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BackgroundThe popularity of web-based patient-professional communication over patient portals is constantly increasing. Good patient-professional communication is a prerequisite for high-quality care and patient centeredness. Understanding health care professionals’ experiences of web-based patient-professional communication is important as they play a key role in engaging patients to use portals. More information is needed on how patient-professional communication could be supported by patient portals in health care. ObjectiveThis systematic review of qualitative studies aims to identify how health care professionals experience web-based patient-professional communication over the patient portals. MethodsAbstract and full-text reviews were conducted by 2 reviewers independently. A total of 4 databases were used for the study: CINAHL (EBSCO), ProQuest (ABI/INFORM), Scopus, and PubMed. The inclusion criteria for the reviewed studies were as follows: the examination of health care professionals’ experiences, reciprocal communication between patients and health care professionals, peer-reviewed scientific articles, and studies published between 2010 and 2019. The Joanna Briggs Institute’s quality assessment criteria were used in the review process. A total of 13 included studies were analyzed using a thematic synthesis, which was conducted by 3 reviewers. ResultsA total of 6 analytical themes concerning health care professionals’ experiences of web-based patient-professional communication were identified. The themes were related to health care professionals’ work, change in communication over patient portals, patients’ use of patient portals, the suitability of patient portals for communication, the convenience of patient portals for communication, and change in roles. ConclusionsHealth care professionals’ experiences contain both positive and negative insights into web-based patient-professional communication over patient portals. Most commonly, the positive experiences seem to be related to the patients and patient outcomes, such as having better patient engagement. Health care professionals also have negative experiences, for example, web-based patient-professional communication sometimes has deficiencies and has a negative impact on their workload. These negative experiences may be explained by the poor functionality of the patient portals and insufficient training and resources. To reduce health care professionals’ negative experiences of web-based patient-professional communication, their experiences should be taken into account by policy makers, health care organizations, and information technology enterprises when developing patient portals. In addition, more training regarding web-based patient-professional communication and patient portals should be provided to health care professionals.

BackgroundElectronic health records (EHRs) are expected to provide many clinical and organizational benefits. Simultaneously, the end users may face unintended consequences, such as stress and increased cognitive workload, due to poor EHR usability. However, whether the effects of usability depend on end user characteristics, such as career stage or age, remains poorly understood. ObjectiveThe objective of this study was to examine the associations of EHR usability and user age with stress related to information systems and cognitive failures among registered nurses. MethodsA cross-sectional survey design was employed in Finland in 2017. A total of 3383 registered nurses responded to the nationwide electronic survey. Multiple linear regression was used to examine the associations of EHR usability (eg, how easily information can be found and a patient’s care can be documented) and user age with stress related to information systems and cognitive failures. Interaction effects of EHR usability and age were also tested. Models were adjusted for gender and employment sector. ResultsPoor EHR usability was associated with higher levels of stress related to information systems (β=.38; P

We investigated the short- and long-term effects of two different evidence-based mindfulness training on students' stress and well-being. A randomised controlled trial with three measurement points (baseline, post-intervention, and 4 months post-intervention) was conducted among undergraduate students of medicine, dentistry, psychology, and logopaedics at the University of Helsinki. The participants were randomly assigned into three groups: (1) face-to-face mindfulness training based on the Mindfulness Skills for Students course (n = 40), (2) a web-based Student Compass program using Mindfulness and Acceptance and Commitment therapy (n = 22), and (3) a control group that received mental health support as usual (n = 40). The primary outcome was psychological distress measured using the Clinical Outcomes in Routine Evaluation Outcome Measure (CORE-OM). Secondary outcomes included hair cortisol concentrations and a wide range of well-being indicators. Psychological distress increased in all the groups from baseline to post-intervention, but significantly less so in the intervention groups than in the control group. At 4-month follow-up, were found no differences between the primary outcomes of the control and intervention groups, but the participants who continued practising mindfulness at least twice a week were less stressed than the others. Our results suggest that participating in a mindfulness course may mitigate health care students' psychological distress during the academic year, but only if the participants continue practising mindfulness at least twice a week.

Background: The early identification of different subgroups of individuals with partial work ability is important for the development of appropriate and effective services in order to prevent exclusion from working life and prolongation of unemployment. Aims: This study aimed to identify different main activity trajectory clusters of people with partial work ability before their participation in work ability support services and to examine sociodemographic, health, work ability and functioning features of the identified clusters. Methods: The sample consisted of clients who had participated in the Finnish Work Ability Programme during 2020–2022. Using the main activity data spanning from 2005 to 2021, optimal matching was applied to examine the similarity between the participants' main activity trajectories. Second, using cluster analysis, participants were categorised into four main activity trajectory clusters. Finally, the sociodemographic, health, work ability and functioning features of clusters were examined. Results: A total of 643 individuals participated in the study. Four clusters were identified: (a) early-onset retirement, (b) from studies to outside the workforce, (c) from employment to unemployment and (d) long-term employment. Individuals in the 'early-onset retirement' cluster had the best perceived work ability and functioning. Problems relating to health, work ability, functioning and well-being were highlighted in the 'from employment to unemployment' cluster. Conclusions: Unemployed individuals with partial work ability form a heterogeneous population who often have several different underlying reasons for decreased work ability. Multiple data sources are needed to identify the special characteristics and needs of the people with partial work ability. [ABSTRACT FROM AUTHOR]

Active commuting can be beneficial for health. We examined whether active commuting by walking or cycling was associated with a lower risk of sickness absence in a Finnish public sector cohort of 28 485 employees. We used negative binomial regression to test associations of weekly active commuting in kilometers (no, low, moderate, and high dose) with all‐cause sickness absence. Sickness absence data from employers registers comprised the number of (1) sickness absence days, (2) short (1–9 days) and (3) long (≥ 10 days) sickness absence episodes during 12‐ and 24‐month follow‐ups. The models were adjusted for sociodemographic factors, lifestyle risk factors, and previous sickness absence. To demonstrate absolute risk, we calculated sex‐ and age‐adjusted incidence for sickness absence per 100 person years for each active commuting exposure group. The associations of cycling and walking were additionally studied in separate analyses. Compared to passive commuters (no active commuting), high dose of active commuting (mean of 61 km/week) was associated with an 8%–12% lower relative risk of sickness absence days and an 18% lower relative risk of long episodes. The absolute rate of sickness absence per 100 person‐years was up to 452 days and 10 long episodes lower in the high‐dose active commuters group. In the further analyses separating cyclists and walkers, similar reduced risks were observed only among high‐dose cyclists. Our findings suggest that regular active commuting by bicycle has potential for reducing sickness absence by reducing the risk of long sickness absence episodes. [ABSTRACT FROM AUTHOR]

Compassion is known to predict prosocial behavior and moral judgments related to harm. Despite the centrality of compassion to social life, factors predicting adulthood compassion are largely unknown. We examined whether qualities of parent-child-relationship, namely, emotional warmth and acceptance, predict offspring compassion decades later in adulthood. We used data from the prospective population-based Young Finns Study. Our sample included 2,761 participants (55.5% women). Parent-child-relationship qualities were reported by each participant's parents at baseline in 1980 (T0) when participants were between 3 and 18 years old. Compassion was self-reported 3 times: in 1997 (T1), 2001 (T2), and 2012 (T3) with the Temperament and Character Inventory (Cloninger, Przybeck, Svrakic, & Wetzel, 1994). By using age at the assessment as a time-variant variable, we applied multilevel modeling for repeated measurements to examine developmental trajectories of compassion from the ages of 20 (the age of the youngest cohort at T1) to 50 (the age of the oldest cohort at T3). On average, compassion increased in a curvilinear pattern with age. Higher acceptance (p = 0.013) and higher emotional warmth (p < 0.001) were related to higher compassion in adulthood. After adjusting for childhood confounds (i.e., participant gender, birth cohort, externalizing behavior, parental socioeconomic status, and parental mental health problems), only emotional warmth (p < 0.001) remained a significant predictor of compassion. Quality of the parent-child-relationship has long-term effects on offspring compassion. An emotionally warm and close relationship, in particular, may contribute to higher offspring compassion in adulthood.

Introduction: The influence of psychotherapy duration on common mental disorder (CMD) outcomes remains a topic of ongoing debate. Whereas most research has focused on CMD symptom change, the evidence on the psychotherapy duration of subsequent CMD‐related work disability and the change in psychotropic drug purchases is scarce. Methods: We used a register‐based cohort representing 33% of the Finnish population. The participants included working‐age individuals (N = 12,047, 76% women, mean age = 36) who initiated long‐term psychotherapy, between 2014 and 2017. They were followed from 2011 to 2021 and psychotherapy duration ranged from less than a year to over 3 years. We used an interrupted time series design to analyze the psychotherapy duration‐dependent changes in CMD‐related work disability (primary outcome, operationalized as depression or anxiety‐related sickness absence, SA, days) and the annual number of psychotropic drug purchases or distinct drugs purchased (secondary outcomes). Results: There were no differences in the levels of work disability or drug purchases before the psychotherapy. We observed a decreasing level and trend in all outcomes across all psychotherapy duration groups. The largest decline in level was observed in the <1‐year duration group (88% decline for SA and 43%–44% for drug purchases) while the smallest decline was in the 3+ years duration group (73% for SA and 27% for drug purchases). Conclusion: Work disability outcomes and duration varied among individuals, even with similar initial mental health‐related work disability or use of auxiliary psychotropic treatments. Compared to longer psychotherapy, shorter psychotherapy was associated with sharper improvements. [ABSTRACT FROM AUTHOR]

Introduction: We examined the associations and proportionate contributions of three well-validated models of stressful psychosocial work environment (job strain, effort-reward imbalance, and organizational injustice) in explaining depressive symptoms among primary school teachers. In addition, we tested the mediating role of different types of sleep problems. Method: The participants included 76 Finnish primary school teachers. The associations between the three work-related psychosocial factors, sleep problems, and depressive symptoms were examined using multiple linear regression analyses and bootstrap mediation analyses, adjusting for gender and age. Relative weight analyses were performed to examine the proportionate contributions of the work-related psychosocial factors on depressive symptoms. Results: Both effort-reward imbalance and job strain showed positive associations with depressive symptoms, whereas the association between organizational injustice and depressive symptoms was not significant. When the proportionate contributions of job strain, effort-reward imbalance, and organizational injustice on depressive symptoms were analysed simultaneously, effort-reward imbalance was found to be the most important predictor. According to bootstrap mediation analyses, sleep problems in terms of nonrestorative sleep explained 18% of the association between job strain and depressive symptoms and 11% of the association between effort-reward imbalance and depressive symptoms. Conclusion: Our findings suggest that, for primary school teachers, particularly effort-reward imbalance but also job strain may be risk factors for depressive symptoms, and that this association might be partly explained by impaired sleep. Adjusting work demands and increasing the rewarding aspects of teachers' work may enhance sleep quality and reduce depressive symptoms in primary school teachers' occupation.

Introduction: Previous studies have shown that manual workers use less psychotherapy than non-manual workers. However, little is known about the match between the use and the need of psychotherapy in different occupational grades. Our study investigates how the prevalence of mental distress corresponds to psychotherapy use rate in different occupational grades by gender. Methods: The data were collected from the Rise of Mental Vulnerability Study (use of psychotherapy) and the FinHealth 2017 Study (prevalence of mental distress). Adjusting for age, we calculated General Health Questionnaire (GHQ-12) caseness (a measure for mental distress), a 3-year psychotherapy use rate, and the ratio between GHQ caseness and the psychotherapy use rate in 3 occupational grades (upper non-manual employees, lower non-manual employees, and manual workers) for men and women separately. Results: In men, for 1 person having used psychotherapy there were 10 persons experiencing mental distress in upper non-manual workers, 14 in lower non-manual workers, and 31 in manual workers. In women, for 1 person having used psychotherapy, there were 6 persons experiencing mental distress in upper non-manual workers, 9 in lower non-manual workers, and 18 in manual workers. Conclusions: At the population level, manual employees use considerably less long-term psychotherapy than upper non-manual workers although their level of mental distress is high. This indicates a mismatch between symptoms and therapy, which was higher for men in all occupational grades. [ABSTRACT FROM AUTHOR]

In recent years, digital health care and social welfare services have been spreading rapidly and partly replacing face-to-face services, particularly in developed countries. This may lead to a pronounced digital inequality. This population-based study of Finnish adults (N = 4495) examined the associations of offline resources with perceived benefits from online services and the mediating effects of access, skills and attitudes in these associations. The results indicated that those with lower personal, economic and social offline resources perceived online services as less beneficial. This was largely explained by poor access to the services, poor digital skills and negative attitudes towards online services. To increase equality, it would be important to improve Internet access and digital skills and implement means to address negative attitudes, especially among vulnerable groups. Moreover, online health and social welfare services should be designed to be more inclusive. [ABSTRACT FROM AUTHOR]

Objectives: Many older adults with depression do not receive adequate treatment. Differences in treatment utilization may reflect the heterogeneous nature of depression, encompassing multiple distinct symptoms. We assessed whether depressive symptoms are differentially associated with subsequent health care utilization with respect to three outcomes as follows: (1) contact with a medical doctor (MD), (2) depression‐specific treatment, and (3) inpatient psychiatric admission. Methods/Design: Longitudinal analyses were based on data from three follow‐up cycles conducted between 2004 and 2013 among 53,139 participants from the Survey of Health, Aging, and Retirement in Europe. Depressive symptoms were self‐reported at baseline of each follow‐up cycle using the 12‐item EURO‐D scale. Health care utilization was self‐reported at the end of each follow‐up cycle. Results: After adjustment for sex, age, country of interview, follow‐up time, educational attainment, presence of a partner in household, body‐mass index, the number of chronic diseases, disability, average/prior frequency of contact with an MD, and all other depressive symptoms, people with more frequent contact with an MD had most often reported sleep problems (IRR = 1.10) and fatigue (IRR = 1.10), followed by sad/depressed mood, tearfulness, concentration problems, guilt, irritability, and changes in appetite. Those treated for depression had most often reported sad/depressed mood (OR = 2.18) and suicidal ideation (OR = 1.72), but also sleep problems, changes in appetite, fatigue, concentration problems, hopelessness, and irritability. Sad/depressed mood (OR = 2.87) was also associated with psychiatric inpatient admission. Similarly to other outcomes, appetite change, fatigue, and sleep problems were associated with inpatient admission. Conclusions: Specific symptoms of depression may determine utilization of different types of health care among elderly. [ABSTRACT FROM AUTHOR]

Cross‐cultural competence is an essential component of the nursing profession, but little is known about the specific psychosocial work characteristics that potentially promote or hinder such competence. In the present study, psychosocial work characteristics were based on Karasek's Job Demand—Control Model. The researchers examined whether Karasek's psychosocial work characteristics, such as high‐strain jobs, high‐strain isolated jobs, active jobs, and active collective jobs, are associated with cross‐cultural competence (empathy, skills, positive attitudes, and motivation), and whether there are differences between native and foreign‐born registered nurses (RN) in these potential associations. A random sample of 744 native RNs (91.0% women) and a total sample (n = 212) of foreign‐born RNs (94.3% women) working in Finland were used. Data were collected using a questionnaire and analyzed with a series of multiple linear regression analyses. High‐strain and high‐strain isolated jobs were negatively associated with all four dimensions of cross‐cultural competence. Active collective jobs, but not active jobs, were positively associated with cross‐cultural skills. There were no differences between native and migrant nurses in these associations. The psychosocial work environment is associated with cross‐cultural competence in both native and migrant nurses. Improvements in psychosocial working conditions, especially minimizing negative factors in the work environment, such as high‐strain and high‐strain isolated jobs, may need to be considered as a part of the efforts aimed to enhance cross‐cultural competence among nursing personnel. [ABSTRACT FROM AUTHOR]

Sociability is a widely studied trait that has been linked both with individual well- and ill-being. Although early childcare has been shown to affect social competence in children, its role in the development of different aspects of adulthood sociability is poorly understood. Using a longitudinal population-based sample (N = 464), this study investigated whether childcare arrangements at ages 3 or 6 are associated with self-reported adulthood sociability at ages 20 to 35 years. A total of five aspects of sociability were measured using three well-established personality inventories (EAS, NEO-FFI, and TCI). Multilevel modeling was applied to examine the association between early care and adulthood sociability, adjusting for several sources of random variation (between-individual variance, within-individual variance between measurement times, variance between used sociability indicators, and error variance that cannot be attributed to the previously mentioned) and potential confounders (disruptive behavior in childhood, parental socio-economic status, parent–child relationship quality, maternal age, and the number of children in the family). Based on our results, in comparison to home care, family daycare and center-based daycare at age 3 and center-based daycare at age 6 were associated with higher sociability later in life. The association was strongest for aspects of sociability that emphasize the willingness to be surrounded by other people and to be attached to them. In other words, characteristics of early care may contribute uniquely to the development of these aspects of sociability with effects that persist into adult life. [ABSTRACT FROM AUTHOR]

Objectives: Although cross-sectional investigations have found a bifactor structure of psychiatric comorbidity that includes a general psychopathology factor plus more specific factors, prospective evidence supporting the bifactor structure is still limited. We evaluated the structural stability (i.e., longitudinal invariance) of the bifactor model in comparison to an alternative structure, a correlated factors model without a general psychopathology factor. We also investigated the models' generalizability to change processes in psychopathology. Methods: The analyses were conducted on 10-year follow-up data from 5,001 respondents in the US National Comorbidity Survey. Invariance was evaluated through a series of nested invariance tests using confirmatory factor analysis, and the models' generalizability to change processes was investigated using change scores of disorder status. Results: The bifactor model and the correlated factors model exhibited an equal degree of strong structural stability over time. Only the bifactor model satisfactorily characterized the structure of temporal changes in psychopathology. Conclusions: The bifactor structure with a general psychopathology factor is stable over time and describes temporal changes in psychopathology. The findings support the notion that the general psychopathology factor describes a transdiagnostic etiology and may therefore provide a useful target for intervention and treatment. [ABSTRACT FROM AUTHOR]

Background: Despite the documented importance of dispositional compassions for a range of health-related outcomes, its role in predicting health behaviors remains unclear.Purpose: This study examined the associations between dispositional compassion and three domains of health behavior, including physical activity, alcohol use, and smoking.Methods: The participants (N = 1,279-1,913) were from the Finnish population-based Young Finns study. We collected self-reports of compassion in 1997 and 2011 and health behaviors in 2001, 2007, and 2011. In addition, an objective pedometer measure of physical activity was collected in 2011. Linear and logistic regression models were fitted to estimate the cross-sectional and longitudinal associations between compassion and the health behavior outcomes.Results: In a cross-sectional analysis, compassion was associated with having never smoked and a reduced likelihood of at-risk alcohol use and binge drinking. There was no robust association between compassion and physical activity. In longitudinal analyses over a 14-year period, the associations remained for at-risk alcohol use and binge drinking.Conclusions: Dispositional compassion may have a protective effect against unhealthy behaviors, especially excessive alcohol consumption. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study is to examine the feasibility of using survey data to identify factors that predict commute mode choice., Design: The study design is cross-sectional., Setting: Survey data from the Finnish Public Sector study (2020) were used., Participants: 42 574 public sector employees, of whom 10 983 were selected for the final sample. These included employees with 5 km or less commuting distances and those working full-time onsite or partly remotely. The mean age was 46 (SD 11) years, and 84% were women., Primary Outcomes: Commute by (1) bike or foot (an active mode) during summer and winter weather and (2) by car (a passive mode) during summer and winter weather., Methods: Using logistic Lasso (least-absolute-shrinkage-and-selection-operator) regression, we developed and tested a prediction model for short commutes of 5 km or less to identify the characteristics of employees most likely to commute actively during summer and winter weather and passively during summer and winter weather., Results: All models had a good predictive ability with a C-index of 0.82, 0.77, 0.72 and 0.71. Cycling and walking during summer weather were predicted by shorter commutes, higher physical activity, lower body mass index (BMI), female sex and higher team psychological safety. Predictors of cycling and walking during winter weather were shorter commute length, higher physical activity, lower BMI and higher age. Commuting by car during summer weather was predicted by longer journey length, higher BMI, lower physical activity, male sex and having children 7-18 years old living at home. Predictors of driving during winter weather were almost identical, but the male sex was replaced by having a spouse., Conclusions: We identified the correlates of active and passive commute choice in different weather conditions with eight variables. This information can be used to develop and target interventions to promote sustainable and healthy commuting modes., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY. Published by BMJ.)

Objectives: The Abilitator is a recently developed self-reported measurement tool for work ability and functioning of people in a weak labour market position. The aim of this study was to describe how self-reported information gathered with the Abilitator corresponds to information drawn from national registers., Design, Setting and Participants: Participants (n=669, mean age 44 years, 55% women) took part in the Work Ability Programme (2020-2023) that provided services for unemployed people with reduced work ability. They filled in the Abilitator questionnaire at the start of the service. Register-based data on participants' health, income and received benefits was drawn from national registers. We evaluated how the different types of indicators concurred., Results: Statistically significant correlations (from weak to moderate) were found between different domains of the Abilitator and register-based data. Also, participants' health status (information on mental health or musculoskeletal disorders) was displayed coherently in the results of the Abilitator. Overall, diagnosed mental health disorders distinguished participants' Abilitator responses more strongly than diagnosed musculoskeletal disorders., Conclusions: These findings provide further evidence on the applicability of the Abilitator as an instrument to evaluate work ability and functioning of people outside the work force., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)