Biomedical subjects

A M Pietilä

Publications and source records attributed to A M Pietilä.

At least 19 recordsLinked to original sources

PubMed2001

Nonpharmacological methods in relieving children's postoperative pain: a survey on hospital nurses in Finland.

AIM OF THE STUDY: The aim of this study was to describe nurses' use of selected nonpharmacological methods in relieving 8-12-year-old children's postoperative pain in hospital. METHODS: The convenience sample consisted of 162 nurses working on the paediatric surgical wards in the five Finnish university hospitals. An extensive questionnaire, including a five-point Likert-scale, on the nurses' use of selected nonpharmacological methods and demographic data was used as a method of data collection. The response rate was 99%. Descriptive statistics as well as nonparametric Kruskall-Wallis ANOVA and the chi-squared test were used as statistical methods. RESULTS: The study indicates that emotional support, helping with daily activities and creating a comfortable environment were reported to be used routinely, whereas the cognitive-behavioural and physical methods included some less frequently used and less well known strategies. The results also show that attributes, such as the nurses' age, education, and work experience, the number of children the nurses had, the nurses' experiences of hospitalization of their children as well as the hospital and the place of work, were significantly related to the use of some nonpharmacological methods. CONCLUSIONS: The nurses used versatile nonpharmacological methods in children's postoperative pain relief, although some defects could be observed. More research is needed on the methods used by nurses to relieve children's pain in different patient groups and the factors which hinder or promote nurses' use of pain alleviation methods in the clinical practice.

Adult↗

PubMed2000

Life control of members of the Kainuu Martha Organization in Finland.

The purpose of this study was to describe the life control of members of the Kainuu Martha Organization (the Marthas), based on their written autobiographic material. The study material consisted of written thematized autobiographies of members of the organization (n = 41). The material was analysed using qualitative content analysis with concepts of the health portrait. The Marthas were classified into three groups (member, participating and leading) on the basis of their participation in Martha activities. According to the generational categorization of Roos, the member Marthas represented the Finnish generations of well-being, structural change and shortage. They did not participate actively in the Martha activities. Their feeling of life control was based on the sense life made to them. The member Marthas emphasized the meaning of family in their lives. The participating Marthas represented the generations of structural change and shortage. They participated in the Martha activities as observers or by attending the functions of their local organizations. Their feeling of life control was related to a favourable attitude towards life and concern for their human relations. The leading Marthas represented the generation of shortage and participated actively in the Martha activities. They believed in the continuity of the Martha Organization in Kainuu. They had a strong feeling of life control. This manifested as an enterprising spirit in everyday life, which included a skill to live life as it occurred. The lives of the leading Marthas were characterized by a favourable attitude, a feeling of responsibility and initiative.

Adaptation, Psychological↗

PubMed1999

Pain in children: qualitative research of Finnish school-aged children's experiences of pain in hospital.

The purpose of the study was to describe school-aged children's experiences of pain in the hospital. Data were collected from 20 children aged between seven and 11 years of age who were inpatients in the pediatric wards of the University Hospital, Oulu, Finland. Each of the children wrote of their experiences of pain in the hospital, and they were interviewed on the basis of this information. The data were analyzed inductively using content analysis. On the basis of the analysis, the situations that caused pain to all children in the hospital were found to be procedures connected with needles. The children described their experiences of pain as both physiological (e.g. poking, stinging, aching) and psychological feelings (unpleasant feelings, terror, anxiety, and fear). In addition, methods of relieving pain (coping mechanisms, help from the medical staff, parental presence, and previous experiences of similar situations) were acknowledged. The results indicate that school-aged children (aged 7-11 years) are able to describe their pain experiences, which should be considered in assessment and treatment of children's pain in nursing practice.

Adaptation, Psychological↗

PubMed1999

A midwife-public-health nurse's work in northern Finland, 1950-87.

This paper describes the work of Jouki Nykänen, a midwife public-health nurse in northern Finland during the years 1950-87. The material for the study was collected by a biographical interview. On the basis of content analysis, the work of the interviewee consisted of the following phases: (i) midwife-public-health nurse in the district of Sevettijärvi (1950-58); (ii) municipal midwife in Pyhäntä (1958-60); and (iii) midwife-public-health nurse in the rural district of Karunki (1962-87). In Sevettijärvi, Jouki's work emphasised independent planning and implementation. In Pyhäntä, her health-care clinics were well organised. In Karunki, another midwife-public-health nurse working with Jouki made conditions flexible, with personal districts for the two nurses. During home visits, Jouki took care of the whole family, from the grandfather to the baby. The Finnish Public Health Act (1972) changed the character of Jouki's work. The number of home visits decreased and clinics, fragmented into several fields of health care, took the place of home visits, requiring efficiency and results. The results of the study showed the core of a midwife-public-health nurse's work in Finland in a changing historical and social context, as well as showing the changes in a midwife-public-nurse's work since the post-war years.

Finland↗

PubMed1998

Life control and health in view of qualitative and quantitative research.

In this paper the experiences of life control and health of Finnish people are described and compared by reference to two studies with different methodologies. The goal of the qualitative study was to describe and understand the human being's health as an individual way of existence on the basis of life descriptions. The qualitative data were gathered through thematic interviews (n = 60, men and women, aged 30-50 years). The data were analyzed with the grounded theory method. The analysis showed life control to be a core category that characterizes health experiences. On the basis of the analysis, the content of concept of life control was defined to describe the data. The goal of the quantitative study was to produce information on life control among young males, their health, health behaviour, experiences of stress and life situations as well as the associations between these dimensions. The definition of life control was based on Antonovsky's theory of sense of coherence and on the study of Söderqvist and Bäckman. The quantitative data were gathered with questionnaires from 2500 (response rate 60%). The data were processed using cross-tabulation and multivariate data analysis (discriminant analysis). The connections between life control and health were obvious in both studies. To a certain extent the results were parallel, but there were also some differences which are discussed here as a starting point for developing further the research on life control and health in the nursing science context.

Adult↗

PubMed1998

Elderly Finnish people's experiences with coping at home.

The aim of this study was to describe the experiences of elderly Finnish people with coping at home. Twenty elderly inhabitants of the city of Oulu in Finland, over 75 years of age, who live at home were interviewed. Content analysis was used as the method. According to the analysis, elderly people's coping at home consisted of social contacts, daily events as the substance of life, and previous life experiences. Social contacts consisted of family, public health services, and neighbours. Daily events as the substance of life included taking part in activities of daily living. The contents of previous life experiences consisted of thinking back to organize one's life experiences and their influence on one's own life. The factors that promoted coping at home were maintenance of health, the experience of well-being, and security. The findings of this study indicate that by supporting elderly people to cope at home, it is possible to influence their sense of safety and well-being and hence their quality of life.

Activities of Daily Living↗

PubMed1998

[Psychological load factors and control in the work of occupational health nurses].

The purpose of the study was to describe the factors causing psychological loads and control in the work of occupational health nurses. The material was collected using a questionnaire (n = 300). In all, the responses from 195 subjects were available for the present analysis. Cross-tabulation, correlations and percentage distributions were used as the statistical methods. Open-ended questions were qualitatively analyzed using content analysis. Occupational health nurses reported frequent loading due to paper work, the excessive scope of their work and multiple problems with clients. A continuous shortage of time, pressure from unperformed tasks and a lack of opportunities to concentrate on work frequently loaded the subjects. Organization of their work was related to changes in the pace of work. Nurses who estimated their working capacity to be excellent mentioned their professionalism and ability to develop along with the requirements of their work. The findings can be used in planning and developing the work of occupational health nurses and for educational purposes.

Attitude of Health Personnel↗

PubMed1998

[The work of a midwife-public health nurse in northern Finland in 1950-1987].

The purpose of this study was to describe the work of Jouki Nykänen, a midwife-public health nurse, in northern Finland in 1950-1987. The material for the study was collected by life-history interview. According to content analysis the work of the interviewee consisted of the following phases: 1) work as a midwife-public health nurse in the district of Sevettijärvi in 1950-1958, 2) work as a municipal midwife in Pyhäntä in 1958-1960, and 3) work as a midwife-public health nurse in the municipality of Karunki, in 1962-1987. In Sevettijärvi, planning and implementation of work were emphasized. The public health nurse-midwife worked whenever people needed her and when they came "to town". In Pyhantä, the clinics were well-organized. The work as a midwife-health nurse in Karunki was flexible, and another public health nurse also worked in the municipality. During home visits the interviewee took care of the whole family from the grandfather to the baby. The Public Health Act (1972) changed the character of the work: the number of home visits decreased and clinics fragmented into several fields of health care took the place of home visits, requiring efficiency and results. The results of the study showed the core of a midwife-public health nurse's work in a historically changing social context as well as the changes in the work between the postwar years and the present day.

Finland↗

PubMed1998

[Conceptual system of health portrait].

The purpose of this paper is to introduce a nursing science perspective to health research. The perspective is outlined using the following key concepts: life control, life situation, health and health choices, resources, and process of change. This conceptual system of health portrait includes concepts used to study health in nursing science. It also reflects a research approach by using empirical examples. As a starting-point, life control is assumed to be reflected in the life situation as well as in health and health choices. As a consequence, life control is also related to each individual's resources in everyday life. Further attention is given to the assessment of the process of change pertaining to health choices during the person's course of life. As an empirical example of the application of the "health portrait" conceptual system, a research project titled Health portrait of adolescents in Kainuu is presented. This project aims to develop an instrument for measuring life control, health and life situation, to evaluate this instrument and to analyze life control data elicited from adolescents. Another aim of this paper is to assess how well an instrument created on the basis of the nursing science and the method of interventive interview used here served as tools for analysing life control and health in the health checkups of school-aged adolescents. On the basis of the knowledge obtained through these analyses we will develop further the conceptual system of health portrait, which could be used as a guideline in health research.

Adolescent↗

PubMed1998

[Family identity and adolescents' choices concerning health habits: an interventive interview method for assessing family strengths].

The purpose of this article is to describe family identity as a strength and as part of the family functioning style. The concept of functioning style includes family identity, information sharing and resource mobilization. The article examines family identity in terms of a family's strengths in coping with seventh-grade adolescents' experiments with smoking, alcohol, and drugs. The data were gathered using interventive interviews and a questionnaire, in which family members (n = 14) assessed the strengths of the family. Finally, the families identified their strengths in a feedback discussion. Content analysis methods were used to analyze qualitative data according to the categories of family identity: commitment, values, time, a sense of purpose and uniformity (Dunst et. al. 1994, Mattus 1994a). Questionnaire data were analyzed quantitatively. The families identified commitment, values, a sense of purpose and uniformity to be the strengths in their family identity. They described commitment as sacrificing for others. The parents' aim was to strengthen adolescents' ability to resist the social pressure to experiment with drugs. The families were also confident in their ability to cope with these situations. It was important for both the parents and the adolescents to have a mutual understanding of what is important and of ways to spend their leisure time. The results indicate that these families possess strengths that enable them to support their adolescents' choices concerning health habits.

Adaptation, Psychological↗

PubMed1998

Life control and health.

This paper describes the life control and its development, concentrating on relationship between life control and health. The main goal is to review the life control and health among Northern Finnish women and men. Life control and its connections with health and life situation make up the theoretical basis of the work. The definition of life control is based on Antonovsky's theory of a sense of coherence. The concept of life control here includes the following subconcepts: comprehensibility (how understandable are the internal and external environments), manageability (ability to influence one's life course at work and in one's whole life), meaningfulness (one's experiences of the meaning of the present or future events) and life satisfaction and human relationships. Future studies need to explain factors affecting the abilities of individuals to control their lives and reach sensible decisions regarding their health and lives overall. New ways of strengthening life control among those who have become marginalized in relation to society need to be identified. A model of factors relating to life control and relationships between such factors could be constructed.

Adult↗

PubMed1997

["It feels like a hedgehog quill sticking in my foot...". School-aged children's experience of pain in the hospital].

The purpose of the study was to describe school-aged children's experiences of pain in hospital. The view of pain as a complex phenomenon and the child's experience of pain considered from the physiological, psychological and experiential perspectives of child development made up the theoretical basis of the work. Data were collected from 20 school-aged children between 7 and 11 years of age who were hospitalized in the pediatric wards of the University Hospital. Each of the children wrote an essay on their experiences of pain in hospital and they were then interviewed on the basis of their essays. The data were analysed inductively using content analysis. On the basis of the analysis, the situations that caused pain to all children in hospital were procedures connected with treatment, and the children described their experiences of pain such as physiological and psychological feelings of pain. The children described physiological pain in a versatile manner (for example as pinching, stinging, aching) and were able to describe mainly the quality of pain. According to the children's descriptions, the psychological feelings of pain were unpleasant feelings, horror, anxiety and fear. The results of this research indicate school-aged children's ability to describe their own experiences of pain. This means that to assess and treat school-aged children's pain, we should listen to the child. Furthermore, painful situations cannot be eliminated in hospital, but we could pay attention to the methods that relieve child's pain and reduce psychological pain in the nursing practice.

Anxiety↗

PubMed1995

The health behaviour of northern Finnish men in adolescence and adulthood.

The aim of the study was to produce data about health behaviour among men born in Northern Finland in 1966. A particular concern was to find out how well health behaviour in adolescence predicts health behaviour in adulthood. The family questionnaire on health and development was submitted in 1980 when the subjects were 14 years of age. The response rate was 97%. The second questionnaire survey was carried out 10 years later with 2500 respondents. The final response rate was 60%. The results indicated that health behaviour in adolescence predicted health behaviour in adulthood as far as smoking and physical exercise were concerned. Over half (65%) of those who were non-smokers in their youth did not smoke as adults. Similarly the majority (71%) of those who had taken physical exercise at least once a week in their youth continued to do so in adulthood. Most of the subjects (85%) used alcohol in adulthood. A good family situation was connected with healthy habits. In the case of drinking, however, the subjects whose fathers belonged to social classes I-II used alcohol to a somewhat greater extent than others. It is important to conceive of health behaviour as an element connected with a person's life situation. Health research should be incorporated into cultural research and should have closer co-operation with other disciplines.

Adolescent↗

PubMed1995

Health and social standing of young men viewed in light of information on their childhood and adolescence.

The purpose of the present study was to examine the relationship of social status in early childhood and adolescence with present health and well-being and to identify factors predicting good health and social status. The study is part of a health survey of young Northern Finnish men and uses longitudinal questionnaire data. The results indicated that background variables in adolescence predicted health and the social index in adulthood as far as physical exercise and school performance were concerned. Good school performance was associated with a good health index and a good social index. Regular physical exercise in adolescence is extremely important when considering the state of health in adulthood. The family background predicted the development of health. The mother's high educational level was associated with good health and social indices. The results also showed that living in a farming family and having mothers working at home seemed to be protective factors for good health. The binary regression model was applied to the factors predicting the health index and the social index in adulthood. A major concern in future research is how to explore factors which affect the abilities of individuals to reach sensible decisions regarding their own health and lives overall, and how families can promote this process.

Achievement↗

PubMed1995

Background factors predicting non-response in a health survey of northern Finnish young men.

The study addresses the characteristics potentially predictive of non-response to a health survey among 2500 24-year-old males, on whom a notable amount of other data was available. The overall non-response rate was 40%, part of which was due to the unreachability of some subjects: 4% of the questionnaires were returned because of unknown addresses. Some (n = 39) of the respondents had concealed the identification number in the questionnaire, which made it impossible to link these data to those collected before in their cases. We were therefore able to use effectively the data on 1450 (58%) responding subjects in this paper. Failure to respond was more common among the subjects who had lived in towns in their youth, had not grown up in a complete family, whose socioeconomic status of the family was unknown, and whose mother was young and had a low educational level. Poorer-than-average school performance at elementary school was also predictive of a high non-response rate. Non-response was heavily associated with previous non-response to a health inquiry. Some aspects of health and behaviour in adolescense, such as smoking at the age of 14, were related to non-response to this survey, too. The non-response was higher than average among those subjects who had suffered from mental disorders (serious mental disorders, less serious mental disorders such as neurotic disorders, adjustment reactions, and psychosomatic disorders and mental retardation). The young men who were employed, were students or were doing military service at the age 24 responded better than those who were unemployed or at disability pension.

Achievement↗

PubMed1994

Factors associated with life control in young men.

This paper reviews life control and relating factors in young men on the basis of information which was gathered from questionnaires. The information shows that factors such as self-evaluated state of health, health behaviour, stress, economical situation and education are connected with life control. It was not possible to make conclusions concerning causality; with most of the variables, the connection worked both ways. Self-evaluated state of health was the most important factor relating to life control. Consideration has to be given to whether it is worthwhile trying to influence particular habits through health education. Future studies might concentrate on factors influencing the ability of individuals to control their lives and to reach reasonable decisions concerning their health and lives.

Adult↗

PubMed1994

Life control among young men in view of their childhood and adolescence.

The analysis of life control and its development is an issue of central concern to modern health research. This article discusses longitudinal questionnaire data in an attempt to identify factors that predict young men's life control in early childhood and adolescence. No factors in the childhood family background predicted strong life control in adulthood. A positive development in the family's social situation showed a positive association with life control in adulthood. Poor school performance and unhealthy habits in adolescence were associated with poor life control in adulthood. According to a regression analysis, the following factors predicted a strong life control in adulthood: regular physical exercise, positive changes in the family's social situation, no school class repeats, no experimentation with intoxicants in adolescence, admission into intermediate level of education, and no smoking in adolescence. It is crucially important for purposes of health promotion to identify factors which predict life control in adulthood. By helping adolescents to achieve life control, we are also helping them to cope with developmental tasks and therefore to promote their health.

Adolescent↗

PubMed1993

[Life control, the core of being healthy. Theoretical-empirical definition of the concept "life control"].

In this article the concept 'life control' is being analysed and defined. A need to define the concept 'life control' emerged during a research that deat with a human being's descriptions being healthy. 'Life control' turned out to be the central category and the main concept organising the whole data. The data were collected by focused interviews (N = 60). Those interviewed represented five different styles of 'life control'. One of these styles that were discovered in the research was chosen as the basis of the conceptual analysis. This style was characterised by 'laissez faire' attitude towards life. Hybrid model was used as the theoretical frame of reference in the conceptual analysis. Thorough study of Finnish and foreign literature about 'life control' leads into an explicit definition of 'life control' describing the data collected by focused interviews: 'Life control' is an individual's basic belief concerning the possibilities to control the course of human life and the extent of this control. An individual either controls his/her life quite independently and completely or only to a certain extent, or it is controlled by factors beyond the influence of a human being. The definition of the 'life control' -concept in the sense that it displays basic beliefs should be examined by studying people's way of thinking with the help of interviews, essays, questionnaires or analysis of autobiographies.

Attitude to Health↗