reasons for long-term sick leave, especially among women. Return to work is often complex and unsuccessful, why more knowledge is needed regarding women’s health and psychological well-being in the return-to-work process. Therefore, the aim was to describe women’s health and psychological well-being in the return-to-work process, from women’s and first-line managers’ perspectives.

Methods

Individual interviews were conducted with 17 women and 16 first-line managers. Qualitative content analysis was performed based on the content areas “Women’s health (i.e. overall well-being, both physical and psychological) throughout the whole RTW process” and “Women’s psychological well-being (happiness, meaning and a sense of being significant) at work after work resumption” Themes and categories were created.

Results

Women and managers had similar descriptions, i.e. that women’s health and psychological well-being depend on the individual characteristics of women themselves, their private life, work and other stakeholders. However, women described relational work tasks (e.g. meeting patients) as beneficial for health, and highlighted small stressors in the work environment, which the managers did not. Having work that was compatible with private life, being in good health, having stimulating work tasks and strengthening relationships at work were important for the women’s psychological well-being.

Conclusions

Based on women’s and first-line managers experiences, promotion of women’s health and psychological well-being during the return-to-work process requires individually adapted assessments and actions involving women’s entire life situation. First-line managers should know that relational work tasks (e.g., meeting patients) can be beneficial for women’s health as well as that minor stressor in the work environment can put their health at risk.

Background: Long-term sick leave due to common mental disorders (CMDs) is a great burden in several countries. Women are more likely to be affected by CMDs. A strong intention to return to work (RTW) as well as symptom relief may facilitate RTW in this group. However, there is a lack of knowledge regarding what constitutes a strong intention. The Theory of Planned Behaviour is well-suited to identifying underlying beliefs about intentions to perform a behaviour. By including psychological well-being and perceived health, a more comprehensive picture of determinants of RTW intention might be achieved. Thus, the aim of the present study was to identify associations between RTW beliefs, psychological well-being, perceived health and RTW intentions among women on long-term sick leave due to CMDs, and to do so based on the Theory of Planned Behaviour.

Methods: The study was cross-sectional. Between October 2019 and January 2020, 282 women on long-term sick leave (>2 months) due to CMDs were included in the study. The questionnaires for data collection were: “RTW Beliefs Among Women-Questionnaire”, the “General Health Questionnaire -12” and the “EuroQol Visual Analogue Scale”. Standard multiple regression analysis was performed both with and without adjustment for potential confounders.

Results: The results showed that more positive attitude towards RTW, stronger social pressure to RTW, higher perceived control over RTW and higher psychological well-being were associated with stronger RTW intention. The adjusted analysis eliminated the importance of psychological well-being for RTW intention, but showed that women who reported that their employer had taken actions to facilitate their RTW had stronger RTW intention. 

Conclusion: The RTW beliefs, derived from the Theory of Planned Behaviour, were all important for a strong RTW intention, while psychological well-being and perceived health showed weaker associations. Furthermore, having an employer that take actions for facilitating RTW was associated with stronger RTW intentions. Though some caution is warranted regarding the representativeness of the sample, the results do improve our understanding of some important determinants of RTW intention among women on long-term sick leave for CMDs. 

Purpose: Long-term sick leave due to common mental disorders (CMDs) is an increasing problem, especially among women. To help these women return to work (RTW) sustainably, we need to know more about their own beliefs about RTW. One applicable theory is the theory of planned behaviour (TPB). Thus, the present study aimed to describe, based on the TPB, women's beliefs about RTW during or after long-term sick leave for a CMD.

Methods: A qualitative approach was used. Twenty women were included during a long-term sick leave period due to a CMD. A deductive content analysis was conducted using predetermined factors from the TPB: behavioural beliefs (advantages – disadvantages of RTW), normative beliefs (supporters and non-supporters of RTW), and control beliefs (facilitators of – barriers to RTW).

Results: The women believed that RTW would give them meaning and balance in life, but also that it would be challenging to maintain balance after RTW. They believed they had several supporters of RTW, but that the support was sometimes perceived as stressful rather than encouraging. Furthermore, individual adaptation and high demands were the most mentioned facilitator and barrier, respectively. Workplace conditions and personal strategies were thought to be important aspects.

Conclusions: By using the TPB, the present study was able to offer new findings on women’s beliefs about RTW after long-term sick leave for a CMD. Based on the findings, we suggest that various RTW stakeholders should focus on striving to provide the tasks and work pace women need so they can maintain their professional competence and sense of meaning.

Common mental disorders are associated with long-term sick leave, especially among women. There is a lack of theory-based research regarding the impact of personal factors on return to work and psychological well-being. Therefore, the aim of this study was to examine whether return-to-work beliefs and perceived health were predictors of return to work and psychological well-being among women during or after long-term sick leave for common mental disorders, based on the Theory of Planned Behaviour. This was a prospective cohort study with a 1-year follow-up. At baseline, women (n = 282) had been on full- or part-time sick leave for common mental disorders for 2–24 months. Data were collected in October 2019–January 2020 and October 2020–January 2021 in Sweden. The Social Insurance Agency identified the women at baseline. The Return-To-Work Beliefs Questionnaire, EuroQol Visual Analogue Scale and General Health Questionnaire-12 were used. Multiple logistic and linear regression analyses were conducted. The women were divided into two groups: full-time sick leave or part-time sick leave at baseline. The results showed that stronger return-to-work intention significantly predicted return to work among women on full-time sick leave at baseline. No significant predictors of return to work were found among women on part-time sick leave at baseline. Psychological well-being was predicted by stronger social pressure to return to work (full-time group) and a more positive attitude toward returning to work and better perceived health (part-time group). We concluded that the Theory of Planned Behaviour can be useful for understanding return to work among women on full-time sick leave, and what underlies psychological well-being in both groups. However, return to work and psychological well-being were predicted by different factors, indicating that a multifactorial approach should be used in supporting women to return to work after long-term sick leave for common mental disorders.

Aim: The aim was to describe individuals’ experiences of living with long-term illness.

Methods: A qualitative approach with a descriptive design was used. Semi-structured interviews were conducted with 16 persons (50–80 years). They were also asked to self-rate their perceptions of their current health status and confidence in their ability to cope with everyday life.

Results: One main theme was identified: new insights and access to resources change the perspective on life. Personal characteristics and support from others were advantageous in finding ways to deal with limitations related to the illness. Most of the persons experienced a changed approach to life, in that they now valued life more than they had before. However, some persons also experienced lost values and found it difficult to accept medications. The persons rated their current health status as slightly above average, but their confidence in their ability to cope with everyday life as high.

There is a lack of knowledge about how older people living with chronic illness describe the meaning of autonomy and participation, indicating a risk for reduced autonomy and participation in their everyday life. The purpose of this study was to describe the meaning of autonomy and participation among older people living with chronic illness in accordance with their lived experience. The design was descriptive with a phenomenological approach guided by Giorgi's descriptive phenomenological psychological method. Purposive sampling was used, and 16 older people living with chronic illness who lived in an ordinary home participated in individual interviews. The findings showed that the meaning of autonomy and participation among the older people emerged when it was challenged and evoked emotional considerations of the lived experience of having a chronic illness. It involved living a life apart, yet still being someone who is able, trustworthy and given responsibility – still being seen and acknowledged. The meaning of autonomy and participation was derived through life memories and used by the older people in everyday life for adjustment or adaption to the present life and the future. Our conclusion is that autonomy and participation were considered in relation to older people's life memories in the past, in their present situation and also their future wishes. Ability or disability is of less importance than the meaning of everyday life among older people. We suggest using fewer labels for limitations in everyday life when caring for older people and more use of the phrase ‘ability to act’ in different ways, based on older people's descriptions of the meaning of autonomy and participation.

AIM: The present study aimed at describing how nursing students engaged in their clinical practice experienced two models of supervision: supervision on student wards and traditional supervision. BACKGROUND: Supervision for nursing students in clinical practice can be organized in different ways. In the present study, parts of nursing students' clinical practice were carried out on student wards in existing hospital departments. The purpose was to give students the opportunity to assume greater responsibility for their clinical education and to apply the nursing process more independently through peer learning. METHOD: A descriptive design with a qualitative approach was used. Interviews were carried out with eight nursing students in their final semester of a 3-year degree program in nursing. The data were analyzed using content analysis. FINDINGS: Two themes were revealed in the data analysis: When supervised on the student wards, nursing students experienced assuming responsibility and finding one's professional role, while during traditional supervision, they experienced being an onlooker and having difficulties assuming responsibility. CONCLUSIONS: Supervision on a student ward was found to give nursing students a feeling of acknowledgment and more opportunities to develop independence, continuity, cooperation and confidence.

Purpose: Most cardiac arrest research has focused on survival inan out-of-hospital context. The knowledge of health and quality of life is sparse, especially regarding in-hospital cardiac arrest (IHCA) survivors. The aim of the current study was therefore to describe neurologic outcome, health-related quality of life (HRQoL), anxiety and symptoms of depression among IHCA survivors.

Materials and methods: This study has a cross-sectional design. Data from the Swedish Register of Cardiopulmonary Resuscitation was used. In the register, data is collected 3–6 months after resuscitation by using a questionnaire including two questions about activities in daily life and mental/intellectual recovery, theEQ-5D-5L and the Hospital Anxiety and Depression Scale (HADS). In addition, Cerebral Performance Category (CPC)-scoring is performed.

Results: Between the 11th of June 2013 and the 7th of May 2015, 488 IHCA survivors with a mean age of 69±13 were included. A majority were men (62%), had a cerebral function of CPC 1 (87%) and no need of assistance from other people in daily life (71%). A large proportion had not made a complete mental/intellectual recovery (27%). Pain/discomfort was the dimension in EQ-5D-5L where most survivors reported problems (64%), while least problems were reported in the dimension self-care (24%). The individual variations of present health state (EQ-VAS) were substantial (range 0–100), with a mean value of 66±22. Anxiety and symptoms of depression were reported by 16% and 15% respectively.

Conclusions: Although the majority of the IHCA survivors reported good neurologic outcome, satisfactory HRQoL, no anxiety or symptoms of depression, the results indicate major individual differences, with a substantial group reporting serious problems. Our findings stress the importance of structured post resuscitation care and follow-up, in order to identify and support those in need.

AIM: To describe health status and psychological distress among in-hospital cardiac arrest (IHCA) survivors in relation to gender.

METHODS: This national register study consists of data from follow-up registration of IHCA survivors 3-6 months post cardiac arrest (CA) in Sweden. A questionnaire was sent to the survivors, including measurements of health status (EQ-5D-5L) and psychological distress (HADS).

RESULTS: Between 2013 and 2015, 594 IHCA survivors were included in the study. The median values for EQ-5D-5L index and EQ VAS among survivors were 0.78 (q1-q3=0.67-0.86) and 70 (q1-q3=50-80) respectively. The values were significantly lower (p<0.001) in women compared to men. In addition, women reported more problems than men in all dimensions of EQ-5D-5L, except self-care. A majority of the respondents reported no problems with anxiety (85.4%) and/or symptoms of depression (87.0%). Women reported significantly more problems with anxiety (p<0.001) and symptoms of depression (p<0.001) compared to men. Gender was significantly associated with poorer health status and more psychological distress. No interaction effects for gender and age were found.

CONCLUSIONS: Although the majority of survivors reported acceptable health status and no psychological distress, a substantial proportion reported severe problems. Women reported worse health status and more psychological distress compared to men. Therefore, a higher proportion of women may be in need of support. Health care professionals should make efforts to identify health problems among survivors and offer individualised support when needed.

Purpose: The aim of the study was to compare healthrelated quality of life (HRQoL) in patients 1, 4 and 12 months after myocardial infarction with regard to (1) differences over time and (2) differences between younger (42–64 years old) and older (65–90 years old) patients.

Methods: A longitudinal, descriptive and comparative design was used for the study, which included 69 younger (39% women) and 79 older (42% women) patients. Data were collected with the SF-36 Health Survey during the period 1999–2001.

Results: Table 1 displays main effects of time and groups. No group-by-time interaction effects emerged. HRQoL increased in younger patients for physical functioning, bodily pain, vitality and social functioning scales between 1 and 4 months, which remained at 12 months. There was also an increase for role-physical and role-emotional scales between 1 and 4 months and a further increase between 4 and 12 months. In older patients the increase for rolephysical, vitality, social functioning and role-emotional scales was found between 1 and 4 months, which remained at 12 months. Moreover, an improvement in the physical functioning scale was found between 4 and 12 months and for the bodily pain scale between 1 and 4 months. An increase for mental health scale in the study group was evident between 4 and 12 months, but when the study group was divided into younger and older patients the change over time disappeared. The general health scale was stable over time. Compared with older patients, younger patients rated higher HRQoL for the physical functioning scale at 1, 4 and 12 months, for the social functioning scale at 1 and 12 months, for the roleemotional scale at 4 and 12 months and for the rolephysical scale at 12 months.

Conclusion: There was an improvement in HRQoL in both younger and older patients, but the improvement was more obvious in younger patients. In addition, younger patients perceived higher HRQoL than older patients in several dimensions and at several points in time. This was most evident at 12 months.

Aims : The general aim of this thesis was to describe the life situation of women and men during their first year after myocardial infarction (MI) with regard to problems in daily life, how they coped with them, the social support available and the patients’ perceived quality of life (QoL). An additional aim was to examine differences over time and between women and men in coping, social support and QoL.

Methods : A consecutive series of 74 women and 97 men were selected 1 month after MI and followed over the first year. A qualitative approach was used to describe experiences of everyday life of 20 women and 19 men from the study group, from the onset of MI through the first months after the event (retrospectively). Focus was on managing problems and support from the network (I). Also experiences at 4 to 6 months and expectations of the future were explored (II). Coping, social support and QoL were compared between women and men both with a cross-sectional (at 1 month; 74 women and 97 men; III) as well as with a longitudinal design (at 1, 4 and 12 months; 60 women and 88 men; IV).

Findings : Physical symptoms and emotional distress were the most commonly described problems during the first months after MI. The patients managed the problems by negotiating with themselves, relying on their own capabilities, changing attitudes and behaviour and taking their own decisions. The network was generally supportive but also communication problems were described (I). Many of the patients had not established a stable health condition after 6 months. They managed the consequences of their disease, found a meaning in what had happened, and confidence in the future. The support from their social network encouraged them to move on (II). Women used more evasive and supportive coping than men 1 month after MI. More women perceived support being available from grandchildren and friends and more men from their partners. Compared with men, women rated lower health-related QoL and QoL (III). Coping and social support were stable over time, women used more evasive coping than men and health-related QoL increased for both women and men. (IV).

Conclusions : The first month after MI seems to be a vulnerable period especially for women. They had difficulties interpreting their heart symptoms, did not want to bother others with their worries and rated lower QoL than men. Patients redefined normal life, found hopes for the future and women did not demonstrate a poorer QoL profile than men over time.

Purpose

The aim of the present study was to investigate relationships between sense of coherence, emotion-focused coping, problem-focused coping, coping efficiency, and mental quality of life (QoL) in patients with chronic illness. A model based on Lazarus’ and Folkman’s stress and coping theory tested the specific hypothesis: Sense of coherence has a direct and indirect effect on mental QoL mediated by emotion-focused coping, problem-focused coping, and coping efficiency in serial adjusted for age, gender, educational level, comorbidity, and economic status.

Methods

The study used a cross-sectional and correlational design. Patients (n = 292) with chronic diseases (chronic heart failure, end-stage renal disease, multiple sclerosis, stroke, and Parkinson) completed three questionnaires and provided background data. Data were collected in 2012, and a serial multiple mediator model was tested using PROCESS macro for SPSS.

Results

The test of the conceptual model confirmed the hypothesis. There was a significant direct and indirect effect of sense of coherence on mental QoL through the three mediators. The model explained 39% of the variance in mental QoL.

Conclusions

Self-perceived effective coping strategies are the most important mediating factors between sense of coherence and QoL in patients with chronic illness, which supports Lazarus’ and Folkman’s stress and coping theory.

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.

Aim: To study differences between two groups, end-stage renal disease (ESRD) and chronic heart failure (CHF), regarding sense of coherence (SOC), General Self-efficacy (GSE), and quality of life (QoL) as well as relationships between these variables. 

Design: Descriptive, comparative and correlative design.  

Sample: A Swedish sample of 100 patients (59 CHF and 41 ESRD) was included. The mean age was 68 years (46 – 80 years).  

Measures: Data were collected with the SOC, the GSE and the Life Satisfaction Questionnaire (LSQ). Age, sex, educational level and living area were also examined.    

Data analysis: Differences were tested with chi-square and Mann-Whitney U-test and correlations with Pearson’s correlation coefficient. 

Results: Both SOC (r=0.58, P<0.01) and GSE (r=0.46, P=<0.01) were positively correlated with LSQ. No significant differences between the two groups were found for the study variables. Older persons (>65 years) rated their personal relationships within QoL higher (P=0.045) and older ESRD patients their SOC stronger (P=0.049). Men with CHF rated their self-efficacy higher (P=0.034).

Conclusions: Our preliminary results indicate that it seems more important how the individual tackle their present situation than what chronic illness they have.  

In Sweden there are approximately about 3500 end-stage renal disease and 250 000 chronic heart failure patients. 

Objectives: The original purpose of the study was to determine differences between two groups of patients with chronic illness (end-stage renal disease and chronic heart failure) regarding the following study variables: coping, sense of coherence, self-efficacy and quality of life. Following this, the aim was to explore the relationships between demographic variables (sex, age, educational level and living area) and quality of life as well as between coping, sense of coherence, self-efficacy and quality of life for the combined sample of patients with end-stage renal disease and chronic heart failure.

Methods: A comparative and correlative design was used with a sample of 100 patients (n=41 end-stage renal disease, n=59 chronic heart failure). The data were collected during 2004, using four standardized questionnaires and regression analyses were conducted.

Results: No significant differences were found between the two groups. Positive correlations were identified between sense of coherence, general self-efficacy and quality of life, whereas negative correlations emerge between emotion-focused coping, sense of coherence, general self-efficacy and quality of life. Sense of coherence, general self-efficacy and emotion-focused coping explained 40% of the variance in quality of life. Those with low sense of coherence and general self-efficacy showed negative correlations between emotion-focused coping and quality of life, whereas no such correlations were shown for those with high values on sense of coherence and general self-efficacy.    

Conclusions: The present results on coping and quality of life correspond with previous research regarding how other groups with chronic illness handled their daily life. Preliminary results indicate that how individuals tackle their present situation is more important than which chronic illness they have. Women used more emotion-focused coping than men, which constitute an important finding for further research.

Aim. This paper describes gender differences in perceived coping, social support and quality of life 1, 4 and 12 months after myocardial infarction.

Background. There is a shortage of studies with a longitudinal research design investigating coping, social support and quality of life in women and men after myocardial infarction.

Methods. A longitudinal, descriptive and comparative design was used for the study, which included 74 women and 97 men. At 12 months, 60 women and 88 men remained. Data were collected using the Jalowiec Coping Scale, a social support questionnaire, the SF-36 Health Survey (health-related quality of life) and the Quality of Life Index-Cardiac version (quality of life). The data were collected during the period 1999–2001.

Results. No statistically significant changes over time in coping assessments emerged in the study group, except for fatalistic coping, which diminished over time in men. Women used more evasive coping than men at 4 and 12 months. The perceived efficiency in coping with physical aspects of the heart disease increased. More women than men perceived available support from grandchildren and staff of the church. Health-related quality of life increased in women and men in physical functioning, role-physical, vitality, social functioning, and role-emotional scales.

Moreover, an improvement in the mental health scale was evident in women and a reduction in pain in men. No statistically significant gender differences were found for quality of life at any point in time.

Conclusions. The findings can be used to inform caregivers that optimistic, selfreliant and confrontational coping were the most frequently used by both women and men over the first year after myocardial infarction, and that confrontational coping has been shown to have positive outcomes in the longer term. Nurses should tell women about the importance of seeking prompt treatment and discuss health problems with caregivers and significant others. Care planning should include family members and significant others so that they can support and encourage patients to cope with problems in daily life.

Research has focused more on symptoms, risk factors and treatment, than on individuals’ experiences of illness and recovery after myocardial infarction (MI). Therefore, the aim of the study was to describe the experiences of present everyday life of women and men 4–6 months after MI and their expectations for the future. Semi-structured interviews were conducted with 20 women and 19 men from January 2000 to November 2001. Data were analysed with content analysis. Two themes, ‘Managing consequences of MI’ and ‘Finding a meaning in what had happened’, were generated. The first theme reveals that many of the patients had not established a stable health condition, even if symptoms and emotional distress had diminished over time. They had to manage health problems, lifestyle modifications, emotional reactions and changes in social life. The support from their social network encouraged them to move on. The second theme shows that patients also found positive consequences of what they had gone through, new life values and hopes in the future. The conclusions were that most of the patients moved on and began to regain a balance in everyday life, but some patients still struggled hard to find this balance. Those patients experienced large difficulties with managing their everyday life and felt a lack of support from their social network. Health professionals can be an important resource in helping patients in their adaptation to changes if they are more sensitive to patients’ needs of support both in a short- and long-term perspective.

Aim. The aim of this review is to summarize current knowledge about gender differences in perceptions of coping and social support among patients who have experienced myocardial infarction.

Rationale. Women with coronary heart disease have physical, social and medical disadvantages compared with their male counterparts, which can influence their perception of recovery after cardiac events. No review has been found which focuses

on gender differences in coping and social support in myocardial infarction patients.

Method. A computerized search was conducted using the keywords ‘myocardial infarction’, ‘coping’, ‘gender differences’ and ‘social support’. Forty-one articles, published between 1990 and October 2002, were scrutinized.

Findings. Two studies report that women used more coping strategies than men. Several qualitative studies found that women used a variety of coping strategies. Women minimized the impact of the disease, tended to delay in seeking treatment

and did not want to bother others with their health problems. Household activities were important to them and aided their recovery. Men were more likely to involve their spouses in their recovery, and resuming work and keeping physically fit were

important to them. Women tended to report that they had less social support up to 1 year after a myocardial infarction compared with men. They received less information

about the disease and rehabilitation and experienced lack of belief in their heart problems from caregivers. Further, they received less assistance with household duties from informal caregivers. Men tended to report more support from their

spouses than did women.

Conclusions. Traditional gender-role patterns may influence the recovery of patients who have experienced myocardial infarction. Caregivers may need to be more sensitive to gender-specific needs with regard to risk profiles, social roles, and the patient’s own role identity. For many women, especially older ones, household duties and family responsibilities may be an opportunity and a base for cardiac rehabilitation.

OBJECTIVE: The study objective was to compare coping, social support, and quality of life in Swedish women and men 1 month after myocardial infarction.

DESIGN: The study design was cross-sectional and descriptive-comparative.

SETTING: The study took place in 1 hospital service area in the middle of Sweden.

SUBJECTS: The sample consisted of 74 women and 97 men.

INSTRUMENTS: The Jalowiec Coping Scale, the Social Network and Social Support Questionnaire, the Short Form-36 Health Survey, and the Quality of Life Index-Cardiac Version were used.

RESULTS: Compared with men, women used more evasive and supportive coping and rated psychologic aspects of the heart disease as more problematic to manage. More women perceived available support from friends and grandchildren, and more men perceived available support from their partner. Women rated lower levels in physical and psychologic dimensions of quality of life.

CONCLUSION: The first month after myocardial infarction is a susceptible period especially for women. They used more evasive and supportive coping and experienced a lower quality of life compared with men.

Aim: The aim is to describe experiences of daily life of women and men during the first four to six months after a myocardial infarction. The focus is on problems, managing problems and support from their network.

Background: A cardiac event is traumatic and may influence well-being during a significant period of time. Few qualitative studies have investigated experiences of both women and men after a myocardial infarction and remarkably little research has been conducted on men’s experiences.

Design: The study design was descriptive, retrospective and qualitative.

Methods: Semi-structured interviews were conducted with 20 women and 19 men from January 2000 to November 2001. Data were analysed using qualitative content analysis.

Results: Three themes were generated from the analysis; ‘Threatening ordinary life’, ‘Struggling for control’ and ‘The ambiguous network’. Physical symptoms and emotional distress were the most commonly described problems during the first months after a myocardial infarction. The informants manage the problems by negotiating with themselves, relying on their own capabilities, changing attitudes and behaviours and taking their own decisions and actions. The network was generally supportive but rather often the informants also experienced communication problems when they interacted with their network.

Conclusions: Women and men strive for balance between problems and resources in daily life after a myocardial infarction. How well they succeeded depends on how secure they feel how well they communicate their needs to their network and how sensitive their network is to their spoken and unspoken needs.

Relevance to clinical practice: The findings provide an insight into what kind of problems women and men may experience after myocardial infarction and how caregivers can aid them to increase security in their daily life. Some risk characteristics that may have increased their problems in daily life are suggested, for women and men respectively.

Aim: The aims of the study were 1) to investigate to what extent nursing students were satisfied with the supervision provided by facilitators (preceptor, head preceptor, and clinical lecturer), 2) to compare nursing students' ratings of facilitators' contribution to supervision as supportive and challenging, and 3) to examine relationships between facilitators' supportive and challenging behavior in supervision and nursing students' perception of fulfillment of expected learning outcomes in clinical education.

Background: Although there are many studies on support of students in clinical education, few have addressed this from the students' point of view or made comparisons between different facilitators.

Methods: A cross-sectional survey study was conducted during April to November 2010, where 107 nursing students, from a university in central Sweden, answered a questionnaire about supervision immediately after their period of clinical education.

Result: Supportive behavior in supervision was rated higher by students for all facilitator groups as compared with challenging behavior. The students rated preceptors and clinical lecturers as more supportive than head preceptors and clinical lecturers as providing more challenges than the two other facilitator groups. Supportive and challenging behavior in supervision explained 39% of the variance in students' overall learning outcomes. However, the regression coefficient was only significant for students' ratings of supportive behavior for the preceptor.

Conclusions: Nursing students were satisfied with facilitators' supervision and by their contribution to fulfillment of overall learning outcomes. Comparisons showed that preceptors in a higher degree were perceived as supportive while clinical lecturers were perceived as more important as challengers for critical thinking, reflection and exchange of experiences between students. The model of supervision seems to be promising, but the roles across facilitators need to be made clearer, especially the head preceptor's role, which seemed to be the most unclear role in this model.

Background

Sensory hyperreactivity (SHR) is one explanation for airway symptoms induced by chemicals and scents. Little is known about health-related quality of life (HRQOL) and coping, in this group of patients. A study was done in patients with SHR to (1) compare the Nottingham Health Profile (NHP) and the Short-Form 36 Health Survey (SF-36) in regard to their suitability, validity, reliability, and acceptability; (2) evaluate how the patients cope with the illness; (3) assess whether there are differences between women and men with respect to HRQOL and coping; and (4) assess whether there are differences between patients and normative data with respect to HRQOL and coping.

Methods

A total of 115 patients (91 women) with SHR were asked to answer five questionnaires: a study-specific questionnaire, the Chemical Sensitivity Scale for Sensory Hyperreactivity (CSS-SHR), the NHP, the SF-36, and the Jalowiec Coping Scale-60.

Results

Eighty-three patients (72%; 70 women) completed all questionnaires. The SF-36 scores were less skewed and more homogeneously distributed and showed fewer floor and ceiling effects than the NHP scores. The SF-36 was also discriminated better between patients with high and low CSS-SHR scores. The reliability standard for both questionnaires was satisfactory. There were no gender differences in HRQOL. Patients with SHR had significantly lower HRQOL scores than the normative data in comparable domains of the NHP and the SF-36: emotional reactions/mental health, energy/vitality, physical mobility/functioning, and pain/bodily pain. In social isolation/functioning, the results were different; the NHP scores were similar to the normative data and the SF-36 scores were lower. The most commonly used coping styles were optimistic, self-reliant, and confrontational. Women used optimistic coping more than men. Compared with the normative group, patients with SHR used confrontational and optimistic coping more and emotive coping less.

Conclusions

The current findings showed that both the NHP and the SF-36 were reliable instruments; but the results suggest that the SF-36 is a more sensitive instrument than the NHP for elucidating HRQOL in patients with SHR. Patients with SHR experienced a poor HRQOL and they followed the Western tradition of preferring problem-focused coping strategies to palliative and emotive strategies.

INTRODUCTION

Patients’ quality of life (QoL) after having survived a cardiac arrest hasbeen reported negatively influenced or acceptable to good [1–3]. Feelings of anxiety anddepression are present in CA patients [3] and depressions have been shown to be related toQoL [4]. There is little known, however about changes over time in anxiety, depression and health-related quality of life (HRQoL) after surviving CA treated with therapeutic hypothermia (TH). Therefore, the aim of the study was to investigate if there were any changes and correlation in anxiety, depression and HRQoL from hospital discharge until one and 6 months after CA in patients treated with TH.

OBJECTIVES

During a 4-year period at three hospitals in Sweden, 26 patients were prospectively included after CA treated with TH.

METHODS

The patients answered the questionnaires Hospital Anxiety and Depression Scale (HADS), Euroqol (EQ5D), Euroqol visual analogue scale (EQ-VAS) and Short Form12 (SF12) at three occasions; in connection with hospital discharge, and at one and 6 months after CA.

RESULTS

There was improvement over time in HRQoL, in EQ5D index (p=0.002) and SF12 physical component score (PCS) (p=0.005). Changes over time in anxiety and depression were not found. Seventy-three percentages scored overall health status with EQ-VAS below 70 (scale 0–100) at discharge from hospital and at 6 months this was found in 41 %. Physical problems were most common cause of affected HRQoL. Correlation was found between depression and HRQoL and this was strongest at 6 months (rs=-0.44 to-0.71,pB0.001).

CONCLUSIONS

HRQoL are affected negatively in patients after CA treated with TH, but improvement over the first 6 months can be seen. The patients scored lower self-reported levels of HRQoL in physical than in mental components. The result indicates that time is an important factor and patients may require more support the first time after discharge from hospital.

REFERENCE(S)

1. Torgersen J, Strand K, Bjelland TW, et al. Cognitive dysfunction and health-related quality of life after a cardiac arrest and therapeutic hypothermia. Acta Anaesthesiol Scand. 2010;54:721–8. 2. Horsted TI, Rasmussen LS, Meyhoff CS and Nielsen SL. Long-term prognosis after out-of-hospital cardiac arrest. Resuscitation. 2007;72:214–8.3. Wachelder EM, Moulaert VR, van Heugten C, Verbunt JA, Bekkers SC and Wade DT. Life after survival: long-term daily functioning and quality of life after an out-of-hospitalcardiac arrest. Resuscitation. 2009;80:517–22. 4. Moulaert VR, Wachelder EM, Verbunt JA, Wade DT and van Heugten CM. Determinants of quality of life in survivors of cardiac arrest. J Rehabil Med. 2010;42:553–8.

INTRODUCTION

The aim was to describe the relatives need for support and information during the acute phase when a next of kin has survived cardiac arrest treated with hypothermia at the intensive care unit (ICU). The aim was also to describe how everyday life is affected.

OBJECTIVES

Twenty relatives were interviewed at the time the person who had suffered acardiac arrest was discharged from hospital, 1.5–6 weeks after the cardiac arrest.

METHODS

The interviews were recorded and transcribed verbatim and were analyzed with qualitative content analysis.

RESULTS

Support and information.The relatives emphasized the importance of support from the family but they could also feel loneliness in difficult moments. The staff’s presence in the ICU was supportive but how much of support the relatives experienced varied among the groups of relatives. Several of them experienced that the contact with other relatives and friends was a requirement and that all telephone calls to other relatives and friends took a lot of time and also that they could not cope with it. The relatives described that the information received at the ICU was adequate and correct. They felt, however, difficulties to assimilate the information because of difficulties in concentration and language confusion affecting the interpretation of the information. They appreciated the opportunity to ask questions but felt that the answers they sought for was not available. In comparison with ICU, the relatives experienced less information and contact with the staff in the medical ward. The relatives wished more written information and were missing information about prevention. Impact on daily life. The relatives experienced that every day life was affected through increased responsibility for the home. They also experienced that they had to support other relatives and had difficulty to take care of other relatives’ worries. The injured person’s disease resulted in a lot of practical things to take care of, like certificate, absence from work and travels to the hospital. They felt worry for the injured person and how the disease had affected them, mostly they were concerned about personality changes. They felt responsible for the injured person and were also concerned about how to cope with daily life after the person being discharged from the hospital. The relatives felt uncertainty about the future but hopeful. The interviews also revealed that many of the relatives had not discussed with the person stricken by the disease what really had happened.

CONCLUSIONS

The most important support when a next of kin had suffered a cardiac arrest was from other family members. The relatives wished repeated and more written information. Increased responsibility for the home and for the person stricken by the disease was the experience by the relatives on how everyday life was affected

Aim of the study: To investigate serum levels of glial fibrillary acidic protein (GFAP) for evaluation of neurological outcome in cardiac arrest (CA) patients and compare GFAP sensitivity and specificity to that of more studied biomarkers neuron-specific enolas (NSE) and S100B. Method: A prospective observational study was performed in three hospitals in Sweden during 2008-2012. The participants were 125 CA patients treated with therapeutic hypothermia (TH) to 32-34. °C for 24. hours. Samples were collected from peripheral blood (n. =. 125) and the jugular bulb (n. =. 47) up to 108. hours post-CA. GFAP serum levels were quantified using a novel, fully automated immunochemical method. Other biomarkers investigated were NSE and S100B. Neurological outcome was assessed using the Cerebral Performance Categories scale (CPC) and dichotomized into good and poor outcome. Results: GFAP predicted poor neurological outcome with 100% specificity and 14-23% sensitivity at 24, 48 and 72. hours post-CA. The corresponding values for NSE were 27-50% sensitivity and for S100B 21-30% sensitivity when specificity was set to 100%. A logistic regression with stepwise combination of the investigated biomarkers, GFAP, did not increase the ability to predict neurological outcome. No differences were found in GFAP, NSE and S100B levels when peripheral and jugular bulb blood samples were compared. Conclusion: Serum GFAP increase in patients with poor outcome but did not show sufficient sensitivity to predict neurological outcome after CA. Both NSE and S100B were shown to be better predictors. The ability to predict neurological outcome did not increased when combining the three biomarkers.

Aim of the study:

To investigate whether there were any changes in and correlations between anxiety, depression and health-related quality of life (HRQoL) over time, between hospital discharge and one and six months after cardiac arrest (CA), in patients treated with therapeutic hypothermia (TH). Method: During a 4-year period at three hospitals in Sweden, 26 patients were prospectively included after CA treated with TH. All patients completed the questionnaires Hospital Anxiety and Depression Scale (HADS), Euroqol (EQ5D), Euroqol visual analogue scale (EQ-VAS) and Short Form 12 (SF12) at three occasions, at hospital discharge, and at one and 6 months after CA. Result: There was improvement over time in HRQoL, the EQ5D index (p = 0.002) and the SF12 physical component score (PCS) (p = 0.005). Changes over time in anxiety and depression were not found. Seventy-three percent of patients had an EQ-VAS score below 70 (scale 0–100) on overall health status at discharge from hospital; at 6 months the corresponding figure was 41%. Physical problems were the most com-mon complaint affecting HRQoL. A correlation was found between depression and HRQoL, and this was strongest at six months (rs = −0.44 to −0.71, p ≤ 0.001). Conclusion: HRQoL improves over the first 6 months after a CA. Patients reported lower levels of HRQoL on the physical as compared to mental component. The results indicate that the less anxiety and depression patients perceive, the better HRQoL they have and that time can be an important factor in recovery after CA.

Aim: To describe relatives’ experiences during the next of kin’s hospital stay after surviving a cardiac arrest (CA) treated with hypothermia at an intensive care unit (ICU).

Methods: Twenty relatives were interviewed when the person having suffered the CA was discharged from hospital, 1.5 to 6 weeks post-CA. Data were analysed using qualitative content analysis.

Results: Three themes are described: The first period of chaos, Feeling secure in a difficult situation, and Living in a changed existence. Relatives found it difficult to assimilate the medical information and wanted it in written form. They wanted honest and clear information about their next of kin’s condition and prognosis. They lacked rehabilitation plans after discharge from the medical ward. Relatives felt a need to maintain telephone contact with family members and friends, which was time-consuming. They felt guilty and had a conscience about these feelings. Relatives felt uncertain about the future, but still hopeful.

Conclusion: Relatives asked for more information and individual rehabilitation plans. Booklets describing CA, the ICU stay and continuing care and rehabilitation directed at both the patients and their relatives are needed. Follow-up visits to the ICU staff, for both patients and relatives, need to be arranged. Hospitals should consider having a rehabilitation plan for this group of patients, which is presented by a team of healthcare professionals and that focuses on the individual’s situation, including the consequences of their heart disease and brain damage.

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.

Preceptors play an important role in the process of developing students' knowledge and skills. There is an ongoing search for the best learning and teaching models in clinical education. Little is known about preceptors' perspectives on different models. The aim of the study was to describe nursing preceptors' experiences of two clinical models of clinical education: peer learning and traditional supervision. A descriptive design and qualitative approach was used. Eighteen preceptors from surgical and medical departments at two hospitals were interviewed, ten representing peer learning (student work in pairs) and eight traditional supervision (one student follows a nurse during a shift). The findings showed that preceptors using peer learning created room for students to assume responsibility for their own learning, challenged students' knowledge by refraining from stepping in and encouraged critical thinking. Using traditional supervision, the preceptors' individual ambitions influenced the preceptorship and their own knowledge was empathized as being important to impart. They demonstrated, observed and gradually relinquished responsibility to the students. The choice of clinical education model is important. Peer learning seemed to create learning environments that integrate clinical and academic skills. Investigation of pedagogical models in clinical education should be of major concern to managers and preceptors.

BACKGROUND:

Preceptors play a critical role in the process of developing nursing students' knowledge, skills and ability to make independent and critical judgments, however relatively little is known about what aspects are associated with nurses' performance as preceptors.

OBJECTIVES:

To investigate structural conditions and professional aspects of potential importance to nurses' perceptions of their performance as preceptors, and to evaluate the validity and reliability of a questionnaire measuring nurses' perceptions of being a preceptor.

METHODS:

The study had a correlational design. Total population sampling (N=1720) in a county council district in central Sweden was used to screen for nurses with recent preceptor experience, 933 nurses responded (response rate 54%), of those 323 nurses fulfilled the inclusion criteria. The present findings are based on data from 243 of these subjects. Data were collected with a questionnaire and analyzed using multiple regressions analyses, exploratory factor analyses and reliability coefficients.

RESULTS:

The results show that aspects such as receiving feedback on the function as a preceptor, being able to plan and prepare the clinical education period, receiving support from unit managers and having specific supervision education explain 31% of nurses' overall view of their performance as preceptors. However, structural conditions and professional experiences could not explain preceptors' use of reflection and critical thinking when acting as preceptors. These findings are discussed within the framework of Kanter's structural theory of power in organizations. Further, the psychometric evaluation showed that the questionnaire is a valid and reliable instrument for measuring nurses' structural conditions for and perceptions of their performance as preceptors.

CONCLUSIONS:

Structural conditions such as feedback and support seemed to strengthen nurses' general view of their performance as preceptors but did not seem to facilitate nurses' work toward the aim of higher education and helping nursing students develop critical thinking.

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. 

Objectives: To determine whether work ability and well-being predict return to work (RTW) among women with long-term neck/shoulder and/or back pain at a 1-year follow-up, and to assess the ability of the Work Ability Index (WAI) and Life Satisfaction questionnaire (LiSat-11) to discriminate between those who did RTW and those who did not RTW. 

Methods: A survey was sent to 600 women receiving time-loss benefits from the Swedish Social Insurance Agency. In total, 208 women responded at baseline, and 141 at a 1-year follow-up. To identify whether work ability and well-being predicted RTW, multiple logistic regression analyses were performed with and without adjustment for type of work and pain intensity. To assess the discriminative ability of the WAI and LiSat-11 for women who did RTW and those who did not RTW, Receiver Operating Characteristic curves were fitted.  

Results: Work ability predicted RTW, and the results remained significant after adjusting for type of work and pain intensity (OR 1.12, 95% CI: 1.04-1.22). Well-being was not significant. The WAI at baseline adequately discriminated between RTW and no RTW after one year (AUC 0.78, 95% CI 0.70-0.86), but the LiSat-11 did not.

Conclusions: Our results indicate that work ability is an important factor for RTW among women on SL for long-term neck/shoulder and/or back pain. The WAI has adequate discriminatory ability in this population, but the LiSat-11 has not.  

Keywords: Life satisfaction, Musculoskeletal pain, Sickness absence, Work status

Background: Sick leave due to long-term musculoskeletal pain is an increasing public health problem, particularly among women, in Western countries. Studies have shown that reduced work ability and well-being are common in this population, but do they really matter for return to work (RTW)?

Purpose: The purpose of the present study was to compare work ability and well-being over time, among sick-listed women with long-term pain in neck/shoulders or back who had RTW and who remained on sick leave.

Methods: A postal survey was sent to 600 women receiving time-loss benefits according to the Swedish Social Insurance registers. Inclusion criteria: (i) age between 18 and 65 years, (ii) Sick leave: ≥ 1 month of their ≥ 50% service, (iii) pain in neck/shoulders or back: ≥ 3 months, and (iv) understanding Swedish. Exclusion criteria: (i) rheumatoid arthritis, (ii) multiple sclerosis, (iii) stroke, (iv) cancer, (v) Parkinson, (vi) bipolar disease, (vii) schizophrenia, (viii) pregnancy. After 12 months, a follow-up survey was sent to the 208 women who answered the survey at baseline. At the follow-up, 64 women had RTW and 41 remained on sick leave. The Work Ability Index (WAI) and the Life Satisfaction questionnaire (LiSat) were used to assess work ability and well-being, respectively. To determine whether the groups (RTW and non-RTW) differed at baseline for WAI and LiSat, respectively, independent t-tests were performed. If significant differences were found, the baseline values were included as a covariate in univariate analysis of variance with change in WAI and LiSat, respectively, as outcome and groups as independent variable. The level of significance was set to p < 0.05.

 Results: For WAI, the groups differed at baseline (t= -7.54, p < 0.001). In the univariate analysis of covariance, the groups changed significantly over time (F= 28.47, p < 0.001) after adjusting for baseline values. The group that returned to work improved more than the group that remained on sick leave. For LiSat, there was no difference between groups at baseline (t= -1.58, p = 0.47). In the univariate analysis of variance, the groups changed significantly over time (F= 9.30, p = 0.003). The group that returned to work improved, whereas the group that remained on sick leave showed the opposite pattern.

Conclusion: It appears that work ability and well-being do matter for RTW. The results for well-being in particular highlight the need to intervene against prolonged sick leave in this population. 

BACKGROUND:

Musculoskeletal pain is one of the leading causes of sick leave, especially among women, in Western countries. The aim of the present study was to identify factors associated with work ability and well-being, respectively, among women on sick leave due to long-term pain in the neck/shoulders and/or back.

METHODS:

A cross-sectional study with a correlational design was conducted on women who were sick-listed due to long-term pain in the neck/shoulders and/or back. A total of 208 participants responded to a survey comprising eight instruments: Multidimensional Pain Inventory scale, General Self-Efficacy scale, Sense of Coherence scale, Coping Strategies Questionnaire, Demand-Control-Support Questionnaire, Hospital Anxiety and Depression Scale, Work Ability Index and Life Satisfaction questionnaire. Multiple linear regression analyses were performed to identify factors associated with work ability and well-being, respectively.

RESULTS:

Women who more strongly believed they would return to the same work had greater work ability (β = 0.39, p < 0.001), whereas women with higher pain intensity (β = - 0.30, p < 0.001) and higher job strain (β = - 0.12, p < 0.05) had lower work ability. Women with higher self-efficacy rated greater well-being (β = 0.14, p < 0.05). As the women's scores for depression increased, their well-being decreased by 48%, which was statistically significant (p < 0.001). The regression models for work ability and well-being were significant (p < 0.001), and their adjusted R- square values were 48% and 59%, respectively.

CONCLUSIONS:

The study suggests that the factors beliefs to be back at the same work, pain intensity and job strain are predictive of work ability. Moreover, the factors self-efficacy and depression seem to be predictive of well-being. The findings highlight factors that should be considered by health care professionals and policy-makers to guide attempts to reduce sick leave.

Background: Musculoskeletal pain is one of the leading causes of sick leave (SL), especially among women in Sweden and in other western countries. It is, therefore, important to know which health- and work-related factors are associated with work ability (WA) among women with long-term musculoskeletal pain.

     Purpose: The aim of this study was to determine whether there is any association between self-efficacy, anxiety, depression, sense of coherence, job strain, support at work, pain intensity, physical activity, beliefs to be back at the same work, coping strategies, and WA.

     Methods: A cross-sectional study was conducted on women with long-term pain who were on SL. Inclusion criteria: (i) age 18-65 years, (ii) SL: ≥ 1 months, (iii) SL: ≥ 50%, (iv) pain in neck, shoulder or back (≥ 3 months), and (v) understanding Swedish. Exclusion criteria: (i) rheumatoid arthritis, (ii) multiple sclerosis, (iii) stroke, (iv) cancer, (v) Parkinson, (vi) bipolar disease, (vii) schizophrenia, (viii) pregnancy. In spring 2016, self-administered questionnaires were sent out to 600 women who were receiving time-loss benefits according to the Swedish Social Insurance registers. Out of these, a total of 208 participants responded and were included in the analysis. For assessing the predictors and the outcome, seven instruments were used: General Self-Efficacy, Hospital Anxiety and Depression Scale, Demand-Control-Support Questionnaire, Sense of Coherence, Multidimensional Pain Inventory, Coping Strategy Questionnaire and Work Ability Index. Two of the predictors, physical activity and beliefs to be back at the same work, were measured by single questions. Multiple linear regression analyses were performed to detect which of the factors were associated with WA.

     Results: Women who more strongly believed that they would return to the same work within 6 months had higher WA (β= 0.39, p < .001), whereas women with higher pain intensity (β= -0.28, p < .001) and higher job strain (β= -0.12, p < .05) had lower WA. The results did not change when age, cohabitant, economic situation and social support were controlled for in the analysis. The regression model was significant (p < .0001), and its adjusted R- square was 48%.

     Discussion and practical implications: Women’s positive beliefs are associated with higher WA in accordance with previous studies. Our study also found that pain intensity and high job strain are associated with reduced WA. The results suggest that health care providers and employers should take women’s beliefs to be back at the same work into account for supporting them to return to work. Furthermore, the focus of rehabilitation program should be on women suffering from high pain intensity to increase WA.

     Conclusion: This study showed that beliefs to be back at the same work, pain intensity and job strain might be predictors of WA. Further studies are needed to identify if these predictors are also important for WA among women with long-term pain who are at work.

Key words: Factors, ability to work, sickness absence, women and pain