Need of support for significant others to persons with borderline personality disorder-A Swedish focus group study.

BACKGROUND: Being a significant other (SO) to a person with borderline personality disorder (BPD) affect their health. High incidence of substance use disorder, post-traumatic stress disorder, stress, fear, anxiety, depression, family burden and grief are common. Some specific therapies for BPD, have included support to SOs, however resources are scarce and to participate in the support it assumes that the person with BPD is included in these therapies. Although the SO support has been shown to be helpful, they all have a similar structure, and only a small exclusive group of SOs have access to the support. AIM: The aim was to describe experiences and need of support for significant others to persons with borderline personality disorder from the perspective of themselves and of health care workers. METHODS: Data was collected via two focus groups. One with five SOs to persons with BPD, one with five health care workers. Two interview sessions in each group were conducted and data were analysed with qualitative content analysis. The study was approved by the research ethics committee of Lund (2016-1026). RESULTS: The results revealed four themes; not being seen by health care professionals creates hopelessness, being seen by healthcare professionals creates trust, experience of support - helpful or shameful and the step from loosely structured support to a structured support group. Both groups expressed a need for further support as a complement to already existing support. CONCLUSIONS: The need of support is extensive. The results suggest a professional coordinator intended for SOs and peer support groups not linked to a particular psychiatric treatment yet offering support in a structured way. Further studies examining these complements to existing support, is therefore recommended.

The Usefulness of Brief Family Health Conversations Offered to Families Following the Diagnosis of Breast Cancer.

Currently, there are few studies which examine targeted family-focused support when a family member is diagnosed with breast cancer. Thus, the aim of this study was to explore families' experiences of participating in a family nursing intervention identified as Brief Family Health Conversations (BFamHC) following the diagnosis of breast cancer. Semi-structured family interviews were conducted with nine families (including 29 family members) 2 weeks following the family-focused intervention of three sessions of BFamHC. Thematic analysis was used to analyze the data. Families reported the BFamHC as positive and as a unique kind of family health conversation, one that afforded them the opportunity to communicate and share their experiences as a family group. A family conversation, even one as time-limited as BFamHC, offered a sense of relational sharing and togetherness, thus preventing feelings of isolation and vulnerability. Therapeutic family-focused conversations, such as BFamHC, hold promise as a useful family nursing intervention following the diagnosis of breast cancer.

Patients´ experiences of pain in the intensive care - The delicate balance of control.

AIM: To explore the patients´ experiences of pain when being cared for in the intensive care. DESIGN: An exploratory, qualitative design was chosen. METHOD: Interviews were performed with patients (October 2015-March 2017) within a week of post-intensive care (N = 16). Thematic analysis was used as method for analysis. RESULTS: The findings generated two themes - a lack of control and to struggle for control. Pain was described as overwhelming, both in body and mind and generating the experience of a lack of control, with feelings of incapacitation, isolation, and having their needs unmet. Feeling in control of the pain and thus in control of the situation was experienced as a constant struggle. Well-planned care, finding ways to handle the pain and good communication were all helpful in this struggle. CONCLUSION: The participants recalled their experience of pain in the ICU and control seems to be crucial for how pain is experienced. They experienced a lack of control due to not only the pain but also the treatment, which can be avoided by the nurse continuously evaluating and individualising the care. Balanced care, meeting the patients' needs and good communication helps the patient feel more in control when experiencing pain. IMPACT: The experience of pain is dependent on control for the intensive care patient. The nurse may help them gain control and thereby handle the experience of pain through including the patient, striving for better communication and implementing individualised care that continuously assesses and treats pain.

Health-Related Quality of Life in Children With Earlier Surgical Repair for Right Ventricular Outflow Tract Anomalies and the Agreement Between Children and Their Parents.

Background: Children diagnosed with right ventricle outflow tract (RVOT) anomalies require surgical repair early in life, reoperations and lifelong follow-up. The aim is to comprehensively describe their health related quality of life (HRQoL) and to assess the agreement in this regard between children and parents. Methods and Results: Child- and parent-reported HRQoL was assessed in 97 children aged 8-18 years using three different HRQoL questionnaires. The mean age was 12.9 ± 3 years. The mean total score for the child report was lower in the PedsQL Cardiac Module than in the PedsQL 4.0 and DISABKIDS (p ≤ 0.001). The mean score for each domain in PedsQL Cardiac Module ranged between 67 (cognitive function) and 79 (physical appearance), and between 72 (school function) and 82 (physical and social function) in PedsQL 4.0. Nearly half of the children reported problems with shortness of breath during physical activity. In the PedsQL Cardiac Module the child-parent agreement was strong for 13 of 22 items. Conclusion: HRQoL problems as perceived by children with RVOT anomalies are best identified with the PedsQL Cardiac Module and relate mostly to cognitive and physical functioning. The agreement findings suggest the need to take into account both child- and parent reports in the assessment of HRQoL.

To assess patients pain in intensive care: developing and testing the Swedish version of the Behavioural Pain Scale.

OBJECTIVES: The Behavioural Pain Scale has previously been translated into Swedish and psychometrically tested. One of the domains- 'compliance with ventilation'- did not show equally as good psychometric proprieties as the other domains, which led to the question whether a development of that domain would be beneficial. This study aimed to develop the domain of 'breathing pattern' in the Swedish version of the Behavioural Pain Scale and then test the instrument for discriminant validity, inter-rater reliability and criterion validity. METHOD: The domain 'breathing pattern' was developed and included when the Swedish version of the Behavioural Pain Scale was psychometrically tested in 360 paired assessments. RESULTS: The instrument showed discriminant validity through a significant positive change on the scale before and during turning and inter-rater reliability with an absence of significant disagreement on the scale between the paired assessments. The developed domain had a better result in discriminant validity than the original domain. The instrument also showed higher sensitivity in discriminating pain compared to assessment without an instrument. CONCLUSION: The Swedish version of the Behavioural Pain Scale, with a developed domain for 'breathing pattern' showed to be a reliable instrument for pain assessment in the adult intensive-care patient.

Psychometric evaluation of the Post Hospitalization Behavior Questionnaire for Ambulatory Surgery and postoperative behavior and recovery in children undergoing tonsil surgery.

The study comprised a prospective, comparative cross-sectional survey in 143 (of 390) children undergoing tonsil surgery. Parents answered the Post Hospitalization Behavior Questionnaire for Ambulatory Surgery (PHBQ-AS), and children answered the questionnaire Postoperative Recovery in Children (PRiC). The PHBQ-AS had positive correlation with the PRiC and with general health. On day 10 after surgery, up to one-third of the children still reported physical symptoms (PRiC). No gender or age differences concerning the items of behavior (PHBQ-AS) were found. The quality of postoperative recovery (PRiC) in girls was lower, with higher levels of nausea, dizziness, coldness, and headache compared to the boys. Children <6 years of age reported higher levels of dizziness and lower sleep quality and lower general health.

Swedish Children's Lived Experience of Ulcerative Colitis.

Inflammatory bowel disease (IBD) is increasing in children. When this lifelong illness is diagnosed in childhood, especially during adolescence, it may have a negative impact on children's quality of life. The aim of the present study was to illuminate the meaning of children's lived experience of ulcerative colitis. Seven children aged between 10 and 18 years were recruited from University Hospital South Sweden and interviewed about the phenomenon under scrutiny. Data were analyzed by means of a phenomenological hermeneutical method. The meaning of the children's lived experience of ulcerative colitis was summed up as a main theme. A daily struggle to adapt and be perceived as normal consisted of 4 subthemes: being healthy despite the symptoms, being healthy despite being afraid, being healthy despite a sense of being different, and being healthy despite needing support. The children strove to perceive themselves as healthy, and they needed to be perceived as healthy, especially when experiencing symptoms of inflammatory bowel disease. Children with inflammatory bowel disease confront various problems, such as ambitions and goals that are hard to achieve, due to reduced abilities as a result of the illness or an insufficiently adapted environment.

Hoping to reach a safe haven - Swedish families' lived experience when a family member is diagnosed with breast cancer.

PURPOSE: When a woman is diagnosed with breast cancer, it affects all family members. Therefore, the aim of this study was to elucidate family members lived experience when a family member is diagnosed with breast cancer. METHOD: The study had a hermeneutic phenomenological design including individual conversational interviews conducted face-to-face with six women with breast cancer and their family members at two different points of time, in order to elucidate families' lived experience, both as individuals and as a unit, from each family member's perspective. RESULTS: Living as a family in the presence of breast cancer is a challenging endeavour to regain an ordinary, safe life, hoping to reach a safe haven. The families felt that life as they knew it had disappeared and they were fumbling in the dark, trying to find support and guidance on their path to ordinary life. The family members were pursuing balance by attempting to keep the family together and maintaining a positive attitude while battling against fear and treatment-related side effects. Finally, the families were struggling with guilt and inadequacy, due to their difficulties in communicating the emotional distress that the illness brought upon them, at the same time as they felt abandoned by the healthcare professionals. CONCLUSIONS: Families experience an unmet need of information and support, which implies that healthcare professionals may want to acknowledge and include the family already at the time of diagnosis in order to help them endure and cope with the distressing experience and thus increase their wellbeing.

Exploring research cultures through internationalization at home for doctoral students in Hong Kong and Sweden.

Cultural skills are fundamental to developing global academic scholars. Internationalization at home can facilitate the acquisition of these skills without students having to go abroad. However, research on the effect of internationalization of higher education is scarce, despite apparent benefits to incorporating cultural sensitivity in research. Further, little is known about the role information and communication technology plays. In this pilot study, we describe the experience of doctoral students with an internationalization-at-home program, and its impact on developing an understanding about different research cultures. Eight doctoral nursing students from Sweden and Hong Kong participated in five webinars as "critical friends". The study followed a descriptive, qualitative design. The results demonstrated that students observed cultural differences in others' research training programs. However, while cultural differences reinforced friendship among local peers, they challenged engagement with critical friends. Challenges led to the perception of one another not as critical friends but as "distant" friends. We discuss the possible reasons for these outcomes, and emphasize a need to nurture connectivity and common goals. This would prepare students to identify, translate, and recognize cultural differences to help develop knowledge of diverse research cultures.

Self-reported postoperative recovery in children after tonsillectomy compared to tonsillotomy.

OBJECTIVES: Tonsil surgery is associated with significant morbidity during recovery. Patient-reported outcome measures (PROM) are the golden standard for the planning and follow-up of delivered care, which should also be an axiom for children. The current aims were to describe self-reported postoperative recovery in children after tonsil surgery, and to compare tonsillotomy and tonsillectomy in this respect. METHODS: In total, 238 children (4-12 years old) with a history of obstructive problems and/or recurrent tonsillitis, and undergoing tonsil surgery were included. Forty-eight per cent were operated with partial tonsil resection/tonsillotomy (TT) and 52% with total tonsillectomy (TE), all in day surgery. Postoperative recovery was assessed on days 1, 4 and 10 using the validated self-rating instrument PRiC, Postoperative Recovery in Children. This includes 23 items covering different aspects of recovery after tonsil surgery. A higher score indicates worse status in the respective items. RESULTS: Daily life activities (sleeping, eating and playing), physical symptoms (e.g., headache, stomach ache, sore throat, otalgia, dizziness, nausea, defecation, urination), and emotional aspects (sadness, frightening dreams) were affected during the recovery period. The TE-girls showed higher scores than the boys regarding stomach ache, defecation and dizziness. Children above 6 years of age reported higher values for the physical comfort variables, while the younger group showed worse emotional states. Postoperative recovery improved from day 1-10 in all surgical groups. The TE-group showed lower recovery compared to the TT-group (p < 0.01-0.001) in most items. CONCLUSION: The goal of postoperative management is to minimize or eliminate discomfort, facilitating the recovery process and avoiding complications. Children are able to describe their recovery, and thus, PRiC seems to be able to serve as a PROM to obtain patient-centered data after tonsil surgery. The recovery process after TT causes less postoperative morbidity and a quicker return to normal activity compared to TE.

The lived experience of recovery during the first 6 months after colorectal cancer surgery.

AIMS AND OBJECTIVES: To describe the lived experience of recovery during the first 6 months after colorectal cancer surgery. BACKGROUND: Colorectal cancer is the third most common cancer diagnosis worldwide. Early discharge places demands on healthcare professionals to prepare patients for their return home and to provide them with appropriate support throughout the recovery process. This requires knowledge of what it is like to recover from colorectal cancer surgery. DESIGN: A qualitative phenomenological design was used to describe the structure of recovery after colorectal cancer surgery. METHODS: Ten patients recovering from colorectal cancer surgery were interviewed at one month and six months after surgery. The descriptive phenomenological method by Giorgi was used throughout the study. RESULTS: Postoperative recovery was described as a progressive process. This process was accompanied by experiences of physical powerlessness, difficulties with food intake, altered bowel function and dependency on others. The experiences were most intense at the beginning of the recovery but disappeared as time went by and normality in life returned. CONCLUSION: While recovering from colorectal cancer surgery, patients experience obstacles that impede their ability to live life as normal. Six months after surgery, those experiences disappear or become adjusted to being part of normal life. RELEVANCE TO CLINICAL PRACTICE: Patients should be provided with information about the expected postoperative recovery before discharge from hospital. The need for professional support appears to be most frequently needed in early recovery, but it should be considered on an individual basis.

Participation in Care Encounters in Heart Failure Home-Care.

The purpose of this qualitative study was to observe care encounters during home visits in Heart failure (HF) home-care to identify and describe participation in care. Seventeen patients diagnosed with HF, and 10 registered nurses participated. Data from 19 video-recorded home visits were analyzed using qualitative content analysis. Two themes were identified: (a) Participation in the care encounter is made possible by interaction, including exchanging care-related information, care-related reasoning, collaboration; and (b) participation in the care encounter is made possible by an enabling approach, including the patients expressing their own wishes, showing an active interest, while the nurse is committed and invites to having a dialogue. The HF home-care context showed good potential for patient participation. Room for discussions and collaboration facilitated for the patients to be active partners in their care, which in turn may have positive effects on outcomes.

Health-related quality of life in children with surgery for CHD: a study from the Swedish National Registry for Congenital Heart Disease.

BACKGROUND: As survival of children with CHD needing surgery has improved significantly, the need for follow-up in terms of health-related quality of life has become increasingly important. In this study, we sought to describe health-related quality of life in children with CHD in relation to cardiac surgery. METHODS: A retrospective Swedish National Registry for Congenital Heart Disease survey measured using DISABKIDS chronic generic measure-short version included 337 children (age 9-17 years; 39% girls). The majority (n=319, 95%) of children had a biventricular heart, whereas the remaining had a univentricular heart. Cardiac surgery was performed in 197 (58%) children. Health-related quality of life was expressed as total score (100 highest) and given as medians and 10-90th percentiles. RESULTS: The overall total score was 95 (88-100). Children with a biventricular heart who had undergone three or more surgeries (n=31; 9%) had the lowest total score of 81 (61-97; p<0.001). Children with two or more surgeries and those with univentricular heart were classified in NYHA II more frequently than children with one or no cardiac surgery (p=0.005 and <0.001, respectively). Children with three or more surgeries and those with univentricular heart needed more help at school (p<0.001). Compared with children with other chronic diseases, children with CHD had a high total score except for children with three or more surgeries who had comparable total scores with children with other chronic diseases. CONCLUSION: Children with three or more cardiac surgeries and those with a univentricular heart appear to have lower health-related quality of life, cognitive ability, and NYHA classification.

Successful factors to prevent pressure ulcers - an interview study.

AIMS AND OBJECTIVES: To explore successful factors to prevent pressure ulcers in hospital settings. BACKGROUND: Pressure ulcer prevalence has been recognised as a quality indicator for both patient safety and quality of care in hospital and community settings. Most pressure ulcer can be prevented if effective measures are implemented and evaluated. The Swedish Association of Local Authorities and Regions initiated nationwide pressure ulcer prevalence studies in 2011. In 2014, after four years of measurement, the prevalence was still unacceptably high on a national level. The mean prevalence of pressure ulcer in the spring of 2014 was 14% in hospital settings with a range from 2·7-36·4%. DESIGN: Qualitative semistructured interviews were conducted. METHODS: A qualitative content analysis, in addition to Promoting Action on Research Implementation in Health Services frameworks, was used in the analysis of the data text. Individual interviews and focus groups were used to create opportunities for both individual responses and group interactions. The study was conducted at six hospitals during the fall of 2014. RESULTS: Three main categories were identified as successful factors to prevent pressure ulcer in hospitals: creating a good organisation, maintaining persistent awareness and realising the benefits for patients. CONCLUSION: The goal for all healthcare personnel must be delivering high-quality, sustainable care to patients. Prevention of pressure ulcer is crucial in this work. It seems to be easier for small hospitals (with a low number of units/beds) to develop and sustain an effective organisation in prevention work. RELEVANCE TO CLINICAL PRACTICE: The nurse managers' attitude and engagement are crucial to enable the personnel to work actively with pressure ulcer prevention. Strategies are proposed to advance clinical leadership, knowledge, skills and abilities for the crucial implementation of pressure ulcer prevention.

Exploring partners' perspectives on participation in heart failure home care: a mixed-method design.

AIM: To describe the partners' perspectives on participation in the care for patients with heart failure receiving home care. BACKGROUND: Partners are often involved in care of patients with heart failure and have an important role in improving patients' well-being and self-care. Partners have described both negative and positive experiences of involvement, but knowledge of how partners of patients with heart failure view participation in care when the patient receives home care is lacking. DESIGN: A convergent parallel mixed-method design was used, including data from interviews and questionnaires. METHODS: A purposeful sample of 15 partners was used. Data collection lasted between February 2010 - December 2011. Interviews were analysed with content analysis and data from questionnaires (participation, caregiving, health-related quality of life, depressive symptoms) were analysed statistically. Finally, results were merged, interpreted and labelled as comparable and convergent or as being inconsistent. RESULTS: Partners were satisfied with most aspects of participation, information and contact. Qualitative findings revealed four different aspects of participation: adapting to the caring needs and illness trajectory, coping with caregiving demands, interacting with healthcare providers and need for knowledge to comprehend the health situation. Results showed confirmatory results that were convergent and expanded knowledge that gave a broader understanding of partner participation in this context. CONCLUSION: The results revealed different levels of partner participation. Heart failure home care included good opportunities for both participation and contact during home visits, necessary to meet partners' ongoing need for information to comprehend the situation.

To Assess Prerequisites Before an Implementation Strategy in an Orthopaedic Department in Sweden.

Promoting Action on Research Implementation in Health Services (PARiHS) asserts that the success of knowledge implementation relates to multiple factors in a complex and dynamic way, and therefore the effects of implementation strategies vary by method and context. An instrument based on the PARiHS framework was developed to help assess critical factors influencing implementation strategies so that strategies can be tailored to promote implementation.The purpose of this study was to use the Evaluation Before Implementation Questionnaire (EBIQ), to describe staff perceptions in one orthopaedic department, and to investigate differences between wards.Staff members in four different wards at one orthopaedic department at a university hospital in Sweden were invited to complete a questionnaire related to planning for the implementation of a clinical practice guideline. The 23 items in the EBIQ were expected to capture staff perceptions about the evidence, context, and facilitation factors that influence the implementation process. Descriptive statistics and differences between wards were analyzed. Although the overall response rate was low (n = 49), two of the four wards accounted for most of the completed questionnaires (n = 25 and n = 12, respectively), enabling a comparison of these wards. We found significant differences between respondents' perceptions at the two wards in six items regarding context and facilitation in terms of receptiveness to change, forms of leadership, and evaluation and presence of feedback and facilitators.The EBIQ instrument requires further testing, but there appears to be initial support for pre-implementation use of the EBIQ as a means to enhance planning for implementation.

General health and state anxiety in patients recovering from colorectal cancer surgery.

AIM: To describe and compare general health and state anxiety before surgery and up to 6 months after surgery in patients with colorectal cancer undergoing elective rectal resection, abdominoperineal resection or colonic resection in an enhanced recovery context. BACKGROUND: Little is known about patient-reported health and anxiety after colorectal cancer surgery in an enhanced recovery context. DESIGN: A prospective cohort study. METHODS: Data were collected from October 2011-February 2013. The questionnaires - EuroQol 5-Dimensions 3-Levels and State-Trait Anxiety Inventory - were answered before surgery, at discharge and 1 and 6 months after surgery. Data were analysed using inferential statistics to describe differences between groups of patients (Kruskal-Wallis test) and between assessments within groups (Friedman's anova). RESULTS: Patients (N = 105), divided into three groups based on surgical procedure, showed a high health index and a low state anxiety in all assessments without differences between the groups. Patients considered for abdominoperineal resection rated their pre-operative health as significantly higher than patients after rectal and colonic resections did. Within groups, patients recovering from abdominoperineal resection and rectal resection deteriorated significantly in health index 1 month after surgery. However, after 6 months they had improved again. After colonic resection, patients improved significantly in self-rated health and anxiety 1 month after surgery with no further discernible improvement after 6 months. CONCLUSION: The study showed that patients generally had a high level of health and a low level of anxiety throughout the study period. Only a few differences occurred between assessments within groups.

Polyethylene Glycol- or Sodium Picosulphate-Based Laxatives Before Colonoscopy in Children.

OBJECTIVES: The purpose of this randomised study was to compare the quality of bowel cleansing using either polyethylene glycol (PEG) or sodium picosulphate (NaPico) (primary outcome) in relation to the tolerability and acceptance of these laxatives among children and their caregivers (secondary outcome). METHODS: The study was a randomised controlled trial that was conducted as an investigator-blinded study within the Department of Paediatrics of Skåne University Hospital in Malmö, Sweden. A total of 72 children (10-18 years of age) were randomly placed into 1 of 2 groups (PEG or NaPico). The Ottawa Bowel Preparation Quality Score was used to evaluate the quality of bowel cleansing. A total of 2 different questionnaires were used to evaluate both the acceptability and tolerability of the laxatives. RESULTS: In total, 71 children completed the bowel cleansing. Of these 71 cleanses, 67 protocols were analysed according to the Ottawa Bowel Preparation Quality Score. No significant difference in bowel cleansing quality was detected between the 2 groups. Rates of acceptability and tolerability were significantly higher in the NaPico group than in the PEG group. CONCLUSIONS: In the present study, both laxatives were found to be satisfactory in terms of aiding the performance of an uncomplicated and successful colonoscopy. NaPico was, however, more tolerable to the children than PEG, and both, the children and their caregivers, were more accepting of NaPico than of PEG. Consequently, NaPico can be recommended as the option for bowel cleansing in children ages 10 years and older.

Self-reported post-operative recovery in children: development of an instrument.

RATIONALE, AIMS AND OBJECTIVES: According to the United Nations (1989), children have the right to be heard and to have their opinions respected. Since post-operative recovery is an individual and subjective experience and patient-reported outcome measures are considered important, our aim was to develop and test an instrument to measure self-reported quality of recovery in children after surgical procedures. METHODS: Development of the instrument Postoperative Recovery in Children (PRiC) was influenced by the Quality of Recovery-24, for use in adults. Eighteen children and nine professionals validated the items with respect to content and language. A photo questionnaire was developed to determine whether the children's participation would increase compared with the text questionnaire. The final instrument was distributed consecutively to 390 children, ages 4-12 years, who underwent tonsil surgery at four hospitals in Sweden. RESULTS: A total of 238 children with a mean age of 6.5 years participated. According to the parents, 23% circled the answers themselves and 59% participated to a significant degree. However, there was no significant difference in participation between those who received a photo versus a text questionnaire. Psychometric tests of the instrument showed that Cronbach's alpha for the total instrument was 0.83 and the item-total correlations for 22 of the items were ≥0.20. CONCLUSION: Our results support use of the PRiC instrument to assess and follow-up on children's self-reported post-operative recovery after tonsil operation, both in clinical praxis as well in research.

Who wants to work with older people? Swedish student nurses' willingness to work in elderly care--a questionnaire study.

BACKGROUND: The aging population is a globally recognized challenge for the health care service. The growing number of older people will probably lead to increased demands for nurses working in elderly care. Clinical practice has been shown to have an impact on how student nurses perceive a particular field of nursing. OBJECTIVES: To compare perceptions of the clinical learning environment in nursing homes among students considering a career in aged care or not, and to examine the difference in age, gender and previous working experience as health care assistants in elderly care between the two groups. DESIGN: This was a cross-sectional study using the Swedish version of the Clinical Learning Environment and Nurse Teacher evaluation scale. METHODS: Consecutive sampling was performed over three semesters from September 2011 to December 2012. The survey was conducted with 183 student nurses. Mann-Whitney U-test was used to examine differences in relation to two groups namely student nurses who did or did not consider to work in elderly care. A chi-square test of independence was performed to examine the difference in age, gender and previous working experience between the two groups. RESULTS: The analysis leaned towards an overall positive evaluation of the clinical learning environment with more positive values for students considering a career. There were no significant differences between younger students (18-23) and older students (24-50) regarding willingness to work in elderly care or not. Neither was any significant difference displayed between students, based on gender nor for previous work experience. CONCLUSION: Age, gender and previous work experiences as health care assistants did not impact on students' willingness to work in elderly care. Future studies need to acknowledge the complexity of why student nurses choose a particular pathway in nursing by longitudinal studies following cohorts of students during the course of the nursing programme.