Biomedical subjects

P Astedt-Kurki

Publications and source records attributed to P Astedt-Kurki.

At least 19 recordsLinked to original sources

PubMed2004

Family dynamics and postnatal depression.

Research has shown that postnatal depression (PND) affects 10-15% of mothers in Western societies. PND is not easily identified and therefore it often remains undetected. Untreated depression has a detrimental effect on the mother and child and the entire family. The purpose of this study was to ascertain the state of family dynamics after delivery and whether the mother's PND was associated with family dynamics. The study used a survey covering the catchment area of one Finnish university hospital. Both primi- and multiparas took part and data were collected using the Edinburgh Postnatal Depression Scale (EPDS) for mothers and the Family Dynamics Measure II (FDM II) for both mothers and fathers. The data were analysed using SPSS statistical programme and frequency and percentage distributions, means and standard deviations were examined. Correlations were analysed using Spearman's correlation coefficients. The significance of any differences between mothers' and fathers' scores was determined with a paired t-test. Of the families participating in the study (373 mothers and 314 partners), 13% of the mothers suffered from PND symptoms (EPDS score of 13 or more). As a whole, family dynamics in the families participating in the study were reported to be rather good. However, mothers having depressive symptoms reported more negative family dynamics compared with other families. With the exception of individuation, mothers having depressive symptoms reported more negative family dynamics than their partners. With the exception of role reciprocity, non-depressed mothers reported more positive family dynamics than their partners. Knowledge of the association of mothers' PND with family dynamics could help to develop nursing care at maternity and child welfare clinics and maternity hospitals. Depressed mothers and their families need support to be able to make family dynamics as good as possible.

Adolescent↗

PubMed2001

Assessment of strategies in families tested by Finnish families.

The aim of this paper was to describe testing a Finnish version of the assessment of strategies in families (ASF) instrument and its construct validity and reliability in Finnish families. The ASF instrument is based on Friedemann's framework of systemic organization and the version used in this study consists of 25 items, each containing three statements. The instrument was developed to estimate family functioning in reaching the four targets of the framework of systemic organization. It provides sub-scores for the targets, family stability (system maintenance and coherence), family growth (system change and individuation), control (system maintenance and system change) and spirituality (individuation and coherence). Data were collected from patients attending the outpatient clinics of pulmonary and rheumatic diseases (N=196). Questionnaires were given to patients capable of understanding the questions and they returned questionnaires by mail directly to researchers. Construct validity was tested with exploratory factor analysis. Factor analysis was done with 22 items. The four factor solution was best suited. Two items were eliminated because of low factor loadings and crossloading. The total of 20 items were left in the instrument. Crohnbach's alpha was used to measure internal consistency. It was computed for each target separately and the total tool. There were discrepancies in the assignment of process dimensions which were expected because of cultural perceptions. The total instrument had a reliability of 0.85. The result of the analyses was a pretested tool with subscales for stability, growth, control and spirituality that have acceptable reliability and concept validity. Less satisfactory was the small number of items representing individuation. Another weakness is the lack of statistical distinction between system maintenance and coherence. The instrument is also usable in these subscales, but it needs further development and retesting. Items need to be added to express individuation, possibly some others. The new items will be formulated freely, paying attention to culture. However, the tool appears good enough to be used as measurement in various research studies.

Adaptation, Psychological↗

PubMed2001

Risk factors of child maltreatment within the family: towards a knowledgeable base of family nursing.

The purpose of this study was to compare family dynamics in child maltreating families (n=42) with that in ordinary families with children (n=77), and to ascertain risk factors of child maltreatment within the family. Child maltreatment was defined as physical, psychological or sexual abuse or neglect of a child by a parent. Data were collected using questionnaires (Family Dynamics Measure 2, FMD 2) (N=119) basing on Barnhill's conceptual framework of healthy family systems and analysed by forming sum variables and logistic regression. The study results indicate that family functioning in child maltreating families is lower on all dimensions of family dynamics (individuation, mutuality, flexibility, stability, communication and roles) than that in ordinary families with children. Furthermore, it seems that specific risk factors, detected with logistic regression analysis, are related to whether child maltreatment occurs in the family or not. These include the parent's low educational background, many children in the family, unemployment of a parent, low individuation of the family members, and poor stability and security within the family. The results of this study provide guidelines for detecting and preventing child maltreatment as well as for recognising its existence, although no generalizations can be made due to the small sample size and complexity of the phenomenon under study.

Adult↗

PubMed2001

Methodological issues in interviewing families in family nursing research.

AIM OF THE STUDY: The aim of this study is to discuss what methodological problems can be met in family research with one family member as an interviewee speaking on behalf of the whole family and, vice versa, what is the meaning of having multiple family members or the whole family unit as informants. BACKGROUND: Family nursing research is part of multidisciplinary research with families. It is a basis for family nursing and contributes to research, especially from the perspective of family welfare and its promotion. Family nursing research generates knowledge concerning families' and family members' wellbeing and experiences and expectations of nursing and health care. METHODS: The examination of methodological problems while pursuing family research is based on two studies conducted in Finland. FINDINGS: Quantitative methods add to the general knowledge of families. Qualitative methods are well suited to the study of family experiences. Family interviews performed for research purposes differ from interviews aiming at caring for families. They aim at obtaining knowledge of families on a general level so as to improve family nursing. Family research has to be looked at as a whole. It faces many challenges such as the definition of the family, gaining access, methods of data collection and data management. CONCLUSIONS: A family is a complex system and research with families need flexible, sensitive and practical methods. Family research should also aim at developing new methods for data collection and analysis.

Adolescent↗

PubMed2001

Humour between nurse and patient, and among staff: analysis of nurses' diaries.

AIM OF THE STUDY: The aim of this study was to investigate the occurrence of humour both between nurses and patients and among nursing staff. BACKGROUND: Humour has positive effects on both a person's physiology and the psyche. Laughter signifies positive things to people; it may add to feelings of togetherness, closeness and friendliness. The use of humour is an indication of mental well-being and it minimizes the effect of negative factors and protects from difficulties. METHODS: The data consisted of diaries written by nurses (n=16), which were analysed inductively using content analysis. FINDINGS: The main categories of humour between nurse and patient were nurse-based humour, co-operation-orientated humour and patient-orientated humour. Humour among staff consisted of the main category of resource-orientated humour. CONCLUSION: The consequences of humour between nurse and patient enabled them both to cope with various unpleasant procedures. It helped them to manage difficult situations and led to an improvement in the working climate. Humour among staff helped nurses to cope with their work and created a better atmosphere on the ward.

Adaptation, Psychological↗

PubMed2001

Family involvement in perioperative nursing of adult patients undergoing emergency surgery.

The purpose of this study was to describe how adult patients undergoing emergency surgery experience family centredness in perioperative nursing practice. The central aim was to generate knowledge to be used while developing the practice, education and management of perioperative nursing. Data were collected using a questionnaire with emergency surgical patients in five regional hospitals in Southern Finland. The number of distributed questionnaires was 132. The response rate was 85% (n = 112). The results were mainly described as frequencies and percentages. The open-ended sections of the answers were analysed using qualitative content analysis. The findings from the open-ended questions were used for deepening and complementing the quantitative description of the results. In the preoperative phase, ascertaining the family situation and informing the family member chosen by the patient were not achieved systematically. Family situation was also rarely examined in the intraoperative and postoperative phases, although it is central to coping after surgery, especially in home care. The results support the view of earlier research about the importance of individuality of patients and their families during the perioperative care process and hence enhance the endeavour to develop nursing based on families' real needs.

Adaptation, Psychological↗

PubMed2001

Importance of humour to client--nurse relationships and clients' well-being.

Humour is an important and integral part of everyday life, social integration and professional nursing care. However, there has been little systematic research into the use of humour in nursing contexts, from the clients' point of view. With a touch of humour, this article aims to describe the positive impact of humour on client-nurse relationship and on clients' well-being. The data consisted of focused interviews (n = 8) and letters (n = 5) received from nursing clients in response to an invitation published in a patient organization newsletter. The data were analysed using the method of content analysis. The results suggest that humour helped the client to cope with difficult situations by offering a moment of rest and a new perspective on an altered life situation. Humour also helped clients to show their emotions and to preserve their dignity. In the nurse-client relationship, humour enabled the client to communicate criticism or to express themselves. Nurses can alleviate clients' anxieties through humour, and humour can help nurses to cope.

Adaptation, Psychological↗

PubMed2001

Interaction between adult patients' family members and nursing staff on a hospital ward.

The purpose of this study was to generate knowledge of the interaction between an adult patient's family members and nursing staff from the staff's perspective. Data were collected from nursing staff (n = 155) working on the wards and out-patient departments for pulmonary, rheumatic, neurological and gastroenterological diseases at a university hospital by using a new questionnaire based on earlier research and the literature. The questions explored the staff's views of interaction with the adult patient's family members. In this study, interaction is seen as an umbrella concept which encompasses giving information to relatives, discussion, contacts between staff and significant others and working together. The instrument included questions about personal and telephone discussions, the provision of written instructions and factors facilitating and complicating interaction. The response rate was 55%. The data were analysed using SPSS software and examined using frequency and percentage distributions and cross-tabulation. The open-ended questions were analysed using qualitative content analysis by reducing, grouping and abstracting the data inductively. Discussions with relatives while they visited the patient in hospital were the commonest form of interaction. The majority of respondents perceived the interaction with the patient and knowing his or her family members as important. Less than one-fourth of the respondents started discussion with family members, while the majority expected family members to initiate interaction. The majority of respondents perceived the patient's presence in discussion as important, but sometimes they thought it was necessary to discuss with family members without the patient. The staff discussed with family members mainly in the ward office or in patient rooms, which were, however, not perceived as peaceful. Discussions primarily pertained to the patient's condition, discharge from hospital and planning of continued treatment. The majority of respondents reported that the opportunity for discussion offered by staff, the patient's positive attitude towards discussion with the family and family members' own interest facilitated interaction. The staff's haste and shift-work, family members' shyness of approaching the staff and the absence of a peaceful place for discussion serve to complicate interaction. Family members are primarily seen as informants and recipients of information. The staff's ability to recognize the importance of family members to successful patient care is relatively adequate. However, insufficient attention is paid to family members and their need for support.

Adult↗

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

Family health in everyday life: a qualitative study on well-being in families with children.

This article describes the subjective health views of young Finnish families with children. The data were collected in unstructured focused interviews with 19 families, most of whom were interviewed twice. Set within a phenomenological-hermeneutic framework, the study applies a qualitative method in order to uncover the meanings attached by the families to different facets of their everyday life. Health is an integral part of the everyday life of families with children, comprising various dimensions of experienced well-being and unwell-being, security and different life-habits. Social networks are crucial to family health: they can either strengthen or undermine experienced health. Professionals working with families in the health care system need to have at least a basic knowledge of the different dimensions of family health: this helps to identify and understand the individual ways in which families work to promote their health and well-being. This knowledge of family health is also important for research purposes. Health care professionals also need to know more about how families cope with their everyday problems and about how client families can be supported. More research is needed on the concepts of family health and on how those concepts are applied to practice in different health care sectors and in education.

Adaptation, Psychological↗

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↗

PubMed1998

Ethical problems in research on families who are abusing children.

Child abuse within the family is a highly sensitive issue and therefore difficult to research. This article is based on our experiences of a child abuse research project in Finland. Special attention is given to ethical considerations during the initiation of the study, and in the sampling procedures, data collection and reporting. Most importantly, all those taking part in studies on sensitive issues must be guaranteed full confidentiality and anonymity. There are also other ethical considerations that go beyond the usual concerns in the research process.

Adult↗

PubMed1998

[For better or worse--description of the problems experienced by elderly spouses of long-term care patients].

The aim of this article is to describe, what problems the spouses of permanently institutionalised patients feel in their lives. The nature of the study is qualitative. Data were collected from six spouses of patients cared for in two hospital wards in primary health care. The data collection method was theme interview. Analysis was made by qualitative content analysis method. The results of the study showed the spouses' experiences. They formed six categories: 1) embitterment of the fate of their own and their spouses, 2) feeling of guilt when living free while the spouse is in a hospital care, 3) feeling of being bound to the patient and losing own possibilities in life, 4) feeling of loss of the spouse, 5) losing contacts to other people outside the family, and 6) missing visions for the future. The results showed many ways how to develop the long-term hospital care toward family-centered care. The family members of the patients do not only form background of the patients or the care. They also need informational and emotional support to manage in their everyday lives.

Adaptation, Psychological↗

PubMed1997

Family members' experiences of their role in a hospital: a pilot study.

The purpose of the study is to explore the experiences of family members in their role of relative in a situation where a next of kin has been admitted to hospital. The questionnaire was used in data collection. The data reported here are from a pilot study. The sample consisted of 70 family members of patients receiving treatment on the neurological wards. It was found that family members spent a lot of time at their relative's bedside, most of them up to several hours a day. The daily routines of families and way of life were also very much affected. The most important way in which the hospital supported families was to keep them informed about the patient's care and treatment. However, this was not possible without an active interest and involvement on the part of family members themselves. There were obvious problems and shortcomings in terms of family orientation: only one third of the family members felt that the nursing staff were seriously interested in the family's well-being, and only one quarter had been told what they could do in hospital. About half of the family members needed to meet nurses to get support from nurses and over one third from doctors. The oldest respondents and women needed more help than did others. Men preferred to turn to doctors rather than nurses for help. In general family members had good experiences of visiting their relative in hospital. They believed that they were expected and that they were of help to their relative. Over half of the family members said they were actively involved in caring for their relative. Only four per cent of the family members reported bad experiences of their visits to hospital, in spite of the obvious shortcomings in family nursing. For this reason it is important that nurses facilitate the involvement and integration of relatives in the process of nursing.

Adult↗

PubMed1997

Self-reported family health and well-being after early discharge from maternity hospital: a phenomenological study.

This paper is concerned with the self-reported health and well-being of families discharged from maternity hospital within 24 hours of childbirth. The empirical data were collected in focused interviews with 12 families; background data were also drawn from hospital documents. Data analysis was based on the phenomenological approach developed by Colaizzi. The informants' accounts of their health and feelings of well-being revolved largely around the process of growth to the new life situation as well as the importance of a sense of feeling at home in one's everyday environment. The well-being of the newborn and other children in the family was highlighted in the parents' descriptions of the family's health. However, physical health was just one dimension in definitions of family health.

Attitude to Health↗

PubMed1997

The client-nurse relationship as experienced by public health nurses: toward better collaboration.

This article presents the findings of a study concerned with the client-nurse relationship in public health nursing settings. The purpose was to look at the ways the client and public health nurse cooperate and to see what makes for efficient collaboration. A phenomenological-hermeneutic approach was adopted. The data consisted of essays written by the public health nurses and focused interviews, which were analyzed by phenomenological method. The outcome is an interpretive description of public health nurses' experiences of collaboration with their clients. Successful collaboration requires an active and committed involvement on both sides and a joint effort to help the client cope with his/her situation. This means there has to be not only a shared understanding of the ultimate goal of nursing, but also open and sincere confidence-building interaction for the creation of a sense of confidentiality and trustworthiness. The results suggest that the contents of the client-nurse relationship are extremely important to both sides of the dyad: both the client's well-being and the public health nurse's feeling of succeeding on the job will depend to a great extent on the kind of relationship they construct. Future research should also look at how clients experience their relationship with the public health nurse.

Adaptation, Psychological↗

PubMed1997

Humour as experienced by patients and nurses in aged nursing in Finland.

Humour is an integral part of everyday life and therefore a component of the care and treatment of elderly patients in the modern health care. This article deals with the role of humour in aged nursing from the perspective of the nursing home residents. It also describes some preliminary results of our study on the meaning of humour to professional nurses. The chief motivation for the study is to provide a deeper understanding of humour as a part of aged nursing and as a 'phenomenon', which should also help us in the continuing challenge to improve the quality of nursing care. In this study the qualitative approach was used because the focus of interest was on an issue that has received only little attention in earlier research. The research material consists of data from patients and nurses. The data were collected via interviews and essay-type responses. The data obtained were analysed using the qualitative method of content analysis. In the light of our findings here, humour can be described as a joie de vivre which manifests itself in human interaction in the form of fun, jocularity and laughter. The assumption is supported by earlier research results which indicated that humour is an individual and personal matter and, in aged nursing care it is also very much a context-bound phenomenon. Humour makes it easier for some of the elderly patients to experience a positive, human relationship with the nurse. According to the results it seems to us that research should be continued and intensified into the role and use of humour in elderly people's everyday life and particularly in gerontological nursing care.

Aged↗

PubMed1996

The family interview: exploring experiences of family health and well-being.

Health and well-being are basic concepts to nursing science and also important to practical nursing care: to provide effective nursing we need to have a good understanding of both health and well-being. Experienced health has been studied quite extensively at the individual level, but the family's point of view has been very much neglected. This study collected data on families' views on health and well-being in interviews with nine families. The interviews were held in a group situation, with all family members present, and they were structured around the three core themes identified by Astedt-Kurki in her doctoral dissertation: 'doing, knowing, feeling'. The emotional bonds that tie together family members may be a factor in the family's tendency to produce rich and detailed knowledge about their well-being in interview situations. On the other hand it is also possible that the family will try to convey as positive an image of itself as possible. For reasons of reliability the nine families taking part in this study were interviewed twice.

Adult↗