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Biomedical subjects

H Leino-Kilpi

Publications and source records attributed to H Leino-Kilpi.

At least 19 recordsLinked to original sources
PubMed2003

Patients' autonomy in surgical care: a comparison of nurses' perceptions in five European countries.

BACKGROUND: This report forms part of the results of an international comparative study funded by the European Commission (1998-2001). AIM: To describe and compare the maintenance of patients' autonomy on surgical wards, from the point of view of nursing staff, in five European countries (Finland, Spain, Greece, Germany and Scotland). Autonomy is defined in terms of information received and decision making by patients. METHOD: The data were collected using a questionnaire specifically designed for use in this study. Responses (response rate 66%) were obtained from 1280 nurses working on surgical wards. Data analysis was based on descriptive statistics, t-tests, analysis of variance (ANOVA) with posthoc Tukey's HSD test and logistic regression. RESULTS: There were clear between-country differences in nurses' perceptions, especially on a north-south axis (Finland and Scotland vs. Greece and Spain), regarding the extent to which the autonomy of surgical patients is supported by nursing staff. Training and ethics education, in particular, were associated with nurses' perceptions of the maintenance of patient autonomy in Finland and Greece. CONCLUSION: Further research is needed to establish whether the results obtained are caused by differences in cultures, nursing practices or roles of health-care personnel or patients in different European countries.

Adult↗
PubMed2001

Privacy: a review of the literature.

The concept of privacy is used in many disciplines and is recognised as one of the important concepts also in nursing. In this review, a description about the perspectives and dimensions of the concept will be made and empirical studies in the area will be analysed. Perspectives include units experiencing privacy, desired-achieved state, and reactiveness. Dimensions are divided into physical, psychological, social and informational. In the empirical studies, the concept of the privacy has mainly been studied in hospital organisations using the physical dimension. The concept needs further clarification in future.

Confidentiality↗
PubMed2001

Medication calculation skills of graduating nursing students in Finland.

The aim of this study was to describe the basic mathematical proficiency and the medication calculation skills of graduating nursing students in Finland. A further concern was with how students experienced the teaching of medication calculation. We wanted to find out whether these experiences were associated with various background factors and the students' medication calculation skills. In spring 1997 the population of graduating nursing students in Finland numbered around 1280; the figure for the whole year was 2640. A convenience sample of 204 students completed a questionnaire specially developed for this study. The instrument included structured questions, statements and a medication calculation test. The response rate was 88%. Data analysis was based on descriptive statistics. The students found it hard to learn mathematics and medication calculation skills. Those who evaluated their mathematical and medication calculation skills as sufficient successfully solved the problems included in the questionnaire. It was felt that the introductory course on medication calculation was uninteresting and poorly organised. Overall the students' mathematical skills were inadequate. One-fifth of the students failed to pass the medication calculation test. A positive correlation was shown between the student's grade in mathematics (Sixth Form College) and her skills in medication calculation.

Clinical Competence↗
PubMed2001

Nursing student-patient relationship: a review of the literature from 1984 to 1998.

AIM AND BACKGROUND: The aim of this review is to examine the research of the nursing student-patient relationship for planning an empirical study in this area. METHODS: A literature search was made focusing on relationship from student and patient perspectives. The sample included 104 articles from 1984 to 1998. The articles were analysed using an inductive analysis of the literature. RESULTS: The review shows that there has been an increasing research interest in the issue since the 1980s, with the main focus on nursing students. Most of the studies were of a descriptive nature, using both qualitative and quantitative approaches. It seems that the relationship with a patient is an important part of a meaningful learning process, teaching nursing students about the patient's individualised care and promoting their personal and professional growth, confidence and self-esteem. Patients are willing to participate in students' learning process and they tend to benefit from therapeutic and social interaction with students. Instruction has the effect of changing students' attitudes and improving their interaction skills, but it does not affect their feelings of anxiety in novel situations. CONCLUSIONS: In future empirical research should be based more firmly on theory-based illuminations of the student-patient relationship.

Bibliometrics↗
PubMed2001

The quality of perioperative care: development of a tool for the perceptions of patients.

AIM OF THE STUDY: To find out how surgical hospital patients (n=874) perceived the quality of perioperative care they received in an operating department and in the recovery room. BACKGROUND: Patients' perceptions of the perioperative care have not been included systematically in the improvement of the care. Accordingly, there is no standardized, valid, and reliable instrument or system in common use that we could use for the evaluation. The nursing care in operating departments has an important role in modern health care, and therefore more research concerning perioperative care quality is needed urgently and the development of the measurement tool is urgent. METHOD: The data were collected using a structured questionnaire in five operating departments in southern Finland during 1998. RESULTS: Physical activities (such as pain management and temperature maintenance) were rated as excellent, as were staff characteristics and the physical and social environment. The most critical comments were made with regard to supporting patient initiative, encouragement and educational activities. Patients stated they would have liked more information and it was felt that they should have been encouraged to ask more questions about unclear matters. Some of the patients said they had only very limited influence over their own care. The patients were very pleased with their care in the recovery room. There were only minor differences between the views of patients from different departments. CONCLUSIONS: Overall the quality of care was considered extremely good, but comparisons of different quality categories did reveal some problems. Although it has already proved to be a useful tool, the questionnaire needs to be developed and tested further.

Adolescent↗
PubMed2001

The qualities of an empowered nurse and the factors involved.

BACKGROUND: In developing the quality of health care attention has recently focused on the professional progress of nurses. Simultaneously, empowerment ideology has been increasingly adopted as the conceptual framework for the development of nursing. The empowerment process has usually been described from an organizational starting point. In the present study empowerment is approached starting from the individual nurse's point of view. AIM: This study aims to explore (a) what an empowered nurse is like, (b) how he/she performs his/her functions, (c) what promotes empowerment, and (d) what prevents empowerment. METHOD: The material was collected by interviewing 30 nurses who had participated in a career advancement project at a university hospital in Finland. The data were analysed by qualitative content analysis. RESULTS: Five categories were discerned: moral principles, personal integrity, expertise, future orientation and sociability. These represented the performance and the qualities of an empowered nurse, as well as the promoting and preventing factors. CONCLUSIONS: Empowerment is a process steered by personal values and endeavours as well as by environmental factors. An empowered nurse possesses those qualities which make possible high self-esteem and successful professional performance and progress.

Decision Making, Organizational↗
PubMed2001

Staff empowerment in Finnish intensive care units.

The purpose of this study was to describe staff empowerment in Finnish intensive care units. The data were collected with a questionnaire comprising demographic background and empowerment items. The concept of empowerment was divided into three components: behavioural, verbal and outcome empowerment. The questionnaire was sent to all registered nurses at Finnish intensive care units (ICUs). Eight hundred and fourteen replied, giving a response rate of 77%. The ICU nurses demonstrated confidence in their own skills and competencies, although least so in the domain of outcome empowerment. Experience of behavioural, verbal and outcome empowerment increased linearly with age. The length of nursing experience was positively associated with behavioural, verbal and outcome empowerment. Experience in ICU nursing correlated positively with verbal and outcome empowerment. Motivation, job satisfaction, respect of job autonomy and the fact that the job of ICU nurses commanded respect in society were associated with behavioural, verbal, and outcome empowerment.

Adult↗
PubMed2001

The role of CNSs in promoting elderly patients' autonomy in long-term institutions: problems and implications for nursing practice and research.

Autonomy has become an important focus within healthcare. Elderly patients, however, are often denied the right to independent decision making on grounds of incompetence and incapacity. In long-term institutions there are several ways in which the clinical nurse specialist can promote the autonomy of elderly patients. This article provides an overview of the concept of autonomy and discusses some of the problems in its realization in long-term nursing institutions. It also outlines strategies for supporting autonomy in elderly patients and concludes with a discussion of the implications of autonomy to nursing practice and research.

Age Factors↗
PubMed2001

The multiple sclerosis nurse as patient educator.

Patient education is an important part of neuroscience nursing. New treatments, such as beta interferon self-injections, have challenged nurses. The purpose of this study was to analyze the patient education given by 35 Finnish nurses who work with patients who have multiple sclerosis. The content and didactic solutions of patient education, evaluation of patients' learning skills, and learning outcomes were analyzed. Also, successful and unsuccessful patient education experiences are described. The results showed that patient teaching is based on individual and unstructured approaches. The role of the patient is important, and there is need for more systematic evaluation of learning outcomes. Results from teaching of beta interferon self-injections are similar. In general, more systematic research in this area is required.

Adult↗
PubMed2000

Power and empowerment in nursing: three theoretical approaches.

Definitions and uses of the concept of empowerment are wide-ranging: the term has been used to describe the essence of human existence and development, but also aspects of organizational effectiveness and quality. The empowerment ideology is rooted in social action where empowerment was associated with community interests and with attempts to increase the power and influence of oppressed groups (such as workers, women and ethnic minorities). Later, there was also growing recognition of the importance of the individual's characteristics and actions. Based on a review of the literature, this paper explores the uses of the empowerment concept as a framework for nurses' professional growth and development. Given the complexity of the concept, it is vital to understand the underlying philosophy before moving on to define its substance. The articles reviewed were classified into three groups on the basis of their theoretical orientation: critical social theory, organization theory and social psychological theory. Empowerment seems likely to provide for an umbrella concept of professional development in nursing.

Female↗
PubMed2000

Ethics in the laboratory examination of patients.

Various value problems are connected with the clinical examination of patients. The purpose of this literature review is to clarify: 1) in which patient examinations ethical problems are generally found; 2) what kind of ethical problems are found in the different phases of the examination process, and 3) what kind of ethical problems are found in connection with the use of examination results. Genetic testing, autopsy, prenatal and HIV examinations were ethically the most problematic laboratory examinations. The most problematic phase in the laboratory examination process proved to be the pre-analytic phase. At present the results of laboratory examination are used more and more often for the prediction of diseases. The problems appear when the examination results are used for discrimination and stigmatization. Because of the lack of empirical ethical research, it is important to chart empirical knowledge about present value conflict situations involved in the laboratory examination process.

AIDS Serodiagnosis↗
PubMed1999

Research in peri-operative nursing care.

This review analyses 97 research reports dealing with peri-operative care which included patients. The literature review was done as the basis of a development project to measure the quality of intra-operative nursing care from the patient's perspective. The pre-operative phase provides information about the teaching, anxiety and stress of patients. Few sources dealt with the intra-operative phase; there were a small amount of reports concerning concrete nursing activities (e.g. surgical position and warming the patient). The most information was available on the post-operative phase, such as recovery, adaptation and the treatment of pain. Peri-operative research is mainly concerned with the quality of nursing care, control of life and ambulatory surgery. The main defects of analysed studies can be characterized as follows: small samples and a single hospital, lack of definition of terms, theoretical ambiguity, short follow-up times, anaesthetic or other drugs used during the care not mentioned in the report (especially in studies on pain and quality). Previously developed research tools had usually been well tested, but there was great variety in the testing of investigator-constructed tools. There were also discrepancies in the evaluation of validity and reliability. Future research should especially deal with treatment of pain and anxiety, information and guidance given to patients, and the costs of surgical care; there is also a need for studies dealing with intra-operative care from the patient's perspective. Although information is already available on the above mentioned topics, more detailed and comprehensive facts are still needed.

Clinical Nursing Research↗
PubMed1999

Applicability of SWOT analysis for measuring quality of public oral health services as perceived by adult patients in Finland. Strengths, weaknesses, opportunities and threats.

OBJECTIVE: To determine the applicability of SWOT analysis for measuring the quality of public oral health services from the adult client's perspective. METHODS: Data were collected using a structured questionnaire developed in an earlier study. The study group consisted of all adult (over 18 years of age) clients (n = 256) using public municipal oral health services in Kirkkonummi, Finland, during 2 weeks in 1995. Before treatment, patients filled out a questionnaire that measured the importance of their expectations in different aspects of oral care. After the appointment, they filled out a similar questionnaire that measured the enactment of these expectations in the treatment situation. The response rate was 51%. The difference between subjective importance and enactment of expectations was tested by Wilcoxon's signed rank test. Results were interpreted using both a conventional analysis of "expectation enacted or not" and SWOT analysis, which is used in strategic planning to identify areas of strengths (S), weaknesses (W), opportunities (O) and threats (T) in an organisation. RESULTS: In 28 statements out of 35, the two analyses revealed similar interpretations. In most areas the patient-perceived quality of the services was good. Weaknesses were found in the following areas: communicating to patients the causes and risk of developing oral diseases, informing them about different treatment possibilities, and including patients in decision-making when choosing restorative materials. CONCLUSION: SWOT analysis provided more structured interpretation of the results, and can be more easily transferred to development of services.

Adult↗
PubMed1999

Informed consent for short-stay surgery.

This study in the context of short-stay surgery is based on a definition according to which informed consent consists of five elements: consent, voluntariness, disclosure of information, understanding and competence. The data were collected in four district hospitals in southern Finland by using a structured questionnaire. The population consisted of short-stay and one-day surgery patients (n = 107). Data analysis was based on statistical methods. The results indicated some problems in the realization of informed consent. Most commonly, consent was expressed by voluntary admission. Most patients had indicated their voluntary consent by making their decision independently. There were also certain problems with information. The respondents were least well informed about the drawbacks of anaesthesia and about alternative forms of treatment. The patients had not understood all the information they had received; problems of understanding were greatest with information about the advantages and disadvantages of anaesthesia. Problems were also reported with competence. These patients had the most difficulty in assessing the advantages and drawbacks of different treatments and anaesthesia.

Adult↗
PubMed1998

Preconditions for and consequences of self-determination: the psychiatric patient's point of view.

In the context of an interview study concerned with self-determination in psychiatric patients, this paper describes the preconditions for and consequences of self-determination from the point of view of psychiatric patients themselves. The data were collected in semi-structured interviews with long-term psychiatric patients (n = 72) and analysed using the method of content analysis. Responses on the preconditions for self-determination were grouped into three categories: firstly, there were those who said that reference to self-determination in the case of psychiatric patients is nonsense; secondly, there were those who said that self-determination requires no preconditions; and thirdly, there were those who said that there are certain preconditions, such as the ability to think and make decisions, activity, obedience, and illness. Both positive and negative consequences were identified in situations where self-determination is maintained, but only negative consequences in situations where self-determination is lost. On the basis of these tentative results, self-determination seemed to be relevant in psychiatric nursing. We are continuing to develop and test an instrument for the evaluation of the opportunity for self-determination in clinical practice.

Adult↗
PubMed1998

Elements of empowerment and MS patients.

Elements of empowerment are: cognitive, experiential, ethical, social, biophysiological, functional and economic. Empirical data from 64 Finnish multiple sclerosis patients were collected. Based on the data, the social element is the most dominating element of empowerment. Patient-center research in nursing care of MS patients should be done to facilitate MS patients abilities toward empowerment.

Activities of Daily Living↗
PubMed1998

Nursing research in Finland from 1958 to 1995.

PURPOSE: To review the methods and content of nursing research carried out in Finland between 1958 and 1996. University-level nursing education and research started in Finland in 1979. In 1997, there were seven universities with nursing programs and, in all of them, active international collaboration. SCOPE: First emperical and nonemperical studies were identified, then the research topics and research methods were analyzed. Some historically interesting evaluations were also documented. SOURCES: Articles published in the Yearbook of Nursing (1958-1988, n = 228), in the Finnish Journal of Nursing Science (1989-1995, n = 116), and all Finnish licentiate and doctoral theses (n = 104). METHOD: Content analysis. FINDINGS: The number of research articles and theses is increasing. Nursing practice has been the most common research topic, and especially primary health care and surgical and medical care. Questionnaires and interviews are the methods used most often, observational methods are rare. Most research is discriptive. CONCLUSIONS: In the future, research is recommended in nursing care of children and adolescents as well as evaluative research.

Finland↗