The aim of this study was to describe and compare family members' experiences of approach in encounters with healthcare professionals and possible feelings of alienation in the professional care within four care contexts: the care of older people, psychiatric care, palliative care and diabetes care. The design was an explorative cross-sectional survey study. Data were collected in Sweden using the Family Involvement and Alienation Questionnaire-Revised (FIAQ-R). It measures family members' experiences of the healthcare professionals' approach and the family members' feeling of alienation from the provision of professional care. A total of 1047 questionnaires were distributed to family members using convenient sampling method, of which 294 were included. Data were analysed using rank-based, non-parametric statistical methods. The results indicated that most respondents experienced a positive actual approach from the healthcare professionals. Many participants rated the importance of approach at a higher level than their actual experience. Participants in the context of diabetes care reported a more negative actual approach from the healthcare professionals than did participants in the other contexts and considered the healthcare professionals' approach towards them as being less important. The results for the entire group indicated that the participants felt a low level of alienation from the professional care. Participants in the context of the care of older people reported significantly lower level of feeling of being alienated than did participants in the contexts of psychiatric care and diabetes care. The differences between participants in diabetes care and other care contexts can possibly be explained by a more fully implemented self-care approach among the patients in diabetes care than in the other care contexts. Even though the results are quite positive, it is still important that nurses consider a family-centred approach to better adapt to the needs of both the family members and the patients.

Purpose: The purpose was to investigate family members’ experiences of the healthcare professionals’ approach and feeling of alienation in nursing homes.

Methods: This study had a cross-sectional design collecting data from seven nursing homes in Sweden using the Family Involvement and Alienation Questionnaire - Revised (FIAQ-R). The final sample consisted 133 family members (response rate 42.6%). Data were analyzed with a variety of rank-based, non-parametric statistical methods.

Results: Family members in general experienced a positive approach from the healthcare professionals and considered that as being of the very highest importance. This could be explained by the skewed sociodemographic characteristics of the sample. The concept of continuity generated the most comments of a negative character indicating the importance of organizational factors in nursing homes.

Conclusion: The results indicate the need to improve continuity in the care of older persons in nursing homes by limiting the amount of different health care professionals surrounding the older person. Also, it highlights the importance of having a specific contact person assigned to each older person living in nursing homes.

AIM: To adapt the Family Involvement and Alienation Questionnaire for use in the care of older people, psychiatric care, palliative care and diabetes care and to evaluate its validity and reliability.

BACKGROUND: Involvement in the professional care has proven to be important for family members. However, they have described feelings of alienation in relation to how they experienced the professionals' approach. To explore this issue, a broad instrument that can be used in different care contexts is needed.

DESIGN: A psychometric evaluation study, with a cross-sectional design.

METHOD: The content validity of the Family Involvement and Alienation Questionnaire was evaluated during 2014 by cognitive interviews with 15 family members to adults in different care contexts. Psychometric evaluation was then conducted (2015-2016). A sample of 325 family members participated, 103 of whom in a test-retest evaluation. Both parametric and non-parametric methods were used.

RESULTS: The content validity revealed that the questionnaire was generally understood and considered to be relevant and retrievable by family members in the contexts of the care of older people, psychiatric care, palliative care and diabetes care. Furthermore, the Family Involvement and Alienation Questionnaire (Revised), demonstrated satisfactory psychometric properties in terms of data quality, homogeneity, unidimensionality (factor structure), internal consistency and test-retest reliability.

CONCLUSION: The study provides evidence that the Family Involvement and Alienation Questionnaire (Revised) is reliable and valid for use in further research and in quality assessment in the contexts of the care of older people, psychiatric care, palliative care and diabetes care. This article is protected by copyright. All rights reserved.

BACKGROUND: Depression is a common experience affecting 121 million people around the world. In high income countries, depression is one of the most common psychiatric conditions among the elderly. Studies show that immigrants are particularly at risk for mental ill health.

AIM: This study investigates the self-reported mental health among two Iranian groups; one born and residing in Iran and one consisting of Iranian immigrants in Sweden, as well as native Swedes living in Sweden. The study also aims to explore and compare self-reported depressive symptoms among three groups.

METHODS: This study is based on a cross-sectional design measuring self-reported health with a study specific questionnaire. The programme SPSS V.17.0 was used for all statistical analyses.

FINDINGS: 1088 participants were approached (668 Iranians in Iran; 105 immigrated Iranians in Sweden; and 305 Swedes in Sweden). Factors effecting self-reported mental health was self-reported health, smoking, satisfaction with social life and also a sense of connection to ones cultural roots and traditions. Also demographic variables such as group belonging (Swedes vs. Iranians), sex and satisfaction with Income were shown to be important when performing the regression analysis. In the chi-square analysis the Iranian samples reported depressive symptoms to a larger extent than the Swedish group in all aspects of self-reported depressive symptoms. Self-reported depressive symptoms were reported to a greater extend in women compared to men. Our findings indicate that the Iranian populations living in both Tehran and Stockholm report depressive symptoms to an extent that merits concern. The findings indicate that Iranians living in Tehran and Iranians who have immigrated to Sweden require more attention regarding mental health care. Health care providers in both countries should be aware of the current state of mental health among Iranians in both Sweden and Iran.

PURPOSE: This paper describes the process of developing and validating a questionnaire to investigate self-reported health and care needs of elders in Iran and Sweden.

BACKGROUND: Both developing and developed countries face dilemmas under the current condition of increasing mental and physical health morbidity globally. In order to fully assess and understand the extent of these dilemmas and the global and local factors that alleviate or worsen them, a comparison of the self-reported health and care needs in a developed and a developing country is required. To these ends, two research teams within a joint international project worked together to construct a questionnaire to measure self-reported health in elders in Sweden and Iran.

METHODS: The questionnaire was developed according to a multiphase process, during which the researchers tested the validity and reliability of the questionnaire using various methods and modified it based on the test results. First, the concepts to be used were agreed upon and a literature review was conducted. Thereafter, face and content validity was measured in Iran, looking at the initial items that were developed. The questionnaire was then translated and back-translated. Finally, both teams conducted a test of content validity using target groups in Iran and Sweden, respectively.

RESULTS: Validity was established by testing face and content validity with the use of expert groups. Reliability was also determined according to two different dimensions, stability and internal consistency. Both methods gave satisfactory results, indicating that the instrument was reliable.

CONCLUSION: The questionnaire was thereby developed and titled, 'Self-reported health and health-care needs'. The results confirm validity and reliability of the final version of the questionnaire.

Research has shown that majority of nurses feel that they lack relevant knowledge about immigrant's cultural backgrounds, and therefore, feel incompetent in providing these patients with good care. Last year alone, 4520 nursing students graduated from nursing schools throughout Sweden. Later on, they will meet and treat people from diverse cultural backgrounds and consequently, it is crucial that their educational training prepares them for their future work in a multiethnic society. The aim of this study was to investigate whether the nursing curricula in Sweden's nursing schools provide students with the necessary tools for becoming culturally competent. The present study was based on two main questions: (i) Do the present educational plans and courses provide nursing students with the opportunity to become culturally competent? (ii) How do the contents of the educational plans match the contents of the course plans? The study was conducted using a quantitative documentary analysis, where the authors analysed the curricula of 26 nursing schools in Sweden and then compared them to the theoretical frame of reference 'The Process of Cultural Competence in the Delivery of Healthcare Services', a model written by Campinha-Bacote. The results showed that 69% (18/26) had included the concept of culture in their educational plans, whereas 77% (20/26) had included this in their courses. In all, 15% (78) from a total of 504 curricula had included the concept of culture in some way or another. However, the analysis found that only three schools provided students with specific training on the topic. Conclusively, the results showed that nursing students were not prepared for their work in a multiethnic society and nursing education in Sweden has failed to implement existing research into the nursing curricula.