Search

Fifty-one young diabetics responded to a questionnaire concerning compliance and were interviewed on two topics: the meaning of care to the subjects and the nature of their support system. Diabetes control was measured by glycosylated haemoglobin (GHB). Interview data were analysed by continuous comparative analyses. The categories obtained were quantified and the relationship between variables analysed by cross tabulation, chi-square test and discriminant analysis. Those who responded with a good compliance showed good control of diabetes as indicated by GHB values and reported sufficient energy and will-power to implement the health regimens. Those young people who reported that they had sufficient energy and will-power considered care important, received encouragement, felt that care brings well-being and had no fears of complications.

Background: Endotracheal-suctioning (ETS) is a procedure that may constitute a risk factor for ventilator-associated pneumonia (VAP) by increasing microbial colonization of the lower airway. Unsafe ETS practices have been observed worldwide during recent years. Because of adverse reactions, practioners need to take all necessary precautions to ensure patient safety and a high quality of nursing care. The aim of the present study was to evaluate critical-care nurses’ performance in relation to current recommendations in their daily practice prior to, during and post ETS events. Methods: A structured, non-participatory, observational study (n=40) was conducted using a 25-item best-practice information sheet to assess critical-care nurses’ ETS practices in a mixed medical-surgical intensive-care unit. One- sample- and independent-samples t -tests were used to compare critical-care nurses’ ETS performance against current recommendations within different ICU experience groups. Results: The quality of observed ETS practices was significantly lower than the required quality of care ( p

This paper presents a hypothetical model of the compliance with self-care of young diabetics, its features, its meaning to them and the preconditions for compliance with self-care. The aim of this research was to develop a model to clarify and expand existing knowledge concerning compliance with self-care among young diabetics and to produce new ideas for planning and implementing this care. Four categories of behavioural pattern were identified. Those young people with good compliance experienced a sense of well-being, health, and freedom. They were responsible, active, and well motivated in voluntarily implementing self-care. The second group were those whose actions deviated only slightly from health regimens but who had undergone many negative experiences with self-care. Their actions were guided only by compulsion. The third group were consciously non-compliant. Their constant neglect of health regimens was associated with feelings of poor health, fears and indifference. They were not motivated to comply, felt that the aims set were too high and the self-care programme too tightly regimented. They felt that they received no encouragement. The young people belonging to the fourth group frankly refused to pursue self-care. Their non-compliance was seen by them as an issue of freedom. In effect, their friends controlled their lives, and they felt that their self-care was all the more unnecessary since nobody encouraged them to keep to it.

Summary Background Ventilator-associated pneumonia (VAP) is the most frequent device-associated, nosocomial infection encountered in critical-care settings, associated with substantial morbidity, a two-fold increase in mortality rates and excess costs. According to previous studies, critical-care nurses' knowledge of and adherence to guidelines for preventing VAP is low in the absence of educational interventions. Aim The aim of this study was to assess the current body of literature regarding the effectiveness of educational programmes, with a focus on learning and clinical outcomes, in order to identify ways to intensify current research. Methods Studies published between 2003 and 2012 contained in seven multi-disciplinary databases (Medline Ovid®, the Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, Scopus, Web of Science, Medic, and Academic Search Premier) were reviewed. A comprehensive literature search strategy was conducted in association with an information specialist. The study selection process was carried out by two researchers independently and objectively. Findings Eight original studies were included in the final review. Increasing the education of intensive care unit (ICU) personnel was linked to a significant improvement in the level of knowledge and adherence to guidelines and significant improvement in clinical outcomes, i.e. decreased incidence of VAP, length of ICU and hospital stays, mortality and costs. Conclusions Education has significant benefits for improving patient safety, and thus the quality of care. Active implementation strategies involving repeated lectures and regular surveys of VAP occurrence would be beneficial. Further research is needed to design multi-centre, randomized, controlled, follow-up studies. Development of a universal method of outcome measurement is required to facilitate further evaluation of the relationship between educational programmes and clinical outcomes.

Aims and objectives To determine the factors that predict the quality of patient counselling from the perspective of hospitalised chronically ill adults. Background In view of the growing number of adults with chronic diseases and a lack of resources in health care, it would be valuable for healthcare professionals to know which factors result in good-quality counselling for such individuals. Design The study used a cross-sectional, descriptive design. Methods Data were collected from chronically ill adults (n = 106) in northern Finland and were analysed using logistic regression. Results Counselling implementation was perceived to be of good quality if it was preplanned (odds ratio = 24·07) and patient-centred (odds ratio = 16·03) and if interaction during counselling (odds ratio = 13·27) was good. Counselling about social support (odds ratio = 14·78), preplanned counselling (odds ratio = 9·69), counselling about the results of investigations (odds ratio = 7·84) and counselling about disease progression (odds ratio = 7·66) were statistically significant predictors of the content being considered good quality. The effects of counselling on disease treatment (odds ratio = 11·33), patient-centred counselling (odds ratio = 9·75) and counselling about the effects of attitudes (odds ratio = 9·52) were statistically significant predictors of highly beneficial counselling. Counselling about the effects of disease treatment (odds ratio = 9·71) and interaction during counselling (odds ratio = 4·91) predicted the quality of counselling materials and methods. Conclusion The results could be used to help healthcare professionals to ensure good-quality counselling by highlighting the areas that are most important to meet the expectations of chronically ill adults. Relevance to clinical practice The results can be used to develop the quality of chronically ill adults' counselling as well as to educate staff to focus better on chronically ill patients' counselling because it is necessary to develop new ways to offer more patient-centred counselling in order to address patients' needs and fit care to patients' lifestyles.

Background: Patient counseling is one of the core elements in healthcare. The number of chronically ill people is increasing, whilst the number of additional stays in hospital that are required has dropped. Thus, there is less time to deliver good-quality patient counseling when they are in hospital. The aim of this study was to describe quality of patient counseling chronically ill patients’ in the hospital. Methods: This study used a cross-sectional design. A convenience sample (n=106) of patients, who had suffered ischemic attack, COPD or cardiac disease was employed. Data were collected using the Counseling Quality Instrument (CQI) questionnaire. Results: Most chronically ill people received patient counseling about their disease symptoms, but there was lack of content of counseling about social support and the disease prediction. Half of the patients reported that their counseling had been implemented in planned manner and that they had experienced positive interaction during that counseling. Sixty percent of chronically ill patients had perceived patient counseling about the result of investigations, but half of respondents did not receive patient-centered counseling. Patient counseling had a positive benefit on the treatment of the chronically ill and their attitudes. Eighty percent of the patients were satisfied with the counseling materials and methods. Those over 60 years old and those who lived alone were the most dissatisfied with patient counseling. Conclusion: The findings indicate that chronically ill patients’ counseling on social support and disease prediction require development. In addition, implementation of patient counseling should be more patient-centered and based on care plan.

Aims and objectives To examine the adolescent's adherence in psychiatric inpatient care that includes both medication and non-pharmacological treatment. Background Adolescents can deny having a problem or being in need of treatment and are therefore prone to defying attempts to engage them in a collaborative treatment process. There is still little information in the literature concerning adherence to psychiatric inpatient treatment among mentally ill adolescents, especially focusing on the entire treatment period and all forms of treatment. Design This is a retrospective, mixed-method study. Methods Data were collected from discharge reports written by doctors (n = 72) and were subjected to inductive content analysis. Adherence to all forms of treatment was considered, over the entirety of the treatment period rather than focusing on a single specific time point. Results Three main adherence-related content categories were identified: non-adherence to treatment, adherence to treatment and challenges of adherence. The last of these categories contains information on factors that affect adolescent treatment adherence. Conclusions We found that adherent adolescents are cooperative, willing to receive treatment and participate actively in therapies aimed at relieving their mental symptoms or illness. Relevance to clinical practice The findings presented herein are likely to be informative in the context of inpatient treatment, and it is expected that the results presented herein will help to improve adolescents' quality of treatment.

Summary Objectives To explore critical care nurses' knowledge of, adherence to and barriers towards evidence-based guidelines for prevention of ventilator-associated pneumonia. Design A quantitative cross-sectional survey. Methods Two multiple-choice questionnaires were distributed to critical care nurses ( n =101) in a single academic centre in Finland in the autumn of 2010. An independent-samples t -test was used to compare critical care nurses' knowledge and adherence within different groups. The principles of inductive content analysis were used to analyse the barriers towards evidence-based guidelines for prevention of ventilator-associated pneumonia. Results The mean score in the knowledge test was 59.9%. More experienced nurses performed significantly better than their less-experienced colleagues ( p =0.029). The overall, self-reported adherence was 84.0%. The main self-reported barriers towards evidence-based guidelines were inadequate resources and disagreement with the results as well as lack of time, skills, knowledge and guidance. Conclusion There is an ongoing need for improvements in education and effective implementation strategies. Clinical implications The results could be used to inform local practice and stimulate debate on measures to prevent ventilator-associated pneumonia. Education, guidelines as well as ventilator bundles and instruments should be developed and updated to improve infection control.

Background: The incidence of type 2 diabetes (T2D) has increased rapidly worldwide during the last two decades.Lifestyle and behavioral factors such as diet, exercise and self-care have a crucial role in the prevention and managementof T2D. The motivation behind the desire to change is a cornerstone of adopting a healthier lifestyle. Motivationalinterviewing (MI) is a counseling technique that emphasizes to individuals incentives to change rather than just givinginformation. There is a lack of scientific evidence to indicate whether MI is a suitable form of care among patients withT2D. The aim of this study was to identify the outcomes of Motivational Interviewing in the context of care of adults withtype 2 diabetes. Methods: A descriptive review of studies published between January 2001 and March 2011 describing motivationalinterviewing in the care of patients with type 2 diabetes was conducted by interrogating electronical databases (CINAHL,Medline, PsycINFO, Web of Science and Scopus) and conducting a manual search. Two researchers selected the studiesand assessed their quality independently. Results: Five studies were selected for inclusion in this review. Our results show that studies describing MI used as a formof therapy in the care of T2D patients yield mixed results. Statistically significant effects for some clinical outcomes andamong behavioral and psychological outcomes were reported. Conclusions: The studies reviewed indicate that although MI seems to be a promising form of care among patients withT2D, further research into applying MI within T2D care is urgently needed.

To describe the development process of a theoretical model of ageing hospital nurses' well-being at work and the subsequent testing of the model itself.Factors evoking well-being at work need to be identified to promote nurses' well-being.Qualitative data (n = 21) from ageing hospital nurses, consisting of interviews, diaries and open data collection forms were collected and analysed using grounded theory method. Based on the finding, a survey was developed. Quantitative data (n = 328) were collected from hospital nurses born between the years 1948-1962. Explorative factor analysis was used to create the theoretical model.The main concepts of the model were nurse-nurse interaction, nurse-patient interaction and patient-care centeredness.According to the theoretical model, well-being at work can be described as nurses' experience of collaboration, cooperation and togetherness with other nurses in a supporting and caring work environment. The aim and possibility of high-quality patient care, in a spirit where nurses and nursing are appreciated, were also revealed.The importance of nurse-nurse interaction and nurse-patient interaction as well as ageing nurses' patient-care centeredness needs to be taken into account in nursing management and leadership.

The objective of this study was to evaluate whether the quality of patient education could be improved by using written education materials.Seventy-five inpatients with rheumatoid arthritis (RA) were provided with individual education sessions during their inpatient stay. The education sessions were supported with written educational materials. A patient education quality instrument was used to assess the sufficiency and implementation of the education and the readiness of nurses and doctors to deliver the education. A Mann-Whitney U-test and content analysis was used to analyse the data.There was a statistically significant difference in the sufficiency of education concerning the disease, medication and treatment after the revised material was introduced (p 0.005). The quality of interaction improved significantly during the intervention (p = 0.004). The strengths of the education included individual treatment, two-way interaction, the opportunity to receive patient education and its sufficiency.Clear, readable and understandable written education material improved the quality of the education of RA patients in terms of implementation, sufficiency and the readiness of nurses and doctors to deliver the education.

Aims: To evaluate the association between descriptions of the stage of change in weight management (using pictures as vignettes) and the changes in the restriction of amount of food and body weight. The goal is to develop counselling methods for helping people to change their lifestyles. Methods: A total of 74 people at high risk of type 2 diabetes participated in six months of group counselling. The data were collected through questionnaires and video-recordings at the beginning and the end of the counselling process, and were analyzed using both deductive content analysis and statistical analysis. Results: Most of the participants were at the contemplation stage at the beginning of the study, and nearly half were at the action stage at six months. There were associations between progression in the lifestyle change process, the restriction of food amount, and weight changes. Judging from this, the descriptions of the change process of weight management using pictures were well made, because the change process progressed in parallel with the changes in weight and restriction of the amount of food eaten. Conclusions: Assessing the stages of change in weight management by using pictures as vignettes is easy to carry out, and feasible. The descriptions of the stages of change were parallel with the changes in restriction of food and changes in weight.

This paper presents a discussion of the use of confirmatory factor analysis to test nursing theory.Theory testing is an important phase in nursing theory development. Testing of theory is intended to give more information about concepts and their usefulness in nursing practice. Confirmatory factor analysis is commonly used in instrument development in nursing science studies, but also in theory testing. However, there has been little discussion of its use in theory testing in nursing science research.Multidisciplinary methodological and research publications from 1990 to 2009 were used.The aim of confirmatory factor analysis is to test nursing theory that has already been established, i.e. researchers have an a priori hypothesis based on theoretical knowledge or empirical indications. Analysis is represented as three phases: preparation, model testing and reporting the results. Preparation involves data screening and preliminary analyses. Model testing is divided into model specification, model identification, model estimation, model evaluation and model modification. The results are reported with standardized regression coefficients of the items related to the latent variables, squared multiple correlations (R²) related to error terms and the model's goodness of fit indexes. Implications for nursing. Testing of theory is intended to give more valid information about the concepts and their usefulness in nursing practice.Confirmatory factor analysis is a good method to test the structure of theory, for example to test the concepts built by concept synthesis or analysis. Tested theories are needed to develop nursing science itself.

The compliance of young patients with diabetes regimens is explored by means of a questionnaire filled in by both the patients and their nurses and compared with the patients' glycosylated haemoglobin (HBA1) levels. The structured questionnaire was completed by 47 diabetics aged between 15 and 17 years. The adolescents had very similar views to the specialist nurse on their compliance with health regimens, and these assessments were also in line with the HBA1 values. One-third of the young patients showed a high degree of compliance with diabetes regimens, while just under a half showed average compliance; the remainder failed to comply adequately. Compliance was highest in the case of insulin treatment, self-care and co-operation with the nursing staff, and poorest in following dietary and home monitoring instructions.

A literature review of nurses' job satisfaction.Little is known about factors evoking job satisfaction among nurses, whereas more is known about stress, burnout and dissatisfaction. The positive viewpoint is an important research area and needs to be studied.Original studies were accessed by a systematic search from electronic databases (Abi/Inform, PsycINFO, Cinahl and Medline Ovid) using the keywords 'nurses' and 'job satisfaction' and chosen by certain criteria. The data chosen for this review consist of 21 scientific articles. Data were analysed using content analysis.and conclusions Most of the studies are quantitative studies, the majority of them were conducted in the United States. Job satisfaction at work varies in different specialty areas of nursing work. Two significant themes in job satisfaction are interpersonal relationships between nurses and patient care. Different ways of organizing work are also relevant for job satisfaction.Nurse managers have a strong role in promoting nurses' job satisfaction: attention should be paid especially to strengthening nurses' interpersonal relationships and facilitate nurses' capacity to deliver high-quality patient care.

Summary Background In intensive care, patients are exposed to a strange and sometimes hostile environment, which can lead to post-traumatic psychological problems. The aim of this study was to describe an intensive care environment from a patient point of view and the events and social contacts during a patient's day. Methods The study had an observational qualitative design. The data were generated by recording on DVD four adult intensive care patients in an intensive care unit over one day ( n = 96 hours). The DVD recording of two patients also included daylight (lx) and decibel (db) measurement. The material was analysed by inductive and deductive content analysis. Results An intensive care patient environment is made up of physical, social and symbolic environments. The hospital, ward and patient room constitute an environment that is indirectly connected to the patient. The patient bed and all that is included in it are directly connected to the ICU patient's physical environment. The social environment includes the people who are near the patient and in direct or indirect contact with them. ICU norms, regulations, values, expectations and knowledge make up the symbolic environment. Taken together, these factors constitute an intensive care unit's way of action. The symbolic environment is connected to the social environment through people and the way of action. Conclusion The patient is connected to the ICUs environment, but is usually not able to influence it. It is important to eliminate things that prevent recovery and to promote feeling safe. Besides the physical environment, things that prevent recovery and increase a feeling of being safe can be found in both the social and the symbolic environment. We also need to learn more about ICU patients’ subjective experiences in order to be able to describe the psychological environment.

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

Title. Psychometric properties of the Multifactor Leadership Questionnaire among nurses Aim. This paper reports a study investigating the psychometric properties of the Multifactor Leadership Questionnaire among nurses. Background. Although the Multifactor Leadership Questionnaire is one of the most widely used instruments to measure the multifactor leadership theory in organizational sciences, inconsistent research findings have been reported for its psychometric properties. Little is known about these properties. Method. Data were gathered by postal questionnaires in 2001–2002 with nurses working in different healthcare organizations in Finland. A follow-up study was performed 1-year later. The sample consisted of 601 nurses and nurse leaders, and the follow-up study had 78 respondents. The internal consistency of the Multifactor Leadership Questionnaire was explored using Cronbach's α coefficient and item-analysis, and the test–retest reliability using Pearson product moment correlation coefficient and intra-class correlation coefficient (single measure intra-class correlation coefficient). The factor structure was studied using exploratory and confirmatory factor analyses. Results. The internal consistencies of the leadership subscales were satisfactory. The Multifactor Leadership Questionnaire was fairly stable measured at the 1-year interval. Although the data fail to support the full nine-factor model, a reduced set of items from the Multifactor Leadership Questionnaire appears to show evidence of the three- and six-factor structures. Exploratory factor analysis showed evidence for the three-factor structure consisting of three distinctive, yet partly related leadership subscales. Confirmatory factor analysis showed evidence for the six-factor structure. Conclusion. The psychometric data suggest that a modified version of the Multifactor Leadership Questionnaire is a highly suitable instrument to measure multidimensional nursing leadership. Validity and reliability were supported. The results can be used in studies applying the Multifactor Leadership Questionnaire.

Objectives. The purpose was to describe the significance of the physical environment in supporting the well-being of the elderly aged over 65 years. The aim was to produce knowledge that will complement the knowledge-base of gerontologic nursing. Study design. The study was qualitative. Thirty-nine home-dwelling elderly persons aged over 65 were interviewed. Methods. The interviews (n = 39) were conducted with the thematic method. The data were analysed with methods of inductive content analysis. Results. The main threats of the northern physical environment to the well-being of the elderly are seasonal variation, temperature, snow, light variation and distances. The supportive characteristics of the northern environment are the natural environment, space, amiliarity with the physical space, cleanliness and safety. Conclusion. The characteristics of the northern physical environment seem to be significant for both urban and rural elderly people living in the northern part of Finland. The different aspects of the natural environment provide opportunities to relax, meet other people and do physical exercise, all of which are important factors of health promotion. (Int J Circumpolar Health 2005; 64(3):246-256) Keywords: elderly, northern environment, physical environment, well-being Keywords: elderly ; northern environment ; physical environment ; well-being

Summary • The purpose of this study was to describe patient education from the perspective of adolescents. • Data were collected by interviewing adolescents who had asthma, epilepsy, juvenile rheumatoid arthritis, and insulin-dependent diabetes mellitus. The sample consisted of 40 Finnish adolescents aged between 13 and 17 years. The interview data were analysed with methods of content analysis. • From the perspective of adolescents with a chronic disease, patient education can be divided into the following categories: routine programmes, problematic planning issues, atmosphere of patient education session and written patient education material. Some features of ideal patient education also emerged. • In a routine programme, patient education was based on the professional knowledge of the physicians and nurses rather than the needs of the adolescents. It was provided at a time that was good for the nurses or physicians. The level of education was not compatible with each developmental level of the adolescent. • Problematic planning issues included a poorly outlined plan of education and a lack of systematic and continuous education. • Educational communication consisted of dialogue between the adolescent and the educator. An encouraging atmosphere developed when the educators motivated the adolescents, respected them and their opinions and encouraged them to express their feelings, to ask questions and to relate experiences. Also, it was important that the adolescents’ opinions were respected. • In ideal patient education, the sessions had been planned well beforehand based on the adolescents’ needs and written patient education material. Ideal patient education helped adolescents to acquire skills to take care of themselves and provided information on how to adjust to different situations and problems. • The results provided useful insight into patient education and served to raise awareness of the problems and difficulties experienced by adolescents with a chronic disease.

The purpose of this study was to describe the factors that predict compliance among adolescents with a chronic illness. The data were collected by questionnaires from adolescents with asthma, epilepsy, juvenile rheumatoid arthritis (JRA) and insulin-dependent diabetes mellitus (IDDM). Groups of 300 adolescents with these illnesses were selected from the Finnish Social Insurance Institution's register, giving a total study series of 1200 individuals. The final response percentage was 88% (n = 1061). The data were analysed with the SPSS software. Logistic regression was used to indicate the predictors of good compliance. The compliance of adolescents with a chronic disease was predicted on the basis of support from parents, nurses, physicians and friends, as well as motivation, energy and willpower. The most powerful predictor was support from nurses. The likelihood of adolescents supported by nurses complying with health regimens was 7.28-fold compared to the adolescents who did not receive support from nurses. The next powerful predictor was energy and willpower. Adolescents who had the energy and willpower to take care of themselves complied with health regimens with a 6.69-fold likelihood compared to the adolescents who did not have energy and willpower. Adolescents who had good motivation were 5.28 times more likely to comply than the adolescents who did not have motivation. Support from parents, physicians and friends similarly predicted good compliance with health regimens.

The purpose of this study was to establish the parental coping' factors associated with having a child in psychiatric inpatient care. The data were collected from 19 hospitals with child psychiatry units. At the time of data collection, all parents of children in psychiatric inpatient care in these hospitals were recruited. The method of data collection was a questionnaire (n = 79). The data were analysed with the Statistical Package for the Social Sciences (SPSS) for Windows statistical software. The connections between variables were studied with cross-tabulation, and the chi2 test was used to determine significance. Changes in internal and external family relationships and matters related to the upbringing of the child with mental problems statistically correlated significantly with parental coping (P < 0.001). Problem-oriented and emotionally-oriented coping strategies, skills and palliative strategies correlated significantly with parental coping (P < 0.001). Emotional support, support for the care and upbringing of the child in inpatient care, and love and acceptance also had statistically significant associations with parental coping (P < 0.001).

Compliance has been studied from a wide range of scientific perspectives including medicine, nursing, psychology and health economics. There is no agreement regarding a commonly accepted definition. Lack of consistency in the definition and measurement of compliance is a major problem in research which becomes more complicated in an international study. The response to the confusion over the term compliance has been to suggest and use alternative terms such as adherence, co-operation, mutuality and therapeutic alliance. These terms are ill-defined and often are used as synonyms. The purpose of this paper is to analyse definitions of the concept of compliance. Abstracts from MEDLINE have been analysed in order to identify the types of compliance research that have been carried out.

The purpose of this paper is to describe the health regimen compliance of adolescents with asthma and some factors related to it. The following research questions were addressed: (i) to what extent do adolescents with asthma comply with health regimens; and (ii) what type of factors are associated with compliance of adolescents with asthma? A total of 300 individuals aged 13–17 years were randomly selected from the Finnish Social Insurance Institution’s register. Every 15th person on the list was included in the sample and were sent questionnaires. A total of 88% (n = 266) of adolescents returned the questionnaire. The results showed that 42% of the adolescents with asthma complied fully with the health regimens, 42% placed themselves in the category of satisfactory compliance, and the remaining 18% reported poor compliance. Compliance with the need to avoid foods, animals and pollens that cause asthma attacks was poorest, while the highest degree of compliance was observed for medication and control visits to medical staff. Background variables, such as age, family size, exercise, smoking, alcohol intake and severity of disease, were significantly associated with compliance (P < 0.001). Good motivation, a strong sense of normality, energy and will-power, support from the parents, physicians and nurses, a positive attitude towards the disease and treatment, no threat to social wellbeing and no fears of complications had statistically significant relation to good compliance (P < 0.001).

The purpose of the study reported in this paper was to evaluate compliance, and factors associated with compliance, in patients who had hypertension. Compliance with lifestyle recommendations, medication and attendance of follow-up visits was evaluated. The data were collected using a questionnaire completed by 138 patients with hypertension aged under 63 years from one town and three municipalities in Finland. The patients responded when they visited a doctor or a nurse in a health centre or an occupational health station. The response percentage was 94%. The data were analysed using the SPSS for Windows software. The results are presented as frequency and percentage distributions. The connections between the variables were studied by cross-tabulations and the chi-square method. The series was 60% female and 40% male. According to the blood pressure readings, the control of hypertension was good in one-tenth of the patients, average in two-thirds and poor in one-fifth. Based on the weight index, the control of hypertension was good in 28% of the patients, average in 30% and poor in 42%. Compliance with the dietary restrictions was poorest, while compliance with medication was best. Symptoms were reported by 61% of the females and 29% of the males. Non-smoking, no symptoms, high level education and female sex were related to good compliance with dietary restrictions. Marital status and family size correlated significantly with smoking. Those who lived alone smoked more.

Qualitative content analysis is commonly used for analyzing qualitative data. However, few articles have examined the trustworthiness of its use in nursing science studies. The trustworthiness of qualitative content analysis is often presented by using terms such as credibility, dependability, conformability, transferability, and authenticity. This article focuses on trustworthiness based on a review of previous studies, our own experiences, and methodological textbooks. Trustworthiness was described for the main qualitative content analysis phases from data collection to reporting of the results. We concluded that it is important to scrutinize the trustworthiness of every phase of the analysis process, including the preparation, organization, and reporting of results. Together, these phases should give a reader a clear indication of the overall trustworthiness of the study. Based on our findings, we compiled a checklist for researchers attempting to improve the trustworthiness of a content analysis study. The discussion in this article helps to clarify how content analysis should be reported in a valid and understandable manner, which would be of particular benefit to reviewers of scientific articles. Furthermore, we discuss that it is often difficult to evaluate the trustworthiness of qualitative content analysis studies because of defective data collection method description and/or analysis description.

The personal meaning and perceived impact of insulin dependent diabetes mellitus (IDDM) were investigated in an exploratory study of 51 Finnish adolescents aged between 13 and 17. Interview data were examined using continuous comparative analysis. The personal meaning of IDDM was described using the following categories: a habit; a little devil; a nightmare; stress; prison; death; and hell. A core concept to emerge was that of control. Young people felt IDDM controlled, or limited, their freedom and independence. Two main themes emerged in terms of the impact of IDDM in the lives of adolescents: a threat to life's equilibrium and a healthy lifestyle. Diabetes was viewed as a threat to physical, psychological and social well-being which disrupted the balance of life. In contrast, the other main category, a healthy lifestyle, revolved around the notion that having IDDM offered a unique opportunity to live a healthy life. The results provided a useful insight into the personal meaning of IDDM and serve to raise awareness of the problems and difficulties experienced by adolescents with this condition.