Biomedical subjects

Eija Paavilainen

Publications and source records attributed to Eija Paavilainen.

At least 19 recordsLinked to original sources

PubMed2005

Family functioning assessed by family members in Finnish families of heart patients.

BACKGROUND: The role of family is central to the wellbeing and health of individuals. Family attitudes, habits and routines affect the way individuals promote their health. Family functioning and family health are threatened when one family member develops heart disease. AIMS: The aim of the study was to describe family functioning and to ascertain factors related to family functioning of families with heart patient as assessed by family members. METHODS: Data collection was done using a questionnaire (FAFHES) in 2000. The sample consisted of 161 family members of patients receiving treatment on two medical wards. The data were analysed by means and tested by parametric and non-parametric tests. The multivariate method used was stepwise regression analysis. RESULTS: The better the family values were materialized and the greater the family's contribution to family health, the better the family's functioning is. Concrete aid was also related to family health. The more concrete aid the family received from nurses, the better family functioning is. When the background variables were included, values and activities remained in the model, but two new variables explained family functioning: family member's age and knowledge of health issues. The older the family member is and the better the knowledge in the family is, the better is family functioning. CONCLUSION: Family functioning of families with heart patients can be supported and developed by family nursing, e.g. concrete aid from nurses. Other aspects of support, e.g. consideration of family member's age and knowledge of health issues also need to be further considered and studied as the basis of care.

Adaptation, Psychological↗

PubMed2005

Patients' perceptions of emotional support and information provided to family members.

The purpose of this quality improvement project was to determine patients' perceptions of the emotional support and information provided to their family members by nurses in a day surgery setting. The project was conducted in a day surgery unit of a hospital in western Finland. Data were collected from 60 participants using a questionnaire designed specifically for the project. The results showed that half of the patients appreciated the presence of their family members during hospital care. The emotional support provided to family members was rated as moderate, and more than 50% of the patients believed their family members were adequately informed. The results were used to help develop tools for patient and family member education.

Adult↗

PubMed2005

Child in hospital: family experiences and expectations of how nurses can promote family health.

AIMS AND OBJECTIVES: This study set out to explore, from the family's point of view, ways in which nursing staff can promote family health during the child's hospital stay. BACKGROUND: Having a child in hospital is a major source of stress and anxiety for the whole family. Earlier studies have described parental coping strategies, ways to strengthen those strategies and to support parental participation in child care, but no one has studied the promotion of family health during the child's hospitalization from the family's point of view. DESIGN: Interviews were conducted in 2002 with 29 families who had a child with a chronic illness which were receiving or had received treatment on the paediatric wards of two Finnish hospitals. METHODS: Data analysis was based on the grounded theory method, proceeding to the stage of axial coding. Data collection and analysis phases proceeded simultaneously. RESULTS: Five domains were distinguished in the promotion of family health: (1) reinforcing parenthood, (2) looking after the child's welfare, (3) sharing the emotional burden, (4) supporting everyday coping and (5) creating a confidential care relationship. CONCLUSIONS: The results strengthen the knowledge base of family nursing by showing how nursing staff can promote family health during the child's hospital stay. RELEVANCE TO CLINICAL PRACTICE: The results have a number of practical applications for nursing, both for clinical practice and research. The results can be used in paediatric hospital wards caring for chronically ill children and their families. The five domains of family health promotion described here should be tested in other paediatric wards and in other geographical locations.

Adaptation, Psychological↗

PubMed2005

Survival of intimate partner violence as experienced by women.

AIMS AND OBJECTIVES: The study set out to describe women's experiences of intimate partner violence, the consequences of such violence, the help they received and women's experiences of their survival. BACKGROUND: Social and health professionals do not have sufficient ability to identify and help families who suffer from intimate partner violence. Methods for identifying and treating partner violence not have been developed adequately. METHOD: The study was conducted in Finland by loosely formulated open-ended interviews with seven battered women. The data were analysed by inductive qualitative content analysis. FINDINGS: Women had past experience of maltreatment and a distressing climate at their parental home. Women experienced both themselves and their spouse as having weak identities; their ideals, patterns of marriage and sexuality were different. Violence occurred in situations of disagreement. Women tried to strike a balance between independence and dependence in the relationship. The different forms of couple violence were interlinked. The women sought help when their health and social relationships got worse. An awareness of the problem, taking action, counselling and social relationships helped them survive. Religiousness was a factor that involved commitment to the couple relationship, made religious demands on women and promoted the recovery of integrity. CONCLUSIONS: Intimate partner violence was associated with the family model, childhood experience of maltreatment, the partners' weak identity and conflicts between individualism and familism. Social and healthcare professionals need competence in early intervention and skills to discuss moral principles, sexuality, and violence in a way that is free of prejudice and condemning attitudes. Spiritual approaches in the context of interventions should be taken into consideration. RELEVANCE TO CLINICAL PRACTICE: In a clinical context, nurses should be aware of the symptoms of violence, and they should have skills in dealing with intimate moral and spiritual issues.

Adult↗

PubMed2005

The diversity of family health: constituent systems and resources.

The purpose of this study was to explore changes in family health associated with child's chronic illness and hospitalization. The aim was to answer the following questions: (i) What kind of changes do families experience when a child in the family is afflicted by a chronic illness; and (ii) What kind of changes do families experience when their child is admitted to hospital? The data were collected in 2002 in interviews with 29 such families whose children were receiving treatment or who had previously received treatment on the paediatric wards of two hospitals in Finland. Data were collected until reaching theoretical saturation, in which no additional data are found. Data analysis was based on the grounded theory method, proceeding to the stage of axial coding. Family health was formed out of two different dimensions: the constituent systems and the resources of family health. The constituent systems describe the impact of the child's chronic illness and period of hospitalization at the level of both individual family members and the family as a whole. These systems were described by five categories: (i) ill child at the centre of family attention, (ii) siblings in a minor role, (iii) the child's illness governs parental well-being, (iv) the roller coaster of the couple relationship and (v) the whole family is ill. The resources promoting and maintaining family health were divided into six different categories: (i) creative and maintaining mental images, (ii) active involvement, (iii) internal coping means, (iv) reinforcement of coping means, (v) awareness and change of values and (vi) social network shares emotional burden and responsibility for care. The results of the study show that family health is highly vulnerable when a child has to be admitted to hospital because of a chronic condition. They should help nursing staff gain a clearer picture of the depth and diversity of family health and support the resources that promote family health. Future research should study the methods of family nursing used in the care of families with children with chronic conditions.

Adaptation, Psychological↗

PubMed2004

Family dynamics of postnatally depressed mothers - discrepancy between expectations and reality.

BACKGROUND: The birth of a new family member always brings changes to family dynamics. The family has to adjust to a new situation and, although the time after childbirth is happy for most families, postnatal depression affects 10-15% of mothers annually. AIMS AND OBJECTIVES: The purpose of this study was to ascertain families' experiences of family dynamics when the mother suffers from postnatal depression. DESIGN: Nine families (nine mothers, five fathers) where the mother had displayed symptoms of postnatal depression took part for the study. METHODS: Data were collected through interviews with nine families where the mother had scored 13 or more on the Edinburgh Postnatal Depression Scale, completed 6-8 weeks after childbirth. Families were offered the opportunity to volunteer for the interview while taking part in a follow-up study of postnatal depression in Finland. Interviews were analysed using the principles of grounded theory. RESULTS: The findings showed that there was great discrepancy between expectations and reality in the depressed mothers' families. Parents, especially mothers, strove for perfection, perceived the infant to tie them down and had high expectations of family life. CONCLUSIONS: Everyday family life and human relationships change, the depression and the parents' attitudes towards the infant manifest themselves in different ways, and support is of great importance. RELEVANCE TO CLINICAL PRACTICE: Women, especially those expecting their first child need a great deal of information about mood changes after childbirth and the opportunity to discuss the changes brought about by the birth of a child.

Activities of Daily Living↗

PubMed2004

Caregivers' experiences of interaction with families expecting a fetally impaired child.

BACKGROUND: On the basis of earlier research, caregivers' actions when interacting with clients should be developed. However, nursing research has focused little attention on the interaction between caregivers and families expecting a fetally impaired child. AIM: The study aimed at generating a practical family nursing theory of caregivers' interaction with families expecting a malformed child. METHODS: A grounded theory study was undertaken at Tampere University Hospital in Finland in 1999-2000. Data consisted of semi-structured interviews with 22 (n=22) nurses and doctors. The data were analysed using the constant comparative method. RESULTS: The interaction process starts when a caregiver informs the parents of the fetal impairment. The process is influenced by caregivers' attitude towards issues related to the family's life situation. Caregivers' views of their job, and of human coping and cultural attitudes towards these issues are also of importance. These factors account for their goals in the interaction, which, in turn, underlie their actions. When the caregiver's interpretation is that the family accepted the help provided, the outcome of the interaction is satisfaction with having been able to help. Correspondingly, in the case of an opposite interpretation, the caregiver experiences strain caused by inadequacy of the help he/she is providing. The core of interaction consists of two dimensions: gaining strength and losing strength in relation to impairment issues. CONCLUSIONS: Caregivers' views of helpful interaction were consistent with earlier research on the subject, but the findings of this study showed that more attention should be focused on the family as a whole. Furthermore, caregivers rarely criticized their own actions, thus their interaction skills should be upgraded by focusing on systematic self-assessment through training. Nursing research deepening our understanding of why interaction fails is warranted. RELEVANCE TO CLINICAL PRACTICE: The study results can be used in the family nursing practice as tools in reinforcing the caregivers' ability to helpful interaction with families expecting a fetally impaired child. The results may enhance caregivers' systematic self-evaluation and conscious use of the self.

Adaptation, Psychological↗

PubMed2004

Determinants of perceived health in families of patients with heart disease.

BACKGROUND: Heart disease is a severe long-term illness, which often requires lifestyle changes and self-care and affects the life of the whole family. Perceived family health is highly complex. It combines people's values and everyday experiences, such as knowledge about their own health, what they do to promote their health, how their life progresses, and how they feel physically and emotionally. AIM: The aim of this paper is to report a study to describe the perceived health of families of patients with heart disease and to ascertain factors related to family health. METHODS: Data were collected by questionnaire with a convenience sample of 161 family members of patients receiving treatment on two medical wards of a university hospital in southern Finland. Data were analysed using means and medians and tested by parametric and non-parametric tests. A stepwise regression analysis was also used. RESULTS: The most important predictors of family health were family structural factors, effect of illness symptoms on daily life, and family relationships. The strongest predictor was family structural factors. It was found that the better the family structure and relationships, the better the family health. Similarly, the greater the effect of the illness on the patient's daily life, the worse the family health. CONCLUSION: The findings suggest that supporting family functioning in the families of people with heart disease is an important challenge for family nursing.

Adaptation, Psychological↗

PubMed2004

Promoting health for families of children with chronic conditions.

AIM: This paper reports a study whose aim was to describe how nurses in a paediatric unit promote the health of families of children with chronic conditions during the children's hospitalization. BACKGROUND: It is stressful for a family when a child has a chronic condition and hospitalized. Nurses have the opportunity to promote family health while a child is hospitalized, and previous studies contain a wealth of recommendations on how this should be done. However, there is little research evidence about family care and how nurses promote the health of a family with a chronically ill child. METHODS: Forty nurses who worked in two paediatric units providing care for children with chronic conditions and their families participated in the study. Data were collected in two Finnish hospitals in 2002 using group interviews, and nursing actions were observed in both units for a period of 84 hours. Data analysis was based on the grounded theory method, proceeding to the stage of axial coding. Data were collected until theoretical saturation was reached. FINDINGS: Family care was based on three distinctive strategies. Nurses used a systematic, selective or situation-specific strategy while promoting family health during a child's hospitalization. CONCLUSIONS: The findings indicate that nurses used different strategies while promoting family health during a child's hospitalization. The systematic way of working with families identified in the study seems a useful strategy. All three strategies of family nursing described here should be tested in other paediatric wards and in other geographical locations.

Adult↗

PubMed2003

Interaction between caregivers and families expecting a malformed child.

BACKGROUND: Earlier research has shown that the care of families expecting a malformed child should be intensified and that the topic is understudied. AIM: This study aimed at generating a practical nursing theory of interaction between caregivers and families expecting a malformed child, as experienced by families. METHODS: A grounded theory study was undertaken at a university hospital, Finland. Data consisted of semi-structured interviews with 29 mothers and fathers, analysed using the constant comparative method. FINDINGS: The interaction process starts with the confirmation of the diagnosis. It usually comes as a shock to the parents, and gives rise to questions about the nature of the malformation, family members' relationship with themselves, family relationships and relationships with people outside the family. These questions are crucial to the family's coping and form the core of interaction. Families' own coping strategies are either reinforced or undermined by caregivers' actions and are reflected in parents' expectations about caregivers, which in part account for their actions and experiences of interaction. The care system as an interactive environment is part of a process which results in the experiences of being helped or being left without help. The core of the interaction process comprises two dimensions: gaining strength and losing strength in relation to malformation issues. CONCLUSIONS: The findings of the study are consistent with earlier research and complement it by providing a detailed delineation of the interaction from the perspective of the family. They can be used to formulate recommendations for improving caregivers' interactive skills and awareness of the topic through training. The care system should be developed to ensure that families receive psychological support and that the family as a whole receives proper care. Consideration of the viewpoint of siblings is a challenge for further research.

Adaptation, Psychological↗

PubMed2003

In-hospital social support for families of heart patients.

Chronic illness in one family member influences all aspects of family life. Research has documented the positive contributions of social support in an unexpected and stressful event such as a family member's heart disease. The aim of the study was to describe in-hospital social support provided by nurses to families of heart patients and to identify factors related to social support. Data were collected using a mailed questionnaire to family members of heart patients (n = 161) receiving treatment on two medical wards of a university hospital in southern Finland. The results show that the family members were not very satisfied with the social support from nurses, because about 40% were dissatisfied with the concrete aid and affirmation they received and about 30% with emotional support. According to regression analysis the most important predictors of social support were family structure, patient's age, gender of family member and whether the patient had been hospitalized for cardiac symptoms. This report shows that supporting families of cardiac patients need development according to the family nursing practice.

Adaptation, Psychological↗

PubMed2003

Functioning of child maltreating families: lack of resources for caring within the family.

The purpose of this study was to develop a preliminary theoretical model of functioning of child maltreating families. Child maltreatment was defined as physical, psychological or sexual abuse or neglect caused by the child's primary caregivers. The aim was to generate knowledge needed in developing understanding and the care of these families. Data were collected using interviews with open-ended questions from child maltreating families (n = 20). Transcribed interviews were analysed by using grounded theory and its constant comparative method. The categories of family functioning included structural factors of the family, relationships between family members, relationships outside the family, family strengths, and risk factors and manifestations of maltreatment. The relationships that emerged between these categories included conflicts and negative circles of family life and the effects of child maltreatment on the family. Lack of resources for caring within the family emerged as the core category which described the phenomenon in general and was connected to all other categories of family functioning. The findings can be useful in developing the care of child maltreating families, in nursing education and in preventing child maltreatment.

Adolescent↗

PubMed2003

Development of a family assessment instrument for transcultural use.

PURPOSE: The article describes challenges related to the transfer of a family assessment instrument, the Assessment of Strategies in Families-Effectiveness (ASF-E), and its theoretical basis to another culture. DESIGN: Instrument development encompassed translation and discussion of theoretical and cultural relevance of the items. Patients from two clinics in Tampere, Finland (N = 196) completed the ASF. Psychometric tests involved factor and reliability analysis. RESULTS: The theoretical constructs of stability, growth, control and connectedness/spirituality were represented in the factor structure, and reliability ranged from .65 to .83. DISCUSSION: There were cultural differences in the interpretation of certain items. Characteristics of Finnish culture with impact on instrument validity were homogeneity and family emphasis on conflict resolution. Insights contributed to further instrument development and broader understanding of culture.

Culture↗

PubMed2003

The use of grounded theory to study interaction.

In this paper Hanna Maijala, Eija Paavilainen and Päivi Astedt-Kurki examine the use of grounded theory from the perspective of data analysis. The paper reports on the findings of a Finnish study of interaction between caregivers and families expecting an impaired child. The objective of the study was to describe and explain the social processes between caregivers and families expecting an impaired child by identifying the central descriptive concepts, their interconnections, and the overall structure of the interaction process. The authors conclude that grounded theory is a diverse approach to studying interaction, and that the constant comparative method is a challenge to a researcher's perseverance and flexibility.

Adaptation, Psychological↗

PubMed2003

Adolescent subjective well-being and family dynamics.

The purpose of this study was to examine the relationships between adolescent subjective well-being (SWB) and family dynamics perceived by adolescents and their parents. A sample of 239 pupils (51% female) from seventh and ninth grades completed the Berne questionnaire of SWB (youth form), two subscales from an original Finnish SWB scale and the Family Dynamics Measure II, and one of their parents (n = 239) filled in the Family Dynamics Measure II. Results indicated that parents assessed family dynamics better than did their adolescent child. Furthermore, there was no association between family dynamics perceived by adolescents and family dynamics assessed by one of their parents or between the adolescent SWB and parental perception of family dynamics. Multiple stepwise regression analysis indicated that certain aspects of family dynamics perceived by adolescents were related to adolescent global satisfaction and ill-being. Specifically, adolescents' perception of high level of mutuality and stability in the family as well as male gender and lack of serious problems in family were predictors of adolescent global satisfaction. Furthermore, disorganization in the family and poor parental relationship perceived by adolescents, being female, serious problems and illness in family predicted a high level of adolescent global ill-being.

Adolescent↗

PubMed2002

Identification of child maltreatment while caring for them in a university hospital.

The purpose of the study was to look at how nurses and physicians of a university hospital rated their ability to identify child maltreatment while caring for those children. In this study, child maltreatment was defined as physical, psychological or sexual abuse or neglect of a child under the age of 18 by parents or caregivers. The total population of staff caring for children (N=513) in a university hospital were surveyed. Data were collected with a questionnaire developed for this study with reference to the literature. Altogether 317 questionnaires were returned, which yielded a response rate of 62%. The data were analysed using statistical methods and quantitative content analysis. Forty per cent of the respondents estimated that they had never cared for a maltreated child. Two-thirds of the respondents believed that they would be able to identify a child maltreatment case. The most distinct signs by which maltreatment could be identified were fractures, multiple bruises and the fact that the child had frequent injuries. The child's or parent's behaviour often aroused suspicion of maltreatment. Seventy-one per cent of the respondents rated the identification of maltreatment as rather difficult or difficult. Awkwardness of the phenomenon, the staff's pressure of work and relative unfamiliarity with the phenomenon were assessed as things that make the identification difficult. The fact that no jointly agreed guidelines were available for handling the matter was seen as a particular weakness. The respondents had fairly much theoretical knowledge about child maltreatment. However, child maltreatment is a multi-dimensional phenomenon that calls forth emotions. The development and improvement of practical nursing and medical care and of staff collaboration require that education be provided to different occupational groups and parties caring for children and that jointly agreed hospital-specific and regional models for operation be developed.

Adult↗

PubMed2002

Caring for maltreated children: a challenge for health care education.

AIM OF THE STUDY: The aim of this study was to establish whether paediatric nurses and doctors in a university hospital need supplementary training in the identification of child physical abuse and whether there is a need to develop health care education on child abuse issues. BACKGROUND: Child physical abuse was defined as actions of a parent or a primary caregiver of a child under 18 years of age, which have caused physical injuries to the child. METHODS: The sample consisted of paediatric staff (n=513) in a university hospital. Data were collected with a questionnaire, and the response rate was 62%. The data were analysed using statistical methods and quantitative content analysis. FINDINGS: Sixty per cent of respondents needed supplementary training in the identification of child abuse. Those having experience in caring for abused children considered the identification most difficult (P < 0.001) and needed training more often (P < 0.005) than the others. The need for training was explained by stating that their basic education had not addressed child abuse issues, and by the complexity of the issue. CONCLUSIONS: The findings indicate that research-based knowledge of the identification and treatment of child abuse should be incorporated into health care education. Supplementary education should address the management of complex and sensitive issues with customers, legislation, division of labour and multiprofessional collaboration in which nurses and doctors have an important, family wellbeing promoting role.

Adult↗

PubMed2002

Sociodemographic factors of families related to postnatal depressive symptoms of mothers.

Postnatal depression in mothers is commonplace as it affects 10-15% of recent mothers. Postnatal depression is still an under-diagnosed illness and if unidentified, is often left untreated. If left untreated, the depression can have an adverse effect not only on the mother, but also on the child's development and on the well-being of the whole family. The aim of this survey was to investigate the prevalence of postnatal depressive symptoms among Finnish mothers and to ascertain the relationship with sociodemographic factors in mothers. A sample of 1000 families at 2 months postnatal was studied by mailing the Edinburgh Postnatal Depression Scale to mothers and a questionnaire on demographic characteristics to mothers and fathers. The response rate was 39%. The data were examined by means of frequency and percentage distributions. Connections were examined using Spearman correlation coefficient and analysis of variance. In all, 373 mothers and 314 fathers took part in the study. Fifty-five (13%) mothers had depressive symptoms. Results show that the number of pregnancies, deliveries or children, the mode of delivery or the mother's age were not associated with depressive symptoms. However, mothers who had depressive symptoms had fewer years of education, shorter duration of breast-feeding and were more dissatisfied with family life compared with mothers who exhibited no depressive symptomatology. The families of mothers with depressive symptoms had also experienced more problems and changes having a profound impact on the family compared with other mothers.

Adult↗