AIM: The aim of this study was to explore the associations between patients' gender, education, health status in relation to: assessments of patient-centered 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 is 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, multi-cultural 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 sub-groups 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-centered care quality; individuality in care and trust in nurses. Sub-group 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-centered, individualised care strategies alongside a stronger focus on people instead of cancer-care related processes and duties.

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. This article is protected by copyright. All rights reserved.

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.

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.

Våra observationer stöder både acceptansen och de psykometriska egenskaperna för SHIS som ett kort, en-dimensionellt frågeformulär för att mäta salutogen hälsa hos ungdomar.

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.

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. 

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 cancer are a common patient group in the healthcare system.

Introduction: User perspective, such as patient assessments of care and care quality are central in developing healthcare services. These assessments have a high value in time when there are reforms in social and healthcare services. One core principle in these reforms is patient-centeredness. Earlier studies have shown that older patients differ from other age-based patient groups in their assessments of care quality elements. They were reported to be more positive in their evaluations.

Aim: The aim of this study was to analyse cancer patients’ perceptions of patient-centered quality and individuality in care and trust in nurses, and to compare these perceptions between patients in the working age and older people. The research questions were: To what extent cancer patients perceive their care is patient-centered quality care, individualised and do they trust in nurses? Are there differences between older cancer patients and those in working age in their perceptions of person-centered quality of care, individuality in care and trust in nurses?

Materials and methods: The study employed a cross-sectional comparative survey design. Data were collected using questionnaires among hospitalised cancer patients (N = 876, n = 599, 68%) in four countries: Greece, Cyprus, Sweden and Finland. The following instruments were used: The Oncology Patients perceptions of the Quality of Nursing Care Scale (OPPQNCS), the Individualised care Scale (ICS-patient) and Trust in Nurses. The data were divided into two sub-samples based on age (cut point 65 years): Older patients (n = 209) and patients in the working age (n = 387). Data were analysed statistically using cross-tabulation and chi-square statistics, or paired samples t-test.

Results: In this study cancer patients’ perceptions about individualization and coordination of care, support of individuality and perceived individuality in care were only moderate. Proficiency and responsiveness as part of care quality were reported well realised. Trust in nurses was strong. Older patients and those patients in the working age did not differ in their perceptions of either patient-centered quality of care, individualised care or trust in nurses.

Conclusions: The results of this study point out topics that need development in order to provide individualised and patient-centered nursing care. Contradictory to many earlier study results, age was not associated with cancer patients’ assessment.

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 School-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.

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.