Purpose: The purpose was to investigate the validity and reliability of short STAI (State-Trait Anxiety Inventory) for measuring children's anxiety in connection with procedures in hospital. Background: The children´s level of anxiety during hospitalization can cause problems and it should be evaluated with a valid and reliable instrument. STAIC-S (STAI for children) has previously been validated in children for this purpose but may be too complex to use. Short STAI has only been evaluated in adults and should be tested in children before it can be used. Methods: Children aged five to 16 filled in both STAIC-S and short STAI before and after an examination or treatment at the hospital. Results: Twenty children were included. Satisfactory internal reliability was found for short STAI with Cronbachs’s alpha 0.82. Correlation coefficients between the instruments were 0.88 before and 0.75 after the procedure. Significantly lower values were found after compared to before demonstrating constructive validity. Short STAI was easy to fill in but seven of 16 participants received help from their parents. Conclusion: Short STAI was shown to be a reliable and valid instrument for measuring anxiety in children, but a larger study is needed to confirm the validity and reliability further

Aim: The aim of this study was to explore gender differences in reasons, facilitators, and barriers for parental presence in the neonatal intensive care unit (NICU) based on statistical analyses of secondary data. Background: Factors that may influence parental presence should be taken into careful consideration by NICU staff These factors are likely to differ between genders, as research studies demonstrated that mothers tend to spend more time with their preterm infants in the NICU than the fathers. Methods: The study was based on secondary data, which was obtained, corrected, and analysed with Fisher's exact test. Findings: For control reasons, a larger proportion of fathers are present at the NICU than mothers. A larger proportion of fathers, as compared to mothers, perceive difficult socio-economic situations as a barrier for parental presence. In contrast, mothers perceive goodquality treatment by hospital staff as a facilitator and poor treatments as a barrier for parental presence. Conclusion: Reasons, facilitators, and barriers for parental presence should be considered in order to increase parental presence in the NICU.

Different ideological standpoints shape the understanding of severe mental illness and the actions taken in psychiatric care and social services. Decentralised and community-based care is today, after the psychiatric reform in Sweden 1995, replacing the mental hospitals. Deinstitutionalisation has thus caused a larger interest in the issue of knowledge and competence when caring for people with severe mental illness. This study focuses on similarities and differences of opinions and attitudes among professional caregivers. A questionnaire was distributed to 162 professional caregivers, 65 from psychiatric care and 97 from social welfare services. The results indicated that professionals within social welfare service did neither consider their knowledge of severe mental illness adequate, nor did they find their options to get further education and supervision satisfactory. Furthermore they felt they did not receive enough information when taking over responsibility from psychiatric care. When the participants were asked what personal characteristic they find most important in their work with people with severe mental illness, none of the questioned, either within psychiatric care or within social welfare service, made a priority to ”believe what a person with severe mental illness says”. Hence, booth organizations appear to put their confidence in professional knowledge, in favor of experiences expressed by people with severe mental illness.Different ideological standpoints shape the understanding of severe mental illness and the actions taken in psychiatric care and social services. Decentralised and community-based care is today, after the psychiatric reform in Sweden 1995, replacing the mental hospitals. Deinstitutionalisation has thus caused a larger interest in the issue of knowledge and competence when caring for people with severe mental illness. This study focuses on similarities and differences of opinions and attitudes among professional caregivers. A questionnaire was distributed to 162 professional caregivers, 65 from psychiatric care and 97 from social welfare services. The results indicated that professionals within social welfare service did neither consider their knowledge of severe mental illness adequate, nor did they find their options to get further education and supervision satisfactory. Furthermore they felt they did not receive enough information when taking over responsibility from psychiatric care. When the participants were asked what personal characteristic they find most important in their work with people with severe mental illness, none of the questioned, either within psychiatric care or within social welfare service, made a priority to ”believe what a person with severe mental illness says”. Hence, booth organizations appear to put their confidence in professional knowledge, in favor of experiences expressed by people with severe mental illness.

The first aim of this study was to investigate how long-term mentally ill persons adjusted to life after de-institutionalisation. The second aim was to estimate the relevance of interpretations made previously in a qualitative study, concerning long term mentally ill person’s incapability to benefit from new experiences. A survey was conducted in 1996 and a follow- up was made in 1998. A randomly chosen sample of longterm mentally ill persons replied to questions about their living conditions as well as interpersonal relations, personal experiences and self-esteem. Most of the participants in the study were living alone and their everyday lives seemed lonely and inactive. In spite of decreased psychiatric consultations after the psychiatric de-institutionalisation, they changed neither their external nor their internal world during the two years covered by this study.

A reflective team (RT) is working to solve current health care problems in a professional team led by a reflection leader. The goal is that through reflection about the team members’ own caring experiences and scientific research create action plans based in proven experience and scientific evidence. This article describes the idea behind the RT, the first attempt to implement the RT and reflection leaders’ preliminary experiences of managing RT.

In this study eleven items concerning wants and needs of severely mentally ill persons were compared with estimations of the same items made by professional caregivers in psychiatric care and social welfare services. A questionnaire with ten-point Likert scales was distributed to 205 participants, 65 professionals within psychiatric care, 97 professionals within social welfare services and 43 severely mentally ill persons. The Likert scales dealt with living conditions, daily activities, nursing interventions and social welfare services. The severely mentally ill persons scored their wants and needs and professional caregivers estimated the importance of every item concerning the same issues. Professional caregivers made quite similar estimations irrespective of their professional or organizational belonging. They did, however, differ quite a lot from the wants and needs made by the severe mentally ill persons themselves.

To withdraw – a viscous circle in severe mental illness. The aim of this study has been to analyse and describe circumstances behind and experiences of severely mentally ill persons’ withdrawal. Six persons, two women and four men, aged 31–57, with experiences of withdrawal due to psychosis, were interviewed. Manifest and latent meanings were described. Factors that led to withdrawals were insufficient medication, alcohol and sleeplessness. The meaning of withdrawal was characterized by a viscous circle. The process starts with the necessesity to avoid external and internal stressors. It continues with changed reality and brooding. Senses of being an outsider are enlarged and the viscous circle is completed with further withdrawal. Psychiatric care is reflected upon as an opportunity for the caregivers to step in early and break up the viscous circle.

The aim: The aim was to illuminate ICU-nurses’ roles in the process of decision-making regarding limitation of life prolonging treatment to sedated patients on ventilators, and to get an insight to related knowledge of ethical and legal guidelines Method: Data consisted of qualitative semi-structured interviews analyzed via qualitative content analyses. Findings: The findings describe the nurses’ legally and ethical competences in relation to their caring role and insight into how the National Guideline is used. The ICU-nurses found decision-making difficult, but viewed their role as crucial through the whole withdrawal process. They took part indirectly in the decision-making concerning withdrawal as they are the ones who mediate their patient observations and next of kin’s wishes. Findings are presented in four categories: the ICU-nurses inclusion and participation in decision-making, deficient documentation, informing the next of kin and uncertainty about ethical and juridical perspectives. Conclusion: A multi-professional dialogue, knowledge about ethical and legal competencies, and content in the National Guideline, are seen as important help to the nurses as they are the ones who stay close to patients and the next of kin.

The aim of this article is to discuss challenges in the development of Specialist Nursing Educations as a result of the 2007 Swedish Higher Education Reform: the implementation of the so-called Bologna process. Certain challenges follow this reform, particularly since the specialist nursing programmes will be part of the second cycle of the higher education system, and it will be possible to combine the professional degree with a masters degree (one year). Possible strategies in four areas related to the Specialist Nursing Education are discussed: integration of researchbased knowledge, experienced-based knowledge, improvement knowledge, and strategies for collaboration between university institutions and clinics. Specific didactical issues are raised.