PubMed Health⌕ Search

Biomedical subjects

Kerttu Tossavainen

Publications and source records attributed to Kerttu Tossavainen.

17 recordsLinked to original sources

Changes in cardiovascular risk factors among adolescents from 1995 to 2004 in the Republic of Karelia, Russia.

BACKGROUND: In Russia, cardiovascular mortality is among the highest in the world. Behaviours related to the development of cardiovascular disease are usually adopted in childhood and adolescence. Very little information exists on prevalence and trends of risk factors among Russian youth. This study aims to investigate changes in the prevalence of cardiovascular risk factors among adolescents in the Republic of Karelia, Russia, from 1995 to 2004. METHODS: Cross-sectional surveys on chronic disease risk factors were carried out among 15-year-old adolescents in Pitkäranta region, in the Republic of Karelia. The surveys were conducted in all 10 secondary schools in the Pitkäranta region. All ninth-grade students in 1995 (N = 385, response rate 95%) and in 2004 (N = 395, response rate 85%) were included in the survey samples. RESULTS: Systolic blood pressure decreased statistically significantly among boys (from 119 to 116 mmHg). Diastolic blood pressure decreased statistically significantly among both girls (from 64 to 59 mmHg) and boys (from 62 to 59 mmHg). Total cholesterol increased statistically significantly only among girls (from 3.9 to 4.1 mmol/l). Body mass index did not exhibit any significant changes in both genders. Daily smoking rate doubled statistically significantly among girls from 7% to 15%. CONCLUSION: The study results show changes in the prevalence of cardiovascular disease risk factors among adolescents in the Republic of Karelia occurring over the last decade. Active measures need to be taken to prevent the increase in smoking prevalence, especially among girls, and to avert the unfavourable development of other risk factors in the future.

Adolescent↗

Occupational well-being of school staff members: a structural equation model.

This study aimed to develop a theoretical basis for the promotion of school staff's occupational well-being. The 'Content Model for the Promotion of School Community Staff's Occupational Well-being' describes the four aspects of the promotion of occupational well-being ('working conditions', 'worker and work', 'working community' and 'professional competence') as well as the functionality and structure of the model. The content model was examined empirically by means of a structural equation model. The project was developed with school staff and occupational health nurses and implemented in 2001-2004. The target group consisted of the staff of 12 comprehensive schools in Eastern Finland in 2002 (n = 211) and 2004 (n = 266). The data were collected using a 'well-being at your work index' questionnaire at both times. A structural equation model for the school staff's occupational well-being, i.e. the 'Occupational Well-being of School Staff Model' (baseline OWSS Model: Study I in the year 2002), was produced. The model was tested with the 2004 data. Based on this, the model was further developed into the final OWSS Model (Study II). The theoretical Content Model for the Promotion of School Community Staff's Occupational Well-being can be used as a framework for planning, implementing and evaluating school staff's occupational well-being.

Adult↗

Nurse teacherhood: systematic descriptive review and content analysis.

BACKGROUND: The concept of 'nurse teacherhood' is multidimensional. In this article, 'nurse teacherhood' includes nurse teachers' tasks and different multidimensional roles as well as their personal experiences of being a nurse teacher. OBJECTIVES: The article examines the topics of nursing research concerning nurse teacherhood, the changes in these topics and the results reported from January 1990 to April 2004. DESIGN AND METHOD: The material was obtained by conducting a systematic review, and it included nursing research papers and Finnish academic dissertations (N=207). The material was analysed by using content analysis. RESULTS: The topics of the studies were divided into three thematic categories: the expansion of nurse teacherhood, the skills of nurse teacherhood and their development, nurse teacherhood and membership in working community. The number of studies on the first two themes had increased (1990-1994:43; 1995-1999:57; 2000-4/2004:65), while those on the third theme had decreased (1990-1994:18; 1995-1999:19; 2000-4/2004:5). CONCLUSIONS: Nurse teacherhood has been studied actively during the past 15 years and approached from several perspectives. Most of the topics of the studies discussed the expansion of nurse teacherhood. The focus of the studies in different years varied depending on the kind of challenges posed to nurse teachers' work in each period of time.

Attitude of Health Personnel↗

Environmental factors as predictors of smoking among ninth-grade adolescents in Pitkäranta (Russian Karelia) and in eastern Finland.

The purpose of this study was to assess whether similar environmental factors predict adolescents' smoking in two different cultures: in the Pitkäranta district in Russian Karelia and in eastern Finland. The data were gathered by self-administered questionnaires from ninth-grade students in 10 comprehensive schools in Pitkäranta (n = 385) and from age-matched students in 24 schools in eastern Finland (n = 2,098). Structural equation modeling (SEM) was used to test whether similar path structures fit for boys and for girls in Pitkäranta and in eastern Finland, and to test whether regression coefficients were similar between the cultures by sex. Smoking by family members and best friends was positively related to adolescents' smoking both directly and indirectly. Environmental factors were similar predictors of smoking between the cultures for boys. For girls, different regression coefficients in Pitkäranta and in eastern Finland were found. Best friend's smoking was the most important predictor of adolescents' own smoking in every sub-sample. When indirect relationships were identified, the significance of parents' and siblings' smoking, in addition to smoking by best friends, was strongly supported.

Adolescent↗

Online discussions mirroring family life during pregnancy.

OBJECTIVE: The aim of this study was to find out what aspects of their parenthood parents revealed, and how they expressed their thoughts concerning maternity care services on an online communication forum. BACKGROUND: The 'Information Society' offers a growing variety of health services as part of public primary health care via the internet. Little is known about the contents produced online by pregnant families, and how they reflect on both family life and maternity care services. METHODS: The data for this study were obtained from online discussions between families (n=21) in Net Clinic, an internet-based service designed for public maternity care. The data included experiences of family life during pregnancy, childbirth and parenting, and was analysed by inductive content analysis. RESULTS: While maturing into parenthood, both women and men recognised the uniqueness of their new role and wanted to prepare for safe childbirth. Online communication in the home environment nourished new social networks among families who were expecting their first, second or third child. In addition, families reflected on maternity care services on the Net Clinic's communication forum. This provided realistic feedback to maternity care professionals. CONCLUSIONS: Today, the relationship between clients and professionals is inevitably changing. More online services and advocacy are needed if families are to have access to online health services. The role of professionals is diversifying from being authorities to supporting and facilitating clients' individual self-care. Based on direct client feedback, the quality of maternity care can be improved.

Adult↗

Consumer-centered nursing with ICT: A futuristic viewpoint.

The purpose of this paper is to describe the views of health care and information technology professionals and patients about the future use and scenarios of information and communication technologies (ICT) in nursing practice. The perspective was set at the year 2010. The Delphi method was used, and the data were gathered during the years 2001 and 2002 with three Delphi rounds from a Finnish expert panel (N = 81). The experts consisted of clinical nurses, clinical nurse managers, nurse educators, professionals of development, research and information technology and patients. The data were gathered and analysed with qualitative and quantitative methods. The use of ICT was observed from the viewpoints of probability and desirability. The experts agreed more often about the desirability than the probability of the use of ICT. Three future nursing scenarios were outlined based on the results: nursing knowledge management and development, patient orientation and self-care, and technology vs. the human being. The scenarios will be take-off points for development in nursing practice and education.

Delphi Technique↗

School staff members' and occupational health nurses' evaluation of the promotion of occupational well-being - with good planning to better practice.

This paper describes occupational health nurses' and school staff members' experiences of work ability maintenance carried out at schools and the development of ideas to promote the collaboration between occupational health care and school community and to enhance work ability maintenance. The data were collected in a baseline situation of an action research project to further plan and develop activities. The data were analysed by inductive content analysis. According to the results, school community staff members' work ability maintenance focused on the employee, the school community, school work and the working conditions as well as professional competence. The practical actions involved some individual and school-specific variation, focusing on actions to maintain individual and physical work ability. It seems that the collaboration between the school community and occupational health service for work ability maintenance took place at the individual level, but an obvious need for more structural collaboration emerged by several suggestions made by the participants (e.g. better information exchange between the school and occupational health care, improved collaboration between the school staff and the co-operative partners). The progress in collaboration may lead towards spontaneous collaboration, in which case both actors have the same target and work in a planned, continuous and natural way to ensure work ability maintenance in the school community.

Cooperative Behavior↗

Potential errors and their prevention in operating room teamwork as experienced by Finnish, British and American nurses.

This study describes how the potential sources of errors and error prevention in operating room (OR) teams are experienced by Finnish, American and British nurses. The data were collected by interviews and analysed using a qualitative content analysis. Results consisted of categories demanding teamwork practice, shared responsibility in teams and organized teamwork. The demanding practice category included fear of errors, turnover in teams, overtime work and emotional distress as potential factors leading to errors in OR teamwork. Shared responsibility emphasized how the familiar teams, safety control and formal documentation of errors prevented errors. At the organizational level, the prevention of errors required scheduling of work, good management, competency and a reasonable physical environment. In order to improve safety in OR teams, recognition should be given to the balance of error-making and learning from them. More effective ways in reporting incidents should be adopted and overall reporting systems should be developed in Finnish OR teams.

Adult↗

How can critical incidents be used to describe health promotion in the Finnish European Network of Health Promoting Schools?

The purpose of this study was to elicit critical incidents that illustrate the reality in which health promotion processes take place in the Finnish European Network of Health Promoting Schools (ENHPS). In this study, critical incidents were used as a data collection method. The data were collected by asking representatives (n = 30) of the schools to describe in writing both positive and negative critical incidents related to health promotion in their school community. Altogether 48 critical incidents were analysed using qualitative content analysis. The results show that collaboration in a network of participants from inside and outside the school community to plan and implement a special school health day was the most commonly described positive critical incident. In addition, the organizational culture of the schools seemed to improve in a positive way. The reorganization of resources for health promotion resulted in positive progress, whereas a lack of resources had a frustrating and negative effect. The most commonly described negative critical incident was a failure to discourage smoking by pupils.

Adolescent↗

Study abroad as a process of learning intercultural competence in nursing.

The aim of this research was to describe an international student exchange programme as a context of learning intercultural competence in nursing. Twelve Finnish nursing students who had participated in an exchange programme in the United Kingdom participated. The data consisted of group interviews, learning documents, background questionnaires and research diary notes, and the method of inductive content analysis was used. Study abroad as a process of learning intercultural competence consisted of three ethno-categories: transition from one culture to another, adjustment to the difference and gaining intercultural sensitivity. The exchange programme as a context of learning intercultural competence was characterized by a problematic orientation phase, a study abroad phase that involved stressful but rewarding adjustment to the intercultural differences and an inadequate re-entry debriefing phase. In order for the international experience of nursing students to have an impact on their understanding of diversity, they need assistance in each phase of the programme. Particularly, the students need intercultural tutoring and mentoring to venture into encounters with local people, including direct client contacts, during their study abroad.

Acculturation↗

Characteristics [correction of charactersistics] of intercultural mentoring--a mentor perspective.

This article reports a study of Finnish preceptors' and British undergraduate nursing students' mentor-student relationship during international placement in Finland from the mentors' perspective. The study aimed to explore the characteristics of intercultural mentorship and the strategies used by the mentors to improve the students' intercultural competence. Altogether 23 mentors and five students participated in this study. The data consisted of mentoring session observations, group interviews and research diary notes. Intercultural mentorship was characterised by concern about the students' adjustment, pervasiveness of the relationship, sense of mutual learning, inadequate school-placement co-operation and concern about learning outcomes. The mentors used a variety of strategies to improve the students' intercultural competence. Mentorship was both a rewarding and a frustrating experience.

Acculturation↗

Relationships with undergraduate nursing exchange students--a tutor perspective.

BACKGROUND: Student exchange has been used increasingly in nursing education throughout Europe as a method of learning intercultural sensitivity. In the host country, each foreign student is assigned a personal tutor to enhance learning. AIM: The aim of this study was to describe tutor-student relationships between Finnish nurse teachers and British exchange students from the tutors' perspective. ETHICAL ISSUES: The researcher's close relationship with the study context and participants caused some ethical concerns, which will be discussed. METHODS: The data consisted of tutorial session observations, research diary notes, group interviews and background questionnaires. They were analysed using Spradley's developmental research sequence method for ethnographic data. FINDINGS: The tutoring relationship was pastoral and clinical rather than academic. The pastoral aspect of the relationship was essential in assisting the students to adjust to the stress of studying in a foreign country. On the other hand, tutors were unable to support all the students to overcome their culture shock. Tutors were uncertain about their role and did not integrate Finnish culture or practice into theory, but found their role pleasant. CONCLUSIONS: A dialogic tutor-student relationship is important for learning intercultural sensitivity. Tutoring strategies should be developed to assist students' adjustment to the differences in the host culture and to encourage their reflection on personal, experiential and scientific cultural knowledge during their study abroad.

Adult↗

Pregnant families' discussions on the Net--from virtual connections toward real-life community.

The aim of this research was to analyze conversations between expectant families (N = 21) in Net Clinic, an Internet-based service designed for patients using public maternity care. The online conversations, shared opinions about experiences of pregnancy, and family life constituted the data for content analysis. The families developed a sense of virtual community, which gradually evolved into a real-life community, by discovering the similarity of their life situations and by giving parent-to-parent support for everyday life events. As a view of daily family life, Net Clinic offers maternity care professionals a deeper understanding of how to enhance safer pregnancy, birth, and growth of the family.

Adult↗

Smoking patterns among ninth-grade adolescents in the Pitkäranta district (Russia) and in eastern Finland.

This study describes how ninth-grade adolescents' smoking behavior in the Pitkäranta district (Russia) differs from their eastern Finland counterparts. Cross-sectional data from the second North Karelia Youth Study and the Pitkäranta Youth Study were used. Subjects were all (n=385) ninth-grade students in 10 comprehensive schools in Pitkäranta and all (n=2098) students of the same age in 24 comprehensive schools in eastern Finland. Students were asked about their smoking status, intentions to smoke, smoking situations, acquisition of tobacco products, and opportunity to smoke in the school area. The results showed very large differences in the smoking prevalence between Pitkäranta and eastern Finland. For boys, the prevalence of daily smoking was 29% and 19% in Pitkäranta and eastern Finland, respectively. The differences in girls were adverse: 7% and 21% of girls in Pitkäranta and eastern Finland, respectively, were daily smokers. However, as many as one third of the nonsmoking girls in Pitkäranta stated that they may experiment or start smoking later. Boys in Pitkäranta had vaguer attitudes about remaining nonsmokers than boys in eastern Finland. This situation anticipates worsening of the smoking epidemic in Pitkäranta and requires an effective prevention policy and cooperation between different groups in society.

Adolescent↗

Benefits/problems of enhancing students' intercultural competence.

European nursing has responded to the challenges of multicultural society by integrating student exchange programmes into nursing education since the 1990s. For students, these programmes provide opportunities to study in another EU member state and to develop intercultural competence as part of the training. The aim of this study was to describe the process of gaining intercultural competence among British undergraduate nursing students during their study abroad in Finland. Fifteen British students participated in this study. Data were obtained from interviews, observations, background questionnaires and research diary notes. The data were analysed with Spradley's developmental research sequence (DRS) method. Campinha-Bacotes' model of cultural competence was used as a framework of rendering the results. Students' intercultural desire, i.e. their effort to become interculturally competent, turned out to be the foundation of the entire process. Study abroad is an intensive experience, and therefore the preparation, the selection of exchange students, the design of the programme and intercultural tutoring warrant careful attention.

Adult↗

Learning about teamwork in operating room clinical placement.

The aim of nursing students' operating room (OR) clinical practice is to gain experience of the perioperative nursing process and to develop skills related to the practice within OR teams in a variety of situations. However, it has previously been problematic to get enough practical experience within OR teams because of the general urgency, e.g. rapid turnover and flow of emergency cases, and preceptors' multiple responsibilities related to their simultaneous need to work as team members. This study describes how Finnish, British and American nursing students (n = 30) experienced learning about teamwork during their OR placement period. The critical incident technique was used for data collection, and data were analysed using a descriptive phenomenological method. Three types of teamwork emerged based on the students' perceptions: functional manifestation of OR teamwork, gaining OR team membership and technical orientation of OR teamwork. The findings are discussed in relation to OR practice, education and research on ways to improve teamwork while maintaining a satisfactory OR learning context and stimulating interest in perioperative nursing.

Attitude of Health Personnel↗