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Nurse teacherhood is composed of many factors. It includes nurse teachers' tasks and different multidimensional roles and also nurse teachers' individual experiences of being a nurse teacher. Nurse teachers' experiences of nurse teacherhood depend on the meanings they give to the different factors. In other words, there are not only one but also several interpretations of what nurse teacherhood is. These interpretations affect what is important for each nurse teacher in their own nurse teacherhood and how satisfied they are with their profession. This paper is part of a larger study examining how Finnish nurse teachers experience their nurse teacherhood in polytechnics. The purpose of this paper was to describe nurse teacherhood during the years 2003 and 2004, when polytechnics and thus also nurse education were actively being developed in Finland. Nurse teachers (N = 34) were interviewed and the data were analysed using the grounded theory method. The categories describing nurse teacherhood were: process of change in the organisation, operating culture of the health care working community, professional self-esteem, focus of competence, relationship with students, the future in one's profession and requirements for staying in the profession. The core category was commitment to nurse teacherhood. Nurse teachers' individual experiences of the significance of the categories describing teacherhood were reflected by their level of commitment to teacherhood. Nurse teachers, whose commitment to nurse teacherhood was weak, were especially unsatisfied with changes related to their teacherhood. Nurse teachers' conceptions of their future as nurse teachers were significant in terms of the direction in which they were developing their own teacherhood. Some nurse teachers who were weakly committed to nurse teacherhood considered it unlikely that they would continue in the profession in the future. [ABSTRACT FROM AUTHOR]

This article by Arja Holopainen, Tuovi Hakulinen-Viitanen and Kerttu Tossavainen explains the five stages of the systematic review process and describes how this method was applied to an analysis of studies dealing with nurse 'teacherhood'. The authors argue that systematic review is an excellent method for summarising research knowledge and for highlighting evidence significant for nursing, nursing education and nursing research. [ABSTRACT FROM AUTHOR]

Background: In Russia, tobacco and alcohol use by adolescents are serious problems. In Finland, as in many other European countries, alcohol use is a growing concern. Aims: This study aimed to find out whether similar environmental factors predict adolescents' alcohol use among 15-year old adolescents in two politically and economically different cultures: in the Pitkäranta district in Russian Karelia and in eastern Finland. Methods: Research data gathered by self-administered questionnaires from the second North Karelia Youth Study and the Pitkäranta Youth Study were analysed. Path models using the structural equation modelling (SEM) approach were constructed to test whether similar path structures fit for boys and girls in both countries, and to test whether regression coefficients are similar between the cultures and by gender. Results: The results showed that alcohol use by family members and best friend is positively related to adolescents' alcohol use both directly and indirectly. The best friend's alcohol use was the most important predictor of adolescents' own alcohol use in every sub-sample. When indirect influences were also identified, the significance of parents' and siblings' alcohol use, in addition to alcohol use by the best friends, was strongly supported. Conclusions: The results highlighted the importance of the process of peer selection for adolescents' choices, and the importance of offering support to the parents and to the health personnel working with children and adolescents. [ABSTRACT FROM AUTHOR]

This study aimed to develop a theoretical basis for the promotion of school staff's occupational well-being. The 'Content Model for the Promotion of School Community Staff's Occupational Well-being' describes the four aspects of the promotion of occupational well-being ('working conditions', 'worker and work', 'working community' and 'professional competence') as well as the functionality and structure of the model. The content model was examined empirically by means of a structural equation model. The project was developed with school staff and occupational health nurses and implemented in 2001-2004. The target group consisted of the staff of 12 comprehensive schools in Eastern Finland in 2002 (n = 211) and 2004 (n = 266). The data were collected using a 'well-being at your work index' questionnaire at both times. A structural equation model for the school staff's occupational well-being, i.e. the 'Occupational Well-being of School Staff Model' (baseline OWSS Model: Study I in the year 2002), was produced. The model was tested with the 2004 data. Based on this, the model was further developed into the final OWSS Model (Study II). The theoretical Content Model for the Promotion of School Community Staff's Occupational Well-being can be used as a framework for planning, implementing and evaluating school staff's occupational well-being. [ABSTRACT FROM AUTHOR]

The purpose of this study was to assess whether similar environmental factors predict adolescents' smoking in two different cultures: in the Pitkäranta district in Russian Karelia and in eastern Finland. The data were gathered by self-administered questionnaires from ninth-grade students in 10 comprehensive schools in Pitkäranta (n = 385) and from age-matched students in 24 schools in eastern Finland (n = 2,098). Structural equation modeling (SEM) was used to test whether similar path structures fit for boys and for girls in Pitkäranta and in eastern Finland, and to test whether regression coefficients were similar between the cultures by sex. Smoking by family members and best friends was positively related to adolescents' smoking both directly and indirectly. Environmental factors were similar predictors of smoking between the cultures for boys. For girls, different regression coefficients in Pitkäranta and in eastern Finland were found. Best friend's smoking was the most important predictor of adolescents' own smoking in every sub-sample. When indirect relationships were identified, the significance of parents' and siblings' smoking, in addition to smoking by best friends, was strongly supported. [ABSTRACT FROM AUTHOR]

The aim of this research was to analyze conversations between expectant families (N = 21) in Net Clinic, an Internet-based service designed for patients using public maternity care. The online conversations, shared opinions about experiences of pregnancy, and family life constituted the data for content analysis. The families developed a sense of virtual community, which gradually evolved into a real-life community, by discovering the similarity of their life situations and by giving parent-to-parent support for everyday life events. As a view of daily family life, Net Clinic offers maternity care professionals a deeper understanding of how to enhance safer pregnancy, birth, and growth of the family. [ABSTRACT FROM AUTHOR]

Objective The aim of this study was to find out what aspects of their parenthood parents revealed, and how they expressed their thoughts concerning maternity care services on an online communication forum. Background The 'Information Society' offers a growing variety of health services as part of public primary health care via the internet. Little is known about the contents produced online by pregnant families, and how they reflect on both family life and maternity care services. Methods The data for this study were obtained from online discussions between families (n=21) in Net Clinic, an internet- based service designed for public maternity care. The data included experiences of family life during pregnancy, childbirth and parenting, and was analysed by inductive content analysis. Results While maturing into parenthood, both women and men recognised the uniqueness of their new role and wanted to prepare for safe childbirth. Online communication in the home environment nourished new social networks among families who were expecting their first, second or third child. In addition, families reflected on maternity care services on the Net Clinic's communication forum. This provided realistic feedback to maternity care professionals. Conclusions Today, the relationship between clients and professionals is inevitably changing. More online services and advocacy are needed if families are to have access to online health services. The role of professionals is diversifying from being authorities to supporting and facilitating clients' individual self-care. Based on direct client feedback, the quality of maternity care can be improved. [ABSTRACT FROM AUTHOR]

This paper describes occupational health nurses' and school staff members' experiences of work ability maintenance carried out at schools and the development of ideas to promote the collaboration between occupational health care and school community and to enhance work ability maintenance. The data were collected in a baseline situation of an action research project to further plan and develop activities. The data were analysed by inductive content analysis. According to the results, school community staff members' work ability maintenance focused on the employee, the school community, school work and the working conditions as well as professional competence. The practical actions involved some individual and school-specific variation, focusing on actions to maintain individual and physical work ability. It seems that the collaboration between the school community and occupational health service for work ability maintenance took place at the individual level, but an obvious need for more structural collaboration emerged by several suggestions made by the participants (e.g. better information exchange between the school and occupational health care, improved collaboration between the school staff and the co-operative partners). The progress in collaboration may lead towards spontaneous collaboration, in which case both actors have the same target and work in a planned, continuous and natural way to ensure work ability maintenance in the school community. [ABSTRACT FROM AUTHOR]

This study describes how the potential sources of errors and error prevention in operating room (OR) teams are experienced by Finnish, American and British nurses. The data were collected by interviews and analysed using a qualitative content analysis. Results consisted of categories demanding teamwork practice, shared responsibility in teams and organized teamwork. The demanding practice category included fear of errors, turnover in teams, overtime work and emotional distress as potential factors leading to errors in OR teamwork. Shared responsibility emphasized how the familiar teams, safety control and formal documentation of errors prevented errors. At the organizational level, the prevention of errors required scheduling of work, good management, competency and a reasonable physical environment. In order to improve safety in OR teams, recognition should be given to the balance of error-making and learning from them. More effective ways in reporting incidents should be adopted and overall reporting systems should be developed in Finnish OR teams. [ABSTRACT FROM AUTHOR]

The aim of this research was to describe an international student exchange programme as a context of learning intercultural competence in nursing. Twelve Finnish nursing students who had participated in an exchange programme in the United Kingdom participated. The data consisted of group interviews, learning documents, background questionnaires and research diary notes, and the method of inductive content analysis was used. Study abroad as a process of learning intercultural competence consisted of three ethno-categories: transition from one culture to another, adjustment to the difference and gaining intercultural sensitivity. The exchange programme as a context of learning intercultural competence was characterized by a problematic orientation phase, a study abroad phase that involved stressful but rewarding adjustment to the intercultural differences and an inadequate re-entry debriefing phase. In order for the international experience of nursing students to have an impact on their understanding of diversity, they need assistance in each phase of the programme. Particularly, the students need intercultural tutoring and mentoring to venture into encounters with local people, including direct client contacts, during their study abroad. [ABSTRACT FROM AUTHOR]

The aim of nursing students' operating room (OR) clinical practice is to gain experience of the perioperative nursing process and to develop skills related to the practice within OR teams in a variety of situations. However, it has previously been problematic to get enough practical experience within OR teams because of the general urgency, e.g. rapid turnover and flow of emergency cases, and preceptors' multiple responsibilities related to their simultaneous need to work as team members. This study describes how Finnish, British and American nursing students (n = 30) experienced learning about teamwork during their OR placement period. The critical incident technique was used for data collection, and data were analysed using a descriptive phenomenological method. Three types of teamwork emerged based on the students' perceptions: functional manifestation of OR teamwork, gaining OR team membership and technical orientation of OR teamwork. The findings are discussed in relation to OR practice, education and research on ways to improve teamwork while maintaining a satisfactory OR learning context and stimulating interest in perioperative nursing. [ABSTRACT FROM AUTHOR]

European nursing has responded to the challenges of multicultural society by integrating student exchange programmes into nursing education since the 1990s. For students, these programmes provide opportunities to study in another EU member state and to develop intercultural competence as part of the training. The aim of this study was to describe the process of gaining intercultural competence among British undergraduate nursing students during their study abroad in Finland. Fifteen British students participated in this study. Data were obtained from interviews, observations, background questionnaires and research diary notes. The data were analysed with Spradley's developmental research sequence (DRS) method. Campinha-Bacotes' model of cultural competence was used as a framework of rendering the results. Students' intercultural desire, i.e. their effort to become interculturally competent, turned out to be the foundation of the entire process. Study abroad is an intensive experience, and therefore the preparation, the selection of exchange students, the design of the programme and intercultural tutoring warrant careful attention. [ABSTRACT FROM AUTHOR]

Background. Student exchange has been used increasingly in nursing education throughout Europe as a method of learning intercultural sensitivity. In the host country, each foreign student is assigned a personal tutor to enhance learning. Aim. The aim of this study was to describe tutor-student relationships between Finnish nurse teachers and British exchange students from the tutors' perspective. Ethical issues. The researcher's close relationship with the study context and participants caused some ethical concerns, which will be discussed. Methods. The data consisted of tutorial session observations, research diary notes, group interviews and background questionnaires. They were analysed using Spradley's developmental research sequence method for ethnographic data. Findings. The tutoring relationship was pastoral and clinical rather than academic. The pastoral aspect of the relationship was essential in assisting the students to adjust to the stress of studying in a foreign country. On the other hand, tutors were unable to support all the students to overcome their culture shock. Tutors were uncertain about their role and did not integrate Finnish culture or practice into theory, but found their role pleasant. Conclusions. A dialogic tutor-student relationship is important for learning intercultural sensitivity. Tutoring strategies should be developed to assist students' adjustment to the differences in the host culture and to encourage their reflection on personal, experiential and scientific cultural knowledge during their study abroad. [ABSTRACT FROM AUTHOR]

This study describes how ninth-grade adolescents' smoking behavior in the Pitkaranta district (Russia) differs from their eastern Finland counterparts. Cross-sectional data from the second North Karelia Youth Study and the Pitkaranta Youth Study were used. Subjects were all (n=385) ninth-grade students in 10 comprehensive schools in Pitkaranta and all (n=2098) students of the same age in 24 comprehensive schools in eastern Finland. Students were asked about their smoking status, intentions to smoke, smoking situations, acquisition of tobacco products, and opportunity to smoke in the school area. The results showed very large differences in the smoking prevalence between Pitkaranta and eastern Finland. For boys, the prevalence of daily smoking was 29% and 19% in Pitkaranta and eastern Finland, respectively. The differences in girls were adverse: 7% and 21% of girls in Pitkaranta and eastern Finland, respectively, were daily smokers. However, as many as one third of the nonsmoking girls in Pitkaranta stated that they may experiment or start smoking later. Boys in Pitkaranta had vaguer attitudes about remaining nonsmokers than boys in eastern Finland. This situation anticipates worsening of the smoking epidemic in Pitkaranta and requires an effective prevention policy and cooperation between different groups in society. [ABSTRACT FROM AUTHOR]

Aims and Objectives: To describe the phenomenon of final assessment of the clinical practice of nursing students and to examine whether there were differences in assessments by the students and their teachers and mentors., Background: Final assessment of students in clinical practice during their education has great importance for ensuring that enough high-quality nursing students are trained, as assessment tasks affect what the nursing student learns during the clinical practice., Design: This study used descriptive, cross-sectional design., Methods: The population of this study comprised nursing students (n = 276) and their teachers (n = 108) in five universities of applied sciences in Finland as well as mentors (n = 225) who came from five partner hospitals. A questionnaire developed for this study contained questions about background variables as well as structured questions scored on a four-point scale, which also allowed the respondents to provide additional comments., Results: When comparing the results related to nursing teachers' presence in the final assessment situation, it was found that teachers and mentors evaluated this as being carried out more often than nursing students suggested. Nursing students noted that fair and consistent assessment is carried out more often than nursing teachers thought. Mentors and teachers said that honest and direct criteria-based final assessment was carried out more often than nursing students evaluated., Conclusions: Nursing students and mentors need support from educational institutions and from nursing teachers in order to ensure the completion of a relevant assessment process., Relevance to Clinical Practice: The findings of this study highlight an awareness of final assessment process. It is desirable to have a common understanding, for example, of how the assessment should be managed and what the assessment criteria are, as this will ensure a good quality process., (© 2017 John Wiley & Sons Ltd.)

Aims: The aim of this study was to find out whether family members' (mother, father, siblings) and best friend's smoking is related to 9th grade pupils' daily smoking in Eastern Finland and in the Pitkäranta district, in the Republic of Karelia, Russia, and whether these relations have changed in these two culturally very different neighbourhood countries from 1995 to 2013., Methods: Data comprised four cross-sectional studies in all schools of the Pitkäranta region and selected schools in Eastern Finland. In data analyses, structural equation modelling techniques were used., Results: Our findings showed that best friend's smoking had the strongest influence on adolescents' smoking in both countries and study years (p < .01). The relations among family members were highly different between Pitkäranta and Eastern Finland, particularly in 2013., Conclusions: Results suggest that health promotion in schools should take into account cultural impacts and pay special attention to pupils who have family members and friends who smoke.

Purpose: Becoming a smoker usually starts during adolescence and is a dynamic process involving experimentation before the establishment of daily smoking. It has been suggested that adolescents who smoke differ from those who do not in their attitudes to smoking. The purpose of this study was to find out whether attitudes related to smoking legislation and restrictions, social pressures in smoking and image of smokers are associated with smoking experimentation, daily smoking and best friends' smoking., Method: The data were gathered with a self-administered questionnaire in North Karelia, Eastern Finland and in the Pitkyaranta district, Republic of Karelia, Russia. The respondents were 15-year-old 9th grade pupils in local schools. In Pitkyaranta, the data analyses covered pupils in all eight schools in the area (n = 179). In North Karelia, the data analyses comprised of selected eight schools (n = 601). Data were analysed with exploratory factor analysis., Results: The models revealed that attitudes related to restrictions and social pressure were significantly associated with experimenting with smoking [OR (95 % CI) 7.923 (5.787-10.847)], daily smoking [OR (95 % CI) 9.575 (6.727-13.628)] and the likelihood of best friends' smoking [OR (95 % CI) 3.154 (2.579-3.858)]. The stronger the young peoples' attitudes and opinions, for example, towards restrictions and with more difficulties in refusing smoking, the higher the likelihood for smoking experimentations, daily smoking as well as the likelihood for their best friends' smoking. The country and factor interactions were not associated with smoking experimentations, daily smoking or best friends' smoking., Conclusion: Regardless of cultural background, adolescents who smoke have more positive attitudes to smoking, and perceive more social support for smoking, than do adolescents who do not smoke. The study stresses the similarity of the results in both Karelia's despite the enormous differences in culture, economy and public policy.

Unlabelled: Aim This study aimed to identify and reach consensus among primary health care participants [registered nurses (RNs) who receive clients, directors of nursing, senior physicians, health promotion officers, and local councillors] on the types of service provider that RNs who receive clients represent in the implementation of health promotion practices in primary health care in Eastern Finland., Background: There is an increasing focus on public health thinking in many countries as the population ages. To meet the growing needs of the health promotion practices of populations, advance practice has been recognized as effective in the primary health care setting. The advance practice nurses share many common features, such as being RNs with additional education, possessing competencies to work independently, treating clients in both acute and primary care settings, and applying a variety of health promotion practices into nursing., Methods: The two-stage modified Delphi method was applied. In round one, semi-structured interviews were conducted among primary health care participants (n=42) in 11 health centres in Eastern Finland. In round two, a questionnaire survey was conducted in the same health centres. The questionnaire was answered by 64% of those surveyed (n=56). For data analysis, content analysis and descriptive statistics were used. Findings This study resulted in four types of service provider that RNs who receive clients represented in the implementation of health promotion practices in the primary health care setting in Eastern Finland. First, the client-oriented health promoter demonstrated four dimensions, which reached consensus levels ranging between 82.1 and 89.3%. Second, the developer of health promotion practices comprised four dimensions, which reached consensus levels between 71.4 and 85.7%. Third, the member of multi-professional teams of health promotion practices representing three dimensions, with consensus levels between 69.6 and 82.1%. Fourth, the type who showed interest towards health policy reached a consensus level of 55.4% in this study.

Aim: The aim of this study was to identify and reach a consensus on the elements needed for the success of health promotion practices delivered by registered nurses (RNs) who receive clients in primary health care among primary health care participants in eastern Finland., Background: Advanced practice nurses are a reaction to the changing health needs of society. These nurses have come to play a significant part in improving health-promotive care in the primary health care setting., Methods: A mixed method two-stage Delphi technique was applied., Results: A health-promoting organizational culture (e.g., the respectful management of health promotion) and nurses' health orientation and development (e.g., nurses' professional growth and work well-being) were found as the main elements required for the success of the health promotion practices in primary health care., Conclusions: A health-promoting organizational culture with the strategic and respectful leadership of health promotion is significant in the implementation of the health promotion practices delivered by RNs in primary health care., (Copyright © 2015 Elsevier Inc. All rights reserved.)

This article is part of a long term project "Promoting the Occupational Well-Being of School Staff-Action Research Project in Finland and Estonia, 2009-2014." The purpose of this article is to describe the significance of action plans in the promotion of the occupational well-being of primary and upper secondary school staff in Finland and Estonia from 2010 to the turn of the year 2011-2012. An electronic open questionnaire was sent to occupational well-being groups in Finland (N=18) and in Estonia (N=39). In Finland, the questionnaire was responded to by 16 (n=16) occupational well-being groups, and in Estonia, by 38 (n=38) groups. The qualitative data were analyzed using the inductive-deductive method and content analysis. The obtained results indicate that the schools had named goals for action plans in all aspects of the promotion of occupational well-being in schools (worker and work, working conditions, professional competence, working community) and that these goals were mainly realized in the schools in a systematic way. Schools felt that the action plan for occupational well-being helped them to set goals for occupational well-being and that the planned actions were realized in a more systematic way than before., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Objectives: To provide an overview of summative assessment of student nurses' practice currently in use., Design: Narrative review and synthesis of qualitative and quantitative studies., Data Sources: With the support of an information specialist, the data were collected from scientific databases which included CINAHL, PubMed, Medic, ISI Web of Science, Cochrane library and ERIC published from January 2000 to May 2014. Sources used in all of the included studies were also reviewed., Review Methods: 725 articles concerned with student nurse clinical practice assessment were identified. After inclusion and exclusion criteria, 23 articles were selected for critical review., Results: Findings suggest that the assessment process of student nurses' clinical practice lacks consistency. It is open to the subjective bias of the assessor, and the quality of assessment varies greatly. Student nurses' clinical assessment was divided into 3 themes: acts performed before final assessment, the actual final assessment situation and the acts after the final assessment situation. Mentors and students need teachers to provide them with an orientation to the assessment process and the paperwork. Terminology on evaluation forms is sometimes so difficult to grasp that the mentors did not understand what they mean. There is no consensus about written assignments' ability to describe the students' skills. Mentors have timing problems to ensure relevant assessment of student nurses. At the final interview students normally self-assess their performance; the mentor assesses by interview and by written assignments whether the student has achieved the criteria, and the role of the teacher is to support the mentor and the student in appropriate assessment. The variety of patient treatment environments in which student nurses perform their clinical practice periods is challenging also for the assessment of student nurses' expertise., Conclusions: Mentors want clinical practice to be a positive experience for student nurses and it might lead mentors to give higher grades than what student nurses in fact deserve. It is very rare that student nurses fail their clinical practice. If the student nurse does not achieve the clinical competencies they are allowed to have extra time in clinical areas until they will be assessed as competent. Further research needs to be carried out to have more knowledge about the final assessment in the end of clinical practice. Through further research it will be possible to have better methods for high quality assessment processes and feedback to student nurses. Quality in assessment improves patient safety., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Aims: The aim of this study was to compare the prevalence of smoking, smoking experimentation and future intention to smoke in the Pitkäranta district, the Republic of Karelia, Russia and Eastern Finland in the years 1995 and 2013., Methods: Cross-sectional studies were carried out among 15-year-old ninth grade adolescents in all schools in the Pitkäranta region (1995: n=385, response rate 95%; 2013: 182, response rate 98%) and a sample of schools in Eastern Finland (1995: n=2098, response rate 91%; 2013: 635 response rate 95%)., Results: The daily smoking prevalence among adolescents did not change either in Eastern Finland or in the Pitkäranta district from 1995 to 2013. However, smoking among Finnish adolescents was more common than among Russians (p<0.001) and boys, in general, smoke more commonly than girls (p<0.001). In Finland, early smoking experimentations declined by half among both genders but in Pitkäranta the girls' smoking experimentations tripled (relative risk 3.03, 95% confidence interval 1.76-5.20) from 1995 to 2013. The combined effect of country and gender was significant (p<0.001) for future intention to smoke. In Finland future intentions to smoke were very similar in boys and girls compared with obvious gender differences in Russia., Conclusions: These results suggest that more attention should be paid for programmes that consider better gender and culture-specific issues in preventing initiation of smoking and promoting an anti-smoking climate in societies., (© 2015 the Nordic Societies of Public Health.)

Aims and Objectives: The aims of this study were to identify and reach consensus among municipal primary health care participants on nurse practitioners' (NPs') required case management competencies in health promotion practices in eastern Finland., Background: The NP's role as a case manager of patients with chronic conditions has been found to have positive outcomes in health promotion, such as reduced hospital lengths of stay and readmission rates. However, the challenging work of health promotion requires NPs to have multidimensional competencies in health promotion, including communication, advocacy, assessment, planning, consultation and implementation., Design: A two-stage modified Delphi study., Methods: Round 1 semi-structured interviews were conducted among municipal primary health care participants (n = 42) in 11 health centres from April-July 2009, and the round 2 questionnaire survey was conducted in the same health centres in eastern Finland in January and March 2011. The questionnaire was answered by 64% of those surveyed (n = 56). Content analysis and descriptive statistics were used for data analysis., Results: We identified a total of 18 required case management competencies for NPs' health promotion practices in municipal primary health care. In 17 of these competencies (such as knowledge, skills and ability to work independently in health promotion), a consensus was reached (51% or over). However, the need to be interested in municipal decision-making (44·6%) did not reach consensus., Conclusion: Consensus was clearly achieved for 17 competencies that NPs were required to have, and these indicated the knowledge or abilities of health promotion. Nevertheless, there was no agreement on the NPs' need to be interested in municipal decision-making., Relevance to Clinical Practice: NPs need a variety of case management skills and abilities to realise health promotion in municipal primary health care and they need to be supported by primary health care leaders to develop health promotion activities., (© 2015 John Wiley & Sons Ltd.)

Aim: Mortality and morbidity from non-communicable diseases (NCDs) is a major public health problem in Russia. The aim of the study was to examine trends and educational differences from 1992 to 2007 in NCD risk factors in Pitkäranta in the Republic of Karelia, Russia., Methods: Four cross-sectional population health surveys were carried out in the Pitkäranta region, Republic of Karelia, Russia, in 1992, 1997, 2002, and 2007. An independent random sample of 1000 persons from the general population aged 25-64 years was studied in each survey round. The total number of respondents in the four surveys was 2672. The surveys included a questionnaire, physical measurements, and blood sampling, and they were carried out following standard protocols., Results: The NCD risk factor trends generally increased in Pitkäranta during the study period with the exception of systolic blood pressure and smoking among men. Especially significant increases were observed in alcohol consumption among both sexes and in smoking among women. Educational differences and differences in trends were relatively small with the exception of a significant increase in smoking in the lowest female educational category., Conclusions: Trends showing an increase in some major NCD risk factors and signs of emerging socio-economic differences call for stronger attention to effective health promotion and preventive policies in Russia., (© 2014 the Nordic Societies of Public Health.)

Background: Assessment received by students affects the way that they conduct their studies and shapes their interests in clinical placements. It is therefore important that mentors and teachers have high quality assessment strategies to ensure the competence of nursing students., Objectives: The objective of this study is to describe the views and experiences of nursing students, nursing teachers, and mentors on the final assessment of nursing students in clinical practice. The study also investigates respondents' views on using a standardized national or European scheme for clinical assessment in the future., Design: Descriptive survey design with a questionnaire., Settings: Implemented in five Finnish universities of applied sciences and in five partner hospitals., Participants: Nursing students (n=276), nursing teachers (n=108) and mentors (n=225)., Methods: A questionnaire was used to collect data. Survey data were analyzed by using SPSS version 19. Descriptive statistics and cross tabulations were used to characterize the data., Results: Nursing students felt that they had spent enough time with their mentors during their clinical practice period to ensure that the mentors could assess their behavior. Mentors also evaluated that they had spent enough time with the students. Students and mentors both indicated occasional difficulties with the language used in the competence assessment document. Most of the nursing students and mentors shared the view that it is always necessary for a teacher to be involved in the final assessment discussion., Conclusions: The study highlights the importance of assessment skills of mentors and the important role of the teachers. Findings from this study indicate that nursing students' clinical practice assessment already includes many good practices, but we still have some difficulties in ensuring effective measures of competence., (Copyright © 2014. Published by Elsevier Ltd.)

Nurses play an important role in promoting public health. Traditionally, the focus of health promotion by nurses has been on disease prevention and changing the behaviour of individuals with respect to their health. However, their role as promoters of health is more complex, since they have multi-disciplinary knowledge and experience of health promotion in their nursing practice. This paper presents an integrative review aimed at examining the findings of existing research studies (1998-2011) of health promotion practice by nurses. Systematic computer searches were conducted of the Cochrane databases, Cinahl, PubMed, Web of Science, PsycINFO and Scopus databases, covering the period January 1998 to December 2011. Data were analysed and the results are presented using the concept map method of Novak and Gowin. The review found information on the theoretical basis of health promotion practice by nurses, the range of their expertise, health promotion competencies and the organizational culture associated with health promotion practice. Nurses consider health promotion important but a number of obstacles associated with organizational culture prevent effective delivery.

A variety of legislation, initiatives and organizations exist to support, encourage and even oblige schools to collaborate more effectively with parents or guardians. However, there is minimal understanding of the experiences and opinions of parents and school staff about their roles, especially in relation to children's health education. This study examined how parents of 10-11-year-old children perceive the roles of both home and school in educating children about health. A questionnaire, based partly on the Finnish national core curriculum for basic education, was administered to 348 parents; the response rate was 53%. Factor analysis was used to define sum variables, which were then used as dependent variables in an analysis of variance examining the effects of children's gender and health; parents' education, gender, work status and year of birth; and school location (urban/rural). The results suggested that parents considered that either health education was mainly their responsibility, or it was a mutual responsibility with the school. Parents living in rural areas and the youngest group of parents were more likely to consider that health education should be shared with schools than were parents living in cities, or older parents. To expand awareness about the role of home and school in children's health education and to develop further health promotion within the whole school community, it is important to gather parents' views regarding health issues. This study was conducted as part of a broader program in the health promotion network of the Schools for Health in Europe (SHE).

Aims and Objectives: To examine nursing staff's perceptions about how often they provide interventions of emotional support and the level of competence needed on neurosurgical wards to support traumatic brain injury patients' family members., Background: Traumatic brain injury in one individual affects the health of their whole family. Studying the emotional support provided by nursing staff is important because such support is crucial for the family members of a traumatic brain injury patient during the acute phase of treatment. Members of the nursing staff provide emotional support to family members by consoling them; this alleviates insecurity, anxiety, hopelessness and depression., Design: A structured self-reported questionnaire presented to 172 nurses working on neurosurgical wards. The response rate was 67% (n = 115)., Methods: Descriptive statistics were used to determine how often nurses provided emotional support to the traumatic brain injury patients family members and one-way anova to examine the relationships between the background variables and the respondents' evaluations of how often they gave emotional support to brain injury patients' family members., Results: Thirty-seven percentage of nurses stated that they always took account of family members' individuality and 65% that they were always respectful. All registered nurses and staff members with long work experience (21 years or more) on a neurosurgical ward reported that they took family members' feelings of anger and guilt into consideration slightly more often than other nursing staff did. Most nurses considered these skills to represent basic competencies., Conclusion: Further service training on dealing with difficult emotions of traumatic brain injury patients' family members could help nurses to face these situations. Both education and work experience affected the frequency at which nursing staff provided emotional support to traumatic brain injury patients' family members., Relevance to Clinical Practice: The results are relevant for example when planning specialised studies or in-service training for neuro-nurses, as well as when selecting the subjects to be addressed during the orientation of a new staff member. In addition, the results should help nursing staff to understand their role in the emotional support of family members., (© 2013 Blackwell Publishing Ltd.)

Background: The effective mentorship of nursing students requires that mentors have a range of personal qualities. However, it is also essential to consider the role of other participants, such as colleagues in placement settings and educators in educational institutions, as well as the relationship with students., Objective: This aim of this study was to describe Finnish and British mentors' (n=39) conceptions of the factors that affect the provision of effective mentorship for pre-registration nursing students in healthcare placements., Design and Methods: The data in this qualitative study were collected by focus group interviews and analysed using a phenomenographical approach., Results: The findings highlighted the factors governing seamless and committed collaboration with all stakeholders involved in student mentorship. Mentors considered that their own advantageous attitude, capabilities and competence, supportive co-operation with colleagues and lecturers, and enthusiasm and active participation of students were all significant factors determining the effectiveness of student mentorship., Conclusions: Nursing organisations and educational units need to develop a well-defined and robust partnership strategy for student mentorship, which would clarify the roles of all stakeholders. This would help to ensure the availability and quality of students' placement learning and mentorship, and develop the joint preparation programmes for student mentorship., (Copyright © 2012 Elsevier Ltd. All rights reserved.)

Pre-registration nursing students require varying levels of support during placement learning. Although they receive support from different stakeholders, the support provided by mentors is considered the most significant. Several challenges are encountered in the facilitation of students in placements, particularly in relation to mentors' roles in support and assessment. This phenomenographical study examines the conceptions of Finnish and British mentors regarding the facilitation of placement learning and professional development of pre-registration nursing students. The findings identified four main categories of description, which grouped the different ways mentors experienced the facilitation of students. Firstly, students should be the focus and respected as individual partners with personal learning goals. Secondly, placements must be fit for students' practice and learning. Thirdly, facilitation was seen as guided co-working and spurring to enable a student to attain stipulated nursing competencies. Finally, ongoing assessment of students' achievements, learning outcomes and professional attributes was viewed as significant. This study highlights the importance of human and pedagogical approaches in the facilitation of students' placement learning and professional development. Hence, mentors are required to have effective communication and evaluation skills, and should therefore be supported through mandatory mentor preparation programmes and updates developed in national and cross-cultural co-operation., (Copyright © 2012 Elsevier Ltd. All rights reserved.)

This systematic literature review describes how adult traumatic brain injury (TBI) patients' family members received support. The research question was "What in healthcare constitutes support for a TBI patient's family members?" The data for this review were based on 22 empirical studies published in scientific journals in 2004-2010, which were found in the Cinahl, PsychINFO, and ISI Web of Knowledge databases. The review includes the study design, sample, method, and main results. The data were analyzed using content analysis. Social support for brain injury patients' family members was divided into 3 main categories: informational, emotional, and practical support. The subcategories of informational support were information about the patient's symptoms, information about care, quality of information, and information about the prognosis. The subcategories of emotional support were taking emotions into account, caring, listening, and respecting. The subcategories of practical support were support in decision making, promoting the welfare of the family, encouraging family members to participate in care, cooperation with the family members, and counseling services. The results are available for nurses in practical work. The review offers nurses a structure for supporting TBI patients' families, and according to this review, supporting TBI patients' families appears to have many dimensions. The results suggest that nurses should be informed that it is important for family members to know the facts about TBI to understand the condition and to receive practical advice on how to help their significant other with TBI with daily activities. In addition, the results provide a basis for further research and development of interventions that support brain injury patients and their family members.

Health-care organizations have a key role in improving the quality of student mentorship in placements. This study presents the findings of Finnish and British mentors' conceptions of how to build organizational capacity for the provision of effective mentorship for pre-registration nursing students during placement learning. The data obtained from nine semistructured focus group interviews were analyzed using a phenomenographic approach. Three categories of description are presented. Organizations were mainly perceived as optimizers of investments in developing clear strategies for the provision of sufficient resources and professional support for mentors. The creation of a positive mentorship culture within a development-oriented, student-centred and goal-directive atmosphere was seen as essential. Furthermore, providing well-prepared placements for clinical practice of students was emerged as crucial, which included adequate working conditions and stakeholders as well as arrangements of learning opportunities. It is concluded that effective student mentorship requires health-care organizations to invest in financial and human resources in order to promote the quality of the placement learning environments. Such provision will enhance students' recruitment, retention and effectiveness, leading to safe practice and cost-benefits for health-care organizations in the longer term., (© 2011 Blackwell Publishing Asia Pty Ltd.)

Aim and Objective: This systematic review describes mentoring of nursing students in clinical placements., Background: Mentoring in nursing has been widely investigated, but mentoring among students has remained vague. There is no universal agreement on student mentoring in nursing placements; therefore, mentoring approaches vary. A unified description of student mentoring is needed to ensure the quality of placement learning in nursing organisations., Design: Systematic review., Method: The data were collected from nursing research articles over 20 years (1986-2006). The articles (n = 23) were analysed using inductive content analysis., Results: Mentoring of nursing students in clinical placements was described according to two themes: (1) facilitating nursing students' learning by creating supportive learning environments and enabling students' individual learning processes, (2) strengthening students' professionalism by empowering the development of their professional attributes and identities and enhancing attainment of students' professional competence in nursing., Discussion: This description of student mentoring in nursing clinical placements integrates environmental, collegial, pedagogical and clinical attributes. To ensure effective student mentoring, an individual mutual relationship is important, but also essential is organisation and management to provide adequate resources and systematic preparation for mentors., Conclusions: The description of student mentoring needs to be systematically reviewed to reflect changes in nursing and education and compared within related concepts to achieve and maintain a workable description. A clear and systematic strategy for student mentoring in nursing organisations could be one opportunity to enhance recruitment of nursing students to the workforce., Relevance to Clinical Practice: A unified description of student mentoring will help improve the quality of placement learning opportunities and support for students, also for exchange students. A clear description of student mentoring enables the development of systematic provisions for mentoring of nursing students in placements and adequate mentor preparation programmes for nurses., (© 2011 Blackwell Publishing Ltd.)

Nurse teacherhood is usually examined from the perspectives of nurse teachers' tasks, roles, skills and managing. The purpose of this study was to discuss how nurse teachers themselves describe their teacherhood. The purpose was also to generate a substantive theory of nurse teacherhood, its development, changes and manifestation. Nurse teachers from different polytechnics (today called universities of applied sciences) in Finland (N=34) were interviewed using a semi-structured interview. The data were analysed by employing the grounded theory method. Nurse teacherhood was found to be a dynamic process influenced by processes of change in the organisation, the operating culture of the health care working community, nurse teachers' professional self-esteem, the focus of nurse teachers' competence, their relationship with students, the future of their profession and requirements for staying in the profession. Commitment emerged as the core feature of nurse teacherhood. It was possible to distinguish eight types of commitment: (1) searching for new content in one's position, (2) being adapted to one's position, (3) trying to advance in one's position, (4) having found one's position, (5) searching for one's position, (6) withdrawing from one's position, (7) being satisfied with one's position and (8) being uncertain about one's position.

Background: The concept of 'nurse teacherhood' is multidimensional. In this article, 'nurse teacherhood' includes nurse teachers' tasks and different multidimensional roles as well as their personal experiences of being a nurse teacher., Objectives: The article examines the topics of nursing research concerning nurse teacherhood, the changes in these topics and the results reported from January 1990 to April 2004., Design and Method: The material was obtained by conducting a systematic review, and it included nursing research papers and Finnish academic dissertations (N=207). The material was analysed by using content analysis., Results: The topics of the studies were divided into three thematic categories: the expansion of nurse teacherhood, the skills of nurse teacherhood and their development, nurse teacherhood and membership in working community. The number of studies on the first two themes had increased (1990-1994:43; 1995-1999:57; 2000-4/2004:65), while those on the third theme had decreased (1990-1994:18; 1995-1999:19; 2000-4/2004:5)., Conclusions: Nurse teacherhood has been studied actively during the past 15 years and approached from several perspectives. Most of the topics of the studies discussed the expansion of nurse teacherhood. The focus of the studies in different years varied depending on the kind of challenges posed to nurse teachers' work in each period of time.

The purpose of this paper is to describe the views of health care and information technology professionals and patients about the future use and scenarios of information and communication technologies (ICT) in nursing practice. The perspective was set at the year 2010. The Delphi method was used, and the data were gathered during the years 2001 and 2002 with three Delphi rounds from a Finnish expert panel (N = 81). The experts consisted of clinical nurses, clinical nurse managers, nurse educators, professionals of development, research and information technology and patients. The data were gathered and analysed with qualitative and quantitative methods. The use of ICT was observed from the viewpoints of probability and desirability. The experts agreed more often about the desirability than the probability of the use of ICT. Three future nursing scenarios were outlined based on the results: nursing knowledge management and development, patient orientation and self-care, and technology vs. the human being. The scenarios will be take-off points for development in nursing practice and education.