Patients are not receiving optimal care to relieve their pain and there is therefore a need for specialized nurses who can give adequate help and support.

The aim of the present study was to develop educational guidelines to be used as a tool for the integration of theory, research and practice to ensure that nursing knowledge and practical skills form the basis of academic nursing education. An additional aim was to describe the nursing competence expected of the students at four academic levels: introductory, intermediate and advanced levels I and II. Clinical nursing education plays a crucial role in assisting nursing students to integrate the theory and practice of nursing at the baccalaureate level, as well as in further specialization and in-depth nursing studies at the advanced level. A research group consisting of lecturers from the Institute of Nursing, Göteborg University, Sweden, was given the objective to formulate educational guidelines for clinical practice within nursing education. The study took the form of a literature search. In addition, the Delphi method, aimed at reaching a consensus of opinion among colleagues, was used. Based on the literature review and the collegial discussions, four core concepts emerged: professional stance, reflective processes, problem-solving processes, and practical skills, from which the educational guidelines were developed. Guidelines were formulated both in general and abstract form. They were not connected to a specific care context, specific patient group or specific nursing problems. The most important objective of academic education is that the student develops abilities and techniques necessary for life-long learning. Students will, in their professional life as nurses, continuously meet situations where they are challenged to take appropriate decisions and actions. This demands training in problem-solving, reflection, decision-making and the ability to use both deductive and inductive learning strategies. The guidelines describe what is expected of the students in terms of nursing competence and personal qualifications to ensure that they will be ready to meet the demands of their future profession.

Our results showed some defining characteristics of the UCP group, but the many similarities between the two groups in their experience of chest pain made it impossible to clearly differentiate the groups' pain profiles.

Abstract. Jerlock M, Kjellgren KI, Gaston-Johansson F, Lissner L, Manhem K, Rosengren A, Welin C (Institute of Health and Care Sciences; Johns Hopkins University; the Sahlgrenska Academy; Sahlgrenska University Hospital ⁄ Ö stra, Gothenburg; Sweden). Psychosocial profile in men and women with unexplained chest pain. J Intern Med 2008; 264: 265-274.Objective. The aim of this study was to compare men and women with unexplained chest pain (UCP) to a randomly selected population sample free of clinical heart disease with regard to sleep problems, mental strain at work, stress at home, negative life events and health-related quality of life (HRQOL).Design and subjects. The study was conducted at a university hospital in Sweden including 231 patients aged 25-69 without any organic cause for chest pain. As a reference group, 1069 participants, were recruited from the INTERGENE population-based study.Results. Patients with UCP had more sleep problems (OR = 1.8, P < 0.0001), were almost three times more worried about stress at work (OR = 2.9, P < 0.0001), or had more stress at home (OR = 2.8, P < 0.0001), and were twice as likely to have negative life events (OR = 2.1, P < 0.0001). Women, but not men, with UCP, had a higher prevalence of cardiovascular risk factors (obesity, smoking, diabetes and hypertension) compared with references. With regard to HRQOL, UCP patients scored significantly lower than references in all dimensions of the SF-36.Conclusions. In comparison with a healthy reference group, patients with UCP reported more sleep problems, mental strain at work, stress at home and negative life events and had lower health-related quality of life. Aside from immigration the strongest independent psychosocial factors were mental strain at work and negative life events last year in men and stress at home in women.

Background: The number of patients suffering from unexplained chest pain (UCP) is increasing. Intervention programmes are needed to reduce the chest pain and suffering experienced by these patients and effective preventive strategies are also required to reduce the incidence of these symptoms. The aim of this study was to describe general coping strategies in patients with UCP and examine the relationships between coping strategies, negative life events, sleep problems, physical activity, stress and chest pain intensity.