Biomedical subjects

M Paunonen

Publications and source records attributed to M Paunonen.

At least 19 recordsLinked to original sources

PubMed2001

The nurse's workload in care situations.

AIM: The aim of this study was to describe the nurse's workload in care situations and on different work shifts on surgical and medical wards. Changes in heart rate, shoulder-neck muscle tension and perceived exertion were measured in these care situations. DESIGN: Nurses' physical fitness was tested using a clinical exercise test. RESULTS: Transportation of a patient to the operating theatre was the most strenuous care situation on morning and evening shifts. Primary care, and situations related to practical nursing procedures were the second most strenuous situations regardless of the shift. Workload in primary care situations and in transporting the patient can be classified as medium heavy based on heart rate and relative workload, whereas in other situations it can be classified on average as moderate or light. The nurse's good physical fitness was reflected in relative workload in care situations so that in primary care and practical nursing procedures there was a statistically significant difference between those who scored high on a fitness test and those who scored low. Transferring tasks and practical nursing procedures involved more shoulder-neck muscle tension than other care situations.

Adaptation, Psychological↗

PubMed2001

Family dynamics of child-bearing families in Athens, Greece: a pilot study.

The purpose of this pilot study was to describe family dynamics in Greek families during the third trimester of a low-risk pregnancy with a first or second child. The description is based on Barnhill's framework for healthy family systems. The sample consisted of families expecting their first or second child. Both mothers (n = 160) and fathers (n = 47) participated in the study. The Family Dynamics Measure and a sociodemographic questionnaire were used in data collection. Data on 160 mothers and 47 couples were analyzed. Fathers perceived their families as having greater stability and role reciprocity than mothers. Fathers also reported clearer communication than mothers. There were no statistically significant relationships among family dynamics dimensions, maternal age and parity. Delayed first-time expectant mothers reported greater flexibility than normative first-time expectant mothers. The results provide some useful clues for prenatal care and also for further family dynamics research in Greece.

Adolescent↗

PubMed2000

First-time mothers and child care when the child is 8 months old.

The aim of the present study was to examine those resources and strengths that mothers find helpful for coping with child care when the child was 8 months old. This study is part of a more extensive longitudinal study project in which the growth into motherhood of first-time mothers was followed for 8 months postpartum. Data were collected by using structured questionnaires between August 1995 and March 1996. The sample comprised 254 first-time mothers and 248 mothers returned the questionnaires by mail. The multivariate method used was a stepwise regression analysis. Predictors included in the multivariate method to explain coping with child care were as follows: the mother's competence, mother's attachment to the child, mother's self-concept, relation to the spouse, breastfeeding, decision-making support from the public health nurse and activity of the child. The strongest predictor was competence as a mother. The more competent the mother felt and the more attached the mother was to her child, the better her coping. The better the mother's self-concept and relationship with the spouse were, the better she succeeded in taking care of the child. If the mother still breastfed her child and received decision-making support from public health nurses, she coped better in child care. Finally the more active the child was, the more the risk for unsuccessful child care increased. The results indicate that the first-time mother's successful coping with child care when the child is 8 months old is associated with her own resources and attachment to the child as well as activity of the child and breastfeeding. A good relationship between the spouses and support for decision making from the public health nurse also contribute to coping with child care.

Adaptation, Psychological↗

PubMed2000

Patient satisfaction and research-related problems (Part 2). Is triangulation the answer?

AIM: The article consists of two parts, the first of which examined the description of patient satisfaction by means of a questionnaire and the problems related to it. The aim of this second part is to complement the topic by explicating patient satisfaction research using a triangulative approach. BACKGROUND: Patient satisfaction has been the object of interest in health care for some time, and is now increasingly used as the basis for quality management and improvement. At the same time, the methods used have been criticised. As it was shown in the first part of this article, traditional questionnaires contain many problems which are difficult to solve in a satisfactory way, for example, by using different methods of analysis. METHODS: The data were collected from the patients of three different hospital wards using an interview (n = 30). The interview themes corresponded to the classification of a questionnaire employed at the same time. The interview material was analysed using content analysis, whereas satisfaction is investigated using a triangulative approach. FINDINGS: The findings confirm that the interview supplements the questionnaire as a data collection method, but that is also produces overlapping information. The interviews gave deeper information on the patients' experiences and feelings. Triangulative examination made it possible to show factors influencing the reliability of the study. CONCLUSIONS: The advantage of a triangulative approach seems to be that it provides a fairly accurate description of patient satisfaction. However, the problem of this method is that it doubles the amount of work needed and is slow to use which is worth considering as patient satisfaction should be followed on a regular basis and the results reported without delay. In spite of these problems, patient satisfaction surveys are important, since information provided by them is needed as basis for quality management, quality improvement and clinical supervision.

Adult↗

PubMed2000

Patient satisfaction and research-related problems (Part 1). Problems while using a questionnaire and the possibility to solve them by using different methods of analysis.

INTRODUCTION: This article comprises two parts describing a research project for validating quality monitoring tools. This is part 1. AIM: To examine the problems of patient satisfaction inquiries by means of the literature, earlier research and an example. BACKGROUND: The topic is of current interest, since quality management by way of research-based knowledge has become an increasingly common demand. In this context, patient satisfaction inquiries are a central method of data collection. Although the problems relating to the reliability of the methods and results of these inquiries have been identified, their comprehensive examination is yet to be done. Quality management is none the less a challenge to nursing administrators requiring a broad-based utilization of feedback data, and this calls for a critical examination of the reliability of these results. METHODS: The exemplary material were collected using a questionnaire from patients (n = 282) on three different hospital wards. Different statistical methods and content analysis were used in the analysis. FINDINGS: The example used in the study indicates that the results of the inquiry were highly positive time after time. The reliability of the instrument presented a problem. The low amount of information collected in the open-ended question was another problem that can be criticised in relation to the amount of work required in the analysis. The results of the factor analysis showed that the questionnaire needs further development. CONCLUSIONS: To conclude, patient satisfaction inquiries yield a relatively small and limited amount of information on quality management and improvement, but this information is necessary specifically for ward sisters for the follow-up of long-term trends in patient satisfaction. The second part of this article (part 2) examines the description of patient satisfaction by means of triangulation.

Adult↗

PubMed2000

Death in the Finnish family: experiences of spousal bereavement.

In this study dimensions of grief were examined using the Hogan model for widowed Finns. The aspects of loss were analyzed from the answers to an open-ended question. The study group consisted of 242 widows and 76 widowers, whose spouse died more than 6 months prior to the data collection. The numerical data were analyzed to determine whether dimensions of grief were gender related. Content analysis was used when analyzing the written answers. The findings of the study demonstrate that there are gender differences in the expressions of grief after the death of a spouse. Widows expressed significantly more intense feelings of panic behaviour than widowers. Both widows and widowers grieved about how to survive after the death of their spouse. Both groups found their families and friends to be the most important source of support when trying to cope with their grief.

Adult↗

PubMed2000

How first-time mothers cope with child care while still in the maternity ward.

The aim of the study was to ascertain those factors that are related to the way first-time mothers assess themselves to be coping with child care when leaving the maternity hospital. The study is part of a wider longitudinal project that follows-up first-time mothers' growth into motherhood for a period of 8 months after the birth. Data collection was done using a questionnaire distributed between January and May 1995. The sample comprised 271 first time mothers. The mothers completed the questionnaire on average on the fifth day after childbirth. A stepwise regression analysis was applied. The mothers who assessed themselves to be coping better with child care were those who went home feeling rested and in a good frame of mind and who had positive experience of child care in the maternity ward. The more functional support the mother perceived herself to receive from members of her social network the better she assessed herself to be coping with child care. Those mothers who had previous experience of taking care of infants also assessed themselves to be coping better with child care. On the basis of the research findings it may be stated that the first-time mother needs support from both nursing professionals and close relatives in order to trust their own abilities to cope better with child care during early motherhood.

Adaptation, Psychological↗

PubMed2000

The staff's experience of the death of a child and of supporting the family.

The purpose of the study was to describe how staff members experience the death of a child and how they support the grieving family. The goal is to find means to improve supporting activities in the university hospital. The data for this study were collected with a questionnaire given to the staff who encounter the death of a foetus or infant at their work (n = 102). The questionnaire contained both structured and open-ended questions. Altogether, 69 members of the staff (68%) answered the questionnaire. The open-ended questions were analysed using content analysis. The staff experiences of a child's death manifested themselves in grief, feelings of injustice, experiences of one's limited resources, and relief. About half (51%) of the respondents estimated that they were able to support families rather well. Education in supporting the grieving family increased the ability to support families. Social support for families included emotional, informational, and concrete support. The majority of the staff expected support from colleagues after the death of a child. The study results show that the hospital staff supports the grieving family, but also recognizes their inadequacy as supporters. The staff also needs support in order to be able to support the grieving family.

Adaptation, Psychological↗

PubMed2000

Oncology ward nurses' perspectives of family grief and a supportive telephone call after the death of a significant other.

To improve family nursing in oncology wards, a new nursing intervention was created: a supportive telephone call after the death of the patient. Nurses who participated in the intervention kept diaries after the call (n = 95). Data were collected also from hospital records. The numerical data were analyzed by using descriptive statistical analysis and the qualitative data by using content analysis. In the diaries, nurses described family grief and mourning as well as content of the supportive telephone call after the death of a family member. Multidimensionality described the family member's grief. The funeral was an important part of the culturally dictated mourning. Support for the family during the patient's last days at the hospital was meaningful with regard to the grief and the onset of coping. Closeness of the nurse-family relationship varied from a close relationship to an uncertain one. A supportive atmosphere during the call made it possible for the survivor to ask questions and talk. During the call, nurses were able to evaluate the family's coping. They also got feedback concerning the nursing care delivered. The call served as a finishing analysis of the family nursing process. The implications of these results for supporting the grieving family by a telephone intervention are considered.

Adaptation, Psychological↗

PubMed2000

Importance of the midwife in the first-time mother's experience of childbirth.

The aim of this study was to examine factors related to how the first-time mother experiences childbirth. The data were collected by questionnaire in a sample of 326 first-time mothers in Tampere University hospital in Finland. The multivariate method used was a stepwise regression analysis. The most important predictors for the nature of the childbirth experience were the characteristics of the midwife, such as empathy, friendliness, tenderness, calmness and lack of hurry; the attitude of the child's father toward the pregnancy; the duration of delivery; and the mother's age and marital status. The more positive the experience the mother had of the attending midwife caring for her, the more positively she experienced childbirth. The positive attitude of the child's father toward the pregnancy and a short duration of delivery were also predictors for a positive childbirth experience. Young and unmarried mothers also had more positive experiences of childbirth. On the basis of the research results, we can state that positive childbirth experiences of first-time mothers are enhanced by the positive characteristics and professional skills of the attending midwife, positive attitude of the spouse/child's father toward the pregnancy, and a short duration of delivery.

Attitude to Health↗

PubMed1999

Factors related to successful breast feeding by first-time mothers when the child is 3 months old.

The aim of the reported study was to gain information on those factors which contribute to the success of breast feeding in first-time mothers when the child is 3 months old. The study is part of a wider longitudinal project which follows-up the growth to motherhood of first-time mothers in Finland over a period of 8 months postpartum. Data collection was by questionnaires distributed between March and September 1995. The sample comprised 271 first-time mothers. The mothers completed the questionnaires when their infants were 3 months old. The analysis applied was a polychotomic logistic regression analysis. When the child was 3 months old those mothers who perceived themselves competent as mothers and who felt that society appreciated motherhood appropriately coped better with breast feeding. Also, those mothers who had worked at home prior to the birth of the child and who felt that breast feeding was important in motherhood coped better with breast feeding. Those mothers whose state of mind was more balanced after the birth coped better with breast feeding. The more affirmation the mother received from members of her social network the better she coped with breast feeding. The research findings suggest that factors influencing successful breast feeding in first-time mothers at 3 months postpartum are the mother's own resources and attitude to breast feeding, support from the social network and the current appreciation of breast feeding in society.

Adaptation, Psychological↗

PubMed1999

Relationships between family dynamics of Finnish child-rearing families, factors causing strain and received support.

The aim of this study was to determine the relationships between family dynamics, the factors causing strain on child-rearing parents and the support available to families from public health nurses. Family dynamics was defined as the family's unique way of functioning and was conceptualized by means of six different dimensions. Questionnaires were sent to 118 families, and of these 85 mothers and 79 fathers participated in the study. According to the findings the majority of parents involved in bringing up children aged 3-4 years assessed their families to be well-functioning. There was a correlation between a low level of factors causing strain on the family and a positive evaluation of family dynamics based on the various dimensions. According to the mothers the support, i.e. emotional, appraisal and instrumental support, received from public health nurses, along with a small number of strain-causing factors on the partner relationship, correlated well with their positive assessments of the mutuality and flexibility of their families.

Adult↗

PubMed1999

Grief and social support after the death of a spouse.

The death of a spouse is one of the most stressful events in a person's life. Social support has been shown to be widely beneficial in moderating the effects of both chronic and acute stress. The answers of Finnish widows and widowers (n=318) were analysed in order to investigate the sources of social support, what is the nature of support received, and whether social support is connected with coping with grief. The Hogan Grief Reactions Checklist was used to describe the grief as well as answers to open-ended questions about what helped the widowed persons cope with their grief. Kahn's theory of social support was used as a framework in the content analysis of the open-ended answers. The results showed that Finnish widows and widowers receive social support most often from their own family and friends. They perceived the received support most helpful, but also the support that the grieving person can give to other family members is seen as important. Results suggest that those who had had social support were able to grieve by allowing themselves to disorganize and experience panic behaviour.

Adaptation, Psychological↗

PubMed1999

Clinical supervision in nursing in the 1990s--current state of concepts, theory and research.

AIM: The aim of this article is to explore the current state and challenges of clinical supervision with regard to its research. BACKGROUND: Clinical supervision in nursing has been debated extensively, but also accepted officially as part of nursing practice. However, it has been claimed that the subject is conceptually vague, theoretically ambiguous and lacking in empirical research evidence. METHODS: A computer-based search was carried out in an international journal database of nursing. Of the published articles on effectiveness, 11 were chosen for a closer examination. FINDINGS: It can be argued that the present studies have failed to show actual effects of clinical supervision reliably and convincingly enough. CONCLUSION: Research into supervisory effectiveness is still in its infancy. To increase the scientific rigour of future research, it would be necessary to expand and clarify the scope of these studies as well as to diversify the range of research methods on the basis of ontological and epistemological analyses.

Clinical Competence↗

PubMed1999

Family member as a hospital patient: sentiments and functioning of the family.

The aim of this pilot study was to find out how families experience the hospitalization of one family member and to chart the participation of the family in the treatment of the hospitalized family member. A questionnaire was used to gather data for the study and the three open-ended questions in the questionnaire were interpreted using content analysis. The study population (n = 70) was the family members of patients in the neurological wards of Tampere University Hospital. The study demonstrated a variety of negative sentiments in the families, such as worry, fear, shock, anxiety and depression at the hospitalization of their family member. The families also expressed neutral and positive sentiments, such as approval, relief and faith in the help given. Nearly 80% of the families' statements dealt with emotional responses. Changes in the everyday life of the family caused by the hospitalization of a family member were also reported, with most changes affecting the immediate family. Hospital visits gave a rhythm to family life. There were changes in the sharing of housework and taking care of affairs, as well as in relationships within the family. Family members spoke of their loneliness, fear and longing. External changes in family life were present in 13% of statements. Helping the patient in hospital involved functions like participation in nursing care, taking the patient to the cafeteria and rehabilitation. Only 20% of statements dealt with emotional support for the patient. Future research could broaden the perspective to include the views of patients, nurses and doctors on the reality of family nursing.

Activities of Daily Living↗

PubMed1999

Social support provided by public health nurses and the coping of first-time mothers with child care.

The purpose of this study was to look at the factors related to the first-time mother's coping with child care when her child is 3 months old. This study is part of an extensive longitudinal project in which the development of mothering skills of first-time mothers was followed up for 8 months postpartum. The data were collected with a questionnaire between March and September 1995, in a sample of 271 first-time mothers. The mothers filled in the questionnaire when their babies were 3 months old. Coping with child care was assessed using Spearman correlation coefficient and stepwise regression analysis. Positive correlation was found between the mother's competence, attachment to the child, health, depression, relationship with the spouse, sense of isolation and role restriction, and the mother's coping with child care. The strongest correlation existed between the mother's competence and her coping. Positive correlation was also found between the child's mood, demandingness and acceptability, and the mother's coping with child care, with the child's demandingness having the strongest correlation. Positive correlation was again found between social support--the average functional support the mother received from her own social network, plus affect, affirmation, and aid from the public health nurses--and the mother's coping with child care. The predictors included in the multivariate method were the mother's competence, health, depression, and attachment to her child; the child's mood and ease or difficulty of care; and the affect and affirmation from the public health nurse. The results show that the first-time mother's coping with child care, when the child is 3 months old, is affected by the characteristics of both mother and child, as well as by the social support received from their social network and from the public health nurses at the child welfare clinic.

Adaptation, Psychological↗

PubMed1999

Patients' fears in coronary arteriography.

This study was concerned with the objects of fear and the intensity of fears related to coronary arteriography (CA) in 378 patients scheduled for coronary arteriography at a university hospital. Intensity of fear was measured on a 10-point Likert-type scale which listed 26 objects of fear. The patients were asked to assess the intensity of their fears both before and after CA. The results showed that the intensity of fear varied depending upon the object of fear. The highest intensity was recorded for fear of coronary artery bypass surgery. A significant increase was found in fear of lying flat in bed after CA and fear of not receiving social support. Fears of uncertainty about the illness, the CA procedure, results of CA, pain, coronary artery bypass surgery and coronary angioplasty decreased significantly after CA. Significant associations were found between objects of fear and patient demographics. It is concluded that patients' fears should be assessed individually both before and after CA. Special attention should be paid to the fears of women, patients under 45 years, upper and lower level employees and the unemployed.

Adult↗

PubMed1999

Finnish nurse teachers' perceptions of their 'scientific thinking' and its development during Master's-level teacher education at university.

There are very few studies on nurse teachers education, since the main interest has been on the demanding nature of a teacher's work. In Finland, the educational system of nursing care is developing rapidly and nurse teachers' education is changing as well. However, there is no research into academic nurse teacher education, even though this can be seen as important with regard to the educational system as well as to the nursing discipline. In this study, the objective was to describe 45 nurse teachers' perceptions of the development of their scientific thinking during Master's-level studies at the university. Open-ended questions were used in collecting the material with a questionnaire. The results of this phenomenographic research show that the need to increase one's scientific knowledge, as well as external demands, were the reasons for applying for admission to the university. Conceptions of the development of scientific thinking differed with regard to the processing of knowledge and to changes or developments in scientific thinking. The teachers' conceptions of the use of scientific nursing knowledge varied as well. The results challenge future teacher education and how it is arranged and developed. Further research, utilising different research methods, is needed into the development of scientific thinking.

Adult↗