Mats T. Gullberg

Quality of life and burden in parents of outpatients with schizophrenia

Since the late 1950s, several studies have reported the burden faced by families living with a mentally ill relative. These studies have pointed out the importance of a progressive mental health service, focusing not only on the treatment of the patients, but also on the needs of the relatives. The aims of the present study were to compare the quality of life of parents of outpatients with schizophrenia with a randomly selected reference group and the relation between quality of life and burden on the parents. The sample comprised all parents (n=38) of outpatients with schizophrenia at an outpatient clinic in 2001, where the patients had contact at least once a week with both parents and staff. The parents were compared with a reference group (n=698). The self-rating scale Quality of Life Index (QLI) was used to assess quality of life in both groups. In the case of the parents, semistructured interviews were supplemented by the data collection to assess the degree of burden with the Burden Assessment Scale (BAS). The outpatients were also interviewed to assess their global function with the Global Assessment of Functioning scale (GAF) and the Clinical Global Impression scale (CGI). The parents were significantly less satisfied with their overall quality of life (p<0.05). There was a correlation between lower overall quality of life and higher perceived burden r=0.58 (p<0.01). There was also a correlation between lower values on the family subscale and social subscale within the QLI and higher subjective burden r=0.54 (p<0.01) and r=0.52 (p<0.01), respectively. These results indicate that caregiving has an influence on the family situation and on the quality of life of parents. These findings suggest that the professions working with the parents must have an approach focusing not only on the care given to the ill daughter or son, but also on the parents’ situation.

Self-efficacy beliefs and fear of childbirth in nulliparous women

Abstract Objective: To explore how childbirth self-efficacy, i.e. outcome expectancy and efficacy expectancy, was associated with fear of childbirth (FOC) and how efficacy expectancy and FOC, respectively were related to socio-demographic characteristics, mental problems and preference for a caesarean section. Methods: In this cross-sectional study, a consecutive sample of 1000 pregnant nulliparous women was sent the Wijma Delivery Expectancy Questionnaire and Childbirth Self-Efficacy Inventory. Statistical analyses were performed on data from 423 women. Results: Outcome expectancy and efficacy expectancy correlated significantly and positively, FOC correlated significantly and negatively with both outcome expectancy and efficacy expectancy. Women with severe FOC (20.8%) had a significantly lower level of education (p = 0.001), and had more often sought help because of mental problems (p = 0.004). They were more likely to have low-efficacy expectancy (p < 0.001) and to prefer a caesarean section instead of a vaginal birth (p < 0.001). Conclusions: Lower efficacy expectancy was associated with higher FOC while preference for a caesarean section was not. Improvement of self-efficacy could be a part of care for women with FOC during pregnancy; however, it would not be enough for fearful women who wish to have a caesarean section.

Quality of life in patients with familial hypercholesterolaemia

Abstract. Hollman G, Gullberg M, Ek A.‐C, Eriksson M, Olsson AG (University of Linköping, Linköping; Huddinge University Hospital, Stockholm, Sweden). Quality of life in patients with familial hypercholesterolaemia. J Intern Med 2002; 251: 331–337.

Nursing education and professional role acquisition--theoretical perspectives

This article deals with professional role acquisition in nurses. All nursing education take place in specific social settings. Each social setting is one element of a complex system of process factors. The student nurses own role-enaction is constantly subject to modification or adaptation. Role-enaction as well as all social interaction can be grouped into three types: change-drama, interchange-ritual and maintenance-routine. Student nurses must learn what is significant for the role of the professional nurse. How is this accomplished and how do they learn the nursess role in a specific situation?

The use of the nurse self description form in Sweden : translation and applicability

. The Nurse Self Description Form (NSDF) is a self-administered paper-and-pencil test and contains 19 items with which respondents mark own self-valuation. The NSDF has previously been used in California (USA) to explore the relationship between sex-role identity and description of self, and to study the perception of professional self among graduating nurses. A translation and adaptation of the instrument into Swedish conditions has been carried out. The applicability of the instrument has been tested with the aid of the result from a pilot study using the NSDF carried out in Sweden and the result from a study presented by Dagenais & Meleis in 1982. The comparison between the Swedish version of the instrument and its opposite number in California indicates that the substance of the Swedish NSDF is not influenced by the translation and adaptation into Swedish.

Nursing education and definition of the professional nurse role. Expectations and knowledge of the nurse role.

The aim of nursing education is a development of the nursing profession. One way to promote development is to clarify the professional role. The role definition for nursing is mostly transmitted through tacit knowledge. We consider that the professional development of the nursing profession in Sweden requires a clear and well-defined nurse role. Stated goals of professional programmes for nursing do not include the entire body of tacit knowledge. The overall development requires recognition of a professional status together with a clear and well-defined role. We have found a significant change in the distribution of role-conceptions which occurred after the nurses had experienced their first year as registered nurses, and which did not occur during the educational process. This indicates that the conceptions of the need for a more clearly defined nursing role are assimilated during work experience. This confirms the necessity and importance of role modelling, role repetition and interactions with a professional group as part of the educational process.

Development of a tool for measuring the concept of good care among patients and staff in relation to Swedish legislation

An instrument for measuring the concept of good care, in relation to the Swedish Health and Medical Services Act, has been developed and tested in short-term care. The instrument comprises 14 statements on good care. The construct validity was estimated by factor analysis based on the results from 240 patients. Five factors explained 62% of the variance of the 14 variables and covered the following areas: information, security, accessibility, continuity, and influence and respect. Patients (n = 240) and registered nurses (n = 57) showed differences in estimations of the concept of good care on all factors. There were only minor differences, however, within the patient group and the nursing group, respectively, on comparing the two samples. The instrument needs further testing in different care conditions.

Fundamental and situational components in a strategy for attaining a positive patient experience of the pelvic examination : a conceptual approach

Since 1983, researchers in medicine, behavior, and health care have been involved in collaborative work concerning attitudes toward the pelvic examination (PE). Important components of the analysis are social actions and conduct, which are conceptualized from role theory. The outcome of the PE is determined by both fundamental and situational components. The purpose is to discover optimal environmental conditions under which the PE should be performed. The medical profession has a long history, primarily established within hospitals. Professional performance has been directed toward diagnosis and cure; consequently, a particularistic view dominates. Throughout history the midwifery profession has had the primary task of supporting the woman in confinement. The dominant view of the midwifery profession is universalistic. The strategy we present is an approach for conceptualizing the bases determining the PE situation. It is a distinct step toward finding gynecological practices that may create positive patient experience of the PE.

Nursing education and professional role acquisition. A longitudinal study of expectations and attitudes towards nurse role acquisition

This article deals with professional role acquisition in nurses and discusses results from three studies concerning expectations and attitudes towards this acquisition. The studies have been carried out in Sweden. The discussion comprises expressed expectations and attitudes of nurse students and registered nurses in relation to our theoretical perspectives presented in a former article. The theoretical perspectives concentrate on three aspects of social action: change-drama, interchange-ritual, and maintenance-routine. The results indicate that the professional nurse role is acquired according to a traditional pattern, in spite of changes in curriculum and goals of nursing education and health care. Changes made to develop and improve the conditions under which role acquisitions take place.