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Aims: This study aims to describe the experiences of women with gynaecological cancer regarding family‐oriented care (FOC) and how they rated their health‐related quality of life (HRQoL) using a 15D instrument (15D©). Design: A cross‐sectional mixed‐method study. Methods: The data were collected by electronic surveys of two Finnish cancer associations from gynaecological cancer patients (n = 53). The qualitative data were analysed using thematic analysis. The HRQoL answers were analysed statistically using IBM SPSS Statistics (Version 27). Results: The results emphasized that FOC is not yet part of the care process. Furthermore, comprehensive encounters are lacking, and the experience of being a woman is forgotten during the care process. The results of the HRQoL analysis suggest that distress and the discomfort and symptoms of cancer patients are perceived as significant factors affecting their quality of life during different phases of treatment. Family status also has an impact on perceived quality of life, whereby those living alone gave worse ratings for the depression and vitality dimensions. Conclusion: In part, the quantitative and qualitative data supported each other, but the descriptions provided a more comprehensive view of issues that affect women in a more multidimensional way, such as sexual health issues. More research on the effectiveness of FOC is needed to develop the capacity for effective healthcare. Implications for the Profession and/or Patient Care: This study was able to identify important areas for improvement in clinical practice from the perspective of patients and their families. Reporting Method: This study was prepared and reported according to the STROBE checklist. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Background: Health professionals should receive lifelong education to maintain competency in medication administration and ensure safe medical practice. Game-based education is one way to enhance and ensure health professionals' medication competency. Objectives: This study aimed to describe registered nurses' experiences of the Imagine 3D game and their views of the effectiveness of this game-based education program in improving their medication competency. Methods: This qualitative interview study included eight registered nurses who completed an education program based on the 3D game Imagine, which aims to strengthen medication administration competency. Data were collected via semi-structured interviews between March and April 2019 and analyzed using content analysis. Results: Three themes were extracted from the study with the following concepts: (1) experiences of playing; (2) the usability of the game in verifying nurses' medication competency; and (3) the game's effectiveness in fostering registered nurses' medical competency. On analyzing the nurses' personal experiences, the game-based education program was valuable in training nurses to enhance their medication administration competency. Participants reported that the game was comfortable to play and useful in repeated medication administration tasks, and it increased their self-reflection and even changed their actions based on learning. The nurses reported that the game was most beneficial to nursing students and recent graduates and was used especially during the introductory period. Moreover, based on the interviews, the game was also useful in continuing education; therefore, it should be applied in all healthcare professionals' training. Conclusions: This study shows that a 3D computer game can be useful for nurses to foster their knowledge and expertise in medication administration tasks. [ABSTRACT FROM AUTHOR]

Background and Purpose: Currently, there is no available Finnish version of the Genomic Nursing Concept Inventory tool (GNCI). This study tested the validity, reliability, and clinical usability of a Finnish translation. Methods: A decision tree algorithm was used to guide the translation, as per International Society for Pharmacoeconomics and Outcomes Research guidelines. Item-Content Validity Index (I-CVI), modified kappa (k*) statistics, and Cronbach's alpha were calculated. Results: The I-CVI and k* values were "good" to "excellent" (I-CVI = 0.63–1.00, k* = 0.52–1.00), and Cronbach's alpha value was "good" (α = 0.816; 95% confidence interval: 0.567–0.956). Conclusion: The Mandysova's decision tree algorithm provided clear and rigorous direction for the translation and validity of the Finnish GNCI [ABSTRACT FROM AUTHOR]

Aim: This integrative review aimed to describe the perceptions of the quality of care of older patients (aged 65 and above) living with cancer in acute‐care settings. Methods: We identified relevant research suitable for inclusion criteria through systematic searches of the PubMed®, EBSCOhost Academic Search Premier®, Scopus® and Web of Science® databases. The Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) framework and the Synthesis Without Meta‐analysis (SWiM) guidelines were used to conduct the research and report the results. The quality of the studies was evaluated using the modified Critical Skills Appraisal Programme (CASP) checklist. Results: A total of 24 studies met the inclusion criteria. The data analysis revealed that care quality could be described through three distinct themes: individuality, a sense of security and respectful encounters. Conclusion: The perceptions of older people living with cancer regarding the quality of acute care have not been extensively covered in the literature. Health‐ and age‐related challenges, patients' overall life situation, clear, realistic information about care and the future and respect during encounters should be given attention. Implications for practice: Patient‐centred and tailored care, considering the heterogeneity of the population and support for independence, is needed. [ABSTRACT FROM AUTHOR]

Aims: To investigate women's childbirth experiences and their relation to self‐esteem development in the postpartum year. Design: A mixed methods study. Methods: Women (N = 125) completed survey questionnaires regarding their self‐esteem and childbirth experiences at three time points in 2020–2021: third trimester of pregnancy (T1), 4–8 weeks postpartum (T2) and 1 year postpartum (T3). The survey results were analysed using qualitative thematic and quantitative path analyses with latent change factors. The open‐ended answers of the women who demonstrated a change in self‐esteem between T2 and T3 were then compared. The STROBE checklist was used as the reporting guideline. Results: The quantitatively measured childbirth experiences predicted statistically significantly and positively the changes in self‐esteem in the following year. The women described their childbirth stories through three main themes: childbirth as a lived experience, childbirth as a relational event and childbirth as a medical event. On the basis of the thematic analysis, we propose that the relationship between childbirth experience and self‐esteem development might only hold for women with extremely positive or negative childbirth experiences. There were mixed results for those women who had mixed experiences, indicating that other factors probably contributed to the changes in self‐esteem. Conclusion: Childbirth is a pivotal event that may have lasting effects on the mother's self‐esteem after childbirth. Especially women with traumatic experiences deserve attention because they are at risk of the most negative consequences. Impact Perinatal services and policy makers must recognize the importance of childbirth experiences in women's well‐being and improve their practices. Different cultural models of childbirth should be recognized and supported to facilitate good experiences and prevent traumatic ones. Patient or Public Contribution: Service users recruited in Finnish Child Health Centers responded to surveys that were used as data for this study. [ABSTRACT FROM AUTHOR]

Aims: (1) To identify and analyse the conceptual framework and operationalise the concept of communication issues related to medication incidents in hospital to facilitate the development of a future tool for measuring frequencies of the communication issues. (2) To determine how the concept is distinct from related concepts. Design: Concept analysis. Data sources: Twenty‐three articles from seven scientific databases covering the years 2010–2020 and two official documents. Methods: Walker and Avant's concept analysis method was used. That was started by a systematised literature review on 2 November 2020 using specified criteria. Two authors evaluated articles' quality by Joanna Brigg's Institute's criteria. Literature review results were analysed deductive‐inductively; conceptual framework was developed and concept defined presenting case scenarios. EQUATOR's standards were used in study reporting. Results: A conceptual framework and the concept of 'communication related to medication incidents in hospitals' were defined, comprising six main attribute categories: (1) communication dyads involved in communication, (2) patients' or professionals' individual issues, (3) institutional, (4) contextual and process issues, (5) communication concerning medication prescriptions and (6) qualitative characteristics of communication. The categories consisted of 128 quantitatively measurable and 10 qualitative attributes describing communication issues. The concept is distinct from related concepts by collating fragmented communication issues into the same concept. Conclusion: The 128‐item conceptual framework and the concept of communication related to medication incidents in hospitals were defined, as there was not one. The concept assembled parts of previous theories and fragmented information to one entity. The concept needs further condensing and validation to develop a tool for measuring communication issues. Impact on medication safety: The conceptual framework can be used in practice and education as indicative rationale for reflection of current communication issues. The concept contributes to research by providing necessary grounding for tool development for measuring communication factors relating medication incidents. [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]

Copyright of Journal of Advanced Nursing (John Wiley & Sons, Inc.) is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aims: This research was conducted to examine psychiatric nursing managers' attitudes towards containment methods. Background: Nursing management is regarded as a key issue in the reduction of coercion and containment. However, there has been little research on managers' attitudes towards containment methods. Methods: This descriptive, cross‐sectional study utilized a survey design. Finnish inpatient psychiatric nursing managers (n = 90) completed the Attitudes to Containment Measures Questionnaire (ACMQ). The results were described with statistics, and the associations between attitudes and background variables were analysed using parametric tests. Results: Psychiatric nursing managers had the most negative attitude towards net bed and mechanical restraint, and the most positive attitudes towards as necessary medication and intermittent observation. A few associations were discovered between attitudes and background variables such as gender and number of employees. Conclusions: In general, Finnish psychiatric nursing managers' attitudes towards containment methods seem to be quite negative, but more research is needed. Implications for Nursing Management: This study provides fresh and unique data on the attitudes of psychiatric nursing managers towards containment methods. Managers' attitudes are important because of their ability to encourage investment in coercion reduction by nursing staff. [ABSTRACT FROM AUTHOR]

Purpose: (a) To describe trigger terms that can be used to identify reports of inadequate staffing contributing to medication administration errors, (b) to identify such reports, (c) to compare the degree of harm within incidents with and without those triggers, and (d) to examine the association between the most commonly reported inadequate staffing trigger terms and the incidence of omission errors and "no harm" terms. Design and Setting: This was a retrospective study using descriptive statistical analysis, text mining, and manual analysis of free text descriptions of medication administration–related incident reports (N = 72,390) reported to the National Reporting and Learning System for England and Wales in 2016. Methods: Analysis included identifying terms indicating inadequate staffing (manual analysis), followed by text parsing, filtering, and concept linking (SAS Text Miner tool). IBM SPSS was used to describe the data, compare degree of harm for incidents with and without triggers, and to compare incidence of "omission errors" and "no harm" among the inadequate staffing trigger terms. Findings: The most effective trigger terms for identifying inadequate staffing were "short staffing" (n = 81), "workload" (n = 80), and "extremely busy" (n = 51). There was significant variation in omission errors across inadequate staffing trigger terms (Fisher's exact test = 44.11, p <.001), with those related to "workload" most likely to accompany a report of an omission, followed by terms that mention "staffing" and being "busy." Prevalence of "no harm" did not vary statistically between the trigger terms (Fisher's exact test = 11.45, p = 0.49), but the triggers "workload," "staffing level," "busy night," and "busy unit" identified incidents with lower levels of "no harm" than for incidents overall. Conclusions: Inadequate staffing levels, workload, and working in haste may increase the risk for omissions and other types of error, as well as for patient harm. Clinical Relevance: This work lays the groundwork for creating automated text‐analytical systems that could analyze incident reports in real time and flag or monitor staffing levels and related medication administration errors. [ABSTRACT FROM AUTHOR]

A cross-sectional study was conducted with a convenience sample (N = 3,093) of Finnish and Italian registered nurses to identify differences related to generation, country, gender, and educational level in their perceptions and opinions about workplace-related dimensions of nursing and their managers' leadership practices. The Multidimensional Nursing Generations Questionnaire (MNGQ) and two subscales of the Transformational Leadership Scale (TLS), "Feedback and Rewards" and "Professional Development," were used as survey tools. Data were analyzed with descriptive and inferential statistics. Statistically significant (p <.05) generational and country differences emerged in the MNGQ components "Conflicts between generations," "Patient safety view," "Relationships between generations," "Working as a multigenerational team," "Orientation to change," "Intention to leave," and "Flexibility and availability." Generational and country differences also emerged for the two TLS subscales. Generational differences existed between registered nurses of different generations and countries, and should be considered in leading multigenerational nurses' workforces. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Advanced Nursing (John Wiley & Sons, Inc.) is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aim: To characterize registered nurses' (RNs') perceptions of nurse leaders' transformational leadership (TL) qualities in Finnish university hospitals and identify predictors of positive and negative evaluations. Background: Transformational leadership can improve health care but requires development. Information on TL is typically derived from survey results, which are vulnerable to confounders. Method: Cross‐sectional survey. Registered nurses' perceptions of nurse leaders were measured with the TL scale. Kohonen's self‐organizing map was used to cluster the data based on RNs' opinions and questionnaire items. Logistic regression explained background characteristics' effects on cluster formation. Results: A total of 1,970 RNs participated and evaluated their nurse leaders' TL qualities as moderate. Giving feedback and rewarding clustered separately from other TL qualities. Females and permanent workers evaluated nurse managers more negatively but nurse directors positively. Positive perceptions of nurse managers' TL predicted better TL among nurse directors. Vice nurse managers gave the most positive evaluations. A total of 197 RNs had no opinions about nurse directors' TL. Conclusions: Registered nurses evaluated nurse managers' TL qualities as moderate and were unfamiliar with nurse directors. Background characteristics affecting evaluations differed between leader types. Implications for Nursing Management: Giving feedback and rewarding should be more closely associated with other TL qualities. Transformational leadership requires transformational approaches from both nurse managers and directors. [ABSTRACT FROM AUTHOR]

No studies have examined the association between patient satisfaction and the allocation of nursing care hours using a workload management system. The aim of this study is to examine the correlation between inpatients' perceived satisfaction with nursing care and nursing workload management in a Singapore hospital. A secondary data analysis was performed based on the results of 270 patients' perceived satisfaction measured by the Revised Humane Caring Scale and nursing workload management data extracted from the TrendCare Patient Acuity System. Data were collected from March to October 2013. There were weak positive (rs = .212 to rs = .120) and negative (rs = -.120 to rs = -.196) correlations between patient satisfaction and nursing workload. Nursing leaders should build positive work environment through maximizing efficient resource allocation and adequate staffing to deliver safe patient care. Future studies could involve other patient outcomes such as incidences of fall and pressure ulcer. [ABSTRACT FROM AUTHOR]

Abstract: Aims: The aim of this study was to describe and summarize workplace characteristics of three nursing generations: Baby Boomers, Generations X and Y. Background: Generational differences affect occupational well‐being, nurses’ performance, patient outcomes and safety; therefore, nurse managers, administrators and educators are interested increasingly in making evidence‐based decisions about the multigenerational nursing workforce. Design: Mixed‐method systematic review. Data sources: Medline, CINAHL, PsycINFO and Scopus (January 1991–January 2017). Review methods: (1) The Joanna Briggs Institute's method for conducting mixed‐method systematic reviews; (2) the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses and (3) the Enhancing Transparency in Reporting the Synthesis of Qualitative Research guidelines. The studies’ methodological quality was assessed with the Mixed‐Methods Appraisal Tool. Quantitative and mixed‐method studies were transformed into qualitative methods using a convergent qualitative synthesis and qualitative findings were combined with a narrative synthesis. Results: Thirty‐three studies were included with three main themes and 11 subthemes: (1) Job attitudes (work engagement; turnover intentions, reasons for leaving; reasons, incentives/disincentives to continue nursing); (2) Emotion‐related job aspects (stress/resilience; well‐being/job satisfaction; affective commitment; unit climate; work ethic) and (3) Practice and leadership‐related aspects (autonomy; perceived competence; leadership relationships and perceptions). Baby Boomers reported lower levels of stress and burnout than did Generations X and Y, different work engagement, factors affecting workplace well‐being and retention and greater intention to leave compared with Generation Y, which was less resilient, but more cohesive. Conclusion: Although several studies reported methodological limitations and conflicting findings, generational differences in nurses’ job attitudes, emotional, practice and leadership factors should be considered to enhance workplace quality. [ABSTRACT FROM AUTHOR]

Aim: To examine reward type preferences and their relationships with the significance of rewarding perceived by registered nurses in Finland. Background: Previous studies have found relationships between nurses' rewarding and their motivation at work, job satisfaction and organisational commitment. Methods: Data were collected in a cross‐sectional, descriptive, questionnaire survey from 402 registered nurses using the Registered Nurses' Perceptions of Rewarding Scale in 2015, and analysed with descriptive and multivariate statistical methods. Results: Registered nurses assigned slightly higher values to several non‐financial than to financial rewards. The non‐financial reward types appreciation and feedback from work community, worktime arrangements, work content, and opportunity to develop, influence and participate were highly related to the significance of rewarding. Conclusions: We identified various rewards that registered nurses value, and indications that providing an appropriate array of rewards, particularly non‐financial rewards, is a highly beneficial element of nursing management. Implications for Nursing Management: It is important to understand the value of rewards for nursing management. Nurse managers should offer diverse rewards to their registered nurses to promote excellent performance and to help efforts to secure and maintain high‐quality, safe patient care. The use of appropriate rewards is especially crucial to improving registered nurses' reward satisfaction and job satisfaction globally in the nursing profession. [ABSTRACT FROM AUTHOR]

Aims and objectives To evaluate the impact of implementing an evidence-based, structured preoperative protocol on day of surgery cancellations in 13 operative specialties. Background Surgery cancellations cause unnecessary harm for patients and organisations as many cancellations could be prevented. Preoperative care has developed in recent years, and several preoperative interventions have been introduced. However, the optimal model for organising preoperative care remains unknown. Cancellations are a commonly used indicator when evaluating the success of preoperative care. Design Observational study with two study phases: before and after. Methods The cancellation data were collected from the hospital register from 1 September 2013-31 May 2014 ( n = 591) and from September 2015-May 2016 ( n = 542). The compliance rate of the preoperative protocol was evaluated in group sessions ( n = 13) during spring 2016 using the participation of preoperative healthcare professionals ( n = 49). The data were analysed statistically. Results Cancellation rates varied between 1.6%-9.7% (in the first phase) and between 1.5%-7.7% (in the second phase). A remarkable decrease was found in patients who failed to attend their scheduled procedures. The mean of compliance to the preoperative protocol across all specialties was 82.3%. A correlation between the rate of cancellation and the rate of compliance with the preoperative protocol was found. Conclusions A preoperative protocol promotes the scheduled arrival of surgical patients to the hospital and therefore decreases cancellation rates. Relevance to clinical practice An evidence-based preoperative care protocol should be introduced for all healthcare professionals working in preoperative care to ensure smooth, safe and high-quality care for surgical patients. [ABSTRACT FROM AUTHOR]

Aims and objectives To describe ways of preventing medication administration errors based on reporters' views expressed in medication administration incident reports. Background Medication administration errors are very common, and nurses play important roles in committing and in preventing such errors. Thus far, incident reporters' perceptions of how to prevent medication administration errors have rarely been analysed. Design and Methods This is a qualitative, descriptive study using an inductive content analysis of the incident reports related to medication administration errors ( n = 1012). These free-text descriptions include reporters' views on preventing the reoccurrence of medication administration errors. The data were collected from two hospitals in Finland and pertain to incidents that were reported between 1 January 2013 and 31 December 2014. Results Reporters' views on preventing medication administration errors were divided into three main categories related to individuals (health professionals), teams and organisations. The following categories related to individuals in preventing medication administration errors were identified: (1) accuracy and preciseness; (2) verification; and (3) following the guidelines, responsibility and attitude towards work. The team categories were as follows: (1) distribution of work; (2) flow of information and cooperation; and (3) documenting and marking the drug information. The categories related to organisation were as follows: (1) work environment; (2) resources; (3) training; (4) guidelines; and (5) development of the work. Conclusions Health professionals should administer medication with a high moral awareness and an attempt to concentrate on the task. Nonetheless, the system should support health professionals by providing a reasonable work environment and encouraging collaboration among the providers to facilitate the safe administration of medication. Relevance to clinical practice Although there are numerous approaches to supporting medication safety, approaches that support the ability of individual health professionals to manage daily medications should be prioritised. [ABSTRACT FROM AUTHOR]

In Finland, the Mental Health Act determines the legal basis for seclusion and restraint. Restrictive measures are implemented to manage challenging situations and should be used as a last resort in psychiatric inpatient care. In the present study, we examined the reasons for seclusion and restraint, as well as whether any de-escalation techniques were used to help patients calm down. Seclusion and restraint files from a 4-year period (1 June 2009-31 May 2013) were retrospectively investigated and analysed by content analysis. Descriptive statistics were calculated. A total of 144 episodes of seclusion and restraint were included to analyse the reasons for seclusion and restraint, and 113 episodes were analysed to examine unsuccessful de-escalation techniques. The most commonly-used techniques were one-to-one interaction with a patient ( n = 74, 65.5% of n = 113) and administration of extra medication ( n = 37, 32.7% of n = 113). The reasons for seclusion and restraint were threatening harmful behaviour ( n = 51, 35.4% of n = 144), direct harmful behaviour ( n = 43, 29.9%), indirect harmful behaviour ( n = 42, 29.1%), and other behaviours ( n = 8, 5.6%). In general, the same de-escalation techniques were used with most patients. Most episodes of seclusion or restraint were due to threats of violence or direct violence. Individual means of self-regulation and patient guidance on these techniques are needed. Additionally, staff should be educated on a diverse range of de-escalation techniques. Future studies should focus on examining de-escalation techniques for the prevention of seclusion. [ABSTRACT FROM AUTHOR]

Aims. The aim of this study was to determine nurses' readiness for evidence-based practice at Finnish university hospitals. Background. Although systematic implementation of evidence-based practice is essential to effectively improving patient outcomes and value of care, nurses do not consistently use evidence in practice. Uptake is hampered by lack of nurses' individual and organizational readiness for evidence-based practice. Although nurses' evidence-based practice competencies have been widely studied in countries leading the evidence-based practice movement, less is known about nurses' readiness for evidence-based practice in the non-English-speaking world. Design. A cross-sectional descriptive survey design. Methods. The study was conducted in November-December 2014 in every university hospital in Finland with a convenience sample (n = 943) of practicing nurses. The electronic survey data were collected using the Stevens' Evidence-Based Practice Readiness Inventory, which was translated into Finnish according to standardized guidelines for translation of research instruments. The data were analysed using descriptive and inferential statistics. Results. Nurses reported low to moderate levels of self-efficacy and low levels of evidence-based practice knowledge. A statistically significant, direct correlation was found between nurses' self-efficacy in employing evidence-based practice and their actual evidence-based practice knowledge level. Several statistically significant differences were found between nurses' socio-demographic variables and nurses' self-efficacy in employing evidence-based practice, and actual and perceived evidence-based practice knowledge. Conclusions. Finnish nurses at university hospitals are not ready for evidence-based practice. Although nurses are familiar with the concept of evidence-based practice, they lack the evidence-based practice knowledge and self-efficacy in employing evidence-based practice required for integrating best evidence into clinical care delivery. [ABSTRACT FROM AUTHOR]

Aim To examine the relationship between nurse staffing and patient length of stay in an acute-care hospital over a 1-year period. Background Although there has been prior research on the relationship between nurse staffing and length of stay in acute-care hospitals, there is a need for more information on how nurse staffing is related to length of stay longitudinally. Methods Retrospective time-series registry data from 20 acute-care inpatient units of a Finnish university hospital as a monthly time series in 2008 were analysed by linear mixed models. Results The ratio of registered nurses to all nurses was 72.4%. Nurses worked mainly (96%) full time, and 63% had permanent employment contracts. Statistically significant variation was found in time series of five variables. Statistically significant relationships were found between length of stay and patient acuity, diagnosis-related group-volume, census and nursing hours per patient day at the unit level. Nursing hours per patient day had the strongest correlation with length of stay. Conclusion and implications for nursing management A rational response to the variations in patient care needs and intensity in the complex care environment is flexible nurse staffing. Increasing nursing hours per patient day to achieve shorter length of stays is not the only solution, well-functioning care processes are also essential. [ABSTRACT FROM AUTHOR]

Aims To study the effects of scale type (visual analogue scale vs. Likert), item order (systematic vs. random), item non-response and patient-related characteristics (age, gender, subjective health, need for assistance with filling out the questionnaire and length of stay) on the results of patient satisfaction surveys. Background Although patient satisfaction is one of the most intensely studied issues in the health sciences, research information about the effects of possible instrument-related confounding factors on patient satisfaction surveys is scant. Design A quasi-experimental design was employed. A non-randomized sample of 150 surgical patients was gathered to minimize possible alterations in care quality. Methods Data were collected in May-September 2014 from one tertiary hospital in Finland using the Revised Humane Caring Scale instrument. New versions of the instrument were created for the present purposes. In these versions, items were either in a visual analogue format or Likert-scaled, in systematic or random order. The data were analysed using an analysis of covariance and a paired samples t-test. Results The visual analogue scale items were less vulnerable to bias from confounding factors than were the Likert-scaled items. The visual analogue scale also avoided the ceiling effect better than Likert and the time needed to complete the visual analogue scale questionnaire was 28% shorter than that needed to complete the Likert-scaled questionnaire. Conclusion The present results supported the use of visual analogue scale rather than Likert scaling in patient satisfaction surveys and stressed the need to account for as many potential confounding factors as possible. [ABSTRACT FROM AUTHOR]

In this study, we examined the validity and reliability of the Revised Humane Caring Scale as used by adult patients in a tertiary hospital in Singapore. A three-phase descriptive quantitative study was conducted. In phase I, an expert panel of nurses and inpatients examined the content validity of the scale; phase II comprised a pilot study on 20 patients; and in phase III, a large-scale study on 235 patients was implemented to test the internal consistency of the scale. The results revealed that the content validity index of the scale ranged from 0.856 to 1, and the scale had a high inter-rater agreement kappa value of 0.940. Cronbach's alpha ranged from 0.798 to 0.877 in phase II, and from 0.579 to 0.760 in phase III, respectively. The Revised Humane Caring Scale revealed good content validity and an acceptable level of internal consistency. The scale is an acceptable measurement tool for evaluating adult patients' satisfaction during hospitalization. [ABSTRACT FROM AUTHOR]

Aim To examine newly hired nurses' and physicians' perceptions of their orientation process in two Finnish hospitals, and to explore correlations between the background variables and the four aspects of a comprehensive orientation process. Background Internationally, health care organisations are being challenged to recruit and retain a competent workforce. Although health care orientation programmes increase retention and provide safe and quality care, studies examining it are limited. Method A cross-sectional, descriptive questionnaire survey of registered nurses ( n = 145) and physicians ( n = 37) working in two specialised hospital settings was conducted in 2009-2010. Result Nurses' and physicians' perceptions regarding the orientation process ranged from low to moderate. The results showed that 'appointed preceptor', 'duration of orientation' and 'profession' correlated positively and significantly with a comprehensive orientation process. Conclusion The orientation process needs to be updated constantly and refined by evaluation data. In addition, incentives and effective support from the hospital organisation must be considered in order to perform the orientation process in a more comprehensive manner. Implications for nursing management The results indicate that investment is needed to improve the orientation process in health care. Health care managers are in a crucial position to support the orientation process in practice and value it as a retention strategy. [ABSTRACT FROM AUTHOR]

Aims: The epidemiological aim was to draw a general picture of spatial patterns of diseases, socio-demographics, and land use in Finland to detect possible under-recognized associations between the patterns. The methodological purpose was to compare and combine two statistical techniques to approach the data from different viewpoints. Methods: Two different statistical methods, the self-organizing map and principal coordinates of neighbor matrices with variation partitioning, were used to search for spatial patterns of 15 non-infectious diseases and 17 direct or indirect risk factors. The dataset was gathered from five Finnish registries and pooled over the years 1991–2010. The statistical unit in the analyses was a municipality (n=303). Results: Variables referring to urban living were related to low incidences of all other diseases but cancer, whereas variables referring to rural living were related to low incidences of cancer and high incidences of other diseases, especially coronary heart disease (CHD), hypertension, diabetes, asthma/chronic obstructive pulmonary disease, and serious mental illnesses at the municipal level. The relationships between diseases other than cancer and risk factors related to socio-demographics and land use variables were stronger than those between cancer and risk factors. Conclusions: The structuration of spatial patterns was dominated by CHD together with land use features and unemployment rate. The relationship between unemployment and spatial health inequalities was emphasized. On the basis of the present study, it is suggested that large heterogeneous datasets are clustered and analyzed simultaneously with more than one statistical method to recognize the most significant and generalizable results. [ABSTRACT FROM PUBLISHER]

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]

The aims of this study were to clarify how a patient's identity was verified before the administration of medication in medical and surgical wards in a hospital, as well as to study the association between patient identification and the registered nurse's work experience, observed interruptions, and distractions. The study material was collected during April and May 2012 in two surgical and two medical wards in one university hospital in Finland, using a direct, structured observation method. A total of 32 registered nurses were observed while they administered 1058 medications to 122 patients. Patients were not identified at all in 66.8% ( n = 707) of medication administrations. Patient identifications were made more often by nurses with shorter work experience in the nursing profession or in the wards (4 years or less), or if distractions existed during medication administration. According to the results, patient identification was not adequately conducted. There is a need for education and change in the culture of medication processes and nursing practice. [ABSTRACT FROM AUTHOR]

This study examined Chinese fathers' feelings about their partners' delivery and views on their presence during labour and birth. A questionnaire survey was conducted with 403 fathers whose partners gave birth in one provincial hospital in China. Data were analysed by descriptive statistics, χ2-test and content analysis. The results indicated that more than 80% of fathers experienced feelings of pride related to fatherhood and of love towards their partners and newborns. Significant differences in fathers' feelings were found between subgroups with regard to age, education, employment, presence in the delivery room, method of birth and whether preparatory visits had been made to the hospital. The majority who answered an open-ended question on the meaning of fathers' presence in the delivery room held a positive attitude towards fathers' presence at labour and birth, as their presence could empower their partners and provide psychological support. This study indicates fathers' presence at delivery and birth is important and that younger fathers need more support. It also provides evidence for clinical practice and future interventions to improve fathers' psychological health and experiences. [ABSTRACT FROM AUTHOR]

The aim of this paper is to analyse how medication incidents are detected in different phases of the medication process. The study design is a retrospective register study. The material was collected from one university hospital's web-based incident reporting database in Finland. In 2010, 1617 incident reports were made, 671 of those were medication incidents and analysed in this study. Statistical methods were used to analyse the material. Results were reported using frequencies and percentages. Twenty-one percent of all medication incidents were detected during documenting or reading the documents. One-sixth of medication incidents were detected during medicating the patients, and approximately one-tenth were detected during verifying of the medicines. It is important to learn how to break the chain of medication errors as early as possible. Findings showed that for nurses, the ability to concentrate on documenting and medicating the patient is essential. [ABSTRACT FROM AUTHOR]

Objective:The objective was to explore mothers’ experiences after assisted reproductive technology (ART).Background:The experience of mothering in women after assisstive reproductions has not been fully understood.Study design:An interpretive phenomenology approach was used to conduct the study.Participants:A purposive sample of nine mothers who had babies through ART participated in the study. Data were collected using semi-structured in-depth interviews.Findings:‘Super-mothering’ was the main theme emerging from the data, describing mothers who wanted to be exceptional by performing all of their mothering responsibilities without fatigue or exhaustion and who were ready to do everything in their power to support the child. This theme incorporates four sub-themes: (1) over-care; (2) over-protection; (3) over-emotional investment; and (4) over-expectation of themselves and others.Conclusion:The challenge to be a mother through ART is a stressful phenomenon, particularly so for the majority who are also first-time mothers. Healthcare professionals need to consider the concept of super-mothering in trying to understand and care effectively for this group. [ABSTRACT FROM PUBLISHER]

Aims and objectives To identify the prevalence, preventability, and severity of adverse drug events in randomly selected adult hospital inpatients, and to study the association between adverse drug events and patient-specific factors. Background Adverse drug events represent one of the major concerns in patient safety. Design A retrospective record review. Methods The study was conducted in an 800-bed university hospital in Finland within a 12-month period. Retrospective reviews of randomly selected discharged patients' ( n = 463) records using the Global Trigger Tool method were undertaken. The prevalence, preventability, and severity of adverse drug events were studied, and the association between patient-specific factors and adverse drug events were examined using a binary logistic regression model and Pearson's chi-squared tests. Results A total of 180 adverse drug events were detected in 125 (27%) patients, of which 74 (41·1%) were preventable, and 94·4% caused temporary harm. An abnormal level of potassium in the blood was the most frequent adverse drug event ( n = 37). The risk of adverse drug events increased with the length of hospital stay and the increased number of drugs patients used. The patients with coronary diseases ( n = 130) had a 2·5 times higher risk of experiencing adverse drug events. In addition, the risk of adverse drug events during hospitalisation increased together with the co-morbidity of patients. Conclusions Adverse drug events were experienced by a quarter of inpatients, while severe adverse drug events were rare. The risk of adverse drug events increased with patients' prolonged hospital stay, polypharmacy, and morbidity. In addition, information of the usefulness of the Global Trigger tool can be used for future development of the method. Relevance to clinical practice Patient-specific risk factors were identified using the Global Trigger Tool method revealing that more efficient monitoring of inpatients with these risk factors may be profitable for decreasing adverse drug events. [ABSTRACT FROM AUTHOR]

Aims This study sought to analyse relationships between nurse staffing and patients' length of stay in acute care units and to determine whether non-linear relationships exist between variables. Background Healthcare systems are complex and it could be assumed that they comprise non-linear associations. However, current planning and evaluation of nurse staffing are based primary on linear reasoning. Design This quantitative study adopted a retrospective longitudinal design. Method Retrospective register data, consisting of information relating to 35,306 patient episodes and administrative information concerning 381 nurses, were used. Data were collected in 2009 from 20 somatic inpatient units at a university hospital in Finland as a monthly time series of 2008 data and analysed using Bayesian dependency modelling. Results Patients' acuity was the most important agent that connected all eleven variables in the dependency network of nurse staffing and short length of stay. Non-linear associations were found between short length of stay and the proportion of Registered Nurses. Skill mix consisting of an average proportion of Registered Nurses (65-80%) was conducive to a short length of stay and predicted a 66% likelihood of short length of stay. Higher and lower percentages of Registered Nurses predicted lower likelihood of short length of stay. Conclusion Flexible nurse staffing is preferable to fixed staffing to provide patients with shorter length of stay in acute care units. In the present research, the Bayesian method revealed non-linear relationships between nurse staffing and patient and care outcomes. [ABSTRACT FROM AUTHOR]

Objective.To explore immigrant Somali women's experiences of reproductive and maternity health care services (RMHCS) and their perceptions about the service providers. Design.Five focus group discussions were conducted from April 1999 to June 2000 using a purposeful sampling strategy in order to reach multiparous female Somali-born Immigrants with experiences from the maternity health care in Finland. Participants.A total of 70 married Somali women aged 18–50 and mother of 2–10 children were studied. Among them, 18 came from Kenya, 32 from Mogadishu and 20 from Hargeysa. Settings.Of the participants, 45 were living in the city of Vantaa, 22 in the city of Helsinki and 13 in the city of Turku. Results.Participants were satisfied with the RMHCS they received in Finland. Despite their satisfaction, the health care providers' social attitudes towards them were perceived as unfriendly, and communication as poor. Conclusions.The women's experiences revealed that they have access to good quality RMHCS in Finland. While their experiences are significant, their perceptions are important for physicians, nurses and midwives in order to achieve culturally competent care. [ABSTRACT FROM PUBLISHER]

Aim To report a trial protocol to determine if a therapeutic play intervention leads to significant reduction in perioperative anxiety, negative emotional manifestations and postoperative pain of children undergoing inpatient elective surgery and in their parents' perioperative anxiety. Background Children undergoing surgery often experience anxiety, exhibit negative emotional manifestations pre-operatively and postoperative pain. Previous studies report that therapeutic play intervention has positive effects on anxiety reduction, while few studies have examined the effects of such intervention on children undergoing major elective surgery. Design Randomized controlled trial with repeated measures is proposed. Methods This study will recruit 106 pairs of 6-14-year-old children undergoing elective surgery in a Singaporean public hospital and their parents (protocol approved in October 2011). Eligible participants will be randomly allocated to either a control group (receiving routine care) or an experimental group (receiving 1-hour therapeutic play intervention plus routine care). Outcome measures include children's anxiety, emotional manifestation and postoperative pain, their parents' anxiety and process evaluation. Data will be collected at baseline (3-7 days before the operation), on the day of surgery and around 24 hours after the surgery. Discussion This study will identify a clinically useful and potentially effective approach to prepare children for surgery by reducing anxiety of both children and their parents during the perioperative period. The reduction of anxiety may lead to reduction of postoperative pain, which will eventually improve the physical and psychological well-being of children. This study was funded by the National Medical Research Council in Singapore. [ABSTRACT FROM AUTHOR]

Nurse managers ( NMs) and registered nurses ( RNs) have key roles in developing the patient safety culture, as the nursing staff is the largest professional group in health-care services. We explored their views on the patient safety culture in four acute care hospitals in Finland. The data were collected from NMs ( n = 109) and RNs ( n = 723) by means of a Hospital Survey on Patient Safety Culture instrument and analyzed statistically. Both groups recognized patient safety problems and critically evaluated error-prevention mechanisms in the hospitals. RNs, in particular, estimated the situation more critically. There is a need to develop the patient safety culture of hospitals by discussing openly about them and learning from mistakes and by developing practices and mechanisms to prevent them. NMs have central roles in developing the safety culture at the system level in hospitals in order to ensure that nurses caring for patients do it safely. [ABSTRACT FROM AUTHOR]

Nurses are generally responsible for administering medication to patients and are, therefore, able to monitor or report medication errors. However, nurses can sometimes be responsible for causing errors, so it is important that they understand the consequences of these mistakes and how to prevent them. This article reports the results of a study that analysed the views of nurses, pharmacists and physicians at a Finnish university hospital on the prevention of medication errors. The findings suggest errors can be prevented by improving work environments and allowing healthcare staff, particularly nurses, to concentrate on the task at hand when dealing with medicines. [ABSTRACT FROM AUTHOR]

Aim The overall aim of this study was to examine nurses' and patients' perceptions of the Magnet model components of transformational leadership and empirical quality outcomes in four Finnish hospitals and to determine if the evidence for transformational leadership and empirical quality outcomes is the same or different in the four hospitals. Background This report presents baseline measurements for a longitudinal study of the adaptation of the Magnet model in Finnish hospitals. Methods Web-based surveys and mailed questionnaires were used in 2008-2009 to collect data from patients ( n = 2566) about their satisfaction with care, and from nursing staff about transformational leadership ( n = 1151), job satisfaction ( n = 2707) and patient safety culture ( n = 925) in the selected hospitals. Results Awareness of the work of nursing leaders was low. Nurses reported a high level of job satisfaction. Patient safety culture varied considerably between the four hospitals. Patients believed they generally received excellent quality care. Conclusions Leadership systems are in transition at the hospitals. Patient safety culture is a complex phenomenon that may be unfamiliar to respondents. The results of the study provide a baseline description to guide the journey toward development of Magnet standards. Implications for nursing management Finnish nursing leaders, especially nursing directors, should increase their visibility by working more closely with their staff. They should also pay attention to giving direct feedback about work generally and patient safety issues in particular. [ABSTRACT FROM AUTHOR]

Family caregivers provide the majority of home care of people with Alzheimer's disease. In this study, we discuss family caregivers' life orientation and changes in life orientation during the first year after the diagnosis of Alzheimer's disease. Family caregivers' unstructured diaries ( n = 83), of the first six months after diagnosis (years 2002-2004), were analyzed using qualitative content analysis. Two core themes emerged from the data analysis: the meaning of the onset of Alzheimer's disease for the lives of family caregivers, and restructuring life in its entirety. Family caregivers face challenges in their life orientation after the onset of their family members' Alzheimer's disease. Their personal milieu, familial cohesion, and conception of the future consequentially change. They face multiple challenges in the process of becoming caregivers. In this study, it was revealed that the process starts before the diagnosis of Alzheimer's disease and has an impact on their future. We conclude that family caregivers' well-being should be assessed at the time of the diagnosis of Alzheimer's disease. [ABSTRACT FROM AUTHOR]

Aims and objectives. To describe the intensive care unit patients' perceptions about the importance of their different needs and how their needs are met in Estonian hospitals, and to determine the correlations between the patients' perceptions and their demographic characteristics and background variables. Background. Meeting needs of patients in intensive care unit is important for avoiding unpleasant experiences and providing patient-centred care. Design. A descriptive questionnaire survey. Methods. The study was performed in sixteen intensive care units (ICUs) in six acute care hospitals in Estonia. Data were collected over six months in 2008 using the structured five-point scale questionnaire Needs of Adult Patients in Intensive Care Unit. The Convenience sample consisted of The adult patients discharged from ICUs to hospital wards able to answer the questionnaire ( n = 166). Data were analysed using descriptive statistics, correlation analysis and statistical tests. Results. Patients' needs varied and were sometimes unmet. The most important needs were physical comfort and feeling safe. Privacy, involvement of family and friends and being involved in decision-making were less important. The more important a need was perceived to be, the better it was met. The need for physical comfort was met best, involvement in decision-making worst. Patients with lower educational level and unscheduled patients agreed more that their needs were met. The better the patients considered their condition when leaving the ICU, the more they agreed that their needs were met. Conclusions. The findings provide a basis for understanding the needs of critically ill adults in Estonian ICUs to provide them more patient-centred care and improve their psychological well-being and quality of life after discharge. Relevance to clinical practice. Identifying and acknowledging the personal needs of patients in intensive care unit is important. When meeting the patients' needs, their individual characteristics should be taken into consideration. [ABSTRACT FROM AUTHOR]

Aim. To investigate the relationships between nursing activities, nurse staffing and adverse patient outcomes in hospital settings as perceived by registered nurses in Finland and the Netherlands and to compare the results obtained in the two countries. Background. Previous research indicates that a higher proportion of registered nurses in the staff mix results in better patient outcomes. Knowledge of the relationship between nurse staffing and adverse patient outcomes is crucial to optimise the management of professional nursing resources and patient care. Design. A cross-sectional, descriptive questionnaire survey. Methods. Registered nurses employed in hospitals in Finland ( n = 535) and the Netherlands ( n = 334), with overall response rates of 44·9% and 33·4%, respectively, participated. Results. The patient-to-nurse ratio was on average 8·74:1 and did not vary significantly between the countries. However, there were fewer registered nurses and significantly more licensed practical nurses among the Dutch hospital staff than the Finnish staff. In addition, Finnish nurses performed non-nursing and administrative activities more frequently than the Dutch nurses and reported more dissatisfaction with the availability of support services. Frequencies of patient falls were related to the patient-to-nurse ratio in both countries. Finnish participants reported the occurrence of adverse patient outcomes more frequently. Conclusions. Significant associations were found between nurse staffing and adverse patient outcomes in hospital settings. Compared with the Netherlands, in Finland, nurses appear to have higher workloads, there are higher patient-to-nurse ratios, and these adverse staffing conditions are associated with higher rates of adverse patient outcomes. Relevance to clinical practice. The findings provide valuable insights into the potential effects of major changes or reductions in nursing staff on the occurrence of adverse patient outcomes in hospital settings. [ABSTRACT FROM AUTHOR]

eneh v.o., vehviläinen-julkunen k. & kvist t. (2012) Journal of Nursing Management 20, 159-169 Nursing leadership practices as perceived by Finnish nursing staff: high ethics, less feedback and rewards Aims The purpose was to examine the perceptions of Finnish nursing staff of their nursing leadership and how nurses' background variables are associated with their perceptions. Background Nursing leadership practices and behaviours influence nursing staff work performances. In Finland, studies examining leadership practices from the perspective of nursing staff are limited. Methods This quantitative, cross-sectional study involved four hospitals in Eastern Finland. A total of 1497 nursing staff completed the structured electronic questionnaire. Results In general, seven out of 10 nursing staff held positive perceptions about leadership ethics and their professional development. Over one-third of nursing staff were dissatisfied with the nursing process and with their feedback and rewards, while only four out of 10 evaluated their nursing director either in a positive or negative way. There were no significant differences regarding their perceptions when different background variables were taken into account. Conclusion Nursing leadership needs the opinion of nursing staff in order to help formulate a favourable work environment where they can utilize their full potential and improve nursing care. Implications for nursing management Nursing staff expect feedback and rewards, involvement in the decision making process, and clear vision from nurse leaders. [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]

Contradictory results have been presented on how music listening affects patients' blood pressure, heart rate, and respiratory rate. The aim of the present study was to evaluate the effects of music listening on blood pressure, heart rate, and respiratory rate on operation day, and on the first, second, and third postoperative days in abdominal surgery patients. Using a quasi-experimental pretest-post-test design, 168 abdominal surgery patients were assigned every second week to the music group ( n = 83) or to the control group ( n = 85) for 25 months. In the music group, the respiratory rate was significantly lower after intervention on both the first and second postoperative days compared with the control group. A significant reduction in systolic blood pressure was demonstrated in the group that received music compared with the control group on both the first and second postoperative days. Evaluation of the long-term effects of music on physiological factors showed that the respiratory rate in the music group was significantly lower compared with the control group. Nurses should offer music listening to surgery patients because of its potential benefit. [ABSTRACT FROM AUTHOR]