Buskerud University College

Self-determination theory proposes a multidimensional conceptualization of motivation comprising autonomous and controlled forms. Whereas autonomous motivation relates positively to individuals’ optimal functioning (e.g., well-being, performance), controlled motivation is less beneficial. To be able to use self-determination theory in the field of organizational behaviour, the Multidimensional Work Motivation Scale was developed and tested using data from 3435 workers in seven languages and nine countries. Factorial analyses indicated that the 19-item scale has the same factor structure across the seven languages. Convergent and discriminant validity tests across the countries also indicate that the psychological needs for autonomy, competence, and relatedness as well as the theoretically derived antecedents to work motivation (e.g., leadership and job design) are predictably related to the different forms of motivation, which in turn are predictably related to important work outcomes (e.g., well-being, commitment, performance, and turnover intentions). Implications for the development of organizational research based on self-determination theory are discussed.

Abstract Purpose The aim of this study is to investigate which factors employers should focus on in their employer branding strategies. The present study tested the employer attractiveness scale (EmpAt) and analysed relationships between dimensions in this measurement scale and the use of social media in relation to corporate reputation and intentions to apply for a job. Design/methodology/approach Electronic questionnaires were distributed to students at three higher education institutions in Norway. The proposed model is analysed on the basis of 366 responses related to three well-known Norwegian engineering firms. Findings The results indicate that several employer attributes are positive for corporate reputation, which again is related to attraction of potential employees. Specifically, the results suggest that innovation value, psychological value, application value, and the use of social media positively relate to corporate reputation, which in turn is positively linked to intentions to apply for a job. Psychological value, which is the strongest predictor, is also directly related to intentions to apply for a job. Furthermore, the validation of the EmpAt scale resulted in different dimensions than in the original study. New dimensions and a re-arrangement of indicators are proposed. Originality/value The research is original in the way it combines employer branding and social media, and this will be of value to employers in their recruitment processes.

OBJECTIVE: A study was undertaken to test the psychometric properties of the Fatigue Severity Scale (FSS), and to explore the relationship between fatigue and sociodemographic variables in the general population. METHOD: A national representative sample of 1893 respondents was randomly selected from a pool of 4,000 Norwegians aged 19-81 years. A mailed questionnaire that included the FSS was used to measure fatigue severity. RESULTS: The FSS showed satisfactory internal consistency (Cronbach's alpha 0.88). The prevalence of high fatigue (FSS score > = 5) was 23.1% in the total sample. More women (26.2%) than men (19.8%) experienced high fatigue (p = 0.004). Respondents with chronic illness (more than six months) reported a higher mean (M = 4.69, SD = 1.35) than the rest of the sample (M = 3.67, SD = 1.17) (p<0.001). An inverse correlation was found between fatigue and level of formal education (r = 0.20, p<0.001). CONCLUSION: The psychometric properties of the Norwegian version of FSS were satisfactory. To avoid over-diagnosing people for high level of fatigue, the threshold for high fatigue probably should be 5 on the FSS scale instead of 4 as had been suggested originally, but further validation of the cut-off point is needed.

BACKGROUND: Recent literature on recovery describes the process as deeply personal and unique to each individual. While there are aspects of recovery that are unique to each individual, this article argues that focusing solely on these overlooks the fact that recovery unfolds within a social and interpersonal context. MATERIALS: Drawing from qualitative data, this article describes aspects of recovery that involve the contributions of others, the social environment and society. DISCUSSION: These aspects of recovery include relationships, adequate material conditions and responsive services and supports. CONCLUSION: The authors consider the implications of these social factors for transforming psychiatric research and theory as well as for recovery-orientated practice.

In nursing science, concept development is a necessary prerequisite for meaningful basic research. Rodgers' evolutionary concept analysis is a method for developing knowledge in nursing science. The purpose of this article is to present Rodgers' evolutionary concept analysis as a valid scientific method. A brief description of the evolutionary process, from data collection to data analysis, with the concepts' context, surrogate and related terms, antecedents, attributes, examples and consequences, is presented. The phases used in evolutionary concept analysis are illustrated with eight actual studies (1999-2009) from nursing research. The strength of the method is that it is systematic, with a focus on clear-cut phases during the analysis process, and that it can contribute to clarifying, describing and explaining concepts central to nursing science by analysing how a chosen concept has been used both within the discipline itself and other health sciences. While an interdisciplinary perspective which stresses the similarities and dissimilarities of how a concept is used in various disciplines can increase knowledge of a concept, it is important to clarify the specific with the discipline. Nursing research should focus on the unambiguous use of concepts, for which Rodgers' method constitutes a possible method. The importance of using quality criteria to determine the inclusion of material should, however, be emphasised in the continued development of the method.

The field of microfluidics has yet to develop practical devices that provide real clinical value. One of the main reasons for this is the difficulty in realizing low-cost, sensitive, reproducible, and portable analyte detection microfluidic systems. Previous research has addressed two main approaches for the detection technologies in lab-on-a-chip devices: (a) study of the compatibility of conventional instrumentation with microfluidic structures, and (b) integration of innovative sensors contained within the microfluidic system. Despite the recent advances in electrochemical and mechanical based sensors, their drawbacks pose important challenges to their application in disposable microfluidic devices. Instead, optical detection remains an attractive solution for lab-on-a-chip devices, because of the ubiquity of the optical methods in the laboratory. Besides, robust and cost-effective devices for use in the field can be realized by integrating proper optical detection technologies on chips. This review examines the recent developments in detection technologies applied to microfluidic biosensors, especially addressing several optical methods, including fluorescence, chemiluminescence, absorbance and surface plasmon resonance.

BACKGROUND: Population-based studies suggest that prevalence of chronic pain is increasing. The purpose of this study was to determine the prevalence of chronic pain in a sample drawn from the general Norwegian population. In addition, the characteristics of chronic pain, as well as differences in demographic characteristics and health-related variables between persons with and without chronic pain were evaluated. METHODS: A total of 4000 Norwegian citizens, were randomly drawn from the National Register, by Statistics Norway and were mailed a questionnaire. RESULTS: The response rate was 48.5%. The majority of the sample was female (51%), married (59%), and working for pay (69%) with a mean age of 45.2 years. The prevalence of chronic pain in the total sample was 24.4%, and 65% of the participants with chronic pain indicated that they had experienced chronic pain for over 5 years. The cause of the pain was not specified by 57% of the participants in chronic pain, and 31% reported no pain treatments. Women, older individuals, persons with less education, and those who were pensioned, reported chronic pain more frequently. The results of a logistic regression analysis indicate that the variables that provide unique contributions to predicting pain group memberships were: gender, education, being frequently ill, or having a chronic illness. CONCLUSIONS: These findings suggest that chronic pain is a significant problem in the general Norwegian population, and that gender, education, being frequently ill, or having a chronic illness are important variables in predicting pain group membership.

Background: Recovery in severe mental illness is often seen as an individual process that occurs in mental health settings. Recent research has begun to explore the nature of recovery as a social process. As a further exploration of this issue, this paper examines processes of recovery as they unfold in everyday life, attempting to capture both the simplicity as well as the complexity of the daily life experiences of people in recovery.Aim: Exploring recovery within the context of the person's everyday life.Method: Qualitative study, using narrative phenomenological methods, based on interviews with individuals in recovery.Results: Four areas of everyday life experiences in recovery were identified: (i) having a normal life, (ii) just doing it, (iii) making life easier, and (iv) being good to yourself.Conclusions: Conceptualizing recovery in severe mental illness within the context of everyday life offers the opportunity to understand mental health problems as an integrated part of people's lives. These findings suggest that recovery unfolds within the context of “normal” environments and activities. As one implication of this study, everyday life expertise should be included in the practitioners' agenda.

OBJECTIVE: The objective of our study was to evaluate the effect of supplementation with docosahexaenoic acid and arachidonic acid for human milk-fed preterm infants. The primary end point was cognitive development at 6 months of age. METHODS: The study was a randomized, double-blind, placebo-controlled study among 141 infants with birth weights of <1500 g. The intervention with 32 mg of docosahexaenoic acid and 31 mg of arachidonic acid per 100 mL of human milk started 1 week after birth and lasted until discharge from the hospital (on average, 9 weeks). Cognitive development was evaluated at 6 months of age by using the Ages and Stages Questionnaire and event-related potentials, a measure of brain correlates related to recognition memory. RESULTS: There was no difference in adverse events or growth between the 2 groups. At the 6-month follow-up evaluation, the intervention group performed better on the problem-solving subscore, compared with the control group (53.4 vs 49.5 points). There was also a nonsignificant higher total score (221 vs 215 points). The event-related potential data revealed that infants in the intervention group had significantly lower responses after the standard image, compared with the control group (8.6 vs 13.2). There was no difference in responses to novel images. CONCLUSIONS: Supplementation with docosahexaenoic acid and arachidonic acid for very preterm infants fed human milk in the early neonatal period was associated with better recognition memory and higher problem-solving scores at 6 months.

We sought to identify clinical characteristics and socio-demographic variables associated with longitudinal patterns of fatigue in multiple sclerosis (MS) patients. A questionnaire including the Fatigue Severity Scale (FSS) was mailed to a community sample of 502 MS patients three times 1 year apart. Three patterns of fatigue were defined: persistent fatigue (PF) (mean FSS score > or = 5 at all time-points), sporadic fatigue (SF) (mean FSS score > or = 5 at one or two time-points) and no fatigue (mean FSS score < 5 at all time-points). Among the 267 (53%) patients who responded at all time-points, 101 [38%, 95% confidence intervals (CI) 32-44] had persistent, 98 (37%, 95% CI 31-43) sporadic and 68 (25%, 95% CI 20-31) no fatigue. Persistent and sporadic fatigue were more common in patients with, increased neurological impairment (P < 0.001), primary progressive MS (P = 0.01), insomnia (P < 0.001), heat sensitivity (P < 0.001), sudden-onset fatigue (P < 0.001) or mood disturbance (P < 0.001) compared with patients without fatigue. Multivariable analysis showed that depression (PF P = 0.02, SF P < 0.001), heat sensitivity (PF P = 0.04, SF P = 0.02) and physical impairment (PF P = 0.004, SF P = 0.01) were associated with both sporadic and persistent fatigue. About 75% of the patients had persistent or sporadic fatigue over a 2 years observation period. Multivariable analyses confirmed a significant association between levels of depression, physical impairment and persistent fatigue.

OBJECTIVES: To describe age differences in chronic pain and to evaluate for differences in demographic and health-related variables among younger (18-39 years), middle-aged (40-59 years), and older adults (60-81 years) who reported chronic pain. METHODS: A total of 4000 Norwegian citizens were mailed a questionnaire that measured pain, quality of life, mood, and demographic and health-related variables. RESULTS: Of the total sample (n = 1912), 19.2% of the younger age group, 27.5% of the middle-aged group, and 31.2% of the older group reported chronic pain (ie, >3 months duration). A total of 58.9% of the participants in chronic pain reported having a chronic disease, with the most common being musculoskeletal problems, chronic pain disorder, and osteoarthritis. Participants in the older age group reported pain of longer duration and more comorbidities and received pain treatment more often. They had higher total quality of life scores, were more satisfied with their material comforts and social life, and reported better mood. The middle-aged group reported the largest number of pain locations, reported having fibromyalgia more frequently, and reported that the cause of their pain was not known. They were less satisfied with their social life than the older age group. The younger age group reported the highest rates of injury and accidents as the cause of their pain, and almost 43% of this age group was not receiving any treatment of their chronic pain. CONCLUSION: This study found that the prevalence rates for chronic pain do vary with age and that the middle-aged group may be a high-risk group of patients with chronic pain.

Person-centredness as a concept is becoming more prominent and increasingly central within some research literature, approaches to practice and as a guiding principle within some health and social care policy. Despite the increasing body of literature into person-centred nursing (PCN), there continues to be a 'siloed' approach to its study, with few studies integrating perspectives from across nursing specialties. The purpose of this paper is to present the results of a study undertaken to explore if the secondary analysis of findings from four different and unrelated research studies (that did not have the main aim of researching person-centredness) could inform our understanding of person-centred nursing. A qualitative meta-synthesis was undertaken of the data derived from the four unrelated research studies undertaken with different client groups with long-term health conditions. A hermeneutic and interpretative approach was used to guide the analysis of data and framed within a particular person-centred nursing framework. Findings suggest 'professional competence' (where competence is understood more broadly than technical competence) and knowing 'self' are important prerequisites for person-centred nursing. Characteristics of the care environment were also found to be critical. Despite the existence of expressed person-centred values, care processes largely remained routinised, ritualistic and affording few opportunities for the formation of meaningful relationships. Person-centred nursing needs to be understood in a broader context than the immediate nurse-patient/family relationship. The person-centred nursing framework has utility in helping to understand the dynamics of the components of person-centredness and overcoming the siloed nature of many current perspectives.

BACKGROUND: Internet-based interventions using cognitive behavioral approaches can be effective in promoting self-management of chronic pain conditions. Web-based programs delivered via smartphones are increasingly used to support the self-management of various health disorders, but research on smartphone interventions for persons with chronic pain is limited. OBJECTIVE: The aim of this trial was to study the efficacy of a 4-week smartphone-delivered intervention with written diaries and therapist feedback following an inpatient chronic pain rehabilitation program. METHODS: A total of 140 women with chronic widespread pain who participated in a 4-week inpatient rehabilitation program were randomized into 2 groups: with or without a smartphone intervention after the rehabilitation. The smartphone intervention consisted of 1 face-to-face session and 4 weeks of written communication via a smartphone. Participants received 3 smartphone diary entries daily to support their awareness of and reflection on pain-related thoughts, feelings, and activities. The registered diaries were immediately available to a therapist who submitted personalized written feedback daily based on cognitive behavioral principles. Both groups were given access to a noninteractive website after discharge to promote constructive self-management. Outcomes were measured with self-reported questionnaires. The primary outcome measure of catastrophizing was determined using the pain catastrophizing scale (score range 0-52). Secondary outcomes included acceptance of pain, emotional distress, functioning, and symptom levels. RESULTS: Of the 140 participants, 112 completed the study: 48 in the intervention group and 64 in the control group. Immediately after the intervention period, the intervention group reported less catastrophizing (mean 9.20, SD 5.85) than the control group (mean 15.71, SD 9.11, P<.001), yielding a large effect size (Cohen's d=0.87) for study completers. At 5-month follow-up, the between-group effect sizes remained moderate for catastrophizing (Cohen's d=0.74, P=.003), acceptance of pain (Cohen's d=0.54, P=.02), and functioning and symptom levels (Cohen's d=0.75, P=.001). CONCLUSIONS: The results suggest that a smartphone-delivered intervention with diaries and personalized feedback can reduce catastrophizing and prevent increases in functional impairment and symptom levels in women with chronic widespread pain following inpatient rehabilitation. TRIAL REGISTRATION: Clinicaltrials.gov NCT01236209; http://www.clinicaltrials.gov/ct2/show/NCT01236209 (Archived by WebCite at http://www.webcitation.org/6DUejLpPY).

PURPOSE: The aim of this review was to provide a comprehensive analysis of the state of knowledge about post-stroke depression (PSD) in the acute phase, focusing on: (a) the prevalence of depressive disorder and depressive symptoms, (b) the dominant depressive symptoms, (c) the factors associated with PSD and (d) the follow-up consequences. METHOD: A computer-aided search in MEDLINE, CINAHL, PsychInfo, EMBASE, British Nursing index, Pub Med and Ovid Nursing Database was performed. We systematically searched for studies including depression within the first month after stroke. RESULTS: Forty articles including more than 5400 informants from 37 cohorts met the inclusion criteria. Only a few studies aimed to describe the nature of PSD. The prevalence of depressive disorder and depressive symptoms in the acute phase ranged widely from 5% to 54%. Multiple tools were used for measuring depressive symptoms in the acute phase. An association was found between early depressive symptoms and the continuation of PSD 12 months after stroke. There is a correlation between depressive symptoms and mortality at 12 and 24 months. CONCLUSION: Depressive symptoms are common in the acute phase after stroke and associated with persistency of depression and mortality after 12 months. A gold standard for the measurement of depressive symptoms in relation to stroke is missing. The knowledge of PSD in the acute phase is still limited, and there is a need for continued empirical research on its profile and patterns.

There is increasing evidence that inflammation plays an important role in the progression of acute ischemic stroke (AIS). The primary aims of this study were to examine the serum levels of 13 cytokines, C-reactive protein (CRP), glucose, and hemoglobin in AIS patients, and their relationship to stroke lateralization, type, and infarct volume. Forty-five patients with AIS were evaluated. Blood samples were taken within 72 h, and volumetric analyses performed within 1-7 days after AIS onset. Cytokines were measured in serum from all patients and from 40 control subjects using Luminex Bio-Plex XMap technology. The levels of interleukin (IL)-1ra (p < 0.001), IL-6 (p < 0.001), IL-8 (p < 0.001), IL-9 (p = 0.038), IL-10 (p = 0.001), IL-12 (p = 0.001), IL-18 (p < 0.001), and GRO-α (CXCL1) (p = 0.017) were significantly higher in the AIS patients than in the controls. The IL-8 level was significantly correlated with age in the patient group (r = 0.52, p < 0.001). None of the variables were found to be associated with stroke lateralization. Infarct volume was significantly positively correlated with CRP level (r = 0.47, p = 0.005). Patients with radiologically confirmed infarctions had significantly elevated serum levels of GRO-α (p = 0.023). The cytokine profile of the AIS patients supports not only earlier findings of a proinflammatory response but also early activation of endogenous immunosuppressive mechanisms. Novel findings of this study are elevated serum levels of IL-9 and GRO-α. Elevated GRO-α in AIS patients with radiologically confirmed infarctions suggests that GRO-α is specific for stroke of known etiology. Our results indicate that CRP plays an important role in the progression of cerebral tissue injury.

Aim. The aim of this qualitative study was to describe from the perspective of 10 women (aged 39–69 years), their experience of living with breast cancer. Background. Although there is increasing research into a variety of aspects associated with breast cancer, there is a continuing need for research to increase nurses' understanding of how women experience living with newly diagnosed breast cancer. Design/methods. Following ethical approval, open‐ended interviews were analysed, using methods influenced by Grounded Theory. Verifiability and empirical grounding of the theory was established through use of the constant comparative method. Findings. Existential issues arose as an important aspect of living with newly diagnosed breast cancer. The will to live emerged as the central theme. All energy was channelled into a tenacious fight for life. Furthermore, results revealed other aspects in the women's awareness of living with breast cancer, such as their experiences in relation to emotional reactions, bodily physical changes, their female identity, meaningful activities and their social network. Conclusions. An understanding of how women experience their new and changed life situation is important to the support nurses give in the process of healing. Nurses need this knowledge to be better able to assist women and their families in their development of coping strategies.

PURPOSE: The aim of this study was to describe prevalence of fatigue and its relationship with demographic and clinical variables during the first 2 weeks (acute phase) following a stroke. METHOD: Data were collected in a cross-sectional correlational study from face-to-face interviews using structured questionnaires and patient's medical records. The sample consists of 115 patients with first-ever stroke admitted to two hospitals in Norway in 2007 and 2008. Post-stroke fatigue was measured with the Fatigue Severity Scale (FSS). The FSS measure was applied in the analysis as a continuous variable, and also used to categorise patients into three groups of fatigue intensity: no fatigue (mean FSS-score <4), moderate fatigue (mean FSS-score = 4-4.9) and severe fatigue (mean FSS-score ≥5). Patients who reported fatigue lasting longer than 3 months before the stroke were defined as having prestroke fatigue. RESULTS: Pre-stroke fatigue was reported by 34 patients (30%). After stroke, 24% had severe fatigue, and fatigue was more common for women (57%). Controlling for sex and prestroke fatigue, the multivariate analysis showed that prestroke fatigue, lower physical function and depressive symptoms were related to post-stroke fatigue. CONCLUSION: Pre-stroke fatigue and fatigue during the acute phase needs to be assessed in relation to physical functioning and depression during recovery and the rehabilitation process.

OBJECTIVE: To explore the predictive value of MRI parameters and tumour characteristics before neoadjuvant chemotherapy (NAC) and to compare changes in tumour size and tumour apparent diffusion coefficient (ADC) during treatment, between patients who achieved pathological complete response (pCR) and those who did not. METHODS: Approval by the Regional Ethics Committee and written informed consent were obtained. Thirty-one patients with invasive breast carcinoma scheduled for NAC were enrolled (mean age, 50.7; range, 37-72). Study design included MRI before treatment (Tp0), after four cycles of NAC (Tp1) and before surgery (Tp2). Data in pCR versus non-pCR groups were compared and cut-off values for pCR prediction were evaluated. RESULTS: Before NAC, HER2 overexpression was the single significant predictor of pCR (p = 0.006). At Tp1 ADC, tumour size and changes in tumour size were all significantly different in the pCR and non-pCR groups. Using 1.42 × 10(-3) mm(2)/s as the cut-off value for ADC, pCR was predicted with sensitivity and specificity of 88% and 80%, respectively. Using a cut-off value of 83% for tumour volume reduction, sensitivity and specificity for pCR were 91% and 80%. CONCLUSION: ADC, tumour size and tumour size reduction at Tp1 were strong independent predictors of pCR.

The article presents a model for understanding the role of customers' commitment to service employees and their intention to stay with the firm. The model consists of two kinds of commitment—calculative and affective—to both the service employee and the service firm. The model is tested with a sample of bank customers. The findings support the direct effect of commitment to service employees on commitment to the service firm and the indirect effect on intention to stay.

OBJECTIVES: The purpose of the study was to explore whether and how loneliness in adults was influenced by life events and experiences in early and later stages in life. Applying a life-course and gender perspective, the current study investigates statuses and transitions that influence self-reported loneliness among men and women in middle age (age 40-59) and when older (age 60-80). METHOD: The panel data are from two waves of the Norwegian study of the life course, ageing and generations. Our sample consists of 3750 people aged 40-80 at baseline who were surveyed in 2002-2003 (T1) and 2007-2008 (T2). Multivariate analyses were used to investigate personal characteristics and life events associated with loneliness at baseline and life events predicting the incidence of loneliness during the five-year period. RESULTS: Adverse childhood events were associated with loneliness by both men and women. In the older group, men's loneliness was related to having been bullied, and conflicts between parents. Women's loneliness was related to economic problems in their childhood family. Regarding the incidence of loneliness - becoming lonely between T1 and T2 - among those aged 40-59, divorce predicted women becoming lonely, but not men. Among those aged 60-80, the partner's death was a stronger predictor of the incidence of loneliness among men than among women. CONCLUSION: The results demonstrate that loneliness is influenced by events and experiences from early childhood to later life, and that some events and experiences influence loneliness in men and women differently.