Agneta Berg

The level of and relation between hope, hopelessness and fatigue in patients and family members in palliative care.

Hope, hopelessness and fatigue are important experiences for patients and family members in palliative care. The aim of the study was to describe the level of and relation between hope, hopelessness and fatigue in patients and family members in palliative care. Eighty-five participants completed the Herth Hope Index, Becks Hopelessness Scale and rated their level of fatigue from none to severe. The level of hope proved to be significantly lower among the family members than among the patients. For the family members, correlations were found between hope and age (–0.358*), fatigue and hope (–0.439*), hopelessness and age (0.484**), age and fatigue (0.403**) and between hope and hopelessness (–0.723**). For the patients, correlations were found between age and hopelessness (0.555**) and between hopelessness and hope (–0.580**). Efforts to increase the experience of hope and decrease hopelessness and fatigue must include not only the patient but also the family members. (*=P<0.5, **=P<0.01)

Effects of systematic clinical supervision on psychiatric nurses’ sense of coherence, creativity, work‐related strain, job satisfaction and view of the effects from clinical supervision: a pre‐post test design

There are few investigations of the type and the outcome of interventions aimed at supporting nurses caring for psychiatric patients. Therefore a prepost–test design study was used in which 22 psychiatric nurses, on a general psychiatric ward were examined before, during and after one year of systematic clinical supervision combined with supervised documented, planned, individualized care. The methods used were the Sense of Coherence scale (SOC), the Creative Climate Questionnaire (CCQ), the Work-Related Strain Inventory and 34 statements from the Satisfaction with Nursing Care and Work Questionnaire (SNCW). In addition 14 statements were developed to evaluate the nurses’ view of the effects from clinical supervision. The baseline values for the CCQ indicated a stagnant organization and a high score in the conflict dimension indicated personal and emotional tensions within the organization. The intervention led to a significantly increased creative and innovative climate in the dimensions for trust, idea time and reduced conflicts. However, the organizational climate remained stagnant. The nurses’ view of the effects from clinical supervision also increased significantly. There were no significant changes in the nurses’ SNCW, WRSI or SOC score. The result of the correlation analysis indicated that a strong sense of coherence was related to low work-related strain but not to unsatisfactory working conditions/milieu. The results gave some support to the idea that systematic clinical supervision and supervised nursing care plans constitute one type of support strategy that improves creativity and the organizational climate. It may, not, however, buffer for interpersonal problems. Further research is required to explore the need for and effects of various support systems depending on the circumstances in the organization.

Courage and nursing practice: A theoretical analysis

This article aims to deepen the understanding of courage through a theoretical analysis of classical philosophers’ work and a review of published and unpublished empirical research on courage in nursing. The authors sought answers to questions regarding how courage is understood from a philosophical viewpoint and how it is expressed in nursing actions. Four aspects were identified as relevant to a deeper understanding of courage in nursing practice: courage as an ontological concept, a moral virtue, a property of an ethical act, and a creative capacity. The literature review shed light on the complexity of the concept of courage and revealed some lack of clarity in its use. Consequently, if courage is to be used consciously to influence nurses’ ethical actions it seems important to recognize its specific features. The results suggest it is imperative to foster courage among nurses and student nurses to prepare them for ethical, creative action and further the development of professional nursing practices.

Moral Responsibility: A Relational Way of Being

This article reports a study exploring the meaning of the complex phenomenon of moral responsibility in nursing practice. Each of three focus groups with a total of 14 student nurses were conducted twice to gather their views on moral responsibility in nursing practice. The data were analysed by qualitative thematic content analysis. Moral responsibility was interpreted as a relational way of being, which involved guidance by one’s inner compass composed of ideals, values and knowledge that translate into a striving to do good. It was concluded that, if student nurses are to continue striving to do good in a way that respects themselves and other people, it is important that they do not feel forced to compromise their values. Instead they should be given space and encouragement in their endeavours to do good in a relational way that advances nursing as a moral practice.

Family intervention sessions: one useful way to improve schoolchildren's mental health.

This study examines the effectiveness of therapeutic conversations with families (through family sessions) in alleviating health complaints among adolescent girls in a school setting. Four girls with recurrent, subjective health complaints and their families were included in the study. Three sessions were held with each family, using genograms, ecomaps, interventive questions, and other family nursing interventions; practicing school nurses were also present. A therapeutic letter was sent to each family at the end of the sessions. The Strengths and Difficulties Questionnaire was used as a pre- and posttest measure. Evaluative interviews were carried out with the families and with school nurses. The families reported feeling relief and described positive affective, behavioral, and cognitive changes as a consequence of the interventions. The school nurses experienced the family sessions as time-saving and easy-to-use tools in their work. Involving the family when schoolchildrens recurrent mental health problems are addressed may reduce future suffering.

Evaluation of a School-Based Program Aimed at Preventing Depressive Symptoms in Adolescents

The aim of this pilot study was to evaluate the implementation of a universal school-based cognitive behavioral program whose target is to prevent depressive symptoms in adolescents. The study had a quasi-experimental design with pretest, posttest, and a 1-year follow-up and provides an illustrative calculation for the implementation costs of the intervention. Sixty-two students (aged 14) and seven tutors participated. A majority of the students and all of the tutors were satisfied with the intervention. The students, both females and males, rated their depressed symptoms as significantly lower after the course; and for the females, this was maintained 1-year postintervention. The implementation costs for the initial 2 years were about US

Exploring student nurses’ reflections on moral responsibility in practice

300 per student. Positive effects of a universal school-based cognitive behavioral intervention aiming at preventing depressive symptoms in adolescents were found, especially among females.

Longing for Reconciliation: A Challenge for Women with Borderline Personality Disorder

Student nurses are faced with a demand for moral responsibility during their clinical education. In order to gain an understanding of how they reflect on the phenomenon of moral responsibility in nursing practice, repeated focus group interviews were conducted. Fourteen student nurses in their final year of the three year baccalaureate programme in nursing were interviewed during their final placement. The interpretive content analysis disclosed the manifestations of moral responsibility as being available for the patient, shielding the patient and being confronted with the voice of conscience. The findings highlighted the importance of space given to ethical reflection on a regular basis as a joint activity. This included by both student nurses and professionals.

Challenges of Documenting Schoolchildren’s Psychosocial Health A Qualitative Study

The aim of this study was to explore the way in which traumatic childhood experiences influenced the daily life of women with Borderline Personality Disorder (BPD). An explorative design comprising in-depth interviews and a qualitative content analysis was used. The findings revealed one main theme—Longing for Reconciliation—comprising two themes: (1) Living with a sense of shame and guilt and (2) Struggling to be released from a sense of being trapped. Longing for reconciliation influenced the womens daily life as well as their search for the meaning of traumatic childhood experiences. New meaning can emerge through change, forgiveness, and reconciliation, thus helping women with BPD overcome their struggle and gain the insight and strength to look into their secret knowledge. Meaning can emerge and help them to develop an empathic understanding of themselves in the context of past and present relationships.

Psychometric Analysis of the Salutogenic Health Indicator Scale (SHIS) in Adolescents

The aim of this study was to explore school nurses’ experience of challenges related to documenting schoolchildren’s psychosocial health in Sweden. Six focus group discussions were carried out. Areas for discussions included questions about situations, especially challenging to document as well as what constrains and/or facilitates documenting psychosocial health problem issues. Qualitative content analysis was used for interpreting the data. The analysis resulted in one overarching theme: having to do one’s duty and being afraid of doing wrong; and three subthemes: uncertainty related to one’s own ability, concerns related to future consequences, and strategies to handle the documentation. School nurses relying on their intuition and using a structured documentation model may increase the opportunities for a reliable documentation. To further develop their professional skills with regular, clinical supervision can be of great importance. This in turn may increase contributions to research and development for the benefit of schoolchildren’s psychosocial health.