Although acts of threats and violence are problems that have received increased attention in recent years within Swedish pre-hospital care, only a handful of scientific studies have been carried out in this field. Threats and violence have a negative influence on the well-being of ambulance personnel. The aim in this study was both to investigate the incidents of threats and violence within the Swedish ambulance service and to describe these situations.

Data was collected with questionnaires answered by 134 registered nurses and paramedics from 11 ambulance stations located in four counties. The respondents’ experiences of pre-hospital care varied from 3months to 41years (mean=12years, median=8years). The results showed that 66% of the ambulance personnel experienced threats and/or violence during their work while 26% experienced threats and 16% faced physical violence during the last year. The most common kind of threat was threats of physical violence with 27% of the respondents experiencing threats involving weapons. Commonly occurring physical violence was in the form of pushes, punches, kicks and bites. In most cases, the perpetrator was the patient himself often under the influence of alcohol or drugs. The most serious situations occurred when the reason for raising the ambulance alarm was intoxication or a decreased level of consciousness.

Aim: To investigate concerns about dying for newly admitted nursing students from California, Norway, and Sweden. Method: A total of 389 undergraduate nursing students who had just started their nursing programme participated. Data was collected with a questionnaire that included two instruments-the Concerns about Dying instrument and the Sense of Coherence instrument-and background questions. The data was analysed using statistical and content analysis. Results: There were statistically significant differences between the three groups of students in terms of their age, their experience in health care, whether they had previously attended a dying patient, the age at which they first encountered the death of a loved one, and their concerns about dying. Two main categories emerged from the analysis of the open questions: 'attending to dying and grieving persons' and 'thinking about one's own death'. Conclusion: The study provides important insights into the concerns that newly admitted students bring to the nursing programme.

Aim: The aim of this article is to explore whether ambulance clinicians in Sweden perceive their working environment to be safe. Method: Twenty four ambulance nurses and nine paramedics at five ambulance stations in urban and rural areas of Sweden were interviewed. Findings: After transcripts of the interviews had been analysed, nine issues that affect how participants perceive the safety of patient care in ambulances emerged: planning before departure; use of safety belts; driving at high speeds; patient first, safety second; equipment design and placement; noise; driving styles; presence of relatives; documentation. Conclusion: Ambulance personnel should have greater involvement in the design of ambulance care spaces and drivers should be given more regular training.

The debriefing phase in human patient simulation is considered to be crucial for learning. To ensure good learning conditions, the use of small groups is recommended, which poses a major challenge when the student count is high. The use of large groups may provide an alternative for typical lecture-style education and contribute to a more frequently and repeated training which is considered to be important for achieving simulation competency. The purpose of the present study was to describe nursing students’ experiences obtained during the debriefing conducted in small and large groups with the use of a qualitative descriptive approach. The informants had participated in a human patient simulation situation either in large or small groups. Data was collected through the use of five focus-group interviews and analysed by content analysis. The findings showed that independent of group-size the informants experienced the learning strategies to be unfamiliar and intrusive, and in the large groups to such an extent that learning was hampered. Debriefing was perceived as offering excellent opportunities for transferable learning, and activity, predictability and preparedness were deemed essential. Small groups provided the best learning conditions in that safety and security were ensured, but were perceived as providing limited challenges to accommodate professional requirements as a nurse. Simulation competency as a prerequisite for learning was shown not to be developed isolated in conjunction with simulation, but depends on a systematic effort to build a learning community in the programme in general. The faculty needs to support the students to be conscious and accustomed to learning as a heightened experience of learning out of their comfort zone.

Simulation is increasingly being used as an approach to learning in nurse education. There is a need for frameworks and valid evaluation tools to help guide educators in implementing the method. The questionnaire, Student Satisfaction and Self-Confidence in Learning, which consists of two subscales, has been developed by the National League for Nursing in the US for evaluating simulation used in nurse education.

The aim of the present study was to test the questionnaire, Student Satisfaction and Self-Confidence in Learning, for psychometric properties in a Norwegian nurse education context.

A sample consisting of 130 nursing students participated in a simulation situation, and 123 responded. When the questionnaire was tested in its entirety, psychometric testing conducted with a principal component analysis did not reveal a stable factor solution. The two subscales were then tested separately. The analysis for Satisfaction with Current Learning suggested a one-component solution, thereby explaining 62.8% of the variance, and the internal reliability was 0.84. With regard to Self-Confidence in Learning, no stable solution was achieved, and an alpha value of 0.64 was shown.

To further validate the questionnaire, Student Satisfaction and Self-Confidence in Learning, more studies by various nursing programmes in different cultural contexts are recommended.

In the use of human patient simulation, there is a need for standardized and validated instruments across both national boundaries and cultural conditions. The aim of the present study was to translate and validate the Debriefing Experience Scale in a Norwegian context. The study was conducted as a survey of 146 bachelor’s nursing undergraduates. An expert group, conventional content analysis, the known-group technique and psychometric testing were all being used. The scale seemed to hold a good potential for evaluating debriefing, but would also benefit from reducing the subscales. Due to testing for validity being an ongoing process, there is a need for more studies to draw conclusions about the properties of questionnaire.

The psycho-social dimension of pain and health-related quality of life in the oldest old Background:  Chronic pain has an impact on the physical and social functioning of older people which in turn may worsen their health-related quality of life. Research with focus on prolonged extensive pain in the most elderly and how pain may interfere with their life situation is scarce. Aims:  The aims were to describe and investigate pain from a multidimensional point of view (duration, location, psycho-social) and health-related quality of life as well as to compare sex and age groups in people aged 80 years and over. Methods:  In this cross-sectional study, a total of 225 of 282 people responded to a questionnaire consisting of two instruments and background questions. The psycho-social dimension of pain was measured using the Multidimensional Pain Inventory-Swedish language version (MPI-S) with five scales: Pain Severity, Interference, Life Control, Affective Distress and Social Support. Health-related quality of life was measured using the Short Form Health Survey-12 (SF-12). Results:  Median duration of pain was 9.0 years, and the mean number of pain locations was 2.04. The MPI-S scale Interference with a negative orientation had the highest mean score, while the mean score for Social Support was the highest for the scales with a positive orientation. The duration of pain was significantly greater for women, and those aged 80-85 years had higher pain severity than those aged >86. Participants with a lower health-related quality of life experienced significantly more severe pain, were more troubled with pain and had less control of their life. Conclusions:  Older people with prolonged pain suffered from a low health-related quality of life. Pain interfered with their lives and contributed to diminished control in their daily lives. Nurses are essential for the identification and prevention of pain and should be aware of how pain affects older people's physical, mental and social health.

In an academic programme, completion of a postgraduate degree project could be a significant means of promoting student learning in evidence- and experience-based practice. In specialist nursing education, which through the European Bologna process would be raised to the master’s level, there is no tradition of including a postgraduate degree project. The aim was to develop a didactic model for specialist nursing students’ postgraduate degree projects within the second cycle of higher education (master’s level) and with a specific focus on nurturing shared involvement between universities and healthcare settings. This study embodies a participatory action research and theory-generating design founded on empirically practical try-outs. The 3-year project included five Swedish universities and related healthcare settings. A series of activities was performed and a number of data sources secured. Constant comparative analysis was applied. A didactic model is proposed for postgraduate degree projects in specialist nursing education aimed at nurturing shared involvement between universities and healthcare settings. The focus of the model is student learning in order to prepare the students for participation as specialist nurses in clinical knowledge development. The model is developed for the specialist nursing education, but it is general and could be applicable to various education programmes.