Self-determination theory and the smoking cessation process: Daily electronic self-reports can identify the initiation of quit attempts.

OBJECTIVES: To examine the motivational predictors of the smoking cessation process at the between-persons and within-persons levels. METHODS: Mediation analyses were conducted on self-report data (N = 236) that were collected using interval contingent sampling over a 39-day study period. RESULTS: There was a high rate of attrition, as nearly 50% of participants were lost to follow-up. There were credible indirect effects of autonomous self-regulation on smoking behavior on the next day and seven-day abstinence through perceived competence and medication use. At the between-persons level, these models explained 17% of the variance in smoking behavior on the next day and 31% of the variance in seven-day abstinence; at the within-persons level, these estimates were 39% and 57%, respectively. CONCLUSIONS: Day-to-day changes in autonomous self-regulation, perceived competence, and medication use are important initiators of the smoking cessation process. PRACTICE IMPLICATIONS: Smokers might be more likely to make a quit attempt if practitioners "tune into" the day-to-day fluctuations of their patients' motivation for stopping smoking, perhaps using an electronic platform to assess and compare smokers' current reports to their previous experiences. Such "motivational attunement" can afford practitioners an opportunity to provide need support when patients are willing and able to initiate a quit attempt.

Registered Nurses working together with family members of older people.

AIM: The aim of the study was to reach a more profound understanding, through looking at nurses' working situation, of those factors that influence how nurses are able to work together with family members of older people living in nursing homes or similar facilities. BACKGROUND: Working with the care of older people as a Registered Nurse provides a varied job with many challenges. Nurses have to co-operate with family members of those in community health care. Co-operation is important and necessary for all involved. DESIGN: Nurses working in elder care in a geographically defined area received a questionnaire with three open-ended questions, on the difficulties and/or problems involved with working together with family members, and the positive or negative aspects of this co-operation. METHODS: Analysis was carried out using the latent content analysis method. RESULTS: Three themes, problems within the system, interaction with families and caring in nursing work, are presented with categories and their subcategories. The nurses wanted their superior to be a nurse so that their working situation would be better understood. Appreciation from their superior and family members was also a very important part of their work as nurses in community health care. The frequent changes and the lack of time in the work of elder care often put nurses under considerable psychological pressure. For the most part family members are a resource for the elder, but sometimes they will avoid contact, which will make co-operating difficult. CONCLUSION: Registered Nurses and family members are dependent on each other in their care of the elder. Relevance to clinical practice. More attention should be paid to the working situation of Registered Nurses in community health care, and their ability to work together with family members of older people.

Older people living in nursing homes or other community care facilities: Registered Nurses' views of their working situation and co-operation with family members.

BACKGROUND: Little attention has been paid to Registered Nurses' working conditions and how they experience their working situation in community health care. The nurses' vocational background is of interest, as well as their apprehension about communicating and co-operating with the older persons' family members. AIMS AND OBJECTIVES: The aim of the study was to describe Registered Nurses' views of their working situation in community health care and of co-operation with family members of older people living in nursing homes or similar facilities. DESIGN: The study was carried out in a geographically defined area in the south of Sweden. A questionnaire was sent to all the Registered Nurses (n = 314) working within community health care of whom 210 Registered Nurses replied to the questionnaires. METHODS: Latent content analysis was used on the comments to six questions, in order to illuminate the statistical findings from the statements of the questions measured by the Likert scale. RESULTS: The results showed that almost half of the Registered Nurses working in care of older people are not satisfied with their working situation. The nurses with less than 5 years working experience find their working situation most stimulating. All of them expressed that it is important that there is co-operation between themselves and the family members and it was also considered important to develop models that could improve co-operation. Male nurses believed, to a lesser extent, that family members were a resource in caring, compared with female nurses; however, all male nurses stressed the importance of facilitating informal caregivers. Nurses with more than 5 years of working experience expressed that it was important that family members show engagement in caring for older people. Furthermore, they expressed that it was necessary that the family members took care of the older persons' interests. RELEVANCE TO CLINICAL PRACTICE: The findings that half of the Registered Nurses are dissatisfied with their working situation have relevance in clinical practice because of the risk of losing competent nurses in this area.