Search

Aims and objectives: To describe nursing staff's assessments of medication management process in the psychiatric and operative domains after introduction of an electronic medication chart. Background: The medication management process includes all structures and practices within the organisation that guide and support medication administration and related procedures. Design: A cross‐sectional survey. Methods: A Finnish version of the Medication Administration System – Nurses Assessment of Satisfaction (modified MAS‐NAS) paper‐based questionnaire was sent to all nursing staff (N = 855) working in operative (n = 498) and psychiatric (n = 357) domains in one central hospital. Data were analysed using statistical methods. Results: In total, 324 nursing staff members participated. More than half agreed that medication management is efficient (64%), safe for patients (76%), and that the current medication administration system provides the necessary medical treatment information (e.g. prescriptions by physicians, medication data) (64%). Respondents' overall satisfaction with medication management process was slightly above average on a scale from 1 to 10 (mean = 6.2; SD = 1.8; median = 7, range 2–9). Respondents who used electronic medication chart reported higher overall satisfaction with medication management process (median = 7, mean = 6.1, SD = 1.8 and range 2–9) than those not using it (median = 6.5, mean = 6.3, SD = 1.6 and range 2–9). No statistically significant difference was found (U = 8552.000, p = 0.33). Conclusions: This study revealed several problems in the medication management process. The results can be used in developing the medication management process. Relevance to clinical practice: Electronic medication chart should be used and developed further in terms of efficacy, safety and access. One year after the electronic medication chart was introduced, only half of the respondents had used it. That is why implementation of electronic systems or technological applications should be carefully considered as a whole. [ABSTRACT FROM AUTHOR]

Background: Depressive mood is a common problem among children in Western countries. Professionals in school and other health services have an important role in identifying children at increased risk for depression. The Short Mood and Feelings Questionnaire (SMFQ) is a widely used screening tool, but its 13 items still make it quite time‐consuming to complete. There is an urgent need for a quick and easy‐to‐complete self‐report depressive mood scale for use in school health examinations. Aim: This paper aims to describe and validate a revised version of SMFQ: FsMFQ‐6 is intended as a short screening tool for the early identification of depressive symptoms in children. Methods: Nationally representative data (n = 95,725) were drawn from the 2017 School Health Promotion Study. The respondents were fourth‐ and fifth‐grade pupils (aged 10–12) in Finnish primary schools. The data were analysed separately by gender. The construct validity of the scale was studied by principal component analysis and confirmatory factor analysis (CFA), convergent validity by both receiver operating characteristic (ROC) analysis and Spearman's correlation coefficient. Reliability was tested by Cronbach's alpha coefficient. Results: Principal component analysis yielded a one‐component model: the Finnish Short Mood and Feelings Questionnaire 6 (FsMFQ‐6). CFA confirmed the validity of FsMFQ‐6. Compared with mood at home (AUC = 0.80) and mood at school (AUC = 0.85), overall sensitivity and specificity were optimal at cut‐off point 0. Cronbach's alpha coefficient was 0.73, indicating good internal consistency. The results for girls and boys were almost identical. Conclusion: The results confirmed the validity and reliability of FsMFQ‐6. FsMFQ‐6 recognises depressive mood in children and is suitable for screening depressive symptoms in fourth‐ and fifth‐grade pupils in Finland. However, it is important to pay close attention to children who choose the 'Sometimes' response option more than once, for that can be a sign of depressive symptoms. [ABSTRACT FROM AUTHOR]

Scand J Caring Sci; 2012; 26; 133-143 The professional nursing practice environment and nurse-reported job outcomes in two European countries: a survey of nurses in Finland and the Netherlands The working environment of nurses is receiving international interest, because there is a growing consensus that identifying opportunities for improving working conditions in hospitals is essential to maintain adequate staffing, high-quality care, nurses' job satisfaction and hence their retention. Thus, the aim of this study was to investigate the relationship between nurse work environment characteristics and nurse-reported job outcomes in hospital settings in Finland and the Netherlands and to compare these results. A comparative cross-sectional nurse survey was conducted. Data were collected from the two countries randomly sampling the countries' National Nurses Association' membership databases. In this paper, the results from Registered Nurses working in hospital settings are used. In total, 869 hospital nurses participated: 535 from Finland and 334 from the Netherlands with the response rate of 44.9 and 33.4%, respectively. Fifty-five items from the Nursing Work Index-Revised were used as a main tool for the practice environment. Exploratory factor analysis was used to identify a set of internally consistent subscales. Further, logistic regression analysis and T-tests were used. Three practice environment characteristics were identified: adequacy of resources, supportiveness of management and assurance of care quality via collaborative relationships. Favourable evaluations of the adequacy of resources and supportiveness of management were positively correlated with nurse-assessed quality of care and job-related positive feelings and negatively correlated with intentions to leave a unit, organization or the entire profession. In neither of the participating countries were adverse incidents affecting nurses related to nurses' evaluations of their current professional practice environment. Compared with Finland, in the Netherlands, RN appears to evaluate the majority of work environment characteristics more positively; nevertheless, to some extent, the results were uniform as adequacy of resources and supportiveness of management were main predictors for nurse-reported job outcomes considered. [ABSTRACT FROM AUTHOR]

Scand J Caring Sci; 2010; 24; 38-45 The objectives of this article are to present a measurement instrument for virtues, and to examine the link between virtues and health. The instrument was tested by the occupational health care at a large Finnish pulp and paper manufacturer and was shown to be consistent, valid and reliable. In developing the scale, we had two samples of employees and used factor analysis and partial least squares modelling (PLS) on both samples. Factor analysis showed that pride is the most important virtue, followed by love and generosity. In the PLS analysis, we found virtues to significantly reduce the number of sick days. In addition, we found significant relationships between virtues and fatigue, depression and happiness. Virtuous behaviour decreased sick leave and depression. The virtues had a positive influence on happiness and on improvement in one's health. The results show that by taking into account virtues in working life, companies can significantly improve their employees' well-being. The measurement instrument helps broaden the traditional view on health and is meant to be used by health care professionals in their daily practice. By addressing a person's physical, mental and virtual well-being, health care practitioners can take care of employees on a broader level than before. [ABSTRACT FROM AUTHOR]

Pain assessment of premature infants continue to be ineffective. The problem may be partly because of misconceptions or lack of knowledge in the assessment of pain in children. Aims: This paper reports a study to describe nurses’ attitudes towards and perceptions of pain assessment in neonatal intensive care and the demographic factors related to these attitudes and perceptions of pain. Methods: The participants consisted of 257 Finnish nurses who were recruited from all five of the country’s university hospitals caring for the premature infants receiving intensive care or monitoring. We collected data by using a Likert-type questionnaire in spring 2006. The response rate was 71% from the represented population. Findings: Almost all (97%) of the nurses agreed that pain assessment in premature infants is important. However, over half (60%) of the respondents agreed that they could assess the premature infants pain reliably without pain scores. The respondents’ perceptions of the premature infants’ ability to sense and express pain indicated rather good knowledge of the topic. Nevertheless, one-fourth of the participants was unaware that a premature infant could be more sensitive in sensing pain than a full term counterpart. Education, work experience and the working unit were the demographic factors that were significantly related to the respondents’ attitudes and perceptions. Conclusions: On average nurses’ attitudes were positive towards the pain assessment in neonatal intensive care. However, there were some gaps in the knowledge concerning the respondents’ perceptions of the items, which is a challenge to nursing and nursing education. [ABSTRACT FROM AUTHOR]

Purpose: This paper describes the process of developing an instrument to test the middle-range nursing theory for the self-care of home-dwelling elderly. Background: Instrument development is a multiphase process, during which the researcher tests the reliability and validity of the instrument with various data and modifies it based on the test results. The aim of the study was to develop an instrument to test a theory, but also to be able to use it later in clinical settings to evaluate the self-care of home-dwelling elderly and factors associated with it. Methods: The instrument development was done in four phases. At the first phase, the initial version was created on the basis of the theory. At the second phase, two home-dwelling elders were pilot-interviewed, and 20 elders completed the structured questionnaire and commented upon its ease of use. The results were used to develop the second version of the instrument. At the third phase, the second version of the instrument was used to collect data from home-dwelling elders aged 75 or more from different parts of Finland (n = 200). Face validity, exploratory factor analyses, correlation coefficients and Cronbach's alpha were used to test and further develop the instrument. At the fourth phase, the content validity of the third version was assessed by three home-dwelling elders. Results: The agreement between the elders and the researchers about the contents of the instrument was acceptable, and exploratory factor analyses verified quite well the structure of the theory. Based on the Cronbach's alpha values (0.49–0.90), the internal consistency of the instrument was fairly good. Conclusion: The results provide sufficient evidence of the validity and reliability of the final version of the instrument, which has nine background questions and 82 items to measure the self-care of home-dwelling elderly and factors associated with it. [ABSTRACT FROM AUTHOR]

Scand J Caring Sci; 2003; 17; 399–408 Family members’ experiences of the quality of geriatric care The quality of institutional geriatric care is a topical issue in Finland. The study to be described here is part of a Finnish project on the quality assessment and development of long-term geriatric care provided by the City of Helsinki. The health care division of the City of Helsinki authorized an outside survey of long-term geriatric care in the hospitals providing such care in 1998. Based on the results, recommendations concerning the development of geriatric care were issued. In the years 1999–2000, a further education programme was arranged for ward nurses, chief nurses and heads of profit centres concerning leadership in long-term geriatric nursing. A re-survey was conducted in 2001, using the same criteria of quality assessment. The purpose of this paper is to report on the quality of institutional geriatric nursing as evaluated by family members in 2001 and to compare the responses to those obtained in 1998. The results are presented as frequency and percentage distributions, means and medians and cross-tabulations. The responding family members were generally content with the care of their elderly relatives: 92% said they were very satisfied or satisfied with the care, and the average of the marks given for geriatric care was 8.3 (range 4–10). Family members were more content now than in 1998, when the corresponding figures were 86% and 7.3 (range 4–10). Nevertheless, the results still highlight certain aspects that should be improved and developed. [ABSTRACT FROM AUTHOR]

Background and Rationale: Comprehensive care and service planning in home care is tailored to older people's individual needs and resources in order to support them living at home. However, little is known about how these individual resources and home‐care‐specific tasks are recognised in older people's care and service plans. Aims: To describe the content of care and service plans in older people's home care with special attention to their individual resources and home‐care‐specific tasks. Design: This was a document‐based cross‐sectional study with mixed‐methods analysis, carried out in Eastern Finland during Spring 2018. Methods: A document analysis using the deductive Finnish Care Classification (FinCC), and an inductively developed framework of older people's care and service plans (n = 71). The data were analysed with descriptive statistical methods. Results: Altogether, 1718 notes were relevant to the FinCC main categories: 707 (41%) focused on older people's needs and 1011 (59%) on nursing interventions. We identified 1104 notes based on the 26 inductively developed main categories: the majority (n = 628, 57%) focused on individual resources and the remainder (n = 476, 43%) on home‐care‐specific tasks. Increasing age resulted in fewer notes on safety and sensory functions. There were fewer notes on resources related to sleeping and wakefulness after longer care and service periods. An increased number of home visits resulted in more documentation on tasks related to pharmaceutical issues, including repeat prescriptions. Discussion Individual resources for older people were documented, to some extent, in their care and service plans. It is necessary to review these alongside home‐care‐specific tasks that support older people's independence and safety at home. Conclusion: Individual resources need to be recognised in order to enable home‐care professionals to provide tailored, high‐quality home care services. Home‐care‐specific tasks should be supported by documentation with updated, sensitive home care classifications. [ABSTRACT FROM AUTHOR]

Rationale and Aim: Nurses caring for critically ill patients need compassionate attention and support, especially during exceptional times. The aim of this study was to provide a trustworthy description of nurses' experiences and expectations for compassionate leadership and compassion at a central hospital in Finland. The study was conducted during the early stage of the coronavirus 2019 pandemic. Ethical Issues and Approval: The voluntary nature and anonymity of the survey were stressed in the cover letter, to make sure that participants did not perceive any undue influence caused by participating in the study. Methods: The participants were 50 intensive care and emergency nurses of a central hospital. An online survey tool with open questions was used to collect data on the meaning of compassion and on nurses' experiences and expectations of compassion and compassionate leadership. Inductive content analysis was used to analyse the data. Results: The nurses reported a great variety of positive experiences of compassion, although the emphasis in this study seemed to be on the absence of compassion, especially in regard to leadership. The nurses expected individual attention and genuine physical and psychological presence from their immediate supervisors. Study Limitations: One researcher analysed the data, which can cause some bias in the qualitative analysis. Conclusions: Immediate supervisors express compassion by being physically present and by fostering an open dialogue. Compassion received from leaders and colleagues may be reproduced in patient contacts, which can increase patients' confidence and psychological safety. Participatory and simulation‐based learning methods, which involve shared reflection, are recommended for compassionate leadership skills. [ABSTRACT FROM AUTHOR]

Aim: To translate and validate the Index of Professional Nursing Governance (IPNG) 2.0 and assess the state of professional nursing governance in Finland. Background: Raising and maintaining quality of care while retaining staff are common problems in healthcare globally. Professional governance is a modern way to tackle them, but a reliable instrument is needed to measure the state of nursing governance in Finland, and elsewhere. Methods: The IPNG that was translated into Finnish by forward‐backward translation, culturally adapted and pilot tested with 20 nurses. A sample of 419 nurses was utilised in a cross‐sectional study to assess the state of professional governance in Finland 2018. Results: Principal component analysis yielded six components with good Cronbach's α values. The results clearly indicate that the IPNG version developed and evaluated in this study has suitable psychometric properties for use in Finnish healthcare settings. The validated IPNG scores indicate that nursing governance in Finland is in the professional governance range. The staff have some input in the governance of Finnish healthcare organisations. However, this perception is strongest among the nurse leaders and experts; other groups do not perceive much change yet. Conclusion: Participants, particularly nurse leaders in Finland, had self‐reported impact in decision‐making. The translated IPNG has acceptable internal consistency and can be used to assess healthcare organisations' governance models in Finland and broader in Nordic countries and Europe. [ABSTRACT FROM AUTHOR]

Background: Pressure ulcers cause economic burden, human suffering, pain and decreased health‐related quality of life in patients. Pressure ulcers are preventable in most cases, and nursing staff knowledge is a key factor in successful pressure ulcer prevention. Further evidence is needed to better tailor pressure ulcer prevention training programmes to the nursing staff. Aim: To evaluate the level of nursing staff knowledge about evidence‐based pressure ulcer prevention practices in both primary and specialised care, and to identify what factors determine nurses' knowledge levels. Methods: A correlational, cross‐sectional study was conducted from 2018 to 2019 in two hospital districts in Finland. The Pressure Ulcer Prevention Knowledge test was used to collect data, and the Attitude towards Pressure ulcer Prevention (APuP) instrument was used as a background variable. The data were statistically analysed with Wilcoxon and Kruskal–Wallis tests, Spearman correlations and multiple linear regression. Results: The pressure ulcer prevention knowledge of the participating registered nurses, practical nurses and ward managers (N = 554) was on average 24.40 (max. 35.00). There was no difference in the participants' knowledge based on the type of unit in which they were working (primary or specialised care). The participants' attitudes (p < 0.0001), current position (p = 0.0042), frequency of taking care of patients with pressure ulcers (p = 0.0001) and self‐evaluated training needs (p < 0.0001) independently explained the variation in the knowledge scores. Conclusions: Special attention needs to be paid to the knowledge of those nurses working in positions that require lower levels of education and those who rarely take care of patients with pressure ulcers. Supporting nurses' positive attitudes towards pressure ulcer prevention should be an essential part of pressure ulcer prevention training. Nurses' self‐evaluations of their training needs can be used to target training. The limitations of the study should be considered when generalising the results. [ABSTRACT FROM AUTHOR]

Aims: To describe the quality of care for older cancer patients in acute care settings as perceived by the responsible nursing staff. Methods: A cross-sectional study design was used. Data were collected using a questionnaire completed by 90 nursing staff at a university hospital and a city hospital. Quality of care was measured using the Revised Humane Caring Scale. Descriptive statistics, reliability analysis, nonparametric tests and linear regression analysis were used to analyse the data. Findings: Generally, the nursing staff perceived the quality of care as good; however, university hospital nursing staff perceived the quality of care to be better than city hospital nursing staff. Compared with other age groups, nursing staff in the 30- to 40-year age group more frequently indicated that patients' information and participation need improvement. Moreover, supplemental education in cancer care was found to have no significant impact on the quality of care. Altogether, nursing staff disagreed the most about their perceptions of staffing, sufficient time and an unhurried atmosphere. Conclusion: Nursing staff should focus more on patients' personal needs, particularly with regard to patients' provision of information and participation in care. Younger nurses need more support and mentoring about complex care from their experienced colleagues when performing their work. Leaders should guarantee availability of the adequate number of competent staff in hospital wards. [ABSTRACT FROM AUTHOR]

Aims: The aim of this study was to evaluate the effects of nurse-led health coaching on adherence to health regimens and lifestyle factors among frequent attenders in primary health care. Methods: One hundred and ten patients were enrolled in the quasi-experimental study. The experimental group (n = 52) received nurse-led health coaching and the control group (n = 58) received conventional care at primary healthcare centres between 2015 and 2016. Data were collected before the intervention and 12 months afterwards using a questionnaire on adherence to health regimens and lifestyle factors. The intervention consisted of individual health coaching provided by a nurse, healthcoaching sessions, and a written action plan. [ABSTRACT FROM AUTHOR]

Background: For about 40 years, Katie Eriksson developed the caritative caring theory at Åbo Akademi University in Finland. However, a description regarding the most substantial concepts and the relationships between these is lacking and thus needs to be explored. Aims: The aim of the study was twofold: to explore and describe central concepts in the development of caritative caring theory from a postdoctoral perspective and to uncover and explore the relationships between the concepts. Methodology: The design of the study was qualitative with a mixed method approach. The material was collected from a postdoctoral group (n = 38) mainly through electronic questionnaires. The texts were interpreted through manifest and latent content analysis. Findings: The analyses generated five main categories including subcategories. The main categories were 'Caring' 'Ethos', 'Suffering' 'Health' and 'The human being'. The relation between the main concepts compiled as 'A tentative synthesis of the main concepts and the relationships between them'. Conclusion: This study contributes to an understanding of the most fundamental and valuable concepts in the development of caritative theory during its first 40 years according to postdoctoral researchers' perspectives. This study also displays that the concepts ethos and caring have the strongest relationship followed by that between caring and health, indicating the inner core of ethos and love within caring which bears the potential of enhancing the patient's well-being and health. [ABSTRACT FROM AUTHOR]

Background: Mental health problems among children and adolescents are a worldwide issue of concern. Health professionals who have sufficient competency in mental health issues are crucial for responding to this situation. Aim: The aim of the study was to describe the competency in mental health issues required by the work of public health nurses in child health clinics and school health services. Methods: This qualitative, descriptive study was conducted with focus group interviews in March 2018. The sample consisted of public health nurses (n = 24) who were working in child health clinics or school health services in Finland. The data were analysed using inductive and deductive content analysis. Results: The competency in mental health issues required by the work of public health nurses was formulated from the identified strengths and topics required in continuing education. In total, 18 competencies were identified as covering mental health promotion, as well as the alleviation and treatment of symptoms and disorders. Intuitive and interpersonal competency was identified as the main strength of public health nurses. The theoretical and evidence‐based competency regarding mental health issues was identified as a main topic needed in continuing education. Conclusion: Public health nurses in child health clinics and school health services need competency in mental health issues for the promotion of mental health, the alleviation of symptoms and treatment of disorders. The results indicate that good interactional skills are not enough: the current competency of public health nurses in mental health issues is insufficient and does not meet the requirements of the work. The results were consistent with existing knowledge, but also provide a more comprehensive and precise insight into the current situation. In the future, the results should be verified with more studies. There is also a need for intervention studies aiming to improve competency in mental health issues. [ABSTRACT FROM AUTHOR]

Background: Consistent practice, an agreed clinical practice based on evidence, has been considered as a base for effective provision of quality and safety of care. As a result, patients have an equal quality of care regardless of the organisation or worker. However, despite the international guidelines, pressure ulcer prevention practices vary in long‐term older people care. Aim: To develop, implement and evaluate the impact of renewed, consistent practice for pressure ulcer prevention, in long‐term older people care. Design: A quasi‐experimental intervention study. Methods: Two long‐term older people care facilities chosen with convenience sampling were randomly allocated to intervention or comparison group. Registered and practical nurses, in total 141/112, participated in the study. The renewed consistent practice based on international guidelines for pressure ulcer prevention was developed and implemented using the Operational Model for Evidence‐Based Practices (OMEBP). Frequencies and agreement of PU prevention practices in line with international guidelines in the care facilities were measured using the PUPreP instrument. Results: In the intervention facility, improvement in line with international guidelines was seen in the frequency of PU prevention practices in risk assessment, nutrition, pressure‐relieving devices and documentation. Furthermore, improvement was seen in the intervention facility in all six areas of agreement on practices. Conclusions: The results of this study support the implementation of PU prevention guidelines in long‐term older people care (LOPC) and more widely in healthcare settings for older people to promote consistent practice, and safety and equal quality of care. [ABSTRACT FROM AUTHOR]

Background: It is important to have a full and detailed understanding of the factors that influence intention to leave nursing. It has been shown to be the best predictor of actual turnover, and turnover has a significant financial impact and also on the provision of care. Aims: The aim is to examine the impact of predictive work environment factors on nurses' intention to leave their position and to explore contributing factors. Methods: Cross‐sectional survey using a convenience sample (n = 605) of Finnish nurses drawn from five clinical settings. The Nursing Context Index, an internationally used and psychometrically validated tool, was used to measure workplace practice environment, work stress, job satisfaction and intention to leave. A response rate of 29.4% was achieved, exceeding power calculation estimates. Results: Personal satisfaction and satisfaction with profession and resources, and organisational commitment were significantly related to intention to leave. Younger nurses reported higher levels of intention to leave and there was variability among clinical specialties. Measures of stress and practice environment had no significant relationship with intention to leave. Discussion: This study provides a new theoretical model for understanding intention to leave. Having a better understanding of the factors that may help reduce intention to leave allows for targeted interventions to be developed and implemented. This would help reduce the personal and financial implications associated with turnover. Implications for practice, policy, management and education: The findings have significant implications for all aspects of nursing. Educators need to prepare new nursing staff for the working environment; policymakers must ensure that nursing satisfaction is promoted to strengthen organisational commitment and nurse managers and leaders respond accordingly in implementing effective interventions. [ABSTRACT FROM AUTHOR]

Background: Studies of nurses' required competence in EOL care in health centres are rare. It is important to produce information about experienced nurses' perceptions of the competence they consider important in their practical work. Aim: The aim of this study was to describe nurses' required competence in EOL care in health centre inpatient wards as experienced by nurses. Method: A descriptive qualitative study using four semi‐structured group interviews (20 nurses) and inductive descriptive content analysis. Results: Five categories describing nurses' required competence in EOL care in a health centre inpatient ward were identified: (1) ethics and courage in action, (2) support for the patient, (3) support for the family, (4) care planning and (5) physical care. Factors promoting nurses' competence in EOL care comprised two categories: (1) professional development in EOL care and (2) an organisation that supports EOL care. Conclusions: End‐of‐life care in health centre inpatient wards requires wide and complex competence from nurses. Nurses' experiences of required competence are associated with holistic care of the patient, encountering the family and multiprofessional cooperation. Nurses' competence in EOL care could be enhanced with postgraduate education, and educational planning should be given more attention in the future. [ABSTRACT FROM AUTHOR]

Background: Parents have responsibilities when their adolescent offspring use alcohol, but little is known about their views on the topic. This knowledge would help healthcare organisations to develop practices to help parents meet their responsibilities. Aim: The aim of this study was to describe parents' perceptions and experiences of their responsibilities and what support they needed to tackle underage drinking. Design and methods: This Finnish study was carried out in 2017. It used a qualitative descriptive method that involved carrying out semi‐structured interviews with 20 parents of adolescents aged 14–15 years. The data were analysed using inductive content analysis. Results: Parents described that it was their responsibility to prevent problems that could have a negative impact on their adolescents' well‐being. When it came to their responsibilities with regard to adolescents using alcohol, parents saw these as guiding and protecting their child, being aware of how parents used alcohol themselves, the way they communicated with adolescents and the rules they set about experimenting with alcohol. Parents said that receiving collaborative support from peers, community and professionals working in health and social care services would be useful. This could help them to prevent adolescents using alcohol, tackle problems that occurred when adolescents drank and enable parents to play a responsible role in their local community. Conclusion: Parents recognised that they had responsibilities to prevent alcohol having a negative impact on adolescents' well‐being. They wanted to ensure that adolescents made sensible and responsible decisions when it came to using alcohol. Parents described that the most important form of support was peer support from other parents. The findings of this study can be used to inform the development of preventive healthcare services and support parents to meet their responsibilities with regard to tackling underage drinking. [ABSTRACT FROM AUTHOR]

Aim: To develop the Nurse Managers' Work Content Questionnaire (NMWCQ) and to describe nurse managers' work content. Background: Restructuring within health care has expanded the nurse manager's role to include organisational, patient and staff demands. Methods: The pilot study employed a cross‐sectional study design. Based on a literature review, the NMWCQ with 102 items was developed and pretested for this study. Data were collected in 2017 from three Finnish acute care central hospitals that provide specialised health care. A total of 61 nurse managers participated, which represents a response rate of 59%. Principal component analysis was used to test the construct validity of the instrument. Cronbach's alpha values were used to analyse the internal consistency of the instrument. In addition, descriptive and nonparametric analysis was used. Results: Ultimately, 13 components with 87 items were identified in the questionnaire. The construct validity and internal consistency of the questionnaire were at acceptable levels. Cronbach's alpha rates of the components were 0.554 ‐ 0.890. The most frequently performed daily work of nurse managers was in the component of organising, and the most infrequently performed daily work was in the component of clinical nursing. Conclusions: The study shows that the Nurse Managers' Work Content Questionnaire (NMWCQ) is suitable for measuring the current content of nurse managers' work. However, the questionnaire is new and needs additional testing such as confirmatory factor analysis with larger amounts of data. [ABSTRACT FROM AUTHOR]

Background: Wide variation exists between the nursing competence requirements seen in the emergency care context and the subsequent design of nursing education programmes. Clarifying nursing roles and scope of practice may shed light on inconsistencies and encourage nurses to work to their full potential. Aim: Describe and clarify the overarching similarities and differences in registered nurses' and nurse specialists' scope of practice in emergency departments. Methods: A qualitative study performed in Finland and Norway, based on 11 interviews analysed by means of qualitative content analysis. Results: The results are presented in three main categories related to nurses' scope of practice: The nurses share the same role, Competence varies and Same accountability and responsibility, with potential for development of the specialist role. Discussion: Given the varying educational systems that currently exist, management teams face a more or less impossible task if attempting to standardise the scope of practice for different professional nurse groups. Still, nurse specialists possess competence that could be utilised to improve patient care and some specialisations seem more suitable for emergency care than others. Individual skills and qualifications should be recognised, which would enable nurses to work to their full potential. Conclusion and implications: No differences were seen between registered nurses' and nurse specialists' role, and professional accountability and responsibilities in the context studied here, although the level of nursing competence differed. Before and even after consensus on uniform competence standards for the different professional nurse groups is reached, management teams should invest in reviewing nurses' competence in relation to different expertise levels, and strategically recruit so that current health needs in the emergency departments can be met. [ABSTRACT FROM AUTHOR]

Background: In Finland, although families generally receive support from child health clinics, some need more help in dealing with their child's emotions, behaviour and psychosocial development. Public health nurses play a central role in providing vital psychosocial support for families, but they often lack the confidence and competence to tackle mental health problems. Aim: To describe how public health nurses used and experienced a working model that combined a psychosocial tool (Strengths and Difficulties Questionnaire, SDQ) to identify disruptive behaviour in four‐year‐old children and an Internet‐based parent training programme with telephone coaching. Methods: This is a descriptive, cross‐sectional survey study. The sample consists of public health nurses (n = 138) who were working in child health clinics in Finland that had used the working model. Statistical data were analysed using SPSS Statistics for Windows. The responses to an open‐ended question were analysed using inductive content analysis. Results: The experiences about the working model were mainly positive. The public health nurses felt that the psychosocial tool, the SDQ, was easy and suitable to use in child health clinics. The availability of an Internet‐based parent training programme provided greater support for parents by overcoming practical barriers. Overall, the working model helped nurses to develop their mental health competencies. Conclusion: Within primary care, the need to tackle psychosocial problems is increasing, and for this, public health nurses need extra support and tools. It seems that the working model, including the SDQ and the online and telephone coaching programme, worked well in child health clinics. This working model can be used to provide parental support and improve nurses' mental health competencies. [ABSTRACT FROM AUTHOR]

Background: Mentors need diverse competencies, sources of motivation and characteristics to successfully mentor nursing students and support students' learning processes. Effective mentoring education can benefit future nursing professionals, students' satisfaction and learning, as well as the general perception of the nursing profession. Objective: The purpose of this study was to evaluate how an educational intervention affects nurse mentors' competence in mentoring nursing students during clinical practice. Design: A quasi‐experimental study design with pre‐ and post‐tests was used. Settings: Educational interventions were conducted in one university hospital and two central hospitals in Finland between 2013 and 2017. The intervention was conducted twice per year with a duration of 3 months for each group. The inclusion criteria for the participants were as follows: volunteer participation to mentor education employment at the university hospital or central hospitals in Northern Finland. Methods: The intervention aimed to increase Registered Nurses' competence in mentoring nursing students. The education lasted 3 months and included online learning as well as three face‐to‐face teaching sessions. A total of 120 nurse mentors completed the Mentor Competence Instrument (MCI), which includes 10 subscales that describe various competence areas, before and after the education. Results: Nurse mentors' mentoring competence increased across all mentoring competence areas after the educational intervention. More specifically, the participating nurses showed a statistically significant increase in their competence regarding knowledge of mentoring practices in the workplace, student‐centred evaluation, identifying student needs, mentoring practices between mentor and student, supporting students' learning processes, goal orientation in mentoring and constructive feedback. Conclusions: On an international level, nurse mentors are not typically required to have completed mentoring education prior to the mentoring of nurse students. Since mentoring education increased nurses' competence at mentoring nursing students, we recommend that all nurse degree programs include mentoring education to prepare future nurses for the important future role in mentoring. [ABSTRACT FROM AUTHOR]

Background: Palliative care is aimed at improving the quality of life of an individual with chronic noncommunicable disease and their care partners. Limitations in the provision of palliative care are mainly lack of knowledge and experience by nurses, fear of treating palliative persons, loss of control over treatment and fear of providing poor‐quality palliative care to persons and care partners. Aim: The aim of this study was to investigate the perception, knowledge and attitudes of palliative care by nurses who use palliative care approaches in practice, as well as the difference in perception, knowledge and attitudes of palliative care between nurses in Slovenia and Finland. Methods: We conducted a cross‐sectional descriptive study. The survey included 440 nurses in clinical environments in Slovenia and Finland with a completed bachelor, master or doctoral level of education. Results: We found statistically significant differences between both countries in the perception of palliative care. Differences between the two countries in the knowledge of palliative care were not confirmed. We confirmed statistically significant differences between both countries in the attitudes of palliative nursing care. Conclusion: Early person‐centred palliative care is an important part of the holistic and integrative treatment of a person who has a disease with disturbing symptoms. For such an approach, it is important to educate nurses about knowledge, expectations, values and beliefs in developing a concept of person‐centred palliative care to improve quality of life. The better perception, knowledge and attitudes of palliative care by nurses may help persons to improve and raise their quality of life, as well as diminish stress in their care partners and improve quality of life. [ABSTRACT FROM AUTHOR]

Rationale: Humanitarian migration to Finland nearly ten‐folded in 2015–2016 from 3 326 asylum seekers' yearly average to 32 476. Earlier research shows that humanitarian migrants sustain suboptimal maternal health in high‐income countries, even though care facilities are available. Aim and objective: This study aimed to investigate what factors do maternity care professionals identify as hindrances and facilitators in humanitarian migrants' maternity care process in Finland. Methodological design: Study employed qualitative design. Eighteen midwives and maternity care public health nurses participated in semi‐structured qualitative interviews that were audio‐recorded and transcribed verbatim. Qualitative content analysis of the interview data produced meaning units, codes and categories. Ethical Issues: Research plan was reviewed and approved by the ethics committee of the local hospital district. Participants signed an informed consent prior the interviews. Findings: Hindrances and facilitators for care were organised in theoretical framework of Three Delays Model. Participants described multiple hindrances for caring process, of which language barrier constantly raised as a significant obstacle for seeking and receiving care, and for perceived quality of care. Correspondingly, interpreters facilitated the caring process at all of its phases. Rural location of asylum centres, long distances and lacking transportation to care hindered reaching the health facility. Complicated bureaucracy was described to affect negatively in receiving adequate care. Refugee and asylum centre workers facilitated decision to seek care, and reaching of health facilities. Conclusion: Interpreters can influence in the caring process in more versatile ways than we might have acknowledged this far. We recommend further research on interpreters' role in the caring process of pregnant humanitarian migrants. [ABSTRACT FROM AUTHOR]

Background: Medication‐related errors are common in elderly care. Most are detected during the preparation and administration stages of the medication process. Nursing staff have a key role in preventing errors, and it is based on adherence to guidelines. Aim: The aim was to determine nursing staff's self‐assessments of how they adherence to guidelines on safe medication preparation, administration and asepsis in the medication process in long‐term elderly care and to identify factors affecting this adherence. Method: Cross‐sectional study was conducted by total sampling at the communal long‐term elderly care wards of one healthcare district in Finland in November 2016. Data were collected from nursing staff by using a previously developed web‐based questionnaire. The response rate was 39.4% (n = 492). Results: One‐third of the nurses stated that they do not always follow guidelines when preparing medication, and around a half deviate from them occasionally, when administering medication. The most serious deviation on preparation stage was crushing of sustained release and enteric‐coated tablets and mixing of crushed tablets together. On administration stage, the deviation of guidelines of giving medicine in recommended time or in relation to food was common. Associations were detected between the adherence to guidelines and the nurses' experience about the adequacy of their knowledge of pharmacology and infection control, and their skill at performing medication calculations. Conclusion: Deviation from guidelines often causes an error. There is a need to review the teaching of pharmacology, infection control and medication calculations during undergraduate and continuing education. In addition, nursing staff must be reminded about the ethical aspects of safe medication processes and the appropriate attitudes to these processes. Nurses must understand why it is important to follow guidelines when preparing and administering medications, in order to avoid errors. [ABSTRACT FROM AUTHOR]

Background: First‐line managers are links between an organizations' administration and the workforce. They transmit information from higher managers to workers and vice versa. Their management skills and especially their interaction with staff are a key point in successful management. Aim: To describe how first‐line managers realized appreciative management in their everyday management practice in health and social care. Method: A quantitative descriptive study was conducted by means of an electronic survey among social and healthcare managers in Finland. Results: Based on the self‐evaluations of the managers, appreciative management is well realized. The most recognition was given to equality and the least to appreciative know‐how. Connections were seen between appreciative management and gender, education, education level and managers with higher education, and those with fewer work units below them tended to have a better realization of appreciative management. Conclusion: The education level of first‐line nurse managers is meaningful when realizing appreciative management in social and healthcare settings. Implications for nursing management: More advanced education levels of first‐line managers help to promote appreciative management in social and health care, together with the amount of work units (meaning outpatient and inpatient wards). A first‐line manager is responsible for the needs of their workforce and needs to be critically assessed so that they might have more time for managing in an appreciative way. Appreciative management should be given increased focus when educating nurse managers. [ABSTRACT FROM AUTHOR]

Background: Localised prostate cancer affects patient's quality of life in many ways. The aim of this study was to explore factors related to self‐rated health and life satisfaction for patients treated for prostate cancer, and to compare the results of these generic quality‐of‐life measures to the prostate cancer‐specific quality‐of‐life measure (UCLA Prostate Cancer Index), which focuses on physical functioning. Material and methods: This cross‐sectional survey was carried out among 183 men who underwent radical prostatectomy in 2012–2015 at a university hospital in Finland and were seen 1 year postsurgery. Approval from an ethics committee and written consents from participants were received. A questionnaire was used to evaluate patients' perceived quality of life. Logistic regression model, Spearman's correlation, Kruskal–Wallis test and Mann–Whitney U‐test were used to analyse factors related to quality of life. Results: Of the 183 men in the study, 63% rated their health status as good, and 70% were satisfied with their lives after prostatectomy. Older age and better urinary function were the only factors that explained both better self‐rated health and better satisfaction with life. The patients seemed not to interpret problems with sexual function as health‐related problems. In our sample, sexual dysfunction was relatively severe, but patients considered them to be less harmful than urinary or bowel symptoms. Interestingly, 24% of the men with low sexual function did not find that dysfunction bothersome. Conclusions: Objectively measured physical functioning is not necessarily in line with patients' experienced satisfaction with life and their self‐ratings of health. More longitudinal and qualitative research is needed about the meanings that patients attach to physical treatment side effects and the extent to which they can adapt to them over time. With a bigger sample and longer follow‐up time, it would be possible to identify men who particularly benefited from pretreatment counselling. [ABSTRACT FROM AUTHOR]

Background: Intensive‐care unit (ICU) nurses have an important role in the recruitment of patients for scientific research and in the performance of clinical research. Aim: A study was conducted to examine ICU nurses' perceptions of ethics‐related aspects of ICU‐based research. The study focused on nurse attitudes and knowledge related to clinical research, with special emphasis on perceptions of the informed‐consent process in ICU research. Method: The study applied a descriptive qualitative approach, involving semi‐structured group interviews and theme‐based inductive content analysis. Subjects were ICU nurses (n = 28) at a university hospital ICU who had experience with research protocols applied in that unit. Findings: The nurses had mainly positive perceptions of clinical studies. They found research beneficial for future patients and for society. The nurses considered the information given to them about the studies inadequate. They were concerned about the fact that the consent for research is almost always obtained at the beginning of the ICU care, when patients and relatives are still in the crisis period. This limits the possibility of understanding and assimilating the information provided on the study. Conclusions: The role of ICU nurses in clinical studies should be more prominent and taken into account in the planning of ICU studies. [ABSTRACT FROM AUTHOR]

Aims and objectives: To explore nursing applicants' perceptions of the nursing profession and to identify the factors influencing their perceptions. Background: Perceptions guide the career choice in nursing and the retainment in the profession. Perceptions of nursing profession are said to be outdated and unrealistic among public. Therefore, more information is needed about the perceptions of nursing applicants. Design: Exploratory qualitative design using focus group interviews. Methods: Three focus group interviews (n = 18) were conducted among applicants to undergraduate Bachelor of Science (BSc) nursing programmes. The focus group interviews were recorded transcribed and analysed using qualitative content analysis. In this study, the ethical principles set by Finnish law and the National Advisory Board on Research Ethics were followed. Findings: Applicants perceived nursing through characteristics of a nurse, content of nursing work, nature of nursing work and career possibilities in nursing. According to applicants, nursing requires suitable attitude and character with knowledge, theoretical competence and good general education. Nurses were seen to work in multi‐professional teams and tasks of a nurse were described through caring role of a nurse. The decision‐making in nursing was regarded limited. Nursing was considered as secure job with versatile career options although the career options or the further educational possibilities were not fully recognised among applicants. Personal factors, family and friends, media and career counselling at school influenced applicants' perceptions. Conclusions: Applicants' perceptions of the nursing profession are one‐sided and partly unrealistic. Future research should concentrate on planning interventions aiming to change the public image of the nursing profession. [ABSTRACT FROM AUTHOR]

Background: Family violence (FV) is a prevalent health issue around the world and health care services have an important role in both recognizing and treating the consequences of violence. However, FV experiences among health care professionals themselves have not been investigated much. We also lack specific knowledge on the associations between FV and mental health. Aim: The purpose of the study was to investigate the prevalence and effects of FV in a sample of Finnish health care professionals. In addition to analysing direct connections between different types of FV and mental health, the mediating effect of sleep quality was also taken into account. Methods: The study followed a cross‐sectional design. The sample comprised 1952 health care professionals from Central Finland, who participated in a survey measuring their health and well‐being. The dependent variables were perceived sleep quality and mental health as measured by depressive symptoms and the mental health continuum short form (MHC‐SF) questionnaire. Data were analysed using cross‐tabulations, anova and structural equation modelling. Results: Thirty‐eight per cent of the participants reported experiencing FV. The most common forms of abuse were 'psychological FV only' and 'psychological & physical abuse'. Participants with FV experiences scored significantly worse on depressive symptoms (p < 0.001), MHC‐SF classification (p = 0.008), sleep quality (p = 0.001) and emotional (p < 0.001), social (p < 0.001), and psychological (p = 0.008) well‐being. The mediation analyses indicated that the harmfulness of FV was at least partially explained by impaired sleep quality. Conclusion: The results indicate that FV experiences are common among Finnish health care professionals and that they can significantly affect their mental health. FV should thus be taken to account in seeking to promote the occupational well‐being of health care professionals. The results also suggest that the harmfulness of FV might be mediated by sleep quality. This finding prompts the need for further investigation and FV‐related interventions. [ABSTRACT FROM AUTHOR]

Universal school health services are expected to offer similar, needs‐based services to all students across schools, service providers and students' socio‐economic statuses and health needs. This study investigates access to school health nurses in Finland. The objectives were to study the differences in access to school health nurse between service providers, schools, students' characteristics and school health nurse resources. Access was examined through a nationwide School Health Promotion study, which is a self‐reporting, voluntary and anonymous survey for 8th and 9th graders (15 to 16‐year old, N = 71865). The ethical committee of the National Institute for Health and Welfare has approved procedure for the School Health Promotion study. Data on school health nurse resources and service providers were obtained from the national database (534 schools; 144 service providers). Multilevel logistic regression was used. Of the pupils, 15% of girls and 11% of boys reported difficult access to a school health nurse. The number of adolescents who reported difficult access ranged between service providers (0%–41%) and schools (0%–75%). Students with lower socio‐economic background, poorer well‐being at school, lack of support for studying and greater health needs reported difficult access more often. School health nurse resources were associated with difficult access only among boys, when resources were under the national recommendations. These findings raise concern about equality and unmet health needs in school health services. [ABSTRACT FROM AUTHOR]

The history of ideas may contribute to an awareness and an opening up of deep‐seated currents of thought that have shaped the inner core of the caring culture and an ethical value base – the ethos of serving in nursing leadership. This article studies how serving as an ethos is represented, which becomes visible and evident in Sophie Mannerheim's, Bertha Wellin's and Bergljot Larsson's nursing leadership. This article also seeks to describe the main features of the idea‐historical research approach the way in which it is represented within the caring science‐tradition. An idea‐historical methodological approach informed by Gadamer's philosophy was used for the hermeneutical interpretation within a caring science perspective. Primary and secondary historical sources were explored in the light of nursing praxis and serving. Three general idea patterns were discovered: the innermost room of the heart as the idea of serving, the action of the hand as acts of love and a cultivation of the head towards nursing leadership. These ideas open for a new vision that can bring out new patterns for action in the present and in the nursing leadership of the future. [ABSTRACT FROM AUTHOR]

Rational: The demand to increase nursing competence is brought on by the requirement of safe, accessible and more effective use of healthcare provider expertise. Clinical nurse specialist competency development dates back to the late 20th century; however, an examination of the literature reveals a lack of research and discussion to support the competency development. Objectives: To describe the formulation and validation process of the clinical nurse specialist core competencies. Design: Exploratory sequential mixed‐method design. Methods: This mixed‐method study, conducted between 2013 and 2017 in Finland, involved four phases: I) a Policy Delphi study (n = 25, n = 22, n = 19); II) cross‐mapping of preliminary competency criteria against international competency sets; III) content validity study of expanded competency criteria (n = 7, n = 10); and IV) verification of competency criteria with practicing CNSs (n = 16). Data were analysed by both qualitative and quantitative analysis methods. Results: Seventy‐four preliminary clinical nurse competency criteria were formulated in the first phase of the study. Through cross‐mapping the competencies against the US and Canadian clinical nurse specialist competency sets, they were further concised to 61 criteria. The examination of Content Validity Indexes and experts' comments led to the clarification and consequent inclusion of 50 criteria to the final scale, with Scale Content Validity Index Average of 0.94. The competency criteria were evaluated to be a solid set with potential to clarify and uniform the clinical nurse specialist roles. Conclusions: Through a rigorous research process, validated clinical nurse specialist competency criteria were formed with a high Scale Content Validity Index Average. The results allude to the potential of formulating international competency criteria to support global role clarity and understanding. However, further research is needed to validate the content and construct of the formulated competencies with a larger population across countries. [ABSTRACT FROM AUTHOR]

Background: Increasing number of older adults lives in their own homes, but needs help in many daily routines. Domiciliary care nursing staff (DCNS) is often needed to support oral home care. However, information of nursing staff's knowledge, skills and activity in this task is sparse. Objectives: The study aimed to assess DCNS knowledge, perceived skills and activities to support oral home care of older domiciliary care clients. Material and methods: The study was conducted among DCNS in one of the largest cities in Finland. All DCNS members (n = 465) received a questionnaire with 14 multiple choice and open questions regarding the perceived skills, knowledge and activities of oral health guidance of older domiciliary care clients. In total, 115 (25%) DCNS members returned the questionnaires. Frequencies, percentages, means and standard deviations were used to describe the samples and study variables. DCNS was categorised according to age and working years for group comparisons, which were assessed with chi‐squared test. Results: Knowledge concerning oral health was mostly on a high level. Around 50% of DCNS considered their knowledge regarding dental prosthesis hygiene as sufficient. Of the DCNS, 67% informed that they had received education on oral health care. However, over 50% of the DCNS had a need for further education in issues related to oral home care. DCNS were active in supporting most oral and prosthesis hygiene means, yet less in guidance concerning toothbrushing. Activity to support cleaning the interdental spaces was the weakest, in which only 12% of the respondents considered having average or excellent skills. Younger DCNS had better knowledge on oral home care due to recent education, but older staff members were more skilful in performing oral hygiene measures. Conclusions: There is a need for structured instructions and training on oral home care for DCNS. Oral home care should be taken into account more often and regularly. [ABSTRACT FROM AUTHOR]

Study's rationale: The significance of care robotics has been highlighted in recent years. Aims and objective: The article examines the adoption of care robots in home care settings, and in particular Finnish home care personnel's attitudes towards robots. The study compares the importance of the Negative Attitudes towards Robots Scale advanced by Nomura and specific positive attitudes related to the usefulness of care robots for different tasks in the home care. Methodological design: A cross‐sectional study conducted by questionnaire. The research data were gathered from a survey of Finnish home care personnel (n = 200). Research methods: Exploratory factor analysis, Pearson's correlation coefficient and linear regression analysis. Measures: The Negative Attitudes towards Robots Scale (NARS), by Nomura, with a specific behavioural intention scale based on Ajzen's theory of planned behaviour, and a measure of positive attitudes towards the usefulness of care robots for different tasks in home care and the promotion of independent living of older persons. Results: The study shows that NARS helps to explain psychological resistance related to the introduction of care robots, although the scale is susceptible to cultural differences. Care personnel's behavioural intentions related to the introduction of robot applications are influenced also by the perception of the usefulness of care robots. Study limitations: The study is based only on a Finnish sample, and the response rate of the study was relatively small (18.2%), which limits the generalisability of the results. Conclusions: The study shows that the examination of home care personnel's attitudes towards robots is not justified to focus only on one aspect, but a better explanation is achieved by combining the perspectives of societal attitudes, attitudes related to psychological reactions and the practical care and promotion of the independent living of older people. [ABSTRACT FROM AUTHOR]

Patient‐centred care and user involvement in healthcare services are much emphasised globally. This study was the first step in a multicentre research project in Finland to improve service users' and carers' opportunities to be more involved in mental health services. The aim of the study was to assess attitudes of professionals towards service user involvement. The data were collected via an online questionnaire from 1069 mental health professionals in four hospital districts. Altogether, 351 professionals responded. Data were analysed using appropriate statistical methods. According to the results, attitudes of healthcare professionals were more positive towards service users' involvement in their own treatment than in other levels of services. There were also differences in gender, age groups, working places and experiences in the attitudes of professionals concerning service users' involvement in their own treatment. These should be taken into account in the future when planning education for mental health professionals. In spite of governmental guidance on service user involvement and the growing body of knowledge of the benefits associated with it, change in attitudes towards user involvement is slow. Special attention should be paid to the attitudes of professionals working in inpatient care and of those with less working experience. [ABSTRACT FROM AUTHOR]

Background: Many women with vulvodynia are women of fertile age, and this syndrome may cause many physical and psychosexual functional disorders. Women with vulvodynia often find that healthcare professionals seem to demonstrate a lack of awareness about the syndrome and its care. These issues have not been previously studied among student healthcare staff. Aim: To investigate awareness and knowledge about vulvodynia and its care among staff in the student healthcare sector in Finland. Method: The study design was cross sectional. A survey instrument called ‘Awareness and knowledge of vulvodynia and its care’ was developed for this study and was used for data collection. The data were collected from a web‐based survey conducted with student healthcare professionals (N = 191, n = 79) in all 13 student healthcare units in Finland. Descriptive statistical methods were used to describe the connections between the factors associated with awareness of vulvodynia and its care. Ethical standards were followed throughout the study. Results: The primary results of the study indicated that the respondents had somewhat good awareness of how to identify vulvodynia and somewhat poor awareness of the treatments for vulvodynia. Participants' awareness of the meaning of encountering patients, as well as the information and support they provided, was good. Based on the knowledge test, knowledge of vulvodynia and its care was estimated to be poor. The respondents' experience‐based skills in treating vulvodynia and education about vulvodynia were mostly associated with better awareness and knowledge about vulvodynia and its care. Conclusion: The student healthcare staff who meet and care for women of fertile age have irregular awareness and knowledge of vulvodynia and its care. The creation of educational programs to develop such awareness and knowledge is recommended to obtain a standard quality of care for all women with vulvodynia. [ABSTRACT FROM AUTHOR]

Background Suffering profoundly touches the human being's inner existence. The different faces of suffering may yet be unknown, and therefore, it is important to further explore suffering in order to reach a new and deeper understanding of it and its alleviation. The aim and research questions The aim of this study was to expand the understanding of suffering. The research questions are what is suffering as described by the human beings themselves and what initiates a movement in suffering towards its alleviation? Research design, participants and research context The study uses a hermeneutical approach and hermeneutical reading. The material consists of interviews with adults who had lived through suffering and regained health. Ethical considerations The data storage, study participation and handling of data for research purposes were approved by the participants when they provided their informed consent. Findings Suffering is portrayed as a deep darkness. The suffering human being is filled with hopelessness and meaninglessness and feels homeless in life. There is often a hidden inner longing in the midst of suffering that may be uncovered. Conclusion Embracing the dark corner of the heart, the suffering, provides the keys for initiating a movement towards its alleviation and implications for how to encounter a suffering human being, for example within different caring contexts. [ABSTRACT FROM AUTHOR]

Purpose/Design This cross-sectional descriptive study describes staff experiences of appreciative management. Methods Data were collected by way of e-survey from staff (n = 87) working in the institutional care of people with intellectual and developmental disabilities . The Appreciative Management Scale ( AMS 1.0) was used and data were analysed by statistical methods. Findings Overall, respondents experienced appreciative management as being well implemented, with equality as the best implemented dimension and systematic management the worst. The promotion of well-being at work was associated with age. Appreciation staff received from management had a positive correlation with systematic management, equality, appreciation of know-how and the promotion of well-being at work. Conclusions The knowledge of weak systematic management in this study may be utilised in developing management strategies. The managers should use the concept of appreciative management to help young and less experienced nurses to increase their competency and willingness to work in this field. [ABSTRACT FROM AUTHOR]

Background Nowadays, patients can be more involved in developing healthcare services with their healthcare professionals. Patient-centred information is a key part of improving regional health information exchange ( HIE), giving patients an active role in care management. Aim The aim was to get a deeper understanding of the flow of information and collaboration in one hospital district area from the viewpoint of patients, healthcare professionals and administrative staff. Methods The data were collected by themed interviews and analysed using both deductive and inductive content analyses. The interview themes were the flow of information and collaboration after 5 years of HIE usage in one hospital district area in Finland. Findings Health information exchange usage had changed the regional flow of information after the 5-year period. The patients were satisfied that their primary care physician was able to access their special care information. The experiences of healthcare professionals and administrative staff also showed that information availability and information exchange had improved regionally. HIE usage was also found to have improved regional collaboration between different organisations in patient health care. Conclusions It was recognised that patients had taken on more responsibility for transferring their follow-up treatment information. Healthcare information exchange between professionals not only improves patient care or patient involvement in their own care, but it also requires that patient self-care or self-care management is integrated into HIE systems to share information not only among professionals, but also between patients and professionals. This information will be used in the development of healthcare systems to meet more the developing of the continuity of care the patient's point of view. [ABSTRACT FROM AUTHOR]

Background Nonprofit cancer societies play an important role in providing social support for patients with cancer through nonprofit electronic counselling services ( ECS) provided by counselling nurses ( CNs) with experience in oncology nursing. To date, there exist only few studies addressing the facilitators and barriers for social support of patients with cancer as reported by CNs. Objective To describe the facilitators and barriers for electronic social support of patients with cancer received from the ECS in the nonprofit cancer societies as reported by CNs. Methods Qualitative design with three group interviews was conducted with 10 CNs in three nonprofit cancer societies in southern and western parts of Finland. Interviews were recorded, transcribed verbatim and content analysed inductively. Findings The facilitators were promotion of the access to ECS, functioning structures of ECS, utilisation of the strengths of an individual CN in ECS, promotion of the life management of patients, patient-centeredness as a basis of ECS and reliability of ECS. The barriers for electronic social support were the unmet paths between ECS and patients, nonfunctioning structures of ECS, inadequacy of mutual communication and lack of shared viewpoints between CNs and patients. Conclusions Facilitators and barriers for electronic social support of patients with cancer were related to organisation, individuals and counselling process. The counselling work in ECS as its best promotes the life management of patients with cancer but, alternatively, can lead to conflicts in communication and therefore be a barrier for electronic social support. Implications for practice To make the nonprofit ECS better known, the cooperation with hospitals is needed to enable social support for patients. To improve communication between CNs and patients, continuous communications skills training and functional working environments are needed. [ABSTRACT FROM AUTHOR]

Background Parental empowerment is known to increase parents' resources and to reduce stress, and therefore to improve family well-being. Professionals working in family services (child health clinics, school health care, day care, preschool and primary school) encounter families in various everyday settings and can significantly support parental empowerment. Aim This study aimed (i) to identify associations between parental empowerment and demographic and family service characteristics (i.e. parents' participation and perceived influence, decision-making and access to information) and (ii) to identify predictors of maternal and paternal empowerment. Method Study design was cross-sectional. Participants were mothers (n = 571) and fathers (n = 384) of children aged 0-9 who were selected by stratified random sampling in 2009. Associations were analysed by t-test, one-way analysis of variance and multiple linear regression analysis. Results Sufficient perceived influence and joint decision-making by family and professionals on family service appointments emerged as significant variables of increased parental empowerment. Access to adequate information about municipal services was also associated with high empowerment. These family service characteristics were associated with parents' sense that they were able to manage in everyday life and had influence on specific service situations and family services in general. Mothers with a child aged under 3 or a child in home care or primary school, and fathers with a lower education feel less empowered in family services than other parents. Conclusion Knowledge about the factors associated with parental empowerment can contribute to further reinforce parental empowerment, help identify parents who need special attention and contribute to the development of family services. [ABSTRACT FROM AUTHOR]

In the recovery process of arthroplasty patients, their family members play an important role due to short hospital stay and increased age of patients. Family members need to have knowledge to be able to support the patient. The aim of this study was to explore expected and received knowledge in family members of arthroplasty patients and describe the relationships between the differences in received and expected knowledge and background factors, country, information and control preferences and access to knowledge. The study was conducted in six European countries (Cyprus, Greece, Finland, Iceland, Spain and Sweden). The study design was cross-cultural, prospective and comparative with two measurement points: pre-operative and at discharge from hospital. Knowledge Expectations of significant other-scale and Krantz Health Opinion Survey were used before surgery and Received Knowledge of significant other-scale and Access to Knowledge at discharge. Patients undergoing elective hip or knee arthroplasty in seventeen hospitals were asked to identify one family member. The sample size was decided by power calculation. A total of 615 participants answered the questionnaires at both measurements. Family members perceived to receive less knowledge than they expected to have, most unfulfilled knowledge expectations were in the financial, social and experiential dimensions of knowledge. Seventy-four per cent of participants had unfulfilled knowledge expectations. Increased access to information from healthcare providers decreased the difference between received and expected knowledge. Compared to family members in southern Europe, those in the Nordic countries had more unfulfilled knowledge expectations and less access to information from healthcare providers. The evidence from this study highlights the need to involve the family members in the educational approach. [ABSTRACT FROM AUTHOR]

Clinical preception in practice plays a significant role in the education of both Registered Nurses and practical nurses. This study presents the evaluation of an interprofessional research and development project (2009-2103) on clinical preceptorship between two universities of applied sciences, two vocational institutes and four healthcare organisations in western Finland. The research question was as follows: How did the participants evaluate the process and outcomes of developing preceptorship through an action-research approach? The primary target group consisted of professionals within the healthcare sector and nursing teachers at the universities of applied sciences and the vocational institutes. The five units represented in the healthcare organisations functioned as clinical practice placements for both nursing and practical nursing students, with Registered Nurses and practical nurses acting as their preceptors. Each unit developed a unique preceptorship model to answer their specific needs. The models were implemented and tested during one academic year followed by a quantitative (a 4-point scale) and qualitative evaluation of the process. The models are presented in another article, and the evaluation results are presented in this article. The evaluation showed that preceptorship has become an important and accepted part of work, including the practice of starting any preception at a unit with a thorough introduction. The project's emphasis on critical thinking, reflection and focus on ethics were valued by the staff. Pedagogical further education should be arranged on a regular basis to strengthen the knowledge base of the preceptors. Furthermore, enough time for preceptorship should be allocated, as it is a pedagogical duty. The implication of this project is that more cooperation between different stake holders is needed, in order to narrow the gap between theory and praxis. [ABSTRACT FROM AUTHOR]

Background Home-care services require access to high quality information. Apart from the provision of right-time organised planning of care and to document information about clients' needs, in home care, the care planning is intended to facilitate continuity and individual nursing through nursing documentation of the assessment of the client. Aims The aim was to describe the contents of older (+75 years) home-care clients' electronic care and service plans and to evaluate how the clients' resources have been taken into account. Design and methods The data were collected from the care and service plans (n = 437) of home-care services during July 2010. The data were analysed by quantitative methods and by thematic content analysis. Results Based on the analysis, medication was the most reported component in all plans (92.7%); other commonly reported components were self-care (85.4%) and coping (78.0%). Components within respiratory, follow-up treatment, life cycle and health behaviour were forgotten. Most of the care and service plans were designed from the home-care professionals' point of view but the plans lacked the perspective of older clients. Conclusion To be able to promote older home clients' ability to live at home, home-care planning needs to be individually designed and must take into account clients' needs and their perspectives regarding meaningful activities and social relationships. In addition, there is a need to develop a more comprehensive care planning system, based on the clients' individual needs and standards of care planning. [ABSTRACT FROM AUTHOR]

Introduction Observing real situations in clinical practice can provide undetected information regarding problems in the medication process. Aims The aims of this study were to describe the frequency, types, and severity of medication errors in medical and surgical inpatients as well as to study the relationship between medication errors and associating factors. Methods A cross-sectional study using direct observations and medication record reviews was conducted to assess how 32 registered nurses administered 1058 medications to 122 inpatients in four medical and surgical wards at a university hospital in Finland between April and May 2012. Observations were recorded using a structured observation form and patients' medication record reviews (n = 122) before and after the observations were conducted. A multiprofessional team analysed and classified all of the detected errors and assessed their severity. A logistic regression was used to analyse the factors (work environment, team, person-specific, patient-specific or medication-related) associated with medication errors. Results At least one error was found in 22.2% (235/1058) of administered medications , 63.4% of which were medication administration errors and 18.3% of which were documentation errors. Of the medication administration errors, 59.1% involved an incorrect administration technique. 3.4% of errors caused harm to patients. Statistically significant factors that increased the risk of medication errors included every other weekday, except Sunday; morning shifts; increased rushes; nurses asking for help; and increased number of medications that patients used. Factors that decreased the risk of errors included administering medications through an oral route, double-checking the drugs, and additional people in the medication room at the same time. Conclusion Medication errors in inpatient care are frequent, and improvements to increase safety are vital. More attention to medication administration techniques, administration instructions and attitudes toward safety are needed to prevent problems. [ABSTRACT FROM AUTHOR]

Rationale People have a fundamental right to know about care and services within health care. This right is also important for persons with memory disorders ( Pw MD) and their significant others ( SO) for empowering them to manage with difficult situations at home and in institution. Aim This study explores the self-assessed level of received knowledge about care and services of the SOs of Pw MDs and the understandability of that knowledge. Methods This study employed an exploratory and correlational survey design in multisite settings for older people. Data were collected in Finland in 2010-2011 from the SOs of Pw MDs (N = 304, n = 264, response rate 87%) using questionnaires, including the Knowledge of Care and Services for Persons with Memory Disorders; the level of knowledge and the understandability of the knowledge were assessed using visual analogue scale ( VAS 0-100). Data were analysed statistically using descriptive statistics, independent samples t-test, one-way analysis of variance and Pearson's correlations coefficients. Results The self-assessed level of received knowledge of SOs about care and services was low (mean 47.7 ± 25.3 out of 100), with the highest level seen in medication (54.5 ± 31.1) and memory disorder as a disease (54.3 ± 30.3) and the lowest level in the services provided at home for Pw MDs (45 ± 30.6) and generally for SOs (38.5 ± 31.7). SOs assessed the received knowledge as being understandable to a moderate degree (53.7 ± 25.5). Conclusion More knowledge could be delivered to Pw MDs to manage in their homes and especially to SOs to take care of Pw MDs. New educational solutions could be created aimed at improving the understandability of the knowledge. [ABSTRACT FROM AUTHOR]

The aim of this study was to deepen the understanding of student nurses' processes of understanding and becoming nurses. The study is phenomenological-hermeneutic in design, comprising data from three focus group interviews in two Scandinavian countries. The process of student nurses' understanding and becoming a nurse emerged as a hermeneutical movement. A caring student-preceptor relationship and a growth-promoting preception in a supportive and inclusive environment provide the frame within which the movement happens. The movement towards understanding and becoming is initiated as students, based on their level of knowledge, are given responsibility. In order to fulfil the responsibility imposed on them, students take their entire repertoire of knowledge into consideration. By tying these threads together, they found the basis for conscious action, and care is provided according to what the current situation requires. The experiences obtained are reflected on and integrated with earlier knowledge, which leads to enhanced understanding. Students form a new base to stand on. They show increased readiness for still more responsibility and action. This movement towards deeper understanding and becoming affects the students also ethically and deepens their ethical awareness. When one loop of understanding and becoming is closed the process continues by passing into a new loop. This movement could be described as a hermeneutical spiral consisting of interconnected loops taking the students further and deeper in their process of understanding and becoming a nurse. The student-preceptor relationship and the ethos permeating it are decisive for students' learning both epistemologically and ontologically. Responsibility is the catalyst in students' understanding and becoming both intellectually and ethically. Understanding and becoming are ongoing processes of appropriation, thus altering students both professionally and personally. Understanding and becoming can be perceived as the hearth of the matter in nurse education. [ABSTRACT FROM AUTHOR]

Aim The purpose of this study was to culturally validate three pain measurement instruments [ Behavioral Pain Scale ( BPS), the Critical- Care Pain Observation Tool ( CPOT) and the Nonverbal Adult Pain Assessment Scale ( NVPS)] for sedated intensive care patients and in doing so to prepare the tools for psychometric testing in the Finnish intensive care environment. Background Most patients feel pain during their stay in an intensive care unit. Pain recognition and assessment is the first step towards effective pain management. The BPS, CPOT and NVPS are the most valid and reliable pain assessment instruments developed to objectively assess pain in sedated intensive care patients. Method The translation and cultural adaptation of the instruments were done according to the guidelines of the International Society for Pharmacoeconomics and Outcomes ( ISPOR). The process included 10 phases aiming to produce semantically correct Finnish versions of the pain assessment instruments. This translation process was chosen due to its rigorousness and systematic approach. Results The 10-step translation and cultural validation process were successfully conducted, although it was complex and time-consuming. The resulting Finnish versions of the three pain assessment instruments showed good evidence of content and conceptual equivalence. Although further work is needed to test these instruments in the Finnish intensive care context, the current Finnish versions are potential instruments for clinicians to use. Conclusion Deciding when this high-quality process is needed requires thorough consideration. However, it is worthwhile to use it when implementing new instruments at a national level. We need a valid, reliable and feasible instrument for pain assessment in sedated intensive care patients in Finland. The next step in our process is conducting psychometric testing of these three instruments to choose the tool with the best properties to be implemented in clinical practice. [ABSTRACT FROM AUTHOR]