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Biomedical subjects

S Janhonen

Publications and source records attributed to S Janhonen.

At least 19 recordsLinked to original sources
PubMed2003

Patients' experiences of psychosis in an inpatient setting.

The aim of this report was to describe patients' experiences of psychosis in an inpatient setting. Mental illness, as a result of psychosis, has traditionally been defined from the viewpoint of clinical experts. Psychiatric nursing, as an interactive human activity, is more concerned with the development of the person than with the origins or causes of their present distress. Therefore, psychiatric nursing is based on eliciting personal experiences and assisting the person to reclaim her/his inner wisdom and power. The design of the study, in the report discussed below, was phenomenological. In 1998, nine patients were interviewed regarding their experiences of psychosis in an acute inpatient setting. The verbatim transcripts were analysed using Giorgi's phenomenological method. The participants experienced psychosis as an uncontrollable sense of self, which included feelings of change and a loss of control over one's self with emotional distress and physical pain. The participants described the vulnerability they had felt whilst having difficult and strange psychological feelings. The informants experienced both themselves and others sensitively, considered their family and friends important and meaningful, and found it difficult to manage their daily lives. Furthermore, the informants experienced the onset of illness as situational, the progress of illness as holistic and exhaustive, and the admission into treatment as difficult, but inevitable.

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↗
PubMed2000

Videotaped recording as a method of participant observation in psychiatric nursing research.

This paper describes videotaped recording as a data collection method when conducting participant observation in a psychiatric nursing study. The videotaped episodes were part of the daily life of psychiatric nursing in a hospital environment. The advantages and limitations of using videotaped recording in nursing research will be discussed. This paper is based on two studies. The data consisted of 21 videotaped episodes of nursing report sessions or interdisciplinary team meetings in the psychiatric clinic of a university hospital. The participants consisted of patients, their significant others, nurses, doctors, social workers and physiotherapists. All videotaped material was transcribed verbatim. An essential advantage of videotaping is that most potentially useful interaction and behaviour can be captured. The advantage in terms of the credibility of videotaping was that the investigator was able to review the same videotaped situations again and again. Videotaped material is rich and provides several possibilities for analysing the data. In these studies data and source triangulation enabled the researchers to reduce personal influence on the results. The investigator must also be aware of the limitations concerning this method. The most essential limitations are mechanical problems and the influence of videotaping on behaviour. Careful ethical considerations are important concerning personal privacy, informed consent and respect for the self-determination of psychiatric patients.

Data Collection↗
PubMed2000

Factors associated with students' orientations to nursing.

Factors associated with students' orientations to nursing This paper presents the results of a study focusing on the factors associated with orientations to nursing. Students' orientations to nursing have not as yet been a focus of nursing research. In some other professions, however, professional orientation has been associated with learning motivation and study performance, and has been seen as a predictor of work satisfaction. In this study, students' orientations to nursing were defined in terms of caring, nursing expertise and life orientation. The hypothesis of whether students' pre-educational experiences of nursing, gender, choice of nursing specialty, problems with nursing studies and intention to stay in nursing were associated with different orientations was tested. The extent to which students were orientated to caring, nursing expertise and their own life was also examined. The orientation to nursing measurement tool, which has been developed on the basis of a qualitative study, was used to collect the data. Nurse teachers collected the data from nursing students (n=184) who were studying in three different nursing programmes in Finland. Non-parametric assessments (Mann-Whitney U-test and Kruskal-Wallis test) of the differences between the students' orientations were carried out. A majority of the students were highly life-orientated, and two-thirds had average nursing expertise or caring orientation scores. The results supported the study hypothesis of an association between students' orientations and their gender, choice of nursing speciality, problems with nursing studies and intention to stay in nursing. However, the hypothesis of an association between students' pre-educational nursing experiences and orientation to nursing was not supported. The contradictions between students' orientation to nursing and the philosophy of nursing underlying the study programme may be a source of motivational problems and dissatisfaction with nursing education. Therefore, nurse educators are challenged to discuss curriculum matters and student supervision in order to promote flexibility in planning personal study programmes.

Adolescent↗
PubMed2000

Data analysis method for evaluating dialogic learning.

The purpose of this paper is to introduce a new method of analysing and evaluating dialogic learning. Dialogic learning offers possibilities that have not previously been found in nursing or nursing education, although some nursing researchers have lately become interested in dialogic nursing interaction between nurses and patients. The stages of analysis of dialogic learning have been illustrated by using an example. The data for this illustration were collected by video-taping a planning process where students for a Master's degree (qualifying them to be nursing instructors in Finland) plan, implement and evaluate a course for nursing students, on the care of terminally ill patients. However, it is possible to use this method of analysis for other dialogic learning situations both in nursing practice (for example, collaborative meetings between experts and patients) and in nursing education (for example, collaborative learning situations). The focus of this method of analysis concentrates on various situations where participants in interaction see the object of discussion from various points of view. This method of analysis helps the participants in the interaction to develop their interactional skills both through an awareness of their own views, and through understanding the other participants' various views in a particular nursing situation.

Communication↗
PubMed2000

Changes in students' orientations to nursing during nursing education.

The purpose of this study was to describe the changes that took place in students' orientations to nursing during nursing education. The theoretical background of the research lay in the model of nursing students' orientation to nursing, which defines students' orientations in terms of caring, nursing expertise and life orientation. The orientations differ from each other as regards the student's pre-educational caring and nursing experiences, the meaning of caring and nursing and the expectations for a career in nursing. The research was conducted qualitatively, but quantitative measures were also used. The interviews of 19 voluntary nursing students concerning their orientation to nursing both at the beginning and at the end of education were analyzed by content analysis. The categories were derived deductively from the model of nursing students' orientation to nursing. The categories were quantified, and paired t-test and Wilcoxon test were performed to test the significance of the changes in students' orientations between the beginning and the end of education.

Education, Nursing, Baccalaureate↗
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

Patient initiatives during the assessment and planning of psychiatric nursing in a hospital environment.

The qualitative study reported in this paper aims to describe the planning and assessment of psychiatric nursing in a hospital environment. The theoretical framework consists of the three types of psychiatric nursing outlined in a developmental model of nursing: confirmatory, educational and catalytic. Confirmatory psychiatric nursing is based on a hierarchical and authoritarian model. Educational psychiatric nursing is based on a professionally driven and behavioural model. Catalytic psychiatric nursing is systematic, theoretical, and research-based. Catalytic psychiatric nursing may vary, depending on the patient's needs, from confirmatory and educational to situationally determined nursing. However, it always enables patient initiatives. The purpose of this paper is to describe patient initiatives during the assessment and planning of patient care by an interdisciplinary mental health team in a psychiatric hospital environment, and the assessment and planning as described by nurses working in a hospital environment. The data, which were collected in two psychiatric hospitals by videotaping interdisciplinary teamwork situations and recording interviews of nurses afterwards, consisted of 384 pages of written text. A total of 640 sentences were identified in the text as reflecting the assessment of care by the interdisciplinary team and by the nurses working in the hospital environment. Deductive content analysis techniques were used to analyse the written data. The results showed that nursing was described by the nurses to be catalytic in 13% of the cases, while the same nurses assessed psychiatric nursing to be most commonly educational (40%) or confirmatory (47%).

Humans↗
PubMed1998

Helping methods used by nurses in a psychiatric hospital environment.

This qualitative study aims to describe the helping methods used by psychiatric nurses in a hospital environment from as evidenced by video observations and nurses' and patients' descriptions. The data, which were collected by videotaping different nursing situations and by interviewing the nurses and patients afterwards, consisted of 520 pages of written text. A total of 569 utterances were extracted from the text to describe the helping methods used in psychiatric nursing. Each utterance constituted a classification unit. Deductive content analysis techniques were used to analyze the data. The results obtained from the nurses' and patients' descriptions and the videotaped episodes showed that the most commonly used helping methods were of the confirmatory kind (50%), while educational methods came second (37%) and catalytic methods third (13%).

Finland↗
PubMed1998

Ethical dilemmas in a psychiatric nursing study.

This article describes the ethical dilemmas encountered by the authors while conducting qualitative research with psychiatric patients as participants. The ethical conflicts are explored in terms of the principles of personal autonomy, voluntariness and awareness of the purpose of the study, with illustrations from the authors' research experience. This study addresses the everyday life of psychiatric nursing in a psychiatric hospital as described by patients, nurses and nursing students. The data were collected in a university hospital in northern Finland, using videotaped observations and recorded interviews. Although no definitive resolutions are proposed to the conflicts, the article endeavours to enhance awareness of the ethically perplexing situations possibly encountered by researchers during a study process. The institution where the study was conducted has a Research Board entitled to resolve ethical questions. The Ethics Review Committee of the Medical Faculty at the University and the Research Board of the University Hospital's Department of Psychiatry reviewed and accepted this research plan. They also recommended solutions to some specific ethical problems that occurred in the course of the study. Moreover, some ethical dilemmas required further study and debate during the process.

Behavioral Research↗
PubMed1997

Teaching practice as a testbench of learning in master's degree education for nurse teachers in Finland.

This article presents the approach and procedures used in a Finnish developmental study on nurse teacher education. The teaching practice period was organized by dividing student teachers into small study groups and assigning the group an entire course to be planned and carried out in teacher/student collaboration. The work process of the groups was videotaped and analysed qualitatively. Preliminary results and ideas concerning the developmental needs of nurse teacher education are presented.

Curriculum↗
PubMed1997

Patient's capable of managing--basic process of psychiatric nursing in a hospital environment.

The aim is to describe the basic process of psychiatric nursing in a hospital environment and to produce a practical theory of psychiatric nursing by the grounded theory method. The data were collected by means of observation and interviews and analysed simultaneously, so that the preliminary results and experience gained in the field shaped the data collection process. The data were subjected to continuous comparison analysis and classified into categories by open coding. The basic process was identified by means of axial coding and theoretical memos. The selective coding consisted of related categories grouped around a core category. The basic process of psychiatric nursing involves the patient's needs for care, the helping methods available and the objectives of care. The patient needs help because of his/her inability to manage in daily life, and the role of nursing is to help the patient to manage. The basis of psychiatric nursing lies in caring for the needs of the patient by employing various helping methods. Patient management consisted of three categories, each subsuming three subcategories. Examination of the content of these led to the identification of different types of psychiatric nursing, labelled as confirming, educating and catalytic. The results suggest that collaborative methods in psychiatric nursing enable and support the patient's participation in his/her care and show that both nurses and patients consider collaboration a good helping method, although requiring a change in attitudes and activities for both the nurse and the patient. In spite of changes in psychiatric nursing, there has been no essential development, as most of the care provided is still normative and traditional and the patient is a passive recipient.

Adaptation, Psychological↗
PubMed1996

Fire-setting from the viewpoint of an arsonist.

1. Arsonists have more psychiatric symptoms, such as self-destructive behavior and alcohol dependency, than other criminal offenders. 2. Arsonists are found to have poor social competence with low social status and a high unemployment rate. 3. The act of arson could be like an attempted suicide, a cry for help.

Adolescent↗
PubMed1993

Finnish nurse instructors' view of the core of nursing.

The purpose of this article is to describe how nurse instructors understand nursing and the necessary conditions for high quality nursing care. The approach of the study was inductive and based on phenomenology and a sociological field research method, i.e. grounded theory. It emerged that the core of nursing is a process, termed here caring, with three stages. Three types of caring emerged. Understanding the client, the art of nursing, co-operation between the nurse and other health care professionals were found to be necessary conditions for a high quality nursing care and it was also found that it is not possible to separate caring from the society and its history.

Attitude↗
PubMed1992

Swedish nursing instructors' views of nursing.

The views of Swedish nursing instructors of the concept of nursing are examined. The approach is an inductive one based on grounded theory, which is derived from phenomenology and sociological field research methods. The data were collected by selective sampling and by interviewing 14 teachers in two nursing schools (one small and one large) in Sweden. The analysis shows that the core of nursing can be described as helping the patients either to manage their daily living or to die with dignity, and it consists of three stages which continually interact. Three types of nursing emerged inside this process of help. The relationships between (1) the nurse and different kinds of the art of nursing, (2) the nurse and various kinds of assumptions concerning the patient, and (3) the nurse and different kinds of co-operation with other health care personnel groups define the different types of process of help. The theory of nursing practice generated here is one that can be employed to test nurse orientation in many contexts.

Attitude of Health Personnel↗
PubMed1992

[The research process in grounded theory: some examples of nursing education and nursing practice research].

The purpose of this paper is to describe the grounded theory method; especially of the research process in studies using the method. The article is based on the examples of authors' studies of nursing education and nursing practice. The grounded theory method is qualitative and inductive, analyzing data from the empirical world, from which categories and concepts are emerged. Analysis is made by coding and memorizing. The emerging categories will be structured, restructured and developed continually during the research process. In the final theory the concepts, the relationships between them and their internal and external differences are defined in the social process. The meaning of a good description of the research process is emphasized, because the evaluation of the research studies using grounded theory method are based on well documented research process.

Models, Nursing↗