Culture as a predictor of resistance to change: a study of competing values in a psychiatric nursing context.

It is well known that a conservative organizational culture can hinder the implementation of new organizational models. Prior to introducing something new it is important to identify the culture within the organization. This paper sets out to detect the feasibility of reform in a psychiatric clinic in a Swedish hospital prior to implementation of a new working method - a structured tool based on the International Classification of Functioning Disability and Health. A survey consisting of two instruments - an organizational values questionnaire (OVQ) and a resistance to change scale (RTC) - was distributed to registered and assistant nurses at the clinic. The association between the organizational subcultures and resistance to change was investigated with regression analysis. The results revealed that the dominating cultures in the outpatient centers and hospital wards were characterized by human relation properties such as flexibility, cohesion, belongingness, and trust. The mean resistance to change was low, but the subscale of cognitive rigidity was dominant, reflecting a tendency to avoid alternative ideas and perspectives. An instrument like the one employed in the study could be a useful tool for diagnosing the likelihood of extensive and costly interventions.

Daily life dialogue assessment in psychiatric care-face validity and inter-rater reliability of a tool based on the International Classification of Functioning, Disability and Health.

This article describes the development of an assessment tool based on the International Classification of Functioning Disability and Health (ICF) adapted to a psychiatric nursing context where both the patient and the nurse assess the patient's ability to participate in various spheres of life. The aim was to test psychometric properties, focusing on face validity and inter-rater reliability. Three Swedish expert groups participated. Analysis of inter-rater reliability was conducted through simulated patient cases. The results of an unweighted kappa value of 0.38, a linear weighted kappa value of 0.65 and a quadratic weighted kappa value of 0.73 were considered as acceptable when using simulated patient cases.

Mentorship: an international perspective.

This paper is an account of a project funded by the European Union as a Leonardo da Vinici pilot project which aimed to produce a framework for a programme which prepares qualified nurses for their role as mentor of the student nurse. Representatives from universities in Norway, Sweden, Iceland, Poland, Portugal and the United Kingdom were the partner countries. The project was developed through the establishment of a series of common meetings sequentially held in each of the partner countries. The aim of these meetings was to devise a common curriculum for the preparation of mentors of students, when in practice, thereby sharing views, experiences and expectations. Initially, the group established a common philosophy specifically theory and practice were seen as a single entity with theory being both related to and drawn from practice. Reflection and reflection on practice was also seen as important; an inductive model which emphasized the dialectical relationship between theory (abstract thinking), practice (concrete experiences), reflected observation (induction) and active experimentation (deduction) and serve to reduce the gap between theory and practice. The process evolved rather than was a predetermined plan but on reflection the process involved several stages: the first lay in the identification of a common understanding of terms and a shared common philosophy. A framework is then devised which allows the partner countries to develop their programme according to local and national needs.