The word 'empowerment' has become a popular term, widely used as an important claim, also within the health services. In this paper the concept's philosophical roots are traced from Freire and his 'Pedagogy of the Oppressed' to the philosophical thoughts of Hegel, Habermas, and Sartre. An understanding of the concept, as a way to facilitate coping and well-being in patients through reflection and dialogue, emerges. Within an empowerment strategy the important claim on the nurse and the patient will be to reveal the patient's own resources and limitations in times with sickness and reduced functionality to promote the patient's choice to act and cope. From this point of view an education-programme for the frail elderly is outlined. If the nurse wants to empower the elderly patient she has to be willing to be educated through the dialogue with the patient, and to look for the patient's own meaning of being frail and elderly. The coping and self-care solutions for the patient may then even be different from the preferences of the nurse, and this does not mean that the empowerment strategy is a failure or that the patient then has to continue without the assistance from the nurse. Within an empowerment strategy, in the Freirerian sense, the important thing is that both the patient and the nurse together critically reflect on the meanings of the sickness so that the patient can be able to make his own conscious choices.

The ability to measure pain across diverse cultures is important for understanding the universal aspects of pain and expediting nursing intervention. The McGill Pain Questionnaire (MPQ) is the most valid and reliable single multidimensional pain instrument available for measuring pain. Although it has been translated in several languages, most efforts, including two Norwegian translations, have resulted in a variety of new versions, all lacking sufficient faithfulness to the original MPQ to allow qualitative or quantitative cross-cultural comparisons. There is a need for direct translations that maintain the original denotation, connotation and numerical value of the MPQ and thus provide a base for future cross-cultural studies of pain. This paper reports on the development and initial testing of a direct translation of the McGill Pain Questionnaire into Norwegian (NMPQ). The translation process involved three phases: translation, back-translation and consensual. In order to evaluate its performance and validity, the NMPQ was administered to a group of adult surgical patients at two different points in time during the postoperative period. The NMPQ was examined for its feasibility, its sensitivity in detecting decreases in intensity of pain postoperatively and for construct validity. A visual analogue scale was used to check for converging validity, and Spielberger's state anxiety scale was used to assess discriminate validity. The initial testing of the NMPQ with adult surgical patients suggests that the NMPQ is culturally acceptable, relevant, sensitive to fluctuations in pain and numerically consistent with the original MPQ. The moderate levels of validity attend lend considerable assurance to the instruments readiness for use in cross-cultural studies of pain.

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