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(side 3)
av Ingrid Poulsen og Mette Rosendal Darmer
(side 4-14)
av Kirsti Henriksen
How to ensure the quality of student placements in Third World?
Engelsk sammendrag

Nearly half of the Norwegian Nursing schools have practical placements for nursing students in an African country. This paper addresses the following issues related to student placements in Third World countries: 1. What is the learning outcome? 2. How can reciprocal beneficial outcomes be ensured? 3. Which factors are essential to ensure the learning outcome? The discussion is based partly on research literature, partly on the author’s experience from establishing practical placements in Third World countries.

Conclusion: Nursing students do benefit from clinical practice in the Third World. The learning outcomes are linked to central dimensions of nursing competence. Reciprocity, as a significant object and a means to ensure learning quality, depends on the design and content of the program. Long-term clinical placements facilitate cultural immersion, which is arguably the most significant factor for learning. Other significant factors are selection of students, preparatory courses, tutoring and program for follow-up programs after return.

(side 15-23)
av Ingrid Drageset
The relationship between dependence and autonomy in home-based nursing
Engelsk sammendrag

In this article, dependence and autonomy in home-based nursing are discussed. Most people who receive home-based nursing are dependant on the help they get. Lack of qualified help might make it impossible for them to live at home. Furthermore, the patients’ autonomy is at issue. Since the patient’s home is his/her own private domain, a main goal for the nurse in home-based nursing is to confirm identity and to promote integrity. Habits and routines are relevant issues since they can create stability and comfort for the patient and as such should be considered by relatives and the nurse. Situations in which medical-technical equipment is placed in the patient’s home involve special challenges. Special challenges might also occur when patients have been through difficult lives and find their home situation uncomfortable. The nurse must be aware of the balance between dependency and autonomy and of how the patient’s life story might influence the situation.

Vitenskapelig publikasjon
(side 24-33)
av Birgit Brunborg
Students training of elderly persons in home-based nursing care
Engelsk sammendrag

The purpose of this paper is to describe students’ experiences from screening and training elderly disabled people. The findings are based on data accrued from qualitative interviews, student experiences and the students’ screening results, logs, and self-evaluations. The discussion is anchored in a pedagogical perspective on learning. Co-operation between student and patient in exercise planning and performance was found to be a good learning method according to the curriculum. Performance of the activation programme challenged the students with regard to their own attitudes and values concerning age and ageing and actual clinical practice. Well-educated nursing staff appeared to be an important factor for satisfactory learning results.

(side 34-42)
av Jacob Birkler
When ethics become visible
Engelsk sammendrag

Based on a qualitative study in which nurses were observed in the clinical field, this article focuses on nursing ethics which reflect several dualities challenging norms and values in clinical practice. With the use of several examples, these dualities will be analyzed in an effort to describe possible connections and concrete lines of action. Results show that the Danish code of ethics as a tool for practical use fails to be relevant to clinical practice. This article concludes that the understanding and development of ethics in nursing practice arise in the nurse-patient relationship. Attention should therefore be drawn to nursing experience and character traits.

(side 43-53)
av Helle Vendel Petersen og Nete Hornnes
Geriatric patients’ self-assessments of their functional levels at discharge
Engelsk sammendrag

A good functional level is the key component in the prevention of re-admission of geriatric patients. Health Care Professionals (HCP) evaluate the functional levels of hospitalized patients to establish the right time for discharge, but patients do not always agree that they are ready to go home. The aim of this cross-sectional study was to examine whether there was a difference between the assessment made by the health care professionals and the geriatric patients respectively of the patients’ functional levels at discharge.

Using the Modified Barthel Index as an interview guide, interviews were carried out with 213 patients. Cognitive function, number of depressive symptoms, and functional level were assessed by HCP as part of the daily routine. Patients were found to be more positive with respect to their functional abilities than the HCP, and we recommend further involvement of patients in the discharge planning.

Vitenskapelig publikasjon
(side 54-70)
av Vibeke Zoffmann og Marit Kirkevold
Relationships and their potential for change Developed in difficult Type 1 diabetes
Engelsk sammendrag

Few researchers have explored how relationships between patients and providers might change problem solving in clinical practice. The authors used grounded theory to study dyads of 11 people with diabetes and poor glycemic control, and 8 nurses interacting in diabetes teams. Relational Potential for Change was identified as a core category that involved three types of relationships. Professionals mostly shifted between less effective relationships characterized by I-You-Distant Provider-Dominance and IYou-Blurred Sympathy. Although rarely seen, a third relationship, I-You-Sorted Mutuality proved more effective than the others in exploiting the Relational Potential for Change. The three types of relationship differed in (a) scope of problem solving, (b) the roles assigned to the patient and the professionals, (c) use of difficult feelings and different points of view, and (d) quality of knowledge achieved as the basis for problem solving and decision making. The authors discuss implications for practice and further research.

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