The Importance of Work-Life Balance Opportunities and Support from the Perspective of Nursing Stu-dents in Dalarna, Sweden

There is a shortage of nurses leading to challenges in recruitment in Sweden and many other countries. Especially for less populated regions recruitment can be chal-lenging. Nurses often face difficulties with work-life balance (WLB). This study aims to identify the importance of WLB opportunities and support that make a work-place attractive from the perspective of nursing students studying in Dalarna. A questionnaire was distributed via email to 525 students enrolled in the nursing bach-elor program at Dalarna University. They were asked to rate the importance of 15 sub questions regarding WLB opportunities and support. These sub questions were asked in order to analyze the importance of 15 components regarding WLB oppor-tunities and support. 196 students (37 percent) answered the questionnaire. Three WLB components, working from home, childcare and rooms for breastfeeding, were found to be not important to nursing students studying in Dalarna. This was reason-able due to the profession of nursing and the WLB support provided by the Swedish government. Cultural factors, such as the organization being positive towards using WLB opportunities and support, were more important than structural factors, such as the possibility to work part-time. Moreover, to have a manager that is supportive towards using WLB opportunities and support was found to be the most important factor and having workplace practical support such as childcare was found least im-portant. Furthermore, contrary to the expected results, no statistical significance was found on the influence on the importance of all combined relevant WLB opportuni-ties and support by the sociodemographic variables; gender, semester of studies, age, having children, months of work experience and work experience in the healthcare sector. However, nine individual components were found to be influ-enced by one or more sociodemographic variables. Therefore, some recommenda-tions on how to target specific groups of individuals were made. However, the con-clusion of the study is that, regardless of the sociodemographic variables and gov-ernmental support, organizations should offer new nurses opportunities and support to gain a balance between work and life, especially in terms of cultural factors.

Chinese Basic Pension Substitution Rate: A Monte Carlo Demonstration of the Individual Account Model

At the end of 2005, the State Council of China passed ”The Decision on adjusting the Individual Account of Basic Pension System”, which adjusted the individual account in the 1997 basic pension system. In this essay, we will analyze the adjustment above, and use Life Annuity Actuarial Theory to establish the basic pension substitution rate model. Monte Carlo simulation is also used to prove the rationality of the model. Some suggestions are put forward associated with the substitution rate according to the current policy.

Can qualitative methods support the development of more flexible and energy saving thermal comfort?

This paper uses examples from a Swedish study to suggest some ways in which cultural variation could be included in studies of thermal comfort. It is shown how only a slight shift of focus and methodological approach could help us discover aspects of human life that add to previous knowledge within comfort research of how human beings perceive and handle warmth and cold. It is concluded that it is not enough for buildings, heating systems and thermal control devices to be energy-efficient in a mere technical sense. If these are to help to decrease, rather than to increase, energy consumption, they have to support those parts of already existing habits and modes of thought that have the potential for low energy use. This is one reason why culture-specific features and emotional cores need to be investigated and deployed into the study and development of thermal comfort.

Al-Mahdi - Gestalt och budskap : En litteraturstudie jämförande sudanesisk Mahdi och indisk Mahdi inom islam

Followers of three world religions, Judaism, Christianity and Islam are waiting for the Messiah. Muslims are even waiting for aspiritual leader al-Mahdi. Two different persons claimed the title of al-Mahdi, at the end of the nineteenth century. Theyappeared almost at the same time, at the totally different places of the earth, with a completely different message and underthe rule of the British colonial power. The aim of the study is to compare the both religious figures, Mirza Ghulam Ahmadfrom India and Muhammad Ahmad from Sudan regarding their different messages, to illustrate the social, political andreligious factors that lead to the entirely different profile and image of these two men and how their organizations havedeveloped after their death up till today. The result shows that the Sudanese Mahdi Muhammad Ahmad claimed hisMahdiship in the year 1881. He became a political leader in a time when Sudan was under the rule of a colonial power. Hetook advantage of the religion for personal purposes and tried to liberate his native country Sudan. The contemporaryMuslim clergy criticized him for his claim because the content of the Hadith traditions did not support his claim ofMahdiship. He maintained his sole right for the interpretation of religion and of the laws of Sharia. He made changes even inthe chief pillars of Islam by asserting that Jehad with sword was more imperative than the pilgrimage journey to Mecca. Heasserted that the Prophet Muhammad himself had entrusted him to launch the holy war against the non-believers. He hadimmense ambitions which were never fulfilled since he suddenly died four years after his claim for Mahdiship, in June 1885.This day his followers are organized as a political party in Sudan with a modest roll in the Sudanese politics. The IndianMahdi Mirza Ghulam Ahmad claimed in 1889 to be Mahdi, Mujaddid, Muhaddas, Messiah and a Prophet at a time of socialand political peace, though Islam as a religion was firmly pushed by the Hindu and Christian missionaries. He had no politicalambitions at all and was utterly loyal to the British colonial power. His mission was to crush the Cross and to demonstrateIslam’s excellence over all the religions of the world through overwhelming arguments. He proclaimed that Jesus was humanand a Prophet and not the son of God. Jesus survived from the cross and died a natural death after he had lived for manyyears. Ahmad claimed that God had commanded him to put stop to the religious wars. The contemporary Muslim clergyblamed him for being an imposter, melancholic and hypochondriac who had self invented the divine revelations. He died year1908, nineteen years after his claim and the communion he found is established today in more than hundred countries of theworld. Reasons for the breakdown of mission of the Sudanese Mahdi were that his objectives were political and he challengedthe colonial power with the sword. Another decisive factor was his sudden death merely four years after the beginning of hismission. Reasons for the success of Indian Mahdi were that his objectives were purely religious and he was wholly loyal to theforeign government. He survived nineteen years after the beginning of his mission which made it possible for him to create acommunion based on solid grounds. His followers continued on the same path and never engaged in local politics where everthey lived. For further studies it will be of great interest to study the life of Mirza Ghulam Ahmad and objectively examine thearguments he presented in support of his divine appointment. Furthermore it is enriching to study the organization andactivities of the Ahmadiyya Muslim community to explore if they are in accordance with the basic principles of Ahmad.

Glädje i vårdandets värld

Föreliggande vårdvetenskapliga studie har som syfte att avtäcka och synliggöra glädjesom idé i vårdandets värld. Glädje sammanbinds med vårdandet genom kärleken somden tongivande kraften hos glädje. Vårdandets sak har genom historien alltid varit attlindra lidande och att tjäna liv och hälsa i en anda av kärlek och barmhärtighet. Dennastudie om glädje i vårdandet har en övergripande idéhistorisk inriktning och resultatetsammanställs i form av ett idémönster. Tolkningen sker genom en hermeneutisk ansatsmed fokus på förståelse av själva vårdandet. För att djupare förstå glädje, dessursprungsidé, väsen och uttrycksformer granskas begreppet ’glädje’ och de näraliggandebegreppen ’glad’ och ’ljus’ i etymologiska ordböcker samt i svenska, engelska ochlatinska ordböcker. Som stöd för tolkningen används klassiska texter innehållandefilosofers tankar om glädje. Glädje som idé glimtar fram i form av ett sjufaldigtmönster. Detta mönster innehåller särdrag hos glädje och det hjärtas natur somrespektive särdrag förverkligas i. I andlig mening utgör hjärtat livets medelpunkt ochkänslornas hemvist. Mönstret bildar bakgrund och blir vägledande vid den hermeneutiska läsningen omglädje, så som den framträder i berättelser om vårdande under åren 1900–1933. Dehistoriska källorna utgörs av facktidskriften Svensk sjukskötersketidning, böcker medberättelser om vårdande, arkivmaterial samt läroböcker om vårdarbete. Resultatetmynnar ut i ett idémönster, där idéer om det som gör glädje verksamt som vårdandeframträder. Dessa är det sanna hjärtats rena glädje – kärlek, glädje är ett kärleksbevis.Det brinnande hjärtats djupa glädje – livsglädje, glädje inspirerar och genererar kraft.Det bärande hjärtats glansfulla glädje – generositet, glädje är en gåva till den andra medlöfte om hjälp. Det inbjudande hjärtats glittrande glädje – gemenskap, glädje inbjudertill gemenskap. Det upprymda hjärtats uppsluppna glädje – integration, glädje gör attmänniskan kan glömma sitt lidande och närma sig den hon önskar vara. Detstämningsfulla hjärtats högtidliga glädje – bevärdigande, glädje skapar en anda ochatmosfär där människan upplever sig hedrad. Det fridfulla hjärtats stora glädje –räddning, en glädje visar sig när människan har erhållit det som kan begäras av gott ochundsluppet ont och är förnöjd med sin levnads lott. Förhoppningen är att dennagrundforskning ska öppna för ett nytt seende som kan leda till att glädjeuppmärksammas i vårdandets värld och artikuleras där.

Narration, Visualization and Mind : Movies in everyday life as a resource for utopian self-reflection

The paper is analyzing how people in late modern society characterized by de-traditionalization, use moving images as a cultural resource for the construction of meaningful subjective world views. As a theoretical concept with several dimensions, “sacralization of the self” (Woodhead & Heelas 2000: 344), is related to media theory. With a critical focus on ‘the self’, as a core aspect in contemporary media society Eric W. Rothenbuhler labels the individual self as one of “the sacred objects of modern culture” (Rothenbuhler 2006: 31).I want to emphasize the need for case studies in order to undertake a critical investigation about ‘the self’ and how consumption of fiction film is interconnected to spectator´s creation of self images, but also to understand how film engagement elicits self-reflection (Giddens 1991, Axelson 2008, Vaage 2009a). The paper make use of empirical data to illustrate and theoretically develop perspectives on how the audience uses fiction film in every-day life for the construction of the self, as well for the construction of more profound and long-lasting ideas of being part of a moral community (Brereton 2005, Jerslev 2006, Klinger 2008, Mikkola et al. 2007, Vaage 2009b). Some empirical findings support a conclusion that moving images creates a transitional space for the human mind, with the capacity of transporting the spectator from real life to fiction and back to real life again, helping the individual with an ongoing process of transforming the self, dealing with who you actually are, and who you want to become (Axelson 2008, Vaage 2009b).

Tha contribution of home-based technology to older people's quality of life in extra care housing

Background: British government policy for older people focuses on a vision of active ageing and independent living. In the face of diminishing personal capacities, the use of appropriate home-based technology (HBT) devices could potentially meet a wide range of needs and consequently improve many aspects of older people's quality of life such as physical health, psychosocial well-being, social relationships, and their physical or living environment. This study aimed to examine the use of HBT devices and the correlation between use of such devices and quality of life among older people living in extra-care housing (ECH).  Methods: A structured questionnaire was administered for this study. Using purposive sampling 160 older people living in extra-care housing schemes were selected from 23 schemes in England. A face-to-face interview was conducted in each participant's living unit. In order to measure quality of life, the SEIQoL-Adapted and CASP-19 were used.  Results: Although most basic appliances and emergency call systems were used in the living units, communally provided facilities such as personal computers, washing machines, and assisted bathing equipment in the schemes were not well utilised. Multiple regression analysis adjusted for confounders including age, sex, marital status, living arrangement and mobility use indicated a coefficient of 1.17 with 95% CI (0.05, 2.29) and p = 0.04 [SEIQoL-Adapted] and 2.83 with 95% CI (1.17, 4.50) and p = 0.001 [CASP-19].  Conclusions: The findings of the present study will be value to those who are developing new form of specialised housing for older people with functional limitations and, in particular, guiding investments in technological aids. The results of the present study also indicate that the home is an essential site for developing residential technologies.

The effectiveness of proactive telephone support provided to breastfeeding mothers of preterm infants : study protocol for a randomized controlled trial

Background: Although breast milk has numerous benefits for infants' development, with greater effects in those born preterm (at < 37 gestational weeks), mothers of preterm infants have shorter breastfeeding duration than mothers of term infants. One of the explanations proposed is the difficulties in the transition from a Neonatal Intensive Care Unit (NICU) to the home environment. A person-centred proactive telephone support intervention after discharge from NICU is expected to promote mothers' sense of trust in their own capacity and thereby facilitate breastfeeding. Methods/design: A multicentre randomized controlled trial has been designed to evaluate the effectiveness and cost-effectiveness of person-centred proactive telephone support on breastfeeding outcomes for mothers of preterm infants. Participating mothers will be randomized to either an intervention group or control group. In the intervention group person-centred proactive telephone support will be provided, in which the support team phones the mother daily for up to 14 days after hospital discharge. In the control group, mothers are offered a person-centred reactive support where mothers can phone the breastfeeding support team up to day 14 after hospital discharge. The intervention group will also be offered the same reactive telephone support as the control group. A stratified block randomization will be used; group allocation will be by high or low socioeconomic status and by NICU. Recruitment will be performed continuously until 1116 mothers (I: 558 C: 558) have been included. Primary outcome: proportion of mothers exclusively breastfeeding at eight weeks after discharge. Secondary outcomes: proportion of breastfeeding (exclusive, partial, none and method of feeding), mothers satisfaction with breastfeeding, attachment, stress and quality of life in mothers/partners at eight weeks after hospital discharge and at six months postnatal age. Data will be collected by researchers blind to group allocation for the primary outcome. A qualitative evaluation of experiences of receiving/providing the intervention will also be undertaken with mothers and staff. Discussion: This paper presents the rationale, study design and protocol for a RCT providing person-centred proactive telephone support to mothers of preterm infants. Furthermore, with a health economic evaluation, the cost-effectiveness of the intervention will be assessed. Trial registration: NCT01806480

A modest start, but a steady rise in research use : A longitudinal study of nurses during the first five years in professional life

Background: Newly graduated nurses are faced with a challenging work environment that may impede theirability to provide evidence-based practice. However, little is known about the trajectory of registered nurses’ use ofresearch during the first years of professional life. Thus, the aim of the current study was to prospectively examinethe extent of nurses’ use of research during the first five years after undergraduate education and specifically assesschanges over time.Method: Survey data from a prospective cohort of 1,501 Swedish newly graduated nurses within the nationalLANE study (Longitudinal Analyses of Nursing Education and Entry in Worklife) were used to investigate perceiveduse of research over the first five years as a nurse. The dependent variables consisted of three single itemsassessing instrumental, conceptual, and persuasive research use, where the nurses rated their use on a five-pointscale, from ‘never’ (1) to ‘on almost every shift’ (5). These data were collected annually and analyzed bothdescriptively and by longitudinal growth curve analysis.Results: Instrumental use of research was most frequently reported, closely followed by conceptual use, withpersuasive use occurring to a considerably lower extent. The development over time showed a substantial generalupward trend, which was most apparent for conceptual use, increasing from a mean of 2.6 at year one to 3.6 atyear five (unstandardized slope +0.25). However, the descriptive findings indicated that the increase started onlyafter the second year. Instrumental use had a year one mean of 2.8 and a year five mean of 3.5 (unstandardizedslope +0.19), and persuasive use showed a year one mean of 1.7 and a year five mean of 2.0 (unstandardized slope+0.09).Conclusion: There was a clear trend of increasing research use by nurses during their first five years of practice.The level of the initial ratings also indicated the level of research use in subsequent years. However, it took morethan two years of professional development before this increase ‘kicked in.’ These findings support previousresearch claiming that newly graduated nurses go through a ‘transition shock,’ reducing their ability to useresearch findings in clinical work.

Life situations and the care burden for stroke pa­tients and their informal caregivers in a prospective cohort study

Background. The purpose of this study was to analyse whether the parallel life situation between stroke patients and their informal caregivers (dyads) shown in cross-sectional studies prevails also in a longitudinal perspective. Methods. A total of 377 Swedish stroke patients, aged ‡65 years, and their 268 informal caregivers were followed from hospital admission and one year on. Analyses were based on patient interviews, functional ability (MMSE) score, Nottingham Health Profile (NHP) score, Hospital Anxiety and Depression (HAD) score, self-rated health score, and the Gothenburg Quality of Life (GQL) activity score. Similar information was obtained by postal questionnaires from informal caregivers, also including information on the nature and amount of assistance provided and on Caregiver Burden (CB) score. Results. Before index admission informal caregivers provided care on average 5 h per week and after discharge 11 h per week (P < 0.0001). Support volume was associated with patient sex (more for men), low patient’s functional ability, low received municipal social service support, closeness of patient–caregiver relation, and short distance to patient’s home. Significant positive associations within the dyads were found for HAD anxiety score (P < 0.0001), total NHP score (P < 0.0001), and GQL activity score (P < 0.0001) after adjustment for patient’s age, sex, functional ability, and patient–caregiver relationship. CB score increased with amount of informal caregiver support, patient’s age, and with low functional ability and low amount of municipal social service support. All these associations were constant across time. Conclusions. There was an association within the dyads regarding anxiety score, NHP score, and activity score. CB score was generally high.

Struggling with daily life and enduring pain : a qualitative study of women's experiences with pelvic girdle pain during pregnancy

Background. Few studies have investigated the experiences of living with pelvic girdle pain (PGP) and its impact on pregnant women’s lives. To address this gap in knowledge, this study investigates the experiences of women living with PGP during pregnancy. Methods. A purposive sample, of nine pregnant women with diagnosed PGP, were interviewed about their experiences. Interviews were recorded, transcribed to text and analysed using a Grounded Theory approach. Results. The core category that evolved from the analysis of experiences of living with PGP in pregnancy was “struggling with daily life and enduring pain”. Three properties addressing the actions caused by PGP were identified: i) grasping the incomprehensible; ii) balancing support and dependence and iii) managing the losses. These experiences expressed by the informants constitute a basis for the consequences of PGP: iv) enduring pain; v) being a burden; vi) calculating the risks and the experiences of the informants as vii) abdicating as a mother. Finally, the informants’ experiences of the consequences regarding the current pregnancy and any potential future pregnancies is presented in viii) paying the price and reconsidering the future. A conceptual model of the actions and consequences experienced by the pregnant informants living with PGP is presented. Conclusions. PGP during pregnancy greatly affects the informant’s experiences of her pregnancy, her roles in relationships, and her social context. For informants with young children, PGP negatively affects the role of being a mother, a situation that further strains the experience. As the constant pain disturbs most aspects of the lives of the informants, improvements in the treatment of PGP is of importance as to increase the quality of life. This pregnancy-related condition is prevalent and must be considered a major public health concern during pregnancy.

Manager's task to support integrated autonomy at the workplace : Results from an intervention

A new managerial task arises in today’s working life: to provide conditions for and influence interaction between actors and thus to enable the emergence of organizing structure in tune with a changing environment. We call this the enabling managerial task. The goal of this paper is to study whether training first line managers in the enabling managerial task could lead to changes in the work for the subordinates. This paper presents results from questionnaires answered by the subordinates of the managers before and after the training. The training was organized as a learning network and consisted of eight workshops carried out over a period of one year (September 2009–June 2010), where the managers met with each other and the researchers once a month. Each workshop consisted of three parts, during three and a half hours. The first hour was devoted to joint reflection on a task that had been undertaken since the last workshop; some results were presented from the employee pre-assessments, followed by relevant theory and illuminating practices, finally the managers created new tasks for themselves to undertake during the following month. The subordinates’ answers show positive change in all of the seventeen scales used to assess it. The improvements are significant in scales measuring the relationship between the manager and the employees, as well as in those measuring interaction between employees. It is concluded that the result was a success for all managers that had the possibility of using the training in their management work.

Patients' experiences of support for learning to live with diabetes to promote health and well-being : A lifeworld phenomenological study

Learning to live with diabetes in such a way that the new conditions will be a normal and natural part of life imposes requirements on the person living with diabetes. Previous studies have shown that there is no clear picture of what and how the learning that would allow persons to incorporate the illness into their everyday life will be supported. The aim of this study is to describe the phenomenon of support for learning to live with diabetes to promote health and well-being, from the patient's perspective. Data were collected by interviews with patients living with type 1 or type 2 diabetes. The interviews were analysed using a reflective lifeworld approach. The results show that reflection plays a central role for patients with diabetes in achieving a new understanding of the health process, and awareness of their own responsibility was found to be the key factor for such a reflection. The constituents are responsibility creating curiosity and willpower, openness enabling support, technology verifying bodily feelings, a permissive climate providing for participation and exchanging experiences with others. The study concludes that the challenge for caregivers is to create interactions in an open learning climate that initiates and supports reflection to promote health and well-being.