AIMS AND OBJECTIVES:The aim of this study was to explore the associations between patients' gender, education, health status in relation to assessments of patient-centred quality and individuality in care and trust in nurses for those <65 (working age) and ≥65 years (older people).BACKGROUND:Patients' assessments of the quality of care they receive are essential for the development of the provision of patient care and services. Previous studies have revealed age of the patient is associated with their assessment of care quality attributes.DESIGN:The study employed a cross-sectional, multicultural comparative survey design.METHODS:The data were collected using questionnaires among hospitalised cancer patients (N = 876, n = 599, 68%) in four European countries: Greece, Cyprus, Sweden and Finland. The data were divided into two subgroups based on age (cut point 65 years) and were analysed statistically.RESULTS:Cancer patients' age, gender and level of education were not related to their assessments of care quality attributes: person-centred care quality, individuality in care and trust in nurses. Subgroup analysis of the older adults and those of working age showed clear associations with patients' assessments of quality-of-care attributes and perceived health status. The lower the perceived health status, the lower the assessment of care quality attributes.DISCUSSION:The results suggest that the cancer itself is the strongest determinant of the care delivered, rather than any patient characteristics, such as age, education or gender. Perceived health status, in association with cancer patient assessments of care quality attributes, may be useful in the development of patient-centred, individualised care strategies alongside a stronger focus on people instead of cancer-care-related processes and duties.CONCLUSIONS:Health status was the only factor associated with cancer patients' assessments of care quality attributes. Cancer itself may be the strongest determinant of the care quality perceptions, rather than any patient characteristics.RELEVANCE TO CLINICAL PRACTICE:The findings of this study have implications for cancer care professionals in terms of patient assessment and care planning. The measures may be useful in assessing quality of cancer nursing care.

Aim: The aim of this study was to investigate the feasibility and cost-utility of a school-based cognitive–behavioral (CB) depression prevention program. Methods: A quasi-experimental trial with an intervention group and a control group, with follow-up measurements obtained at three and 12 months after baseline, was conducted. The setting was six Swedish municipalities. The participants were students in grade 8 (median age: 14). A total of 462 students (79% girls) were allocated to the school-based CB prevention program, and 486 students (46% girls) were allocated to the control group. The school-based CB prevention program, Depression in Swedish Adolescents (DISA), was presented by school health service staff and teachers once per week for 10 weeks. Results: The main outcome measures were self-reported depressive symptoms and self-rated health; the secondary outcome measures were adherence and cost-utility. The intervention group decreased their self-reported depressive symptoms (as measured by the Center for Epidemiological Studies Depression Scale) and improved their self-rated health (as measured by the visual analog scale) at the 12-month follow-up more than the control group (p < .05). Conclusions: Given the challenges of conducting a study in a complex, everyday school setting with baseline differences between the intervention and control group, it is difficult to make accurate interpretations of the effectiveness of the intervention. However, with these limitations in mind, the results indicate that the DISA program is a feasible school-based prevention program.

Skolskoterskors utmaningar med att dokumentera skolbarns psykosociala halsa – en kvalitativ studieSyfte: Syftet med studien var att undersoka skolskoterskors utmaningar relaterat till dokumentation av skolbarns psykosociala halsaMetod: Sex fokusgruppsdiskussioner genomfordes. I diskussionerna ingick fragor om situationer som var sarskilt utmanande att dokumentera samt vad som begransar och/eller underlattar dokumentationen av den psykosociala halsan. Kvalitativ innehallsanalys anvandes for att tolka data. Resultat: Analysen resulterade i ett overgripande tema: Att gora sin plikt och radsla for att gora fel samt tre underteman: osakerhet relaterat till den egna formagan; radsla for framtida konsekvenser och strategier for att hantera dokumentationen. Slutsats: Skolskoterskor som forlitar sig pa sin intuition och som anvander en strukturerad dokumentationsmodell okar mojligheterna till en tillforlitlig dokumentation. For att ytterligare utveckla sina yrkeskunskaper kan regelbunden yrkesmassig handledning vara av stor betydelse. Detta kan i sin tur bidra till okad forskning och utveckling till forman for skolbarns psykosociala halsa.

Purpose: To explore and compare cancer patients' perceptions on the quality of nursing care in four European countries.Methods: Data were collected in Cyprus, Finland, Greece and Sweden. The sample comprised 596 hospitalized cancer patients. The quality of nursing care was measured using the "Oncology Patients' Perceptions of the Quality of Nursing Care Scale" (OPPQNCS). Patient characteristics were also collected. Analysis of variance was used to examine the effects of country on the perceptions of the quality of nursing care.Results: Patients' age ranged from 18 to 86 years, and 58% were male. The comparison of cancer patients' perceptions regarding the quality of nursing care between the four countries showed a statistically significant difference in the total OPPQNCS scores (p <0.001) as well as in the subscales responsiveness (p <0.001), individualization (p<0.001), co ordination (p<0.001) and proficiency (p<0.001). The Cronbach's alpha coefficient for the OPPQNCS ranged between 0.89 and 0.95. A multivariate analysis of variance for the OPPQNCS controlled by respondents' demographic characteristics revealed that only the patient's country was significantly related with the patients' perceptions of quality care.Conclusion: Quality of nursing care as perceived by cancer patients was high, but differed between the four countries. The impact of the clinical status of cancer patients on the quality of nursing care and managerial factors such as staffing/nursing care delivery models that influence the ability of nurses to offer high quality care should also be explored by more focused studies.

Vara observationer stoder bade acceptansen och de psykometriska egenskaperna for SHIS som ett kort, en-dimensionellt frageformular for att mata salutogen halsa hos ungdomar.

Background: Cancer is considered as chronic condition, especially in the older people. Prevalence of cancer is especially high in the Nordic countries and Mediterranean countries. People with cance ...

Background: Providing high quality nursing care for patients with malignancies is complex and driven by many factors. Many of the associations between nursing care quality, trust, health status and individualized care remain obscure.Objective: To empirically test a model of association linking hospitalized cancer patients' health status, nursing care quality, perceived individuality in care and trust in nurses.Design: A cross-sectional, exploratory and correlational study design was used.Settings: This multi-site study was conducted in cancer care clinics, in-patient wards of five tertiary care hospitals in Cyprus, Finland, Greece and Sweden. Sample: Out of 876 hospitalized patients with a confirmed histopathological diagnosis of cancer approached to participate in the study in consecutive order, 599 (response rate 68%) agreed to participate and the data from 590 were used for path analysis. Methods: Data were collected in 2012-2013 with the Individualized Care Scale-Patient (ICS-Patient), the Oncology Patients' Perceptions of Quality Nursing Care Scale (OPPQNCS), the Euro-Qol (EQ-5D-3L) and the Trust in Nurses Scale. Data were analysed statistically using descriptive and inferential statistics. Mplus version 7.11 was used to determine the best Trust model with path analysis.Results: Although the model fit indices suggested that the hypothesized model did not perfectly to the data, a slightly modified model which includes the reciprocal path between individualized care and nursing care quality demonstrated a good fit.Conclusion: A model of trust in nurses was" developed. Health status, individualized care, and nursing care quality were found to be associated with trust. The model highlights the complexity of caring for cancer patients. Trust in nurses is influenced by the provision of individualized care. Generating and promoting trust requires interventions, which promote nursing care quality, individuality and patients' health status. (C) 2016 Elsevier Ltd. All rights reserved.

The aim of the study was to follow up inter-professional experiences of improvement work one year after a completed CII improvement program aiming at improve health care and social services for people with mental disabilities living in ordinary housing. This study was performed with a qualitative descriptive approach which employed six focus group interviews followed by a thematic analysis. The results revealed four themes; Self-awareness and insights; Behavior and actions in daily practice; Organizational cultures and subcultures; and Organizational practices, using Ken Wilbers' integral theory of four quadrants of realities as a holistic frame in the discussion.

The aim of this study was to describe health care- and social service professionals' experiences of a quality-improvement program implemented in the south of Sweden. The focus of the program was to develop inter-professional collaboration to improve care and service to people with psychiatric disabilities in ordinary housing. Focus group interviews and a thematic analysis were used. The result was captured as themes along steps in process. (I) Entering the quality-improvement program: Lack of information about the program, The challenge of getting started, and Approaching the resources reluctantly. (II) Doing the practice-based improvement work: Facing unprepared workplaces, and Doing twice the work. (III) Looking back—evaluation over 1 year: Balancing theoretical knowledge with practical training, and Considering profound knowledge as an integral part of work. The improvement process in clinical practice was found to be both time and energy consuming, yet worth the effort. The findings also indicate that collaboration across organizational boundaries was broadened, and the care and service delivery were improved.

Aim: The aim of this study was to test the psychometric properties of the Salutogenic Health Indicator Scale (SHIS) in an adolescent population. Methods: The investigation was performed among Swedish students aged 13–15 years (n = 817; 58% girls). The SHIS was assessed for respondent acceptability, and its psychometric properties were evaluated according to classical test theory (regarding unidimensionality, targeting, reliability, and external construct validity). Results: The adolescents found it easy to complete the questionnaire, which was completed in an average of 4 minutes. Exploratory factor analysis, which is based on polychoric correlations, identified one factor, supporting the instrument’s unidimensionality. Floor/ceiling effects were ⩽ 3.3%. Reliability estimates yielded a Cronbach’s alpha value of 0.93; the test–retest reliability (n = 50; 2-week interval) coefficients were 0.89 for the total SHIS score and 0.52–0.79 for item scores. Spearman correlations with other variables were based on a priori expectations (self-rated general health, 0.595; depressive symptoms, −0.773; anxiety, −0.577; and sleep problems, 0.519). Conclusions: Our observations support both the acceptability and the psychometric properties of the SHIS as a brief, unidimensional assessment tool for salutogenic health in adolescents. Further studies using modern test theory are needed to better understand the measurement properties of the SHIS, including the functioning of its response categories and its comparability between adolescents and adults.

The aim of this study was to describe hospitalised cancer patients' perceptions of individualised care in four European countries and compare these perceptions using the patients' socio-demographic characteristics and the Individualized Care Scale. The patients' socio-demographic characteristics used were: education, age, gender, type of hospital admission, previous hospitalisation and hospital length of stay. The Individualized Care Scale has two parts (1) nurses' support of individuality and (2) patients' receipt of individuality. Data (n = 599) were collected in Cyprus (n = 150), Finland (n = 158), Greece (n = 150) and Sweden (n = 141). Multivariate analysis of variance models were constructed and differences in perceptions of individualised care were analysed using the patients' socio-demographic characteristics as covariates. The level of support for individuality and receipt of individualised care was reported as moderate and good respectively. Generally, the highest assessments were made by the Swedish respondents and the lowest by those in Greece. This study revealed some between-country differences in patients' perceptions of care individualisation. These differences, for example, conceptual, educational, based in clinical practice or in the health organisation, require further research. Enquiry into the individualised care perceptions of health care providers and the families of cancer patients would also be useful.

As patients are different, only one way of delivering care is neither appropriate nor efficient. Care needs to be tailored according to individual characteristics in more general and extents to include individualized nursing care. Individualized care has a positive impact on patient outcomes and is therefore worth of studies and implementation in clinical practice. The aim of this study was to describe and compare hospitalized cancer patients' perceptions of individualized care, controlled by their socio-demographic characteristics, in four European countries. The quality of individualized nursing care was represented by hospitalized patients' perceptions of the (1) nurses' support of individuality and (2) receipt of individuality as measured by the two-part Individualized Care Scale (ICS). Patients' socio-demographic characteristicsincluded education, age, gender, type of hospital admission, previous hospitalization, and hospital length of stay. Data (n=599) were collected in Cyprus (n=150), Finland (n=158), Greece (n=150) and Sweden (n=141). Multivariate analysis of variance models were constructed. The main effect of country on perceptions of individualized care was analyzed using socio-demographic characteristics as covariates. The level of support of individuality was reported as moderate and receipt of individuality on care as good. The assessments were generally the highest by the respondents in Sweden and the lowest in Greece. Shortcomings in the individualized nursing care were found based on patients' assessments. This study revealed some between-country differences in patients' perceptions of care individualization, controlled by the sample characteristics, and allows the researcher to further analyze the possible reasons for these differences whether conceptual, differences due to the education, clinical practice or organization of nursing care and services

BACKGROUND:Supporting positive mental health development in adolescents is a major public health concern worldwide. Although several school-based programs aimed at preventing depression have been launched, it is crucial to evaluate these programs and to obtain feedback from participating adolescents. This study aimed to explore adolescents' experiences with a -based cognitive-behavioral depression prevention program.METHODS:Eighty-nine adolescents aged 13-15 years were divided into 12 focus groups. The focus group interviews were analyzed using qualitative content analysis.RESULTS:Three categories and eight subcategories were found to be related to the experience of the school-based program. The first category, intrapersonal strategies, consisted of the subcategories of directed thinking, improved self-confidence, stress management, and positive activities. The second category, interpersonal awareness, consisted of the subcategories of trusting the group and considering others. The third category, structural constraints, consisted of the subcategories of negative framing and emphasis on performance.CONCLUSIONS:The school-based mental health program was perceived as beneficial and meaningful on both individual and group levels, but students expressed a desire for a more health-promoting approach.

This study looked at 13 mental health nurses and social workers who were recently trained as case managers (CMs) and the work-related challenges they faced in community mental health services. Data were collected during ten peer supervisions sessions. Participants expressed pride and enthusiasm about their new function as CMs, but they also acknowledged that their new position meant they had to confront existing systems and posed several challenges, including organizational hindrances, economic prerequisites, nominated administrators, role function, and model fidelity. We conclude that the existing organizations seemed to be unprepared to hold and facilitate more person-centered approaches, such as designating CMs. The model fidelity is important, but has to be flexible according to clients' daily state.

Background: Supporting positive mental health development in adolescents is an important school health concern, but there is a need to investigate the suitability of the interventions used. Aim: The aim is to investigate the experiences of school health professionals in conducting a universal school-based programme aimed at preventing depressive symptoms in adolescents. Methods: Twenty-two school health professionals participated in four focus groups. The interviews were analysed using qualitative content analysis. Findings: The overall theme identified in the study consists of ‘striking a balance between strictly following the manual and meeting the students’ needs’. Three subthemes emerged: ‘doing good and sowing seeds for the future’, working with insufficient tools, and ‘personal development as a professional and as an individual’. Conclusions: School health professionals conducting the programme found it valuable in a school setting, but considered support from the school administration essential.

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$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.