Nurses´ experiences of strain and their reactions in the care of severely demented patients.

All nurses (N = 132) on the wards specializing in the care of the demented within a municipality were given two scales to assess their view of common patient actions and how easy they thought those actions were to deal with in the care situation, and to assess their emotional reactions during the provision of care. Also the Maslach burnout Inventory (MBI) and the Work Related Strain Inventory (WRSI) were used to test concurrent validity. Based on principal component analysis, the nurses' view of patient actions resulted in being agitated, unruly, living empty lives, being peaceful, dependent, non-responsive and cooperative, and the nurses' view of difficulties in dealing with patient actions revealed ability to manage deprivation, agitation, desertedness, wilfulness, peacefulness and cooperation. A three-factor solution was chosen for the emotional reactions: feelings of devotion - rejection, association - dissociation and usefulness - uselessness. Agitated and dependent patient actions were found to be most common while agitation and desertedness were regarded as most difficult. Patient seen as agitated and living empty lives related to the provision of care being difficult while dependence related to care as being easy to provide. Thus the findings gave further support to the belief that viewing the patient's life as meaningful as well as being able to develop a cooperative nurse-patient relationship is crucial for nurses' experience of strain. Thus support should be directed towards achieving this kind of relationship.