Biomedical subjects

K Vehviläinen-Julkunen

Publications and source records attributed to K Vehviläinen-Julkunen.

At least 19 recordsLinked to original sources

PubMed2001

Hope, despair and hopelessness in living with HIV/AIDS: a grounded theory study.

BACKGROUND: Hope, despair or hopelessness have been detected in several research reports as important elements of the lives of persons living with human immunodeficiency virus (HIV) (PLWH) or acquired immunodeficiency syndrome (AIDS) (PLWA). However, there is an obvious gap in the literature suggesting a need to study the overall dynamics of hope (including both hope and despair or hopelessness) along the HIV spectrum from PLWHs' and PLWAs' perspective. AIM: The purpose of this study was to describe the dynamics of hope in living with HIV/AIDS. METHODS: The data were collected through interviewing 10 PLWHs/PLWAs and analysed using a grounded theory method. FINDINGS: The dynamics of hope is a multifaceted and complex combination of 'hope', 'despair' and 'hopelessness'. It comprises balancing between 'believing life to be worth living at the present and in the future', 'losing one's grip and sinking into narrowing existence vs. fighting against sinking' and 'giving up in the face of belief in nonexisting future'. A dynamic alternation between hope, despair and hopelessness takes place in the presence of factors that contribute to the 'folding' and 'unfolding' possibilities in everyday life. Factors contributing to the folding possibilities include 'losing', 'fear', 'uncertainty', 'problems in care', 'HIV/AIDS in close ones', 'difficulties in relationships' and 'negative public images and attitudes concerning HIV'. Factors contributing to the unfolding possibilities are 'constructive life experiences', 'wishing not to have HIV while uncertain', 'constructive relationships', 'ability to control one's life', 'finding the meaning of life and zest for life', 'caring', 'noticing one's improved health and the continuance of life', 'increasingly positive attitudes concerning HIV-positive people' and 'protection by law'. CONCLUSIONS: The dynamics of hope discovered in this study present new conceptualization, where hope, despair and hopelessness are viewed in relation to each other. The emerged definitions may be used in clinical practice to identify these phenomena in individuals with HIV/AIDS. The discovered factors contributing to the folding and unfolding possibilities can be used in clinical practice to help the individuals along the dynamics of hope.

Acquired Immunodeficiency Syndrome↗

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↗

PubMed2001

Knowledge, assessment and management of pain related to nursing procedures used with premature babies: questionnaire study for caregivers.

The aim of the study was to discover how much Finnish nursing staff know about the pain experienced by premature babies and about pain assessment. The types of helping methods used by caregivers in the nursing of premature babies were also studied. A semistructured questionnaire was sent in autumn 1995 to all registered nurses, practical children's nurses and medical laboratory technologists who take heel blood samples (n = 280) working in paediatric intensive care units in all Finnish university hospitals. The response rate was 70.4%. The structured questions were processed quantitatively at Kuopio University with the SPSS/PC+ data processing program (SPSS, Chicago, IL, USA), and the open questions were processed using quantitative content analysis. The results indicate that the respondents have rather extensive knowledge about the pain experienced by premature babies, pain assessment, pain management and about nursing and helping methods. Pain was assessed mostly on the basis of behaviour and physiological changes, and only infrequently on the basis of biochemical changes. The respondents described the helping methods they use in considerable detail. The most common was to increase the baby's feeling of security. The answers to the open questions revealed that the actions used by the respondents in pain assessment and pain management were not completely consistent with their knowledge. The results demonstrate that caregivers do not use their knowledge adequately in their pain management practices. Future studies should observe the three groups of caregivers in order to discover how they treat premature babies' pain.

Caregivers↗

PubMed2001

Dynamically fluctuating hope, despair and hopelessness along the HIV/AIDS continuum as described by caregivers in voluntary organizations in Finland.

The purpose of this study was to describe the dynamics of hope in a) people fearing a diagnosis of HIV or living with HIV/AIDS and b) their significant others, from the perspective of caregivers working in voluntary organizations in Finland. Individual interviews with eight caregivers were analysed using the grounded theory method. Living with the fluctuating waves of hope, despair, and hopelessness based on factors constructing them emerged as the core category describing the dynamics of hope in a person fearing a diagnosis of HIV, becoming aware of HIV contagion, and living with HIV/AIDS. Mirroring the fluctuating waves of hope, despair, and hopelessness based on factors constructing them emerged as the core category describing the dynamics of hope in a significant other of a person fearing a diagnosis of HIV, or living with HIV/AIDS. It is important to take into consideration the dynamics of hope in taking care of people fearing a diagnosis of HIV or living with HIV/AIDS and their significant others.

Acquired Immunodeficiency Syndrome↗

PubMed2000

Ways of being a father: how first-time fathers and public health nurses perceive men as fathers.

The purpose of this paper is to describe the different ways of being a father identified in a sample of Finnish men. The data consisted of 71 interviews with fathers and 175 essays written by public health nurses. The fathers and public health nurses described different ways of being a father: bystander, supporter of spouse, partner, and head of the family. The spouse, relatives and maternity health care workers could encourage the father to choose a specific way to be a father, or discourage them from adopting a specific way. The information obtained in this study will be helpful in supporting the different kinds of fathers and their individual needs in family nursing.

Adult↗

PubMed2000

Finnish nursing research: issues and challenges.

Finnish nursing science has advanced by leaps and bounds during the past two decades. The overriding objective of nursing research has been to increase our understanding and knowledge of nursing phenomena to better promote the health and well-being of individuals and, by the same token, influence the nation's public health. This article provides an overview of issues and challenges of Finnish nursing by using the results of recently published evaluation reports of Finnish nursing research, nursing education and nursing organizations.

Evidence-Based Medicine↗

PubMed1999

Ethical considerations in a grounded theory study on the dynamics of hope in HIV-positive adults and their significant others.

The purpose of this article is to describe and reflect ethical challenges in a grounded theory study on the dynamics of hope in HIV-positive adults and their significant others. It concentrates on the justification of a research problem, sensitive research and the relationship between the researcher and the participants in data collection. The basis of ethically sound nursing research on the dynamics of hope in these two vulnerable groups lies in the relationship between the researchers and the participant. However, it is also obvious that the content, the process, the methods used and the ethics of the study cannot be divorced from this relationship. In conducting grounded theory research on the dynamics of hope in this research population, the researcher has to consider the surrounding world, that is, the reality in which these people live in hope or despair.

Adaptation, Psychological↗

PubMed1998

Fathers' experiences of childbirth.

OBJECTIVE: To describe how fathers who are present during childbirth experience the event, what they feel during childbirth and how they understand the meaning of childbirth. DESIGN: Survey using questionnaire. SETTING: Maternity unit in Finland. PARTICIPANTS: A non-random sample of fathers (n = 137) who were present at the birth of their baby at one university hospital in Finland. The response rate was 81% (n = 107). MEASUREMENTS AND FINDINGS: Young fathers and those expecting their first baby reported feeling uncomfortable during delivery more frequently than others. Almost all said that they had plenty of good experiences, younger fathers more so than older fathers. The fathers expressed their confidence in the staff and described the environment at the hospital as pleasant. They said their presence at delivery was important for their growth into fatherhood. The best experience was the moment that the baby entered the world. The hardest things were the pain experienced by their partner and being unable to help. Most of the fathers were very pleased with current midwifery practices followed in childbirth, however, it was felt that more attention ought to be paid to pain relief and to supporting and providing guidance to the father during delivery. IMPLICATIONS FOR PRACTICE: The work of midwives should be planned so that fathers can feel secure and comfortable. Further studies are needed into the ability of midwives to support fathers in their fatherhood.

Adolescent↗

PubMed1998

Participation of expectant mothers in decision making in maternity care: results of a population-based survey.

The purpose of the study was to acquire knowledge of the opportunities that expectant mothers had to participate in decision making regarding their care in maternity clinics during their last pregnancy. The study is a part of a larger national survey 'Family planning services in Finland' carried out by the National Research and Development Centre for Welfare and Health. The rationale for the study were the known benefits of participation in one's care and its emphasis in health policy documents. The subjects were a random sample of women aged between 18 and 44. The response rate was 73% (n = 1289). The data were gathered by a mailed questionnaire and analysed statistically. According to the results mothers had fairly good opportunities to participate in decision making. However, there were statistically significant differences in opportunities between the women. The mothers who were most satisfied were aged 25-29 years, lived in a permanent relationship, had 12 years of basic education and had three children. Opportunities to participate in care have improved from the 1970s to the 1990s. The results have many implications for the development of nursing practice in maternity clinics and the deepening of the knowledge base in nursing education. The study, being the first national survey on this topic, also gives suggestions for further studies.

Adolescent↗

PubMed1997

Hope in nursing research: a meta-analysis of the ontological and epistemological foundations of research on hope.

The purpose of this study is to describe the ontological basis of hope and the epistemological solutions adopted in research on hope by reviewing research articles concerned with the subject in the field of nursing science. The material consisted of 46 articles published between 1975 and 1993, and the examination was based on the meta-analysis method. References to the ontology of hope were inductively clustered according to the principle of continuous comparison. For the analysis of epistemological solutions, the purpose of the study, population/respondents, and methods of data collection and analysis were identified. The articles reviewed focus on the essence and distinctive characteristics of hope. Although rich in detail and quite vivid, there is a certain lack of precision about the descriptions. Hope may be described as an emotion, an experience or need. A distinction is made between generalized and particularized hope. There is a clear emphasis on the necessity and the dynamism of hope. As far as its dynamics are concerned, the most important dimension is the dialectic between hope and despair. An affective, functional, contextual and temporal as well as relational dimension are distinguished in the process of hope. Research on hope consists in the main part of descriptive cross-sectional research that focuses on individuals who are unwell. The most common method of data collection is the questionnaire, while the analyses are typically based on quantitative methods. There is need for further work to clarify the concept of hope. In the field of nursing research, there is obvious need to carry out more qualitative longitudinal research. More attention should be paid to healthy individuals and families at different stages of their life cycle.

Attitude to Health↗

PubMed1997

[Fathers' childbirth experience and nursing interventions].

The purpose of the study was to describe the childbirth experience of fathers and nursing interventions used during labour and delivery. The data were collected by questionnaires from fathers attending delivery room during one month (n = 137). Five fathers refused to participate. The return rate was 81% out of 132 fathers. Data analysis included cross tabulations, factor analysis as well as content analysis for open ended questions. Nursing interventions which fathers found supportive were infant care, getting information and attention from the staff. Most of the respondents felt they got encouragement to take care of the infant. They also got information of the delivery and newborn's welfare. However, about half felt they got little encouragement to show their own feelings. Fathers found that being present at the delivery was an important part of their fatherhood. The best moments were attached to enjoyment of taking care of the newborn. Fathers felt themselves unable to help their partner enough. They felt very difficult to see their partner in pain. Most of the father were quite satisfied with nursing interventions used during labour. They wanted more attention to be paid to pain management. Fathers would like to get more advice during labour.

Adult↗

PubMed1997

[From man to father--a review of nursing research].

This literature review describes the work that has been done in the field of nursing research on growth into fatherhood starting from pregnancy and through the infant's first year of life. The purpose is to describe and analyse the existing research knowledge on this subject. The material of this review consists of 56 articles derived from the Cinahl (1983/1995) and Medline (1966-9/1995) databases using the keywords father, fathers, fathering and fatherhood. The method of content analysis was employed. The focal concern was with the contents of the articles and with the research designs and methods used. Five main content areas were identified: man's health, growth from manhood into fatherhood from the points of view stress and social support, fatherhood as a significant life experience, the relationship between father and child, the couple relationship and family functioning. It is obvious that more information is needed in Finland on male processes also in nursing research so that we can better understand those processes and further improve nursing interventions. Male processes have primarily been studied by using quantitative methods and cross-sectional settings. The main difficulties with the studies have been their small sample sizes and accordingly lack of generalizability. More qualitative information is required so that we can reach a deeper understanding on male processes, expectations and wishes.

Adult↗

PubMed1997

[Patients' viewpoint about the most importants aspects of the Humane Caring Scale].

Humane Caring Scale has been developed at the Kuopio University Hospital. The purpose of this study was to investigate which items of Humane Caring Scale were important and relevant to the patients at the hospital and which issues were missing. The data (n = 501) were collected in April 1996 by a questionnaire. The response rate was 77%. The data were analysed using statistical methods and content analysis. Majority of the items were important to the patients. Professional care and understandable communication were the most important issues. Aspects such as professional working, holistic care, physical environment, enough staff and patient-doctor relationship were also important. Women considered more aspects more important than men. Missing parts of the scale were no question for preparing patients to home care, supporting of rehabilitation and outcomes of the patients. Humane Caring Scale should be tightened up and the concepts used in the instrument clarified. The caring at the Kuopio University Hospital was estimated as good on the average by the patients. Young patients were more critical than elderly ones.

Adolescent↗

PubMed1995

Teaching family nursing.

This study looks at the teaching of family nursing in the broader context of nursing education. The aim was to find out how Finnish teachers in nursing colleges define the concept of family, what sort of theoretical premises lie behind their teaching, and what kind of teaching methods they use. Teachers' information needs, as well as the use of knowledge concerning family nursing, were also explored. The data were collected from a total of 134 teachers in 42 nursing colleges. The results are presented in the form of descriptive frequencies, percentage distributions and cross-tabulations. According to the results the teachers took a fairly broad-minded approach to defining the family, going well beyond the notion of a traditional nuclear family. Almost all teachers also drew attention to the principle of family-orientation in nursing. On the other hand, the notion of family nursing was not very familiar to the respondents. About half of them associated the family with the metaparadigmatic concepts of individual or environment. The teachers said they used various different methods to teach their students how to work with families. However, almost one-third reported that they rarely ever provided instruction in the skills needed in family interviews. Only a small minority felt that they had the necessary theoretical competence to deal with the issue and to provide adequate training. Most of the material they used in teaching consisted of textbooks, whereas research data were used very sparingly.

Adult↗

PubMed1995

Family training: supporting mothers and fathers in the transition to parenthood.

This study discusses the views of mothers and fathers on family training and on how family training supports them in the transition to parenthood. The data were collected in 1993, using a questionnaire submitted about 9 weeks after the birth of a child. The same questions were asked of the 189 mothers and the 127 fathers who replied. According to the results both mothers and fathers consider it essential that their views and expectations are given due attention in the planning of family training. Specific issues that were thought to require priority attention in family training were the actual process of childbirth, themes related to parenthood, pain alleviation during labour, and abnormal childbirth. Less importance was attached to the themes of sex, contraception and certain aspects of health education. Both mothers and fathers agreed that they had had ample opportunity to talk with their group leaders and that there had been enough lectures. By contrast, it was widely felt that there was not sufficient opportunity to talk with other group members. It is suggested that efforts be continued to further develop family training schemes so that they offer not only more support to families but also better opportunities for open discussion.

Adolescent↗

PubMed1994

The function of home visits in maternal and child welfare as evaluated by service providers and users.

This study looks at how public health nurses and clients of maternal and child welfare clinics evaluate the function and meaning of home visits. Another concern is with the options available to the service user. The data were collected during November and December 1992 from a total of 203 health centres across Finland; responses were obtained from 263 public health nurses and 323 clients. The results are presented in the form of frequencies, percentages and cross tabulations. According to the results, the clients felt that the most important function of home visits was to have a competent professional examination of the newborn. They also attached much importance to the information function, i.e. learning about the growth and care of small children. The public health nurses, on the other hand, felt that the most important function of home visits was to support and encourage parents and to ensure the continuity of care. The advantages of meeting in the client's home environment were equally stressed by both sides. By contrast, clients and public health nurses had very different views on the options available to the client. Almost all nurses said that the client can freely choose between home visits and visiting the clinic; however, only about half the clients felt they could choose the service they best preferred.

Adolescent↗

PubMed1994

What do Finnish women want from the home visits of public health nurses?

The article describes the results of a study that measured the attitudes of Finnish mothers towards the contents of home visits in maternal and child health care. The material was collected by a postal questionnaire from 400 clients in November and December 1992. This article describes the results obtained from 345 clients (response rate 80%) out of 203 health centers around Finland. The results indicate that although it was recognized that the nature of home visits had changed, they were still thought to play an important role in clinic services. The clients said that the most important function of home visits is related to the examination of the newborn carried out by a public health nurse. One can say that Finnish clients also attached much importance to the information function, that is, learning about the growth and care of children. It was widely considered important that the child is weighed and the skin and umbilicus are examined during the home visits. One can conclude that Finnish women emphasize much on the child 2 weeks after the delivery, not so much on the whole family.

Adult↗

PubMed1994

[Clients' and public health nurses' views of home visits in maternal and child health care].

The purpose of this study was to describe the views of clients and public health nurses of home visits in maternal and child health care and their advantages. In addition, a description of freedom to choose between home visits or child health care clinics visits is given. The data were gathered using semi-structured questionnaires from 263 public health nurses and 323 clients during October-November 1992 from 203 Finnish health centers. Methods of statistical description included frequencies, percentage distributions and cross-tabulation. Clients regarded the home visits to be important for them in public health nursing. Clients described that the most important function of home visits was the information they got of child's growth and care. As for the public health nurses, support given to the clients and continuity of the care were considered to be the most important issues. Both clients and public health nurses regarded it to be important that the family and the child can stay at home and the mother does not need to go to the clinic. In addition, public health nurses described that the advantages of home visits were the possibilities to get a picture of family's situation and circumstances. The disadvantages were connected with the time-consuming nature of the home visits. Clients and public health nurses had different opinions of the clients' possibilities to choose either home visit or regular visit to the health center. About half of the clients described that they could make a choice. On the other hand, the majority (90%) of public health nurses felt that clients had opportunities to choose what they want.

Adult↗