Biomedical subjects

M Nikkonen

Publications and source records attributed to M Nikkonen.

At least 19 recordsLinked to original sources

PubMed2006

Conceptions of patients and personnel concerning the substance of post-ward outpatient visits in psychiatric care.

In post-ward outpatient services patients discharged from hospital are provided further care by the same ward personnel. The aim of this study was to describe and analyse the conceptions concerning the substance of post-ward outpatient visits (PWOV). A phenomenographic approach was used. The data were gathered by interviewing post-ward outpatients, personnel at psychiatric wards and in outpatient care and administrative personnel in psychiatric units. Seven main categories of describing the PWOV were formed: natural interaction, continuous assessment, follow-up of the implementation of pharmacotherapy, relapse prevention, search for coping methods, establishing motivation for treatment and family members' participation in care. The patient's health, life situation and coping in everyday life were constantly evaluated and followed up in diverse ways during the PWOV. To make PWOV successful, treatment should be planned individually based on the patient's needs, and the patient should have a close and functional cooperative relationship with the nurse.

Activities of Daily Living↗

PubMed2006

Hope and schizophrenia: an integrative review.

The purpose of this article is to describe the current status of research on hope and schizophrenia. The CINAHL database was used to identify the articles that met the criteria. The searches were conducted using the terms 'hope', 'hope instillation (IOWA NIC)', 'hope (IOWA NOC)', 'schizophrenia' and their combinations. The findings were limited to research articles. In addition, Pub Medical database was used by searching the words 'hope' and 'schizophrenia' from the fields 'title' or 'abstract'. Four new articles were found. The data consist of 17 articles on hope and schizophrenia published in peer-reviewed journals, which were analysed using content analysis. Existing research has focused on people with schizophrenia (n = 8), significant others (n = 4), staff (n = 2), hope-engendering interventions (n = 2) and treatment evaluation related to hope (n = 2) in the care of people with schizophrenia. Different data collection methods have been used in these studies. The most common method was interview (n = 9), followed by questionnaires (n = 8) and observation (n = 1). Most studies used quantitative methods (n = 9). Hope is considered a positive factor in the life of a person living with schizophrenia, in significant others as well as in staff members. Existing research provides evidence of the following themes: factors associated with hope and factors contributing to hope in people with schizophrenia; hope from the perspective of significant others of people with schizophrenia; staff hopefulness and factors contributing to their hope, hope-engendering interventions and treatment evaluation in regard to hope. Based on this review, research evidence of hope in the context of schizophrenia is quite scant and limited, even though the importance of hope in schizophrenia has been underlined in research reports and the literature. It is clear that hope is important to people with schizophrenia, their significant others and the healthcare personnel caring for them. It is therefore also important to study hope among these people.

Adaptation, Psychological↗

PubMed2005

Continuity of care in psychiatric post-ward outpatient services--conceptions of patients and personnel concerning factors contributing to the continuity of care.

A structural change of the psychiatric services was started in Finland in the 1980s. Its primary objective was to shift the main emphasis from hospital to outpatient services. Hence, the number of psychiatric beds has declined to a third of the maximum rate, inpatient periods have shortened and the number of outpatient appointments has increased significantly. International research shows that when the emphasis of psychiatric services shifts to outpatient services and hospitalization becomes short-term, diverse individual alternatives are needed to support patients' coping. Several Finnish psychiatric hospitals initiated in the 1990s outpatient services provided at inpatient wards, which means, that after the period of hospitalization, further care is provided to the patient at the same ward where s/he was hospitalized. The purpose of this study was to describe and analyse the conceptions of patients, ward personnel, outpatient services personnel and administrative personnel in psychiatric units concerning the factors improving the continuity of care. A phenomenographic approach was used and the objective was to find the different empirical variations of the conceptions, through which people experience, comprehend and become conscious of the phenomena in the surrounding world. The data were gathered by interviewing post-ward outpatients (n=5), personnel at psychiatric wards and in outpatient services (n=18) and administrative personnel in psychiatric units (n=5). As a result of the analysis seven categories of the factors improving the continuity of care were formed: (1) adherence to a good cooperative relationship; (2) adherence to the care environment; (3) flexibility in tailoring care; (4) active maintenance of contacts in care; (5) constant possibility to contact the ward; (6) up-to-date patient data; and (7) active cooperation between outpatient services and other collaborators.

Attitude of Health Personnel↗

PubMed2004

Primary health care practitioners' tools for mental health care.

The purpose of this study was to describe and analyse the content of mental health care from the practitioner's point of view. The specific aim of this paper was to outline the types of mental health care tools and the ways in which they are used by primary health care practitioners. The data were derived from interviews with doctors and nurses (n = 29) working in primary health care in six different health care centres of the Pirkanmaa region in Finland. The data were analysed by using qualitative content analysis. The tools of mental health care used in primary health care were categorized as communicative, ideological, technical and collaborative tools. The interactive tools are either informative, supportive or contextual. The ideological tools consist of patient initiative, acceptance and permissiveness, honesty and genuineness, sense of security and client orientation. The technical tools are actions related to the monitoring of the patient's physical health and medical treatment. The collaborative tools are consultation and family orientation. The primary health care practitioner him/herself is an important tool in mental health care. On the one hand, the practitioner can be categorized as a meta-tool who has control over the other tools. On the other hand, the practitioner him/herself is a tool in the sense that s/he uses his/her personality in the professional context. The professional skills and attitudes of the practitioner have a significant influence on the type of caring the client receives. Compared with previous studies, the present informants from primary health care seemed to use notably versatile tools in mental health work. This observation is important for the implementation and development of mental health practices and education.

Adult↗

PubMed2002

Patient initiatives in psychiatric care concerning shame in the discussion in co-operative team meetings.

The aim of this paper is to describe patients' experiences of shame and the way in which this experience is discussed in co-operative team meetings in acute psychiatric care. As an experience, shame is described as a painful and ugly feeling, which results in personal devaluation, isolation and a feeling of inferiority compared to others. This paper is based on 11 videotaped episodes of co-operative team meetings in two psychiatric units. The study approach was narrative. Shame was found to be the core narrative. The narrative of shame was laid out as an experience, and shame caused difficulties in the patients' daily lives and finally led to feelings of difference and loneliness. When the psychiatric patients and significant others tried to speak about the experience of shame with the professionals, the professionals either did not respond or changed the topic of discussion by asking questions about the patient's daily life and rationalizing the experience of shame. The participants did not share a common objective in the co-operative team meetings. Further research is needed to find new ways of co-operative team discussion and to develop the co-operative team meetings towards a patient-orientated model.

Adult↗

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↗

PubMed2000

Feeling of 'lacking' as the core of envy: a conceptual analysis of envy.

The aim of this paper is to explore the subjective experience of envy through concept analysis. Further, the study on which it is based aimed to answer questions about the composition and manifestations of envy. From the viewpoint of nursing science, the analysis of envy is based on a desire to understand human beings from the perspective of subjective health and illness and thus from a health promotion perspective. Envy is conceived of as a dimension of a person's health and illness. The concept is therefore meaningful from the viewpoint of nursing; it describes a phenomenon which enables us to deepen our understanding in a way relevant to nursing science. In the study the hybrid model developed by Schwartz-Barcott et al. was used for conceptual elaboration. In the theoretical phase of the study the subjective experience of envy was explored from the viewpoints of philosophy, religion, Finnish folklore and psychoanalysis, as well as nursing science. As a synthesis of these, a conceptual analysis of envy adapted from Wilson was conducted and a working definition of envy was proposed. In the fieldwork phase, envy was examined by means of an empirical analysis using a phenomenological approach. As a result, a classification describing the experience of envy was presented. The core experience of envy has been defined as a 'lacking', and the object of envy as something good possessed by someone else. Envy manifests itself in both destructiveness and creativity. The trends of development of envy are inflexibility and emancipation, and the essence of envy is multidimensional. Finally, the working definition of the concept was elaborated on the basis of the empirical phase and a new definition reflecting the composition and manifestations of envy was proposed.

Caregivers↗

PubMed2000

Life control of members of the Kainuu Martha Organization in Finland.

The purpose of this study was to describe the life control of members of the Kainuu Martha Organization (the Marthas), based on their written autobiographic material. The study material consisted of written thematized autobiographies of members of the organization (n = 41). The material was analysed using qualitative content analysis with concepts of the health portrait. The Marthas were classified into three groups (member, participating and leading) on the basis of their participation in Martha activities. According to the generational categorization of Roos, the member Marthas represented the Finnish generations of well-being, structural change and shortage. They did not participate actively in the Martha activities. Their feeling of life control was based on the sense life made to them. The member Marthas emphasized the meaning of family in their lives. The participating Marthas represented the generations of structural change and shortage. They participated in the Martha activities as observers or by attending the functions of their local organizations. Their feeling of life control was related to a favourable attitude towards life and concern for their human relations. The leading Marthas represented the generation of shortage and participated actively in the Martha activities. They believed in the continuity of the Martha Organization in Kainuu. They had a strong feeling of life control. This manifested as an enterprising spirit in everyday life, which included a skill to live life as it occurred. The lives of the leading Marthas were characterized by a favourable attitude, a feeling of responsibility and initiative.

Adaptation, Psychological↗

PubMed2000

Utilising the concept of protection in health maintenance among the Bena in Tanzania.

This article reports the findings of a study of the protective health care actions by the Bena. The article is based on an ethnographic research project that dealt with cultural care among the Bena tribe in the Ilembula villages in Tanzania. The data were collected with open-ended interviews and participatory observation. Forty-nine villagers were interviewed. The findings show that childhood and adulthood include some sensitive phases of the Bena life span that require protective actions to ensure reproductive, physical, and mental health. The following main protective actions were related to health protection in the sensitive phases: taking local herbs, avoiding sexual relations, hiding menstruation and early pregnancy from others, avoiding contacts with magic, avoiding kitchen work, using one's own utensils, and omitting greeting others.

Aged↗

PubMed1999

A midwife-public-health nurse's work in northern Finland, 1950-87.

This paper describes the work of Jouki Nykänen, a midwife public-health nurse in northern Finland during the years 1950-87. The material for the study was collected by a biographical interview. On the basis of content analysis, the work of the interviewee consisted of the following phases: (i) midwife-public-health nurse in the district of Sevettijärvi (1950-58); (ii) municipal midwife in Pyhäntä (1958-60); and (iii) midwife-public-health nurse in the rural district of Karunki (1962-87). In Sevettijärvi, Jouki's work emphasised independent planning and implementation. In Pyhäntä, her health-care clinics were well organised. In Karunki, another midwife-public-health nurse working with Jouki made conditions flexible, with personal districts for the two nurses. During home visits, Jouki took care of the whole family, from the grandfather to the baby. The Finnish Public Health Act (1972) changed the character of Jouki's work. The number of home visits decreased and clinics, fragmented into several fields of health care, took the place of home visits, requiring efficiency and results. The results of the study showed the core of a midwife-public-health nurse's work in Finland in a changing historical and social context, as well as showing the changes in a midwife-public-nurse's work since the post-war years.

Finland↗

PubMed1998

'A good person does not feel envy': envy in a nursing community.

The definition of envy is commonly based on psychoanalytical views of organizational culture. The purpose of this paper is to describe envy in a nursing community. The population study consisted of random sample of 120 subjects drawn from among the employees of one central hospital in Finland. The study material consisted of data collected by questionnaires (response rate 65%). The data were processed by various statistical methods. Open-ended questions were analysed by inductive content analysis. The results of this study indicated that the employee's view of his/her official position in the nursing community, his/her relationships with his/her fellow workers and the management as well as relationships with other nursing communities are all related to envy. The employee's view of his/her official position intensified his/her feelings of envy, if he/she had other negative feelings, anxiety, dissatisfaction with him/herself, and negative feelings towards fellow workers. The major object of envy was fellow workers' salaries. Envy towards other nursing communities was generated by alleged differences in the amount of labour, or by the charge nurse's greater interest in other sections. Employees coped with envy by hiding these feelings and being modest. Women coped with envy by being silent, while men denied the value of the object of envy.

Adaptation, Psychological↗

PubMed1998

[The work of a midwife-public health nurse in northern Finland in 1950-1987].

The purpose of this study was to describe the work of Jouki Nykänen, a midwife-public health nurse, in northern Finland in 1950-1987. The material for the study was collected by life-history interview. According to content analysis the work of the interviewee consisted of the following phases: 1) work as a midwife-public health nurse in the district of Sevettijärvi in 1950-1958, 2) work as a municipal midwife in Pyhäntä in 1958-1960, and 3) work as a midwife-public health nurse in the municipality of Karunki, in 1962-1987. In Sevettijärvi, planning and implementation of work were emphasized. The public health nurse-midwife worked whenever people needed her and when they came "to town". In Pyhantä, the clinics were well-organized. The work as a midwife-health nurse in Karunki was flexible, and another public health nurse also worked in the municipality. During home visits the interviewee took care of the whole family from the grandfather to the baby. The Public Health Act (1972) changed the character of the work: the number of home visits decreased and clinics fragmented into several fields of health care took the place of home visits, requiring efficiency and results. The results of the study showed the core of a midwife-public health nurse's work in a historically changing social context as well as the changes in the work between the postwar years and the present day.

Finland↗

PubMed1997

["A good person does not feel envy"--envy in nursing communities].

The purpose of this study was to describe the nature, manifestation, and amount of envy among the staff of a nursing community. The definition of envy is commonly based on views of essence of envy and organisational culture. The population study consisted of random sample of 120 subjects drawn from among the employees in the Kainuu Central Hospital. Frequency and percentage distributions were used to present the data. The correlations between the variables were examined using cross-tabulation. Summarized variables were formed for nature of envy, and the Cronbach alpha coefficient was used to test the internal consistency of those. Factor analysis and cross-tabulation were also used. Open-ended questions were analysed by qualitative contact analysis. These results were used to complement quantitative data. The results of this study indicated that the employee's view of his/her official position in the nursing society, his/her relations with his/her fellow workers and the management as well as the relations to other nursing societies are all related to enviousness. The employees's view of his/her official position intensified his/her feelings of envy, if he/she had other negative feelings (anxiety, dissatisfaction with him/herself, and feeling if looks could kill). If the employee was ambitious and hard-working, his/her envy manifested in a comparison of his/her own work and the work of other employees. The major object of envy was fellow workers' salary. Envy was also caused by new, proficient, and senior co-workers and possible favourites or proteges of management. Envy towards other nursing community was generated by alleged differences in the amount of labour, or by the charge nurse's greater interest in other section. Employees coped with envy by hiding these feelings and being modest. Women coped with envy by being silent.

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

Professional nursing care in Tanzania: a descriptive study of nursing care in Ilembula Lutheran Hospital in Tanzania.

The purpose of this ethnonursing study is to find new knowledge of the professional nursing care practised in a Bantu cultural context in Tanzania. The main questions are: How do Bantu nurses describe nursing? What components are there in professional nursing care in Ilembula Lutheran Hospital? The data were collected through participant observation, interviews and personal working diaries in Ilembula Lutheran Hospital. Six Tanzanian nurses were interviewed. The findings indicated that nursing was based on formal training on one hand, and on a natural mother-child relationship on the other hand. The idea of respect towards life, which is central to the Bantu philosophy of life, guided nursing care. In professional nursing care there emerged curing and caring components. Protection, encouragement and comfort were distinguished as the main constructs of caring.

Attitude of Health Personnel↗

PubMed1996

Life after the mental hospital: the way of life of deinstitutionalized psychiatric patients.

This article describes and analyses the way of life of deinstitutionalized long-term psychiatric patients in Northern Finland. The major focus of the paper is the central areas of life of the outpatients as one dimension of subjectivity. The data were collected by interviewing 25 discharged long-term psychiatric patients. The findings suggest that home was the central area of life for the outpatients but they differed in their relation to it. Some of the patients were actively building their home. For some others home was an asylum in which to hide from social life. Many patients had hobbies that only took place inside their homes. One of the problems that the outpatients had to face was lack of work. The elderly patients who generally regarded work as a virtue experienced difficulties in finding something to do in their modern suburban homes. Social participation was mostly labelled by the old and familiar hospital models. The patients had no new acquaintances. They kept contact with their former fellow patients.

Adaptation, Psychological↗

PubMed1995

The life situation of a long-term psychiatric patient: some restrictions in, and possibilities of, open care.

This paper describes and analyses, from a sociocultural viewpoint, the ways of life of discharged long-term psychiatric patients in northern Finland. The paper focuses on subjectivity: control of life and fundamental experiences in life. The data consist of interviews with 25 outpatients who have moved to live in residential homes, rehabilitation centres or their own homes after receiving preparatory training in the psychiatric hospital. The findings suggest that the way of life of the outpatients did not significantly differ from that of other people belonging to the same generation of Finns. With respect to control of life, a conspicuous feature was the strong tendency to let themselves be led by others, and to self-sacrifice for the good of others. For the patients, independence was the best aspect of open care. Fear for being branded as a psychiatric case or as a former mental patient threatened the patients' external control of life. The central element of control of life of the Finns is work. The outpatients thought work a matter of honour and they did not find their present, inactive way of life satisfactory.

Activities of Daily Living↗

PubMed1994

Caring from the point of view of a Finnish mental health nurse: a life history approach.

Finnish mental health care went through a major change in the 1980s. Its institutions were being run down and there was a shift to a caring system that stresses non-institutional practices. The schooling and work of the mental health nurse had to adapt to the new situation. The purpose of my study was to describe and analyse the mental health nurse's work, i.e. caring, as it is experienced by a nurse in the preparation of long-term psychiatric patients for non-institutional care. The data consist of repeated interviews with Vuokko, who has been a mental health nurse for about 30 years and is now approaching her retirement. In the light of the data, the central features of caring are caring about and taking an overall responsibility for the patient, and teaching the patient to cope with everyday life. Caring is based on practical knowledge, the essential elements of which are intimacy and feelings.

Adaptation, Psychological↗