Gørill Haugan

Stress, sense of coherence and emotional symptoms in adolescents

This paper aims to investigate the association between the domains of stress, sense of coherence (SOC) and emotional symptoms (depression and anxiety) in adolescents, as well as the potential moderating role of SOC on the relationship between stress and emotional symptoms. The study is based on a cross-sectional sample of 1183 adolescents aged 13–18 who attend public elementary and secondary schools in Mid-Norway. The results showed that girls scored higher than boys on stress related to peer pressure, home life, school performance, school/leisure conflict and emotional symptoms. Conversely, boys reported higher SOC than girls. Results from multiple hierarchical regression analyses showed that for boys, stress related to school performance was positively associated with symptoms of both depression and anxiety, whereas stress from peer pressure was associated with depressive symptoms. For girls, stress from peer pressure, romantic relationships and school was associated with more depressive symptoms. SOC was strongly and inversely associated with emotional symptoms, especially anxiety in girls. SOC also moderated the association between stress related to peer pressure and depressive symptoms in both genders. The study provides evidence of the association of SOC with stress and emotional symptoms during adolescence.

Nurse–patient interaction is a resource for hope, meaning in life and self-transcendence in nursing home patients

BACKGROUNDnSpiritual dimensions such as hope, meaning in life and self-transcendence have been found to be predictors of successful ageing, life satisfaction and well-being in older individuals. Connectedness and communicating with others have been seen to facilitate hope, meaning in life and self-transcendence among nursing home patients.nnnAIMSnThis study aimed to investigate the associations between hope, meaning in life, self-transcendence and nurse-patient interaction in a nursing home population.nnnDESIGN AND METHODSnA cross-sectional design was employed, collecting data in 44 different Norwegian nursing homes (NHs) from 250 patients who met the inclusion criteria. Approval by all regulatory institutions dealing with research issues in Norway and the Management Unit at the 44 NHs was obtained. A sample of 202 cognitively intact nursing home patients responded to the Herth Hope Index, the Purpose in Life test, the Self-Transcendence Scale and the Nurse-Patient Interaction Scale. A structural equation model (SEM) of the hypothesized relationships between the constructs was tested.nnnRESULTSnThe SEM model fit well with the present data. Significant direct relationships of nurse-patient interaction on hope, meaning in life and self-transcendence were displayed. Meaning and the interconnectedness dimension of hope appeared to be particularly dynamic resources, revealing significant influences on all the constructs in the SEM model tested.nnnCONCLUSIONnNurse-patient interaction influences hope, meaning in life and self-transcendence in cognitively intact nursing home patients and might be an important resource in relation to patients health and global well-being. Thus, care providers are above all fundamental for nursing home patients. Advancing caregivers interacting and communicating skills might facilitate patients health and global well-being and inspire professional caregivers as they perform their daily care practices. More research of the effectiveness of such strategies is greatly needed.nnnLIMITATIONSnThe SEM model tested comprised 20 variables, indicating a desirable sample size of n = 200, while the present effective sample was n = 187. Also, cross-sectional data do not allow making conclusion on the causality.

The relationship between nurse–patient interaction and meaning-in-life in cognitively intact nursing home patients

AIMnTo investigate the associations between nurse-patient interaction and meaning-in-life in a nursing home population.nnnBACKGROUNDnMeaning has been found to be a strong individual predictor of successful ageing and life satisfaction as well as an important psychological variable that promotes well-being. Meaning seems to serve as a mediating variable in both psychological and physical health. Connecting and communicating with others have been seen to facilitate meaning-in-life among older individuals.nnnDESIGNnCross-sectional descriptive study.nnnMETHODSnThe data were collected in 2008-2009 using the Nurse-Patient Interaction Scale and the Purpose-in-Life test. A total of 250 cognitively intact nursing home patients met the inclusion criteria and 202 (81%) participated. A structural equation model of the hypothesized relationship between nurse-patient interaction and meaning was tested by means of LISREL 8.8.nnnFINDINGSnThe structural equation model fit well with the data. A significant direct relationship between nurse-patient interaction and meaning-in-life in cognitively intact nursing home patients was displayed.nnnCONCLUSIONnNurse-patient interaction significantly relates to meaning and purpose-in-life among cognitively intact nursing home patients and might be an important resource in relation to the patients mental health and global well-being. High-quality nurse-patient interaction and in-house activities aiming to increase patients meaning might increase psychological and physical health, well-being and psycho-spiritual functioning in this vulnerable population.

Self-transcendence and nurse-patient interaction in cognitively intact nursing home patients

AIMS AND OBJECTIVESnThe aim of this study was to test whether nurse-patient interaction affects cognitively intact nursing home patients interpersonal and intrapersonal self-transcendence, as well as testing the psychometric properties of the Nurse-Patient Interaction Scale (NPIS).nnnBACKGROUNDnSelf-transcendence is considered a spiritual developmental process of maturity in adulthood, and a vital resource of well-being at the end of life. The concept of self-transcendence has previously been explored in various populations, yet the nurse-patient interactions potential influence on self-transcendence in nursing home patients has not been published previously.nnnDESIGN AND METHODSnA cross-sectional design employing the Self-Transcendence Scale and the NPIS was adopted. A sample of 202 cognitively well-functioning nursing home patients in Norway was selected. The statistical analyses were carried out using lisrel 8.8 and structural equation modelling.nnnRESULTSnStructural equation modelling-analysis indicates statistical significant effect of nurse-patient interaction on the patients self-transcendence. Direct influence on the intrapersonal and indirect influence on the interpersonal self-transcendence aspects was disclosed.nnnCONCLUSIONnNurse-patient interaction significantly affected both interpersonal and intrapersonal self-transcendence among cognitively intact nursing home patients. Hence, facilitating caring interventions can be significantly beneficial to older patients self-transcendence and thereby well-being, both emotional and physical.nnnRELEVANCE TO CLINICAL PRACTICEnCaring behaviour signifies the vital and ultimate qualitative nursing behaviour, which promotes self-transcendence and thereby well-being. These findings are important for clinical nursing that intends to increase patients well-being.

Meaning-in-life in nursing-home patients: a valuable approach for enhancing psychological and physical well-being?

AIMS AND OBJECTIVESnTo investigate the associations between meaning-in-life and physical, emotional, functional and social well-being in a cognitively intact nursing-home population.nnnBACKGROUNDnMeaning-in-life is understood as an influential psychological variable that promotes health and well-being; meaning-in-life has been found to be a mediating variable in both psychological and physical health.nnnDESIGN AND METHODSnThe study employed a cross-sectional design. Data were collected in 2008 and 2009 using the purpose-in-life test and the FACT-G quality-of-life questionnaire. A total of 250 cognitively intact nursing-home patients who met the inclusion criteria were approached and 202 attended. The hypothesised relationships between meaning and multidimensional well-being were tested by means of structural equation modelling.nnnRESULTSnThe structural equation modelling model fit well with the present data, showing significant direct relationships between meaning-in-life and emotional and functional well-being, and a significant mediated influence of meaning on social and physical well-being.nnnCONCLUSIONnMeaning-in-life is associated with all dimensions of well-being and likely plays an important role in both emotional and physical well-being.nnnRELEVANCE TO CLINICAL PRACTICEnFacilitating patients perceived meaning-in-life might help ease emotional distress and physical symptoms, thus fostering well-being in cognitively intact nursing-home patients. Therefore, advancing staff nurses competence in facilitating meaningful involvement, connectedness, nurse-patient interaction and symptom management is important for care quality and global well-being in nursing homes.

The Self-Transcendence Scale: An Investigation of the Factor Structure Among Nursing Home Patients

Purpose: Self-transcendence, the ability to expand personal boundaries in multiple ways, has been found to provide well-being. The purpose of this study was to examine the dimensionality of the Norwegian version of the Self-Transcendence Scale, which comprises 15 items. Background: Reed’s empirical nursing theory of self-transcendence provided the theoretical framework; self-transcendence includes an interpersonal, intrapersonal, transpersonal, and temporal dimension. Design: Cross-sectional data were obtained from a sample of 202 cognitively intact elderly patients in 44 Norwegian nursing homes. Results: Exploratory factor analysis revealed two and four internally consistent dimensions of self-transcendence, explaining 35.3% (two factors) and 50.7% (four factors) of the variance, respectively. Confirmatory factor analysis indicated that the hypothesized two- and four-factor models fitted better than the one-factor model (cx2, root mean square error of approximation, standardized root mean square residual, normed fit index, nonnormed fit index, comparative fit index, goodness-of-fit index, and adjusted goodness-of-fit index). Conclusions: The findings indicate self-transcendence as a multifactorial construct; at present, we conclude that the two-factor model might be the most accurate and reasonable measure of self-transcendence. Implications: This research generates insights in the application of the widely used Self-Transcendence Scale by investigating its psychometric properties by applying a confirmatory factor analysis. It also generates new research-questions on the associations between self-transcendence and well-being.

The relationships between self-transcendence and spiritual well-being in cognitively intact nursing home patients

BACKGROUNDnSelf-transcendence is considered a developmental process of personal maturity and a vital resource of well-being in later adulthood. Measurement of the associations between self-transcendence and spiritual well-being in cognitively intact nursing home patients has not been previously published.nnnAIMSnThe aim of this study was to identify the relationships between self-transcendence and spiritual well-being in cognitively intact nursing home patients.nnnMETHODSnA cross-sectional design using the self-transcendence scale and the FACIT-Sp spiritual well-being questionnaire was adopted. A sample of 202 cognitively intact nursing home patients in mid-Norway was selected to respond to the questionnaires in 2008 and 2009. Statistical analyses were conducted using lisrel 8.8 (Scientific Software International, Chicago, IL, USA) and structural equation modelling.nnnRESULTSnA hypothesised structural equation model comprising a two-factor construct of self-transcendence and a three-factor construct of spiritual well-being demonstrated significant direct relationships between self-transcendence and spiritual well-being and total effects of self-transcendence on spiritual well-being.nnnIMPLICATIONS FOR PRACTICEnFacilitating patients self-transcendence, both interpersonally and intrapersonally, might increase spiritual well-being among cognitively intact nursing home patients, which is seen to be of great importance to nursing home patients overall satisfaction and satisfaction with staff. The two-factor construct of self-transcendence and the three-factor construct of FACIT-Sp allow a more complex examination of the associations between the constructs and prove more specific guidelines for nursing interventions promoting well-being in nursing home patients.

Self-transcendence in cognitively intact nursing-home patients: a resource for well-being

AIMnThis article reports an empirical study of self-transcendence in cognitively intact nursing-home patients. The aim was to investigate the interrelationships between self-transcendence and nursing-home patients physical, social, emotional and functional well-being.nnnBACKGROUNDnFinding new and alternative approaches to increase well-being among nursing-home patients is highly warranted. Self-transcendence is considered a developmental process of maturity in adulthood and a vital resource for well-being at the end of life, thus self-transcendence could be a useful approach.nnnDESIGNnCross-sectionalnnnMETHODnThe self-transcendence scale and the Functional Assessment of Cancer Therapy General (FACT-G) Quality of Life questionnaire were used. A sample of 202 cognitively intact nursing-home patients in Mid-Norway was selected to respond to the instruments in 2008 and 2009. Analysis was applied by means of LISREL 8·8 Structural Equation Modelling.nnnRESULTSnA two-factor construct of self-transcendence showed that intrapersonal self-transcendence directly affected functional well-being and indirectly influenced physical, emotional and functional well-being. Interpersonal self-transcendence directly affected social and emotional well-being. Additionally important influences were disclosed from functional to emotional and from emotional to physical well-being.nnnCONCLUSIONnFinding nursing interventions to enhance both intrapersonal and interpersonal self-transcendence might benefit nursing-home patients overall well-being. In a holistic perspective of body-mind-spirit, this research generates new-research questions about the pathways between the different dimensions of well-being in nursing-home patients, which is important to holistic nursing practice.

The Effect of Self-Transcendence on Depression in Cognitively Intact Nursing Home Patients

Aims. This studys aim was to test the effects of self-transcendence on depression among cognitively intact nursing home patients. Background. Depression is considered the most frequent mental disorder among the elderly population. Specifically, the depression rate among nursing home patients is three to four times higher than that among community-dwelling elderly. Therefore, finding new and alternative ways to prevent and decrease depression is of great importance for nursing home patients well-being. Self-transcendence is related to spiritual as well as nonspiritual factors, and it is described as a correlate and resource for well-being among vulnerable populations and at the end of life. Methods. A two-factor construct of the self-transcendence scale (interpersonal and intrapersonal) and the hospital anxiety and depression scale (HADS) was applied. A sample of 202 cognitively intact nursing home patients in central Norway was selected to respond to the questionnaires in 2008/2009. Results. A hypothesized SEM model demonstrated significant direct relationships and total effects of self-transcendence on depression. Conclusion and Implication for Practice. Facilitating patients self-transcendence, both interpersonally and intrapersonally, might decrease depression among cognitively intact nursing home patients.

The Hospital Anxiety and Depression Scale—Dimensionality, reliability and construct validity among cognitively intact nursing home patients

BACKGROUNDnDepression and anxiety are particularly common among individuals living in long-term care facilities. Therefore, access to a valid and reliable measure of anxiety and depression among nursing home patients is highly warranted.nnnAIMnTo investigate the dimensionality, reliability and construct validity of the Hospital Anxiety and Depression scale (HADS) in a cognitively intact nursing home population.nnnMETHODSnCross-sectional data were collected from two samples; 429 cognitively intact nursing home patients participated, representing 74 different Norwegian nursing homes. Confirmative factor analyses and correlations with selected constructs were used.nnnRESULTSnThe two-factor model provided a good fit in Sample1, revealing a poorer fit in Sample2. Good-acceptable measurement reliability was demonstrated, and construct validity was supported.nnnLIMITATIONSnUsing listwise deletion the sample sizes were 227 and 187, for Sample1 and Sample2, respectively. Greater sample sizes would have strengthen the statistical power in the tests. The researchers visited the participants to help fill in the questionnaires; this might have introduced some bias into the respondents׳ reporting. The 14 HADS items were part of greater questionnaires. Thus, frail, older NH patients might have tired during the interview causing a possible bias.nnnCONCLUSIONnLow reliability for depression was disclosed, mainly resulting from three items appearing to be inappropriate indicators for depression in this population. Further research is needed exploring which items might perform as more reliably indicators for depression among nursing home patients.