Biomedical subjects

H Kyngäs

Publications and source records attributed to H Kyngäs.

At least 19 recordsLinked to original sources

PubMed2001

Coping with the onset of cancer: coping strategies and resources of young people with cancer.

A chronic illness, such as cancer, causes permanent changes in a person's way of life and their way of adapting to changes. The purpose of this study was to describe the coping strategies and resources of adolescents and young adults with cancer. The data were collected by interviewing adolescents and young adults aged 16-22 (n = 14) who had had cancer for more than 2 months and who came to a university hospital for treatment or control check ups. The interview material was analysed by content analysis. Emotion-focused, appraisal-focused and problem-focused coping strategies were used. The major coping strategies were social support, belief in recovery and getting back to normal life as soon as possible. The subjects discussed with health care providers their disease, its treatment and how they could cope with everyday life as well as their energy and will-power to cope. The family was the most important source of emotional support. Also, gaining knowledge about cancer and its treatment was a good coping strategy. Moreover, a positive life attitude, belief in one's own resources, belief in God, earlier life experiences and willingness to fight against the disease were resources for coping with cancer.

Adaptation, Psychological↗

PubMed2001

Factors associated with the coping of parents with a child in psychiatric inpatient care.

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

Adaptation, Psychological↗

PubMed2001

Predictors of good compliance in adolescents with epilepsy.

The purpose of this paper was to describe the factors that predict compliance in adolescents with epilepsy. Altogether 300 individuals aged 13-17 years were randomly selected from the Finnish Social Insurance Institution's register. Every fifth person on the list was included in the sample. Seventy-seven per cent (N= 232 ) of the selected adolescents with epilepsy returned the questionnaire. The data were analysed with SPSS software. Using the logistic regression model, the compliance of adolescents with epilepsy was predicted on the basis of support from physician and parents, motivation and the disease not being a threat of social well-being. The most powerful predictor was support from the physician. The likelihood of adolescents supported by their physicians complying with their health regimens was 10.56-fold compared with the adolescents who did not receive support from their physicians. Another powerful predictor was support from parents. The adolescents who received support from their parents complied with the health regimens with a 10.47-fold likelihood compared with adolescents who did not receive support from their parents. Adolescents with good motivation were 9.77 times more likely to comply than adolescents who did not have good motivation. Adolescents who did not feel the disease to be a threat to their social well-being complied with health regimens with an 8.38-fold likelihood compared to those who felt the disease to be a threat to social well-being. The value of the -2Log likelihood was 64.68 and the goodness of fit index was 214.735. The value of Nagelkerke was 0.893, which indicates that the logistic regression model explains 89% of the variance. The model predicts correctly 97% of compliance in adolescents showing good compliance. These values show the logistic regression model to be good and to match well with the data.

Adolescent↗

PubMed2000

Conceptual analysis of compliance.

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

Cognition↗

PubMed2000

Compliance of adolescents with chronic disease.

The purpose of this paper is to describe the factors that affect compliance in adolescents with a chronic illness and to compare compliance and factors connected to compliance between adolescents with asthma, epilepsy, rheumatoid arthritis (JRA) and insulin dependent diabetes mellitus (IDDM). The data were collected by questionnaire. Altogether 1200 individuals were selected from the Finnish Social Insurance Institution's register. The response percentage was 88 (n = 1061). One-fifth (23%) of adolescents with chronic disease felt that they had complied fully with health regimens, while 60% placed themselves in the category of satisfactory compliance and the remaining 17% reported poor compliance. In each patient group compliance was promoted by good motivation, a strong sense of normality, a positive attitude towards the disease and treatment, energy and will-power, experience of results, support from the parents, nurses and physicians, and a feeling that the disease was not a threat to social well-being.

Adolescent↗

PubMed2000

Compliance of adolescents with diabetes.

The purpose of this article is to describe the compliance of adolescents with diabetes and some factors connected to it. Altogether, 300 individuals aged 13 to 17 years were randomly selected from the Finnish Social Insurance Institution's register. Every fifth person on the list was included in the sample. Ninety-seven percent (N = 289) of the adolescents with diabetes returned the questionnaire. The data were analyzed by using the Statistical Package for the Social Sciences (SPSS) software. Only about one fifth (19%) of the respondents with diabetes felt that they complied fully with the health regimens, whereas 75% placed themselves in the category of satisfactory compliance and the remaining 6% reported poor compliance. Compliance with home monitoring was poorest: Only 25% said they fully complied with the home monitoring instructions, and 51% showed poor home monitoring compliance. The highest degree of compliance was reported for insulin treatment, with 81% of the patients ranking in the top category. Some statistically significant (p < .001) relationships between the degree of compliance and the background variables, such as the duration of disease; exercise; smoking; alcohol intake; and serum glycosylated hemoglobin (GHbA1c) value, were found. Good motivation, a strong sense of normality, energy and willpower, support from parents; physicians; and nurses, a positive attitude toward the disease and its treatment, no threat to one's social well-being, and fears of complications explained good compliance (p < .001).

Adolescent↗

PubMed2000

Compliance with health regimens of adolescents with epilepsy.

The purpose of this paper was to describe the compliance of adolescents with epilepsy and some factors connected to it. Altogether 300 individuals with epilepsy aged 13-17 years were randomly selected from the Finnish Social Insurance Institution's register. Every fifth person on the list was included in the sample. Seventy-seven per cent (n= 232) of the selected adolescents with epilepsy returned a questionnaire sent to them relating to compliance. The data were analysed using the SPSS software. Twenty-two per cent of the adolescents with epilepsy felt that they complied fully with their suggested health regimens, while 44% placed themselves in the category of "satisfactory compliance", and the remaining 34% reported poor compliance. Compliance with their recommended life-style was poorest, while the highest degree of compliance was recorded for medication. Background variables, such as the duration of the disease, exercise, smoking, alcohol-intake and the number of seizures, were statistically significantly related to compliance (P< 0.001). Good motivation, a strong sense of normality, experience of results, subjective outcome, energy and will-power, support from parents, physicians and nurses, and a positive attitude towards to the disease and its treatment, no threat to social and emotional well-being and no fears of complications and no fear of seizures explained good compliance (P< 0.001).

Adolescent↗

PubMed1999

Compliance of patients with hypertension and associated factors.

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

Adult↗

PubMed1998

Adolescents' perceptions of physicians, nurses, parents and friends: help or hindrance in compliance with diabetes self-care?

Although compliance with self-care amongst adolescents with diabetes is known to be problematic, this issue has rarely been examined from the perspective of young diabetics themselves. The purpose of the study was to explore how adolescents with diabetes perceived the actions of physicians, nurses, parents and friends in relation to compliance with self-care. Fifty-one young diabetics aged from 13 to 17 responded to a questionnaire concerning compliance and were interviewed on the topic of compliance. Interview data were analysed by content analysis. The categories obtained were quantified and the relationship between compliance and the actions of physicians, nurses, parents and friends analysed by cross-tabulation. Interviews with 51 adolescents showed that the actions of physicians, nurses and parents described as motivating were associated with better compliance. Good compliance was also more evident when parental actions were perceived as accepting. Young diabetics whose friends offered silent support, or who viewed friends as irrelevant, were more likely to report good compliance. In contrast, physicians' actions described as routine/negligent, disciplined control by parents, and domination by friends were linked with poor compliance.

Adolescent↗

PubMed1998

Nurse caring behaviours.

The purpose of this research paper is to examine caring behaviours and how they relate to nurses practice from the psychiatric and general nurses' views. Whether this caring is influenced by the nurses' age, gender or qualification is also examined. The convenience sample used were nurses (n = 118) of all grades and experience in a general hospital and in a psychiatric hospital. The Care-Q instrument was used. The response rate was 66%. Statistical analysis included rankings of sub-scale and individual items and the chi-square test of association. The results show that nurses ranked physically based caring behaviours higher than affective behaviours. They emphasized monitoring and comforting behaviours but paid less attention to anticipatory behaviours. Gender appeared to have the greatest influence on what caring behaviours were valued. Male nurses were less likely than female nurses to be accessible, forming trusting relationships or performing comforting behaviours. The results challenge both nurses and nurse educators to examine caring behaviours in nursing practice.

Adult↗

PubMed1998

Factors associated with the adaptation of parents with a chronically ill child.

The purpose of this paper is to describe the adaptation of parents who have a child with a chronic condition and some factors connected to it. Data were collected by a questionnaire from 189 parents who had a child with a chronic condition, such as diabetes, rheumatoid arthritis or asthma. Most (85%) of the responses were from mothers. The data were analysed using factor analysis. A four-factor model turned out to describe best the adaptation of the parents and their coping with the care of a chronically ill child. Two factors showed good adaptation and two poor adaptation. Emotional and instrumental support were connected to adaptation on each of the four factors. Support from health care staff and the parents' need to obtain more information were not connected to adaptation as clearly as emotional and instrumental support. Parents wished for support more in families where the child was under nine years old than in families where the child was over nine years old.

Adaptation, Psychological↗

PubMed1998

[Compliance of patients with hypertension].

The purpose of this study was to evaluate the compliance of patients with hypertension and the connections between compliance and control. The research material was collected using a questionnaire, which was filled in by 138 patients aged under 60 from one city and from three municipalities. The response percentage was 94%. The results are presented as a frequency and percentage distributions. Means and medians are also presented. The material was analysed using the SPSS for Windows program. Hypertension control was determined on the basis of blood pressure readings and a weight index. According to the blood pressure readings the control of hypertension was good in one tenth of the patients, medium in two thirds and poor in one fifth. Based on the weight index, the control of hypertension was good in less than one third, poor in almost one third and medium in the rest of the patients. Two thirds of the respondents were obese and men were more often obese than women. According to the findings, there were no significant correlations between compliance and control. Compliance with visits and dietary restrictions was poorest, while compliance with medication was best. In the future, we will have to study further the connections between compliance and control in patients with hypertension. The development of a reliable measuring instrument is a long process and requires further research in a large study population.

Blood Pressure↗

PubMed1998

[Challenges of the grounded theory approach to a novice researcher].

The grounded theory approach has been used in nursing research since 1970. The latest methodological books describe the research process in details. However, there are many problems involved in the grounded theory approach, which especially need to be considered by a novice researcher. One of these problems is the question of how deeply and widely the researcher should get familiar with the research topic before the empirical study. The problems also include the need to focus the research problem and to choose the sampling method. Data analysis is a multistage process, which demands from the researcher sensitivity and time to work out the findings which emerge from the data. In this paper, the grounded theory approach is described as a process undertaken by the researcher. The purpose of this paper is to discuss the challenges of the grounded theory approach and the problems encountered by a researcher using the method for the first time.

Adaptation, Psychological↗

PubMed1997

[Model development in nursing science; the construction of a theoretical model].

The aim of the paper is to describe the development of nursing theory. As an example, a theoretical model of the compliance of young diabetics and related factors is built. The content of the theoretical model is not described but the process of developing the model is presented. In the first phase, a hypothetical model of young diabetics' compliance was developed inductively. The data were collected by interviewing 51 young diabetics aged 13-17 years, by observing the behaviour of 18 of these young people during an adaptation course and by analysing their drawings (N = 17). The data were analysed by using continuous comparative analyses and content analyses. In the second phase, an instrument for testing the model was developed. For this purpose, data were collected with a questionnaire from young diabetics aged 12-17 years (N = 91). The content validity, construct validity and reliability of the instrument turned out to be quite good. In the third phase, the hypothetical model was tested and developed further by using LISREL (linear structural relations) analyses. The data were collected with a questionnaire from young diabetics aged 13-17 years (N = 346). In the fourth phase, the model was expanded using the qualitative data (N = 51). The categories which had been discovered by continuous comparative analyses were quantified. The data were analysed by cross-tabulation, the chi square test and discriminant analyses. A summary of the results has been presented by building a theoretical model of young diabetics' compliance and related factors.

Adaptation, Psychological↗

PubMed1997

[Compliance with health regimens: statistical verification of conceptual structure].

The use and definition of the concept compliance has been variable. The concepts compliance, adherence and co-operation have been used in the English literature. The terminology in the Finnish literature is also variable such concepts as hoitomyöntyvyys, hoitomyötäys, hoitokuuliaisuus and hoitoon sitoutuminen have been used. The purpose of this study is to illustrate the empirical structure of the concept compliance. The baseline was the definition of compliance of young diabetics. According to this definition, compliance is an active, intentional and responsible process by which young diabetics work to maintain their health in collaboration with the health care staff. The data were collected (1994) by a questionnaire from young diabetics aged 13-17 years (N = 403). To test the structure of the concept compliance, LISREL-analysis was used. The results of the study support the baseline definition of compliance.

Adult↗

PubMed1997

[Parents' coping with a diabetic child].

The purpose of this study is to describe and understand the process of parental coping with diabetic children in early childhood. The parental coping process was followed for a four-week period after the diagnosis of diabetes. The parents of two girls whose diabetes was diagnosed in early childhood served as study subjects. The data were collected by interviewing and observing the parents over four separate periods, first in hospital and later at home. The data were analyzed by the timeseries and content analysis methods. The main categories were formulated on the basis of coping theories. The subcategories were developed inductively from the data. Six phases of the parental coping were identified, which were named: 1). Disbelief, 2). Lack of information and Guilt, 3). Learning of Care, 4). Normalization, 5). Uncertainty and 6). Reorganization. In the different phases of parental coping the parents' experience of stress, coping strategies and sense of control varied. In the phase of Disbelief, parents tried to explain away the child's diabetes by questioning the diagnosis. The initial information given to the parents regarding their child's diabetes proved to be very important for parental coping. In the second phase of Lacking Information and Guilt, the parents sought for a reason for their child's diabetes and they felt guilty about it. As coping responses, the parents sought support from each other and from people who have undergone the same experience. In the Learning of Care phase, they recognized the demands caused by diabetes and took responsibility for the child's care. The parents responded that supervision based on their problems was the best. In the Normalization phase, the parents prepared to go home with the diabetic child. Getting back to normal life was one of the most effective parental coping responses. In the Uncertainty phase, the care to be given to the diabetic child changed the daily routines of the family. In the Reorganization phase, the parents adapted to the diagnosis of diabetes and the care of the diabetic child. The parents felt that the life of the family became normalized and controlled. The important parental coping responses consisted of concrete models of functioning, which they developed to control the demands caused by the child's diabetes.

Adaptation, Psychological↗

PubMed1996

Diabetic adolescents' compliance with health regimens and associated factors.

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

Adolescent↗

PubMed1996

Young diabetics' compliance in the framework of the MIMIC model.

The compliance of 346 young diabetics aged 13-17 years with health regimens is analysed in the framework of a MIMIC (multiple indicators, multiple causes) model. The data were compiled by means of a questionnaire on compliance, conditions for compliance, the meaning attached to treatment and the impact of the disease, and the model constructed using the LISREL VII programme, treating compliance as an unobserved variable formulated in terms of observed causes (x-variables) and observed indicators (y-variables). The resulting solutions are entirely satisfactory. The goodness-of-fit index is 0.983, the root mean square residual 0.058 and the chi-squared statistic 43.35 (P < 0.001). The values for the individual parameters in the model are also shown to be reliable and valid. The model shows compliance to be indicated by self-care behaviour, responsibility for treatment, intention to pursue the treatment and collaboration with the physician, and to be greatly determined by motivation, experience of the results of treatment and having the energy and will-power to pursue the treatment and, to a lesser extent, by a sense of normality and fear.

Adolescent↗