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The purposes of the study were to find out relatives' opinions about the care of dying patients as well as to find out how relatives assess the nursing care which was given to their nearest on the hospital wards. In order to collect the data for the study, the family members of patients (N = 628) who had died not more than one year before in the hospital, were interviewed. The interviewing was done by sending a questionnaire to every other relative (N = 314), 210 of which (62%) answered the questions. The answers to the structured questions were analyzed with the SAS-software and open-ended questions by the content analysis method. The relatives found that the hospital ward was quite a suitable environment for the nursing care of a dying patient. They found visiting hours flexible but they wished that they had the possibility to rest or stay over night in the hospital. The health care professionals responsible for the care of dying patients were considered to succeed in the field of the patient's rest and hygiene, but they took less well care of patient's physical exercise and dental hygiene. The relatives were satisfied with the pain relief the patient got. According to the relatives, examinations, medication, nursing interventions or the "futile" care given did not cause additional suffering. Although the nurses did not response to patients' spiritual well-being or needs of affections, they were able to make the patients happy with their kindness, presence and with good basic care. The relatives were best informed about patients' every day well-being, medication as well as practical matters concerning the time after the death of the patient. If the patient was transferred to another hospital for the terminal care, the relatives found, however, that they didn't get enough information of the situation. The health care professionals did not console the relatives for their grief and they had not been encouraged to participate in the care of their family members.

The aim of the study is to describe the features of bereavement and the life situation among the bereaved psychiatric outcare-patients. The impact of social support on stress and adaption has been indicated in previous studies. Social support of the patients belongs to the nursing care. The possibilities of the family-centered nursing to support the relatives in bereavement will also be discussed. The sample consisted of new patients' in psychiatric outcare (N = 32). The ground of the need to the care was the dead of their relative. The information has been gathered of the care records and it has been analysed by the content analysis. Following contents have been described: The features of the bereavement and the relations to the relatives. The features of the bereavement consisted of following categories depressive behavior, anxiety, hate and fear, self-destructive behavior and feelings of guilt. Relations to the other relatives consisted of following categories: Rejected by the relatives and disappointed in the relationship. The results indicated, that the patients did not receive social support in their daily life. The family-centered nursing will allow the social support also to the relatives after the dead of the patient.

In this study 3-8 year old children's pain assessment and management after tonsillectomies were evaluated on two otological wards. The sample consisted of 80 children, 40 from both wards and the response rate was 92%. The groups were compared with each other: on one ward nurses used the Faces Scale in children's self assessment of pain while the other was a comparative ward. The data were collected using measurements: 1. background of children, 2. intensity of children's pain after the operation observed by their parents, 3. parents' satisfaction with children's assessment and management of pain, 4. children's self assessment of pain with the Faces Scale and 5. documentation of children's pain management. The data were analysed by cross-tabulations, mean-values, t-test, Pearson's correlation and content analysis. 40% of children had severe or intolerable pain after the operation observed by their parents. Children's self assessment of pain and parents' observations correlated highly (r = .74, p < .05). Children had less pain (the difference was statistically significant) on the ward, where the Faces Scale was used in pain assessment. The parents were also more satisfied with their children's pain assessment and management on this ward. However, there were differences in pain management practices between there two wards. Nurses need more education to be able to assess and manage children's pain adequately.

The purpose of the study was to describe the factors causing psychological loads and control in the work of occupational health nurses. The material was collected using a questionnaire (n = 300). In all, the responses from 195 subjects were available for the present analysis. Cross-tabulation, correlations and percentage distributions were used as the statistical methods. Open-ended questions were qualitatively analyzed using content analysis. Occupational health nurses reported frequent loading due to paper work, the excessive scope of their work and multiple problems with clients. A continuous shortage of time, pressure from unperformed tasks and a lack of opportunities to concentrate on work frequently loaded the subjects. Organization of their work was related to changes in the pace of work. Nurses who estimated their working capacity to be excellent mentioned their professionalism and ability to develop along with the requirements of their work. The findings can be used in planning and developing the work of occupational health nurses and for educational purposes.

The grounded theory approach has been used in nursing research since 1970. The latest methodological books describe the research process in details. However, there are many problems involved in the grounded theory approach, which especially need to be considered by a novice researcher. One of these problems is the question of how deeply and widely the researcher should get familiar with the research topic before the empirical study. The problems also include the need to focus the research problem and to choose the sampling method. Data analysis is a multistage process, which demands from the researcher sensitivity and time to work out the findings which emerge from the data. In this paper, the grounded theory approach is described as a process undertaken by the researcher. The purpose of this paper is to discuss the challenges of the grounded theory approach and the problems encountered by a researcher using the method for the first time.

The aim of this article is to describe, what problems the spouses of permanently institutionalised patients feel in their lives. The nature of the study is qualitative. Data were collected from six spouses of patients cared for in two hospital wards in primary health care. The data collection method was theme interview. Analysis was made by qualitative content analysis method. The results of the study showed the spouses' experiences. They formed six categories: 1) embitterment of the fate of their own and their spouses, 2) feeling of guilt when living free while the spouse is in a hospital care, 3) feeling of being bound to the patient and losing own possibilities in life, 4) feeling of loss of the spouse, 5) losing contacts to other people outside the family, and 6) missing visions for the future. The results showed many ways how to develop the long-term hospital care toward family-centered care. The family members of the patients do not only form background of the patients or the care. They also need informational and emotional support to manage in their everyday lives.

Ethel M. Russaw is one of twenty-one American Fulbright grantees in Finland during the 1997-98 academic year. The University of Kuopio and the University of Turku are proud to host this outstanding scholar in nursing science. An exceptional background in nursing and a profound appreciation of other cultures enrich Dr. Russaw's contributions to the Fulbright experience. In addition to sharing a piece of American culture with her Finnish colleagues, Dr. Russaw plans to impart information pertaining to nursing education in Finland with her American peers.

The purpose of this study was to evaluate the compliance of patients with hypertension and the connections between compliance and control. The research material was collected using a questionnaire, which was filled in by 138 patients aged under 60 from one city and from three municipalities. The response percentage was 94%. The results are presented as a frequency and percentage distributions. Means and medians are also presented. The material was analysed using the SPSS for Windows program. Hypertension control was determined on the basis of blood pressure readings and a weight index. According to the blood pressure readings the control of hypertension was good in one tenth of the patients, medium in two thirds and poor in one fifth. Based on the weight index, the control of hypertension was good in less than one third, poor in almost one third and medium in the rest of the patients. Two thirds of the respondents were obese and men were more often obese than women. According to the findings, there were no significant correlations between compliance and control. Compliance with visits and dietary restrictions was poorest, while compliance with medication was best. In the future, we will have to study further the connections between compliance and control in patients with hypertension. The development of a reliable measuring instrument is a long process and requires further research in a large study population.

The aims of this study were to describe, firstly the perceptions and the experiences of the patients concerning the holistic guidance in a hospital, and secondly to describe their perceptions about how the guidance of the patients promoted patients' readinesses of self-care. Fifteen somatic and 10 psychiatric patients between 23 to 80 years of age participated in the study. The sample consisted of 12 men and 13 women. The data were collected by theme-interviews in three hospitals. The phenomenographic interpretive analysis was used for analysing the data. The psychiatric patients perceived the guidance as activating and developing the patient. The social management in the daily life was mainly emphasized in the guidance. They wished to discuss more about their feelings and their situation at the beginning and in the end of the nursing care in the hospital. The somatic patients regarded the guidance as informing and advising them how to observe their vital functions. They were dependent on the nursing experts during the hospitalization whereas the psychiatric patients thought they were more dependent when leaving the hospital. The somatic patients wished to discuss with nurses when they felt physically better. The psychiatric nursing emphasized the viewpoint of the human situation and the somatic the viewpoint of the organism. The guidance promoted the self-care readinesses of the patients when they handled their experiences of health and caring with nurses and when their own resources were used. The nurses need continuously to consider the ethical questions with which they could develop the guidance of the patients.