Chronic pain causes great suffering for those affected and treating it is one of the most common assignments in the health service. The aim of the study was to investigate the meaning of the experiences of persons with chronic pain in their encounters with health service staff. The study had a descriptive design with a phenomenological approach based on the perspective of caring science. Interviews were carried out with eight patients. The study showed that patients experienced a positive approach and that the staff had understood the serious nature of the situation. A positive approach can communicate hope and help to strengthen the patient. It is important to ask the patient about how he/she experiences his/her situation and thus gain an insight into this person's lifeworld. Participation entailed being active oneself and calling attention to one's needs and wishes for treatment. The study also showed that a negative approach by the staff played a prominent part in their experiences and appeared to be engraved in their memories. A negative approach is felt as being insulting and belittling. Patients with chronic pain felt that they were discredited and that their experience of their situation was called into question. They had to fight to get care and had to suggest treatments and examinations. There were also patients who had neither been asked about their pain experience nor had the opportunity to assess their pain with an assessment scale. Some of the phases in Travelbee's relationship model could be seen in several of the encounters but not all. The participants did not always feel that the manner of the nursing staff was empathetic or sympathetic, which led to greater suffering.

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Purpose -The purpose of this study is to use an international dataset to examine what determines employee training from an organisational perspective, and to what extent training investments enhance company performance. Design/methodology/approach -Data from 5,824 private-sector organisations are used to examine determinants of training and the connection between training and profitability. OLS regressions and Probit estimates are used in the statistical analyses. Findings -The results indicate that the provision of company training is largely determined by firm-specific factors, such as human resource management (HRM) practices. The results further show that two widely used measures of training -incidence and intensity -are largely determined by different factors. Staff turnover (mobility) does not appear to be a decisive factor in explaining the provision of training on a national or company level, although it is associated with lower profitability to some extent. However, the single most important factor associated with profitability is how much is invested in training (intensity), suggesting that the economic benefits of training outweigh the cost of staff turnover. Originality/value -This study contributes to the existing training literature by offering extensive access to internal measures of training, profitability, HRM practices, workforce characteristics and staff turnover for companies in 26 countries worldwide.

This study examines the accuracy of individual perceptions (self-estimates) of acquired competence. A concept of relative competence is introduced to account for variation in rater elevation and differences in importance (significance) of specific competencies. The results indicate that the self-estimates of job-specific competencies are well executed. Because the distortion in elevation and stereotype accuracy is largely associated with general constructs, the findings suggest that we should focus on modeling competencies to the job. The results also show that even without a correction for interrater differences or a correction for the importance of different competencies, the competency model carries value-relevant information.The author is very grateful to Maria Martensson who conducted the interviews and who worked extensively with the organization in selection of relevant competencies for the second study. The author also thanks Jan-Erik Grojer, Ulf Johanson, Les Shaps, and participants at the Human Resources Global Management Conference, in Barcelona, 2001, for comments and suggestions on this paper.