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ti Kuntoutumista edistävän hoitotyön merkitys korostuu ikääntyvässä Suomessa. Tutkimusten mukaan kuntoutumista edistävä hoitotyö edistää ikääntyneiden toimintakykyä. Vanhuspalvelulaki velvoittaa kuntia tekemään ikääntyneen väestön tukemiseksi suunnitelman, jossa painotetaan kotona asumista ja kuntouttavia toimenpiteitä. Suuri osa valmistuneista lähihoitajista tulee työskentelemään ikääntyneiden parissa, joten lähihoitajien koulutuksen tulee vastata työelämän tarpeita. Tutkimuksen tavoitteena oli tuottaa uutta tietoa kuntoutumista edistävän hoitotyön toteutumisesta ikääntyneiden palvelujärjestelmässä sekä ikääntyneiden kuntoutumista edistävän hoitotyön koulutuksesta ammatillisessa oppilaitoksessa. Tutkimusaineisto kerättiin syksyllä 2020 yksilöteemahaastatteluilla lähihoitajaopiskelijoilta (n=8). Aineisto analysoitiin induktiivisella sisällönanalyysilla. Lähihoitajaopiskelijoiden kokemukset ikääntyneiden kuntoutumista edistävästä hoitotyöstä liittyivät hoitajien ajankäyttöön, organisaation toimintaan, hoitajien osaamiseen, hoitajien asenteisiin, hoitajien omiin toimintatapoihin, organisaation toiminnan kehittämiseen, käytännönläheisen opetuksen toteuttamiseen ja kehittämiseen, apuvälineiden käyttöä heikentäviin ja parantaviin tekijöihin sekä apuvälineiden teknologiaan tulevaisuudessa. Johtopäätöksenä voidaan todeta, että koulutuksen sisältö ja käytännön työelämä eivät kohtaa. On välttämätöntä lisätä kuntoutumista edistävän hoitotyön osaamista ja kehittää organisaatioiden toimintoja. Abstract Practical nurse students’ experiences of restorative care for older adults and restorative care education The meaning of restorative care is emphasized in ageing Finland. Studies show that restorative care promotes the functional ability of older adults. The Finnish elderly services law obliges municipalities to make a plan to support the elderly population with an emphasis on promoting living at home with the support of restorative care. Most of the graduating practical nurses will work among older adults, so the education should meet the needs of working life. The aim of this study was to produce new information on the implementation of restorative care in the service system for the elderly and on the restorative care education in vocational institutions. In autumn 2020, data were collected by individual focused interviews with graduating practical nurses (n=8). The data were analyzed by inductive content analysis. Practical nurse students’ experiences of restorative care were related to nurses’ time usage, the organization’s operation, nurses’ competence, nurses’ attitudes, nurses’ way of working, developing the organization’s operations, implementation and development of practical teaching, reducing and increasing the use of assistive devices, and the future of assistive device technology. In conclusion, the content of education and practical working life do not meet. It is necessary to increase competence in restorative care and develop the functions of organizations.

Aim The aim of the study was to explore the adherence to self-management of patients with multimorbidity, identify associated factors, and determine explanatory factors of their adherence to self-management in terms of the Theory of Adherence of People with Chronic Disease. Background Adherence to self-management is essential for successful care of multimorbid patients, but multimorbidity poses challenges for both patients and practitioners due to its care complexity and broad impact on patients' lives. Design A cross-sectional, descriptive exploratory design with the STROBE reporting checklist was applied. Methods Adult multimorbid patients who attended primary healthcare consultations in Finland were surveyed using self-administered questionnaires with several instruments including the Adherence of People with Chronic Disease Instrument, Kasari's FIT Index, and Alcohol Use Disorders Identification test. Responses of 124 patients were analysed using descriptive statistics, Spearman correlations, binary logistic regression analysis, and Chi-squared, or corresponding, tests. Results Most patients' responses indicated good or adequate adherence to care regimens and medications. However, adherence to self-management for a healthy lifestyle was more frequently inadequate. Adherence was significantly associated with several patient-related factors, including demographic and health-related factors, perceived adequacy of loved ones, and patient activation. Significant explanatory factors for adherence included energy and willpower, motivation, results of care, sense of normality, fear of complications and additional diseases, and support from nurses, from physicians, and from family and friends. Various factors were relevant for specific aspects of self-management. Conclusions Multimorbid patients' adherence to self-management is not an 'all or none phenomenon, but a multifaceted process with numerous associated and explanatory factors. Relevance to clinical practice The findings highlight needs for an individualised whole-person approach in multimorbid patients' care to provide the required support for good adherence to self-management. Healthcare professionals, especially nurses working in primary health care, are well-positioned to meet this need.

Older people are present in a variety of nursing settings and have distinct care needs. Evidence about the competencies required is crucial when developing the profession. The aim of the study was to describe competence areas relevant in gerontological nursing. A qualitative, descriptive study design was used with 27 participants included. Finnish gerontological nursing professionals who worked at several healthcare organizations and in education were interviewed in five focus-group interviews. The interviews were carried out between October 2017 and February 2018 and were analyzed using inductive content analysis. The study is reported according to SRQR guidelines. Analysis indicated four main competence areas for gerontological nursing: clinical nursing competence; competence in promoting health and well-being; interaction competence; and ethical competence. Registered nurses (RNs) must possess multiple competencies when caring for older people which should be taken into account in nursing and education.

Aim The study aimed to describe and explain the self‐assessed gerontological nursing competence levels of Finnish nursing students and factors relating to it. Design A cross‐sectional study design, reported by The Strengthening the Reporting of Observational studies in Epidemiology guidelines. Methods Data were collected with the GeroNursingCom instrument, which features 53 items relating to 11 competence factors. The K‐clustering technique and the Chi‐squared, Kruskal‐Wallis and Mann Whitney tests were used to analyse the data. Results Seven hundred and ninety‐nine nursing students from nine randomly selected higher education institutions were invited to participate in 2019. Three distinct student profiles were identified according to the data (N = 274): Profile A—lower intermediate competence (23.1% of students), Profile B—intermediate competence (45.8%) and Profile C—high competence (31.1%). The strongest competence area for all students was appreciative encounter and interaction, and the weakest was supporting the older person’s sexuality. Nursing students have diverse backgrounds and their overall competence in gerontological nursing is shaped in part by their previous education, motivations and work experience. Relevance to clinical practice Recognizing students’ different gerontological nursing competence profiles enables the implementation of targeted education to improve competence in clinical practice.

This study aimed to describe visual performance and the need for vision care services among Finnish older people receiving home care. We evaluated the applicability of the Resident Assessment Instrument of Home Care (RAI HC) in identifying visual impairment (VI) and the need for vision care services among older people.A descriptive quantitative, cross-sectional design.Visual impairment and the need for vision care services for older people receiving home care (N = 70) were determined by an optometrist's screening examination and vision assessment by home care workers using the RAI HC instrument. In this study, the definition of visual impairment was visual acuity (VA)0.63 (logMAR0.2).According to the distance VA measurements, 41% of the participants showed VI (0.63) of the better eye, while the RAI HC assessment revealed VI among 36% of the participants. The Kappa value for interrater reliability in classifying VI was 0.137. The optometrist's vision screening examination recognized a previously unknown and unmet need for vision care services more than twice as often as the RAI HC assessment.

The study was conducted to describe long-term perceived health among patients after a percutaneous coronary intervention as well as clarify the associations between perceived health and various factors.Perceived health is an important outcome for coronary heart disease patients who have undergone percutaneous coronary intervention. Poor perceived health predicts low adherence to treatment, morbidity and mortality.An explanatory and descriptive survey with a six-year follow-up (STROBE Statement: File S1).Baseline data (n = 416) were collected in 2013, with follow-up data collected from the same study group in 2019 (n = 154) at two university hospitals and three central hospitals in Finland. The employed self-reported questionnaire was based on the EuroQoL visual analogue scale and EuroQol five-dimensional scale. Data were analysed using descriptive statistics and multivariate methods.Perceived health did not significantly differ four months or six years after percutaneous coronary intervention. The respondents most commonly reported pain and discomfort (62.1%), problems in mobility (50.3%), issues with usual activities (27.5%), and anxiety and depression (24.0%). Managing self-care (8.5%) was least likely to be an issue for the respondents. A majority of the reported problems were of a mild nature. The consumption of an adequate amount of vegetables, lower systolic blood pressure, regular follow-up treatment, lack of prior invasive procedures, and younger age predicted better scores for both perceived health and its separate dimensions.Regular follow-up is important to ensure after percutaneous coronary intervention to identify patients with pain and discomfort, mobility problems, depression and anxiety. Healthcare professionals should pay particular attention to elderly patients, who have undergone severe invasive procedures.This study confirms the importance of regular follow-ups for post-percutaneous coronary intervention patients.Patients have completed a self-reported questionnaire based on informed consent.

Aims To investigate the well-being at work and analyze relevant predictors of it among nurses working in psychiatric outpatient settings including following specific objectives 1) describe the current state of well-being at work among psychiatric nurses; and 2) examine how background characteristics and exposure to violence predict well-being at work. Design A cross-sectional survey design. Methods Two-staged sampling was used to select participants from psychiatric outpatient units. Data were collected with printed Nordic Questionnaire for Monitoring the Age Diverse Workforce (QPSNordic-ADW) and Violence Incidence Assessment (VIA-Q) questionnaire from January 2019 to June 2019. Descriptive statistics were performed to summarize the collected data and binary logistic regression was used to identify predictors related to the well-being at work. Results The respondents (n = 181) generally evaluated well-being at work quite positively but were more critical towards interaction with their immediate superior, organizational culture, interaction between work and private life, and organizational commitment. Working experience in psychiatric nursing and experiences of harassment were identified as strong predictors of well-being at work. Conclusion The management of healthcare organizations should discuss nursing ethics and morale more, as well as pay attention to the ethical environment to prevent moral distress among nurses. Several weaknesses seem to exist especially in the management of psychiatric outpatient units which influence nurses' well-being at work. Identification of these can help organizations to develop management and implement interventions to increase nurses' well-being at work. Conversations about the managerial culture and collegial climate should also arise at the organizational and unit levels.

This study describes the self-estimated functional ability of older adults with visual impairments (VI) living at home prior to and after 24 months of individual low vision rehabilitation (LVR) according to the International Classification of Functioning, Disability and Health (ICF) framework. The LVR was carried out according to regular standard of care in Finland. The study provides knowledge that is relevant for improving both LVR as well as other services for older adults living with VI. Thirty-nine older adults with VI initially participated in the study with 28 remaining for the follow-up at 24 months of LVR. Data were collected by an orally administered questionnaire including items from the Oldwellactive Wellness Profile instrument. Data were analyzed using the marginal homogeneity test, and the outcomes were divided into four categories according to the ICF framework. Comparisons between the baseline and 2-year follow-up revealed statistically significant decreases in daily functions, including going outdoors ( p = .011), washing oneself ( p = .016), taking care for personal hygiene ( p = .046), dressing ( p = .034), preparing meals ( p = .041), and doing heavy housework ( p = .046), following 2 years of received LVR. A statistically significant increase in the need for help was also observed during the study period ( p = .025). The independence of older adults with VI decreased, and the need for external services or help increased during 24 months after the onset of receiving LVR. Visual problems were shown to widely affect functional ability. Activities and participation dimension together with loneliness are most affected and need attention in individual LVR.

Intensive care professionals (ICPs) have a key role in counselling adult intensive care unit (ICU) patients and their family members. The counselling provided to ICU patients and their family members can be described based on the content, implementation, benefits, and resources.The study had two specific aims: first, to assess ICPs' perceptions of the quality of counselling provided to ICU patients and their family members; and second, to explore which factors ICPs feel is associated with the quality of counselling.A cross-sectional survey of ICPs working in adult ICUs in Finnish university hospitals. Data were collected using the Counselling Quality Instrument. The data were analysed by descriptive statistics and chi-square and t-test statistical methods.A total of 182 ICPs returned the questionnaire, reflecting a response rate of 18.6%. Most of the respondents were nurses (97%) and the mean age was 42 years. The ICPs reported having adequate time for patient- (77%) and family-centered (73%) counselling, but only 47% felt that their units had the appropriate facilities. There were statistically significant differences between patient- and family-centered counselling and the ICP's self-assessed competence (p .001), goal-oriented counselling (p .001), and atmosphere during counselling (p .001). ICPs' attitudes towards counselling impacted how these professionals assessed patients' and family members' confidence, along with patient recovery (p .001).This study confirms that the provision of high-quality counselling has beneficial effects; however, it also indicates that there is a need for training that considers each ICP's professional experience and patient- and family-centered factors, which may differ from one another.According to ICPs, the quality of counselling can be enhanced by empowering ICPs to improve counselling and providing appropriate ICU facilities for counselling, such as a private room for family members.

Purpose To describe the feasibility and clinical utility of the Finnish FLACC scale when assessing children's pain in a Pediatric Intensive Care Unit (PICU). Design and methods A non-experimental, descriptive cross-sectional study design was used to describe the feasibility and clinical utility in a Finnish PICU between May and August 2018. The nurses were asked to complete a data collection questionnaire about the feasibility and clinical utility of the Finnish FLACC every time they used the scale to assess pain in children. In total, the data consisted of 157 pain assessments cases. Quantitative data were analyzed statistically and responses to open-ended questions were analyzed using content analysis. Results In most cases, the nurses agreed that the Finnish FLACC scale was clearly structured (97%), easy to use (98%), helpful in assessing pain intensity (77%), and useful when reassessing pain after interventions (67%). Nurses found the scale more useable for children over one year old than for younger children. When assessing cry and consolability, pain was easier to score if the child was not intubated. Conclusions The Finnish FLACC scale exhibits adequate feasibility and clinical utility when assessing pain in children in a PICU. However, more information is needed about its use during painful short-term procedures and with children under one year old. Practice implications The Finnish FLACC scale is a helpful tool for nurses when assessing children's pain in a PICU. However, the Finnish version of the modified FLACC is needed for use with intubated children in the future.

To develop and psychometrically test an instrument - GeroNursingCom - that measures gerontological nursing competence of nursing students.An instrument development guided by COSMIN guidelines.The development and testing of the GeroNursingCom instrument proceeded according to four distinct phases: (a) establishing a theoretical background; (b) testing face and content validity; (c) examining structural validity; and (d) testing internal consistency. The items of instrument were based on a theoretical framework developed from a comprehensive literature review and focus group interviews with experts (N = 27) in spring 2018. Content validity was assessed by nine experts in gerontological nursing, while face validity was tested in a pilot study including 36 nursing students. Structural validity was examined with exploratory factor analysis with 267 nursing students from nine universities of applied sciences. The internal consistency was established with Cronbach's alpha. The data were collected in spring and autumn 2019. The data analysis was conducted with multivariate statistical methods.The GeroNursingCom development and testing process yielded an instrument that includes 53 items across 11 factors: (a) appreciative encounters and interactions with older people; (b) medication for older people; (c) nutrition for older people; (d) safe living environment for older people; (e) supporting the functioning of older people; (f) end-of-life care; (g) developing one's competencies; (h) supporting an older person's mental well-being; (i) supporting an older person's sexuality; (j) guiding self-care among older people; and (k) responding to challenging situations. The instrument was able to explain 66.15% of the total observed variance, while Cronbach's alpha values for individual items varied from 0.75-0.89.TheGeroNursingCom instrument can be used to measure gerontological nursing competence among nursing students to improve gerontological nursing education and/or geriatric care.Graduating nursing students must develop versatile competencies to face the multiple needs of older patients and curriculums need to be further developed to ensure students are prepared for gerontological nursing.目的: 为对工具GeroNursingCom进行开发和心理计量试验--衡量护士生的老年护理能力。 设计: 根据基于共识的健康测量工具选择标准(COSMIN)进行工具开发 方法: GeroNursingCom工具的开发和测试过程将分为以下四个不同的阶段:(a)建立理论背景;(b)测试表面与内容效度;(c)检验结构效度;以及(d)测试内部一致性。工具项目的理论框架源于综合文献综述以及2018年春季专家(27位)进行的焦点小组访谈。内容效度由九位老年护理专家进行评估,同时以36名护士生为研究对象,对表面效度进行初步研究。通过采用探索性因素分析方法,以9所应用科技大学的267名护士生为研究对象,进行结构效度试验。采用克隆巴赫系数测试了内部一致性。数据收集于2019年春季和秋季,并采用多元分析方法进行数据分析。 结果: 在GeroNursingCom的开发和测试过程中,对其包含的11个因素进行了53个项目的测试:(a)与老人见面和互动;(b)老年人用药;(c)老年人所需营养;(d)老年人的安全生活环境;(e)对老年人机能的支持;(f)临终关怀;(g)能力发展;(h)支持老年人的心理健康;(i)支持老年人的性欲;(j)指导老年人自我照顾;以及(k)对具有挑战性的情况做出回应。该工具可说明61.5%的总观测方差,且单个项目的克隆巴赫系数值在0.75至0.89之间。 结论: GeroNursingCom工具可用于衡量护士生的老年护理能力,以改善老年护理教育和/或老年护理。 影响: 护士生在毕业前须多方面地发展自身能力,以面对老年患者的多样需求。应进一步完善课程,以确保学生能够应对老年护理。.

The aim of this study was to describe the well-being supportive home environment of elderly people (n = 37) with visual impairment (VI) and its relationship with health-related quality of life (HRQoL). Data were collected during home visits six (6) months after the commencement of individual low vision rehabilitation (LVR) process. A structured well-being supportive environment instrument and a general HRQoL instrument were administered. Background variables had no detectable effect on the HRQoL. The HRQoL correlated significantly with the symbolic environment, living-related fears and feelings of general restrictiveness. The participants generally saw their home environment to be comfortable and supportive of well-being, but many felt that their life was too much restricted to home environment.

Ikääntyneelle on tärkeää saada käyttää omia vahvuuksiaan ja taitojaan, saada myönteisiä kokemuksia sekä kokea yhteenkuuluvuutta ja merkityksellisyyden tunnetta. Tutkimuksen tarkoituksena oli kuvailla kotihoidossa olevien ikääntyneiden kokemuksia omista vahvuuksista, voimavaroihin vaikuttavista tekijöistä sekä kotihoidosta. Tutkimuksen tavoitteena on lisätä ymmärrystä ikääntyneiden vahvuuksien hyödyntämisestä voimavaroina, sekä herätellä ikääntyvien parissa työskenteleviä pohtimaan ikääntyvien oikeutta tulla kuulluksi ja kohdatuksi, sekä otetuksi huomioon yksilöllisten vahvuuksien ja voimavarojen kautta. Tutkimusaineisto koostui kotihoidon asiakkaan (n=10) haastattelusta. Aineisto analysoitiin eksistentiaalista fenomenologiaa soveltaen. Tutkimusmenetelmän valinta perustui holistiseen ihmiskäsitykseen sekä inhimillisen kokemuksen ontologiseen analyysiin. Haastattelut toteutettiin avoimena haastatteluna, koska tutkittavien haluttiin kuvaavan yksilökohtaisia ja yksityiskohtaisia kokemuksiaan. Ikääntyneen elämänhistorian tunteminen, yksilöllisten vahvuuksien, voimavarojen ja toiveiden huomioiminen mahdollistaa arvokkaan elämän sekä laadukkaan vanhustyön toteutumisen. Kotihoidossa ikääntyneen kuulluksi tuleminen ja kohtaaminen auttavat havaitsemaan yksilölliset tarpeet ja elämäntilanteet. Tämän avulla voidaan arvioida ikääntyneen tarvitsemaansa yksilöllistä tukea ja palveluntarvetta. Sosiaalisiin suhteisiin liittyvät seikat ovat merkittävässä asemassa, kun tarkastellaan ikääntyneiden vahvuuksia, voimavaroja tai heidän toiveitansa.

To evaluate how effective preparatory interventions for paediatric day surgery are at reducing parents' anxiety and stress and children's pain and fear.A systematic review was conducted according to Joanna Briggs Institute (JBI) guidelines and reported using the PRISMA 2020 checklist. PubMed, CINAHL (EBSCO), Scopus, Medic and Web of Science were screened for original research published up until December 2020, while Mednar and EBSCO Open Dissertations were used to identify any relevant grey literature. The methodological quality and risks of bias were evaluated according to JBI guidelines by two authors. The eligibility criteria were parents of a preschool (2- to 6-year-old) child going through day surgery with preparatory interventions, outcomes measured anxiety, stress (parent), fear and pain (child), and randomised controlled trial (RCT).Two thousand and three hundred and fourteen RCTs were screened. Fifteen studies (including 1514 participants) were chosen for narrative synthesis of parental anxiety and stress and children's fear and pain. Nine studies underwent a meta-analysis of parental anxiety (n = 970). The interventions were categorised as functional, informative or a combination of both. Four interventions reduced parents' anxiety while two significantly alleviated children's postoperative pain. The interventions found to be effective combined various ways of providing information. The meta-analysis did reveal a statistically significant impact on parents' anxiety (SMD =0.22, 95% Cl [0.03, 0.41], z = 2.28, p = .023). None of the studies dealt with parental stress or fear in children.The studied interventions used various preparatory approaches, some of which were effective at reducing parental anxiety. More RCT studies are needed to find the most effective methods for preparing parents and their children for day surgery.Preparation for day surgery through appropriate interventions can reduce anxiety among parents and postoperative pain in children.

The role of geriatric nurses is essential in preventing oral health problems of older people with impaired daily functioning. Nurses have reported low self-efficacy with regard to oral health care practices and wish to receive more information on the topic. The main aim of this pilot study was to develop an instrument to measure the self-efficacy beliefs, challenges and knowledge of geriatric home care nurses with regard to the oral health care of older. A questionnaire was developed to evaluate geriatric home care nurses’ self-efficacy beliefs, challenges and knowledge regarding the oral health care of the older people. In this case, 18 nurses participated in a one-day intervention and filled in the questionnaire before and after the intervention. The comments and questions of the nurses were analysed utilising the principles of inductive content analysis. Cronbach’s alpha for the scales varied between 0.69–0.79. The interactive intervention improved both nurses’ self-efficacy beliefs and oral health-related knowledge, and most of the challenges faced by nurses in older people’s oral health care were diminished. Financial resources and older people’s self-determination were the most common limitations to oral care. In this pilot study, we developed an instrument to measure geriatric home care nurses’ self-efficacy beliefs, challenges and knowledge regarding older people’s oral health care. In the future, this instrument can be validated with a larger study population.

Collaborative digital learning is becoming increasingly popular in higher education. However, the use of collaborative digital learning does risk placing too big a responsibility on the learner and reducing face-to-face interaction with the educator. The aim of this quasi-experimental study was to evaluate the effects of a digital educational intervention on collaborative learning in nursing education. The intervention group ( n = 87) studied using a collaborative digital learning environment and the control group ( n = 38) studied in the traditional classroom setting. There were no significant differences between the groups in terms of student satisfaction. However, the students' satisfaction of studying decreased in the intervention group after completion of the course. In the intervention group students had higher satisfaction in the area of promoting collaborative group work and received statistically significant higher grades in the final course evaluation. This study emphasizes that collaborative digital learning can be an effective approach in nursing education in terms of learning outcomes. It also shows that more study is needed on the role of the teacher in collaborative digital nursing education.

Background According to previous studies, gender-related differences have been found in relation to the experience of well-being. There are also research results indicating that environment and seasonal variation have an influence on the well-being. Aim The aim of the study was to describe how adolescent girls living in northern Finland experience nature, winter and seasonal changes and meaning of these to their well-being. Methods In this descriptive, qualitative research, 17 girls aged 13-16 who live in northern Finland participated in five focus group interviews where they presented photographs of nature they took themselves. Participation for the girls was voluntary, and the data were analysed by using content analysis. Findings Three main categories were found: winter which expresses participative and confrontational meanings, natural environment that provides meaningful stimulus and seasonal variations binding experiences. Winter had a dual effect on girls' well-being. Nature's healing elements were described by the girls as invigorating, varying and stimulating of a wide range of senses. Nature offered soothing and revitalising experiences for the girls. On the one hand, seasonal changes were seen as a refreshing change, but on the other hand, the changes were described oppressive and burdensome. Conclusion The girls described how they experienced the multiple elements of nature and environment through different senses. These sensations and feelings seem to transport the girls to a larger experience in which nature and seasonal changes were partially elements that fulfilled the girls' needs but also required adaptation. Relevance to clinical practice This experiential description encourages us to develop new means of promotive actions and brings a novel perspective and understanding about how to incorporate and implement these findings to enhance girls' well-being. Findings from this study need to be understood in this particular context in northern Finland among adolescent girls.

Aim was to explore the health-related quality of life (HRQoL) and related factors among older adults with visual impairment (VI). A total of 39 independently living subjects aged ⩾65 years (83 ± 6.5), referred to the Low Vision Center of the Oulu University Hospital, Finland during one year participated in the study. The participants had low vision or blindness as defined by the World Health Organization (WHO). The 15D, a generic HRQoL instrument, was used to assess the HRQoL, and an ophthalmic examination was performed to assess vision. A population-based control group ( n = 1074) was available for comparison. The mean 15D index scores for the participants and the control group were 0.768 ( SD = 0.089) and 0.827 ( SD = 0.044), respectively, ( p .05), habitation (alone 0.768, with someone 0.770, p > .05), or age ( r = –.084), nor did the extent of low vision appear to affect the 15D index in this material. The older adults with VI had poorer 15D index score than Finnish population of equal age, but they scored better in the dimension of mental function. Mental skills may indeed be crucial for independent living despite VI.

Aims To identify associations between perceived health and treatment adherence six years after percutaneous coronary intervention. Design A non-experimental descriptive long-term follow-up study. Methods Baseline data (n = 416) were collected in 2013, with follow-up data collected in 2019 (n = 154), using the EuroQoL scale, EuroQoL visual analogue scale, and Adherence of Patients with Chronic Disease Instrument. Data were analysed using descriptive statistics and multivariate methods. Results The average age of the 154 respondents was 68.5 years (SD 7.01), with a majority males (n = 118, 86.6%). Adherence to a healthy lifestyle, good perceived results of care, support from nurses, high sense of normality, low fear of complications, motivation, older age, and duration of coronary artery disease were associated with better general perceived health as well as its dimensions (mobility, self-care, usual activities, pain/discomfort, and anxiety/depression). Conclusion Support from nurses is a key factor to ensuring high perceived health among post-percutaneous coronary intervention patients. This support must be continuous and motivate the patient to adhere to a healthy lifestyle. Patients should feel comfortable sharing their problems and fears. This type of relationship will allow health care professionals to assess the patient's current situation and address potential problems about mobility, pain and discomfort, as well as anxiety and depression to strengthen the patient's sense of normality and enable them to confidently lead a normal life. Impact The research aimed to gain knowledge about how perceived health is associated with treatment adherence six years after percutaneous coronary intervention. The results emphasise that a nurse's support of patients is crucial to the care process, as adherence to treatment showed a clear positive association with perceived health in the analysed sample of post-PCI patients.

Background: Dementia causes behavioural changes in people that often lead to earlier placement in a nursing home. Staff can find these behavioural changes challenging and require specific competencies to support and care of people living with dementia. However, there is little information regarding the competencies nurses require in dementia care. Thus, the aims of this study were to determine the prevalence of challenging situations in nursing homes of older people with dementia, characterise the nursing staff’s responses to such situations and contribute to a model outlining competences that dementia care nurses require. Methods: Data were collected using mixed methods in a cross-sectional survey of views of nursing staff (n = 106) in two nursing homes in Finland during May to June 2018 using a structured questionnaire including open-ended questions. Quantitative data acquired were analysed statistically, and responses to the open-ended question were analysed using content analysis methodology. Results: Most nurses (98%) reported that challenging situations occurred daily or weekly. The most common reported forms of challenging behaviour were as follows: wandering, restlessness, constant leaving, repeated inquiries and requests and opposition to treatment (mentioned by 95%, 90%, 85%, 83% and 83% of respondents, respectively). Five key competencies were identified from their responses: practical knowledge, theoretical knowledge, therapeutic use of self, social competence and self-management. They also indicated significant correlations between leadership and both the impact of challenging behaviour on coping at work and use of physical restraints on older people with dementia. Conclusion: Challenging situations in nursing homes of older people with dementia are very common. There is a need to identify specific competencies for caring for people with dementia in addition to updating official guidelines to handle such situations. The support of supervisors and competencies related to therapeutic use of self in nursing are highly important for nurses providing care for people with dementia.

Background: According to previous studies, the natural environment positively influences well-being, including that of adolescent girls. However, knowledge is lacking on what motivates adolescent girls to spend time in nature. A secondary analysis of qualitative data was conducted employing three preexisting sets of interview data that had formed the basis of previously published research reports. A novel perspective on what motivates adolescent girls in the Arctic to spend time in nature was uncovered—a finding that previous articles have not reported. Aim: The aim was to describe what motivates adolescent girls in the Arctic to spend time in nature. Methods: The participants were adolescent girls aged 13 to 16 living in the province of Finnish Lapland. The girls wrote about well-being (n = 117) and were interviewed (n = 19) about the meaning of seasonal changes, nature and animals’ influence on well-being. Also, five focus group interviews (n = 17) were held. The materials were analyzed by inductive content analysis. Results: After the secondary analysis, three generic categories were found: 1) wanting to have pleasant emotions, 2) the possibility of participating in activities and 3) a desire to feel better. The main category of “need to experience positive sensations” was formed. Conclusion: Based on these results, through personalized guidance and advice, it is possible to strengthen adolescent girls’ willingness to spend time in nature.

Aim: The purpose of the study was to identify and describe the characteristic profiles of evidence-based practice competence of educators in the social, health and rehabilitation sectors and to establish relevant background factors. Design: This study was carried out as a descriptive cross-sectional study. Methods: Data were collected from social, health and rehabilitation sector educators working in the 21 Finnish universities of applied sciences and seven vocational colleges (n = 422; N = 2,330). A self-assessment instrument measuring evidence-based practice competence was used. Competence profiles were formed using a K-cluster grouping analysis. Results: Three distinct competence profiles were identified and delineated. Most educators feel that they can guide students' critical thinking and are able to seek and produce scientific knowledge. Evidence-based practice competence was explained by background factors such as year of graduation (for higher degree), level of education, job title, current employer and current field of work. publishedVersion

WHAT IS KNOWN ON THE SUBJECT?: There is a scarcity of studies concerning violence in psychiatric outpatient settings in the 2010s in spite of the deinstitutionalization of psychiatric services. Previous research on violence in psychiatric outpatient settings has failed to consider the association between the psychological consequences of violence, exposures to violence and background factors. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: It has been known for some time that exposures to violence are harmful for psychiatric inpatient nurses; the paper demonstrates that psychiatric outpatient nurses are also at risk. The psychological consequences of exposure to violence are highly individualized and influenced by background factors. Nurses who face harassment have a greater risk of suffering psychological symptoms. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: De-escalation interventions should be implemented in psychiatric outpatient settings. Organizations should consider the possibility of internal violence occurring when planning preventive interventions to manage and reduce workplace violence. Education targeted at violence prevention, management and debriefing should be organized systematically in psychiatric outpatient units and be taken into consideration in the mental health nursing curriculum. ABSTRACT: Introduction There is a scarcity of studies concerning violence and its consequences in psychiatric outpatient setting. Aim This study aimed to explore the occurrence of workplace violence and the psychological consequences of exposure to violence among nurses working in psychiatric outpatient settings. Method Research followed a cross-sectional survey design. Data were collected with the VIA-Q instrument. Results During the 12 months prior to the study, nurses (n = 181) had most often experienced psychological violence, with fatigue being the most common consequence. Harassment most often caused feelings of violated integrity, whereas physical violence most often caused insomnia. Significant relationships between exposure to violence and psychological consequences were identified. Discussion Workplace violence can manifest in a broad array of psychological symptoms and be harmful for nurses in psychiatric outpatient settings. It is important to discuss the subject of workplace violence and its place in the nursing curriculum and to reflect on how nurses are educated and trained to face violence in psychiatric nursing. Implications for Practice De-escalation interventions should be implemented in psychiatric outpatient settings. Organizations should take steps to abolish internal violence. Nurses need appropriate education in order to prepare them to manage workplace violence.

Rather than measure demographic factors such as socioeconomics, the aim of this study was to examine the lived experience of frequent attenders by synthesizing findings on their encounters with healthcare personnel. The Scopus, CINAHL, PsycARTICLES, and PubMed (Medline) databases were searched in May 2020 in order to screen studies by title and abstract (n = 1794) and full‐text (n = 20). Findings from the included studies (n = 6) were then pooled using meta‐aggregation, yielding the following results: difficulties in resolving frequent attenders’ situations may create “service circles,” frustrating patients with their situation; frequent attenders’ own expertise regarding their condition should be recognized and valued alongside that of healthcare professionals when performing collaborative care; a lack of empathy and disparagement may make frequent attenders feel misunderstood and unappreciated; frequent attenders should be recognized as individuals by taking their circumstances into account and providing support accordingly. Frequent attenders’ experiences demonstrate the importance of shared decision‐making, continuity of care, and acknowledging these patients’ individual circumstances. Identifying the variety of frequent attenders’ service needs by synthesizing their experiences is a practical way of organizing patient‐centered healthcare services.

Background Frequent attendance is largely a temporary phenomenon, but only few previous studies have made a distinction between long-term frequent attenders (FAs) and short-term FAs. Aims The aim of this study is to compare the characteristics of middle-aged long-term FAs and short-term FAs. Methods Data from a large Northern Finland Birth Cohort 1966 study's (NFBC1966) 46-year follow-up study (performed in 2012, N = 10 321) were used. The participants (n = 4390) had used public primary healthcare (PPHC) services at least once during 2013-2016 according to Finnish national register data on outpatient visits. A FA was considered a patient who had used PPHC services ≥8 times during 1 year. A long-term FA: a patient who was a FA in at least 3 years during 2013-2016. A short-term FA: a patient who was a FA in 1 or 2 years in 2013-2016. Cross-tabulation, Pearson's chi-squared test, Mann-Whitney U test, and univariate and multivariate binary logistic regression analyses were used. Results Of the 4390 participants, 132 (3.0%) were long-term FAs, 645 (14.7%) were short-term FAs, and 3613 (82.3%) were non-FAs. During 2013-2016, long-term FAs accounted for 34.8% of PPHC visits, while short-term FAs accounted 15.4%. Compared to short-term FAs, depression and high income (preventive attribute) were associated with long-term FAs. Female gender and managing usual activities were associated with short-term FAs. Poor self-reported health was associated with both long-term FAs and short-term FAs but increased the risk of being a long-term FA over three times compared to short-term FAs. Conclusions Middle-aged long-term FAs and short-term FAs have distinct characteristics; namely, depression and high income differentiate long-term FAs from short-term FAs. Poor self-reported health was associated with long-term FAs in particular. In order to identify FAs with prolonged service needs and to develop far-reaching interventions, the focus of research should be on long-term FAs.

Background Emergency care clinicians are expected to use the latest research evidence in practice. However, emergency nurses do not always consistently implement evidence-based practice (EBP). An educational intervention on EBP was implemented to promote emergency nurses' use of EBP, and the effectiveness of it was evaluated. Aims This study aimed to evaluate the effectiveness of an EBP educational intervention on emergency nurses' EBP attitudes, knowledge, self-efficacy, skills, and behavior. The study also examined learners' satisfaction with the EBP educational intervention. Methods A randomized controlled trial with parallel groups with evaluations before the education, immediately after it, and 6 and 12 months after the education was conducted at four emergency departments in two university hospitals. The experimental group (N = 40) received EBP education while the control group (N = 40) completed self-directed EBP education. The primary outcomes were emergency nurses' EBP attitudes, knowledge, self-efficacy, skills, and behavior, while the secondary outcome was satisfaction with the EBP education. Results Thirty-five participants of an experimental and 29 participants of a control group completed the study. There were no statistically significant (p

Visual impairment (VI) problems are increasing as the global aging population grows. Mobile devices have become essential to interacting with friends and society. Because the visually impaired are no exception, it would be useful to determine the functionalities that best support the independence of people with VI. The currently available functionalities and applications were analysed to provide insight about which features the visually impaired value most.A Webropol survey with structured and open-ended questions was carried out. The participants (A majority of the participants were active users of mobile devices. Substantial variation was observed in the evaluations of how useful various applications are to different everyday tasks. The participants suggested numerous improvements, such as additional customization, to the current mobile devices and applications.Implications for RehabilitationPeople with VI benefit from the use of mobile devices in the same way that the population with normal vision does, and mobile devices and applications can be pivotal to supporting their independence.The participants offered innovative ideas and suggestions for how mobile devices and applications could be designed to better meet the needs of the visually impaired.

Background: In Finland, approximately 40% of emergency medical service (EMS) missions do not result in transport of the patient to a hospital by ambulance, and there is wide variability in the reasons underlying non‐transport decisions. The aim of this study was to describe the context of these EMS non‐transport missions. Methods: The data were collected retrospectively between 3 September and 20 October 2014 by investigating non‐transport EMS charts (n = 1154). Event information and patients′ main symptoms were extracted from information found in EMS charts and quantified using content and statistical analyses. Results: Patients’ need for EMS were explained by various reasons. One‐third of the missions were caused by organ‐specific symptoms, whereas in 30.8% of cases the reason for EMS was unspecified. Sudden onset symptoms were noted for 38.4% of the cases, whereas in 14.7% of cases the symptoms had persisted for days or weeks before EMS contact. EMS personnel offered guidance instead of treatment in 79.2% of the missions. Conclusions: Non‐transport missions represent a significant daily work load for the EMS. Although most of the symptoms showed acute onset, the majority of these missions involved only assessment of medical necessity and/or guidance without any medical treatment. It is questionable whether this use of the EMS is cost‐effective for any healthcare system.