Aims: To describe how nurses perceive and promote inpatients' needs for physical activity during their stay at the ward.

Design: A qualitative descriptive design was employed providing an exploration of how nurses perceive and promote inpatients' need for physical activity.

Methods: Seven semi-structured focus group discussions were held between November 2016 and February 2017 with 29 nurses in three hospitals in Sweden. Both interaction analysis and content analysis of the data were conducted.

Results: Patients are dependent on nurses' prioritizations and promotions to be sufficiently physically active during their stay at the ward. The external environment and the integration of physical activity affected the promotion of physical activity. The nurses perceived that understanding the patient's expectations was important and that promotion of physical activity was a joint responsibility of patient, relatives and healthcare professionals. The interaction analysis revealed no clear hierarchical pattern as all members in each focus group took initiative to open the discussions. The Registered Nurses contributed with more new ideas.

Introduction: Rehabilitation for cancer patients aims at preventing and reducing the physical, mental, social and existential consequences of a cancer disease and its treatment. The aim of this study is to describe the patients' self-perceived interest in participating in cancer rehabilitation (CR).

Material and methods: A total of 1179 cancer patients, diagnosed with 28 different cancer diagnoses, from November 2015 to October 2016, were identified via the national cancer quality registers. A questionnaire was developed for the purpose of this study, the Cancer Rehabilitation Interest. The questionnaire comprises 16 different rehabilitation activities. This study describes what activities the patients are interested to participate in.

Results: The response rate was 62% and the final sample comprised 728 patients. The rehabilitation activities wanted by the cancer patients were Psychoeducational support group together with others with the same cancer diagnosis, Open lectures on cancer, Individual weight training with a physiotherapist and Personal support from a social worker. Most interested in cancer rehabilitation were women, younger patients, university educated patients and those who had received their diagnosis >= 12 months prior. Patients with a mandatory educational level had the lowest interest in all suggested activities compared with those having medium or high education.

Conclusions: The interest of cancer rehabilitation of all approached patients in this study were 21%. Most interested were women, young patients, university educated and those who received their diagnosis >= 12 months earlier. About 30% of the participating cancer patients reported an interest of information and supportive groups, physical training and support from a hospital social worker. Patients with low level of education reported a low interest in CR. There are limitations in rehabilitation accessibility and that might affect a person's motivation to participate in this study.

Purpose: Patients with brain tumors constitute a vulnerable group, and it is important that they receive the highest quality of care (QoC). The study aim was to describe the perceptions of QoC and its association with health-related quality of life in brain tumor patients undergoing proton beam therapy in a newly established clinic.

Method: Data were collected at the start of treatment and after 3 and 6weeks. Adult patients (18years old) with brain tumors (n=186) completed two self-administered questionnaires: a modified Quality from the Patients' Perspective, which measures perceived reality and subjective importance of care, and the EORTC QLQ-C30. Data were analyzed using parametric and non-parametric statistical tests.

Results: The perceived QoC was highest for treatment information and lowest for dietician and smoking information, whereas interaction with doctors and nurses was rated as the most important aspect of quality of care. Subjective importance ratings were significantly higher than perceived reality ratings for 60% of items. A better global health was moderately correlated with a higher perceived support for fatigue.

Conclusions: A need for quality improvement was identified for several aspects of patient care. Greater symptom distress during the treatment period led to greater perceived importance of symptom support. Ensuring QoC is complex and collaboration with other health care professionals is essential.

Relevance to clinical practice: The clinic could improve QoC regarding information about possible symptoms, adjust care according to patient perceptions of importance, and involve patients in care decisions.

Felt stigma is an internalized sense of shame about having an unwanted condition, along with fear of discrimination. The Stigma-related Social Problems (SSP) scale was constructed to measure the impact of health-related stigma on psychosocial functioning in people with different diseases and disorders. The performance of the SSP scale was tested in 3,422 subjects from the general population (Mid-Swed Health Survey) and in subgroups according to gender, age, occupation, and education. The homogeneity and construct validity of the Distress and Avoidance scales were confirmed by exploratory factor analysis and the two factors were accurately reproduced across gender and age subgroups. The internal consistency reliability was high for both the Distress and Avoidance scales. Reliability coefficients were above the 0.90 standard for the Distress scale in all subgroups and for the Avoidance scale in most subgroups. The SSP scale is an instrument with sound psychometric properties that can be used to identify psychosocial disturbances.

OBJECTIVES: To explore symptom clusters during proton beam therapy in patients with primary brain tumors and investigate associations among symptom clusters, demographic variables, and comorbidity in this patient population.

SAMPLE & SETTING: Data were collected from 187 adult patients with primary brain tumors during their treatment periods in the Skandion Clinic in Uppsala, Sweden. Symptoms were assessed with the Radiotherapy-Related Symptoms Assessment Scale, and comorbidity was evaluated with the Self-Administered Comorbidity Questionnaire.

METHODS & VARIABLES: The study used a quantitative and longitudinal design. Exploratory factor analysis was used to determine the underlying structure of symptom clusters.

RESULTS: Three clusters were identified: mood, reduced appetite, and reduced energy. The mood cluster had the highest factor loadings (0.71-0.86). In addition, demographic and comorbidity characteristics were associated with symptom clusters in this group of patients.

IMPLICATIONS FOR NURSING: Building knowledge about how these symptoms interact and are clustered will support healthcare professionals to more efficiently relieve symptom clusters during proton beam therapy.

AIMS AND OBJECTIVES: To explore ambulance nurses' (ANs) experiences of non-conveying patients to alternate levels of care.

BACKGROUND: Increases in ambulance utilisation and in the number of patients seeking ambulance care who do not require medical supervision or treatment during transport have led to increased nonconveyance (NC) and referral to other levels of care.

DESIGN: A qualitative interview study was conducted using an inductive research approach.

METHODS: The study was conducted in a region in the middle of Sweden during 2016-2017. Twenty nurses were recruited from the ambulance departments in the region. A conventional content analysis was used to analyse the interviews. The study followed the COREQ checklist.

RESULTS: The ANs experienced NC as a complex and difficult task that carried a large amount of responsibility. They wanted to be professional, spend time with the patient and find the best solution for him or her. These needs conflicted with the ANs' desire to be available for assignments with a higher priority. The ANs could feel frustrated when they perceived that ambulance resources were being misused and when it was difficult to follow the NC guidelines.

CONCLUSION: If ANs are expected to nonconvey patients seeking ambulance care, they need a formal mandate, knowledge and access to primary health care.

RELEVANCE TO CLINICAL PRACTICE: This study provides new knowledge regarding the work situation of ANs in relation to NC. These findings can guide future research and can be used by policymakers and ambulance organisations to highlight areas that need to evolve to improve patient care.

Background: Felt stigma is an internalized sense of shame about having an unwanted condition along with fear of discrimination due to imputed inferiority or unacceptability. Various illnesses and symptoms of disease are associated with health-related stigma and individuals may experience stigma that strongly affects their quality of life. The Stigmarelated Social Problems scale (SSP) was developed for measuring the impact of health-related stigma on social functioning in people with different diseases and disorders.

Objective: The aim of the study was to evaluate the validity of SSP in the general Swedish population.

Method: In 2015, SSP was sent to a random population sample (n=8140). Tests of the internal consistency reliability of scale scores (Cronbach’s alpha), the unidimensionality and homogeneity of scales (factor analysis), item-scale convergent validity, ceiling and floor effects, and known group analysis were conducted.

Results: The response rate was 42%. Reliability coefficients were high (< 0.93) for both scales. Factor analyses confirmed the unidimensionality. Item-scale correlations for both scales indicated satisfactory item-scale convergent validity (r ≥ 0.40). The proportion of subjects scoring at the lowest possible score level (floor effect) was 25% for the Distress scale and 28% for the Avoidance scale, while ceiling effects were marginal (<1%). The proportion of missing items was generally low, ranging from 0.8-1.5%.