Biomedical subjects

S Lauri

Publications and source records attributed to S Lauri.

At least 19 recordsLinked to original sources

PubMed2001

Patient participation in decision making about care.

The purpose of this study was to find out how cancer patients perceive patient participation in decision-making and to see which factors in their view facilitate and restrict participation. Data were collected in focus group interviews with 25 patients, most of whom had breast cancer. Data interpretation was based on the method of qualitative content analysis. The results showed that patients, nurses and physicians all play a part in terms of how patients participate in decision-making. Patients defined participation in decision-making in terms of asking questions, obtaining/providing information and choosing from/presenting different alternatives. Among the factors that were thought to promote participation in decision-making were the patient's activity, the presence of a primary nurse/physician, the encouragement of nurses and physicians to participate, the treatment of patients as equals, and nurses and physicians having enough time for patients. As for factors hindering participation in decision-making, reference was made to patient ignorance, physical and mental imbalance and shyness on the part of the patient. Obstacles to participating in decision-making that originated in the nurses and physicians were the tendency for them to treat patients as objects, to fall in a routine, problems with information dissemination and lack of time.

Adult↗

PubMed2001

Attitudes of patients with breast and prostate cancer toward complementary therapies in Finland.

This study aimed to describe the attitudes of patients with breast cancer and those with prostate cancer toward complementary therapies. The data were collected with a postal questionnaire administered to 216 patients with breast cancer (response rate, 55.4%) and 1 90 patients with prostate cancer (response rate, 54.9%) in southern and southwestern Finland. The questionnaire was composed of 44 Likert-type statements, which were analyzed using descriptive statistics, chi2 tests, t tests, and two-way analyses of variance. More than half (54%) of the patients with breast cancer and 45% of the patients with prostate cancer believed that people with cancer may benefit from complementary therapies, although they did not think these therapies actually could cure cancer. More than half of the respondents were dubious about using complementary therapies as long as there was no solid scientific evidence. Most believed that complementary therapies were used because they gave people hope (women, 88%; men, 72%) or "something to cling to" (women, 83%; men, 76%). The respondents believed most in dietary therapies and least in healing. There was much confusion and uncertainty about the professional competencies and expertise of the people who provided complementary therapies. Approximately one fourth of the respondents had spoken to their physician about complementary therapies. Only a few had talked about the matter with nursing staff. About half of the respondents thought that physicians and nurses took a negative attitude toward complementary therapies. In both groups, patients who had talked with their physician about complementary therapies tended to show a more positive attitude.

Adult↗

PubMed2001

How relatives adjust after the death of a patient with cancer in hospice.

This study aims to discover (1) how relatives adjust to their new life situations following the death of a patient with cancer in hospice and (2) how those relatives have been supported by healthcare professionals both before and after the patient's death. The data were collected with a structured questionnaire administered to relatives of patients with cancer who died in a Finnish hospice in 1998 and 1999. The questionnaires were administered by the hospice staff to all family members who met the criteria specified (n = 589). The final sample comprised 258 family members, most of whom were the deceased patients' spouses. The Mann-Whitney U-test and the Kruskal-Wallis test were used to analyze the data. Instrument reliability was ascertained by the Cronbach alpha coefficient. The relatives had little difficulty accepting their new life situation and adjusting to their new role. The main factors affecting adjustment were being the patient's spouse and the age of both patient and relative. Relatives believed that they received a moderate amount of support from healthcare professionals, both before and after the patient's death. Most of the information they received concerned the patient's illness and treatment and daily condition. Communication was honest and based upon the relatives' needs. Emotional support before the patient's death consisted mainly of accepting the relative and listening to what relatives had to say.

Adaptation, Psychological↗

PubMed2001

An exploratory study of clinical decision-making in five countries.

PURPOSE: To identify the cognitive processes nurses use in their decision-making in long- and short-term care settings in five countries, and the demographic variables associated with their decision-making. METHOD AND SAMPLES: The instrument used was a 56-item questionnaire that has been shown to be reliable in earlier studies. The sample consisted of five convenience samples of registered nurses working in either geriatric wards (n = 236) or acute medical-surgical wards (n = 223) in hospitals or nursing homes in Canada, Finland, Sweden, Switzerland, and the United States. FINDINGS: Five models of decision-making were identified on the basis of factor analysis. They represent both analytical and intuitive cognitive processes. Analytical cognitive processes were emphasized in information collection, problem definition, and planning of care, and intuitive cognitive processes were emphasized in planning, implementing, and evaluating care. Professional education, practical experience, field of practice, and type of knowledge were significantly associated with decision-making models as well as with country of residence of the participants. The highest proportion of analytically oriented decision-makers was found among nurses in long-term care, the decision-making of nurses in short-term care was more intuitively oriented. CONCLUSIONS: The results indicate that decision-making of participants varied from country to country and in different nursing situations. Future research should be focused on reasons for these differences, the relationship between the task and the nurses' type of knowledge, and how nurses use their knowledge to make decisions in different nursing situations.

Canada↗

PubMed2001

Cancer patients' views and experiences of participation in care and decision making.

The purpose of this study was to explore the views and experiences of adult cancer patients about patient participation in care and decision making and the preconditions for this participation. The data were collected by means of focused interviews; in addition the patients completed depression and problem-solving instruments. The sample comprised 34 cancer patients from the haematological and oncological wards of one university hospital in Finland. The results revealed considerable variation in the patients' views on their participation in care and decision making. Some of the patients understood participation either in terms of contributing to the decision making or in terms of expressing their views on treatment options. Some considered that their participation in care was impossible. Patient participation in care and decision making was promoted by good health, access to information, assertiveness, good interactive relationships with nurses and physicians, and encouragement by nurses and physicians to participate. Factors restricting such patient participation were poor health, ignorance, anxiety, age, time pressures of staff, lack of time, high staff turnover and poor interactive relationships. With regard to participation in medical decision making, the patients were divided into three groups: (1) active participants (n = 7), (2) patients giving active consent (n = 9), and (3) patients giving passive consent to medical decisions (n = 18).

Adult↗

PubMed2001

Security associated with pregnancy and childbirth--experiences of pregnant women.

The aim of this study was to describe security associated with pregnancy and childbirth. Security was described as a human need and as human value. Data were collected in semi-structured interviews in two maternity health care clinics. Data interpretation was based on the method of content analysis. A convenience sample of 20 volunteer Finnish women was interviewed during pregnancy. The elements creating security associated with pregnancy and childbirth were maternity health care, social support, sense of control, and attitudes. The feeling of security was manifested in different resources, feelings and behavior. If the feeling of security associated with pregnancy and childbirth was impaired, the participants would resort to their network of social support, contact health care or social welfare services, or try to achieve a sense of security by their own resources. Feeling secure during pregnancy influences the pregnant woman's resources, feelings and behavior. It is important that professionals in maternity health care talk with the client about issues that influence her individually-experienced security associated with pregnancy and childbirth. These include examination of the client's network of social support and informing the client about the health care and social welfare services available.

Adaptation, Psychological↗

PubMed2000

Informational and emotional support for cancer patients' relatives.

The purpose of this study was to find out what cancer patients' relatives think about the actions of health care professionals in terms of providing informational and emotional support. The sample consisted of 168 relatives of patients from oncological wards all over Finland. The data were collected with a questionnaire specifically developed for this study. Non-parametric tests were used for statistical analysis. The results clearly highlighted the importance of informing relatives about the patient's illness. However, less than one-third of the relatives said they received much information. Relatives' need for emotional support was clearly at a lower level than their need for information. Even so, only very little support was provided in relation to relatives' needs.

Adult↗

PubMed2000

Self-care in adults with asthma: how they cope.

The purpose of this study was to find out how well adult asthma patients in Finland cope with self-care in three areas of asthma treatment. The areas of physical, psychological and social asthma treatment were examined. Associations between demographic background data and self-care were also studied. Data (n = 130) for the study were collected using a questionnaire specially developed for this study. A deductive perspective was employed in data analysis. Respondents showed fairly good competence in self-care in all three areas of asthma treatment. However, up to 30% of the asthma patients had pets and 16% were smokers. Extra stress was reduced by exercise and positive thinking. Humour was also important in helping most of the respondents cope mentally. Social support played a significant part in fighting the sense of powerlessness which is caused by asthma. According to the results, women coped better than men in the social area of self-care.

Adaptation, Psychological↗

PubMed2000

Participation of relatives in the care of cancer patients.

This study aims to find out how important it is for relatives to take part in the care of cancer patients and to see to what extent they actually do take part. Participation is defined as consisting of concrete care activities, emotional support and participation in decision-making concerning the patient's care. The sample comprised 168 relatives of cancer patients from oncology wards all over Finland. Data were collected with a questionnaire specifically developed for this study. Nonparametric tests were used for statistical analyses. The results showed that the most important aspect of relatives' participation was supporting the patient emotionally; providing concrete care and participation in decision-making were both considered less important. Over 80% of the relatives said they gave a considerable amount of support to the patient. Most relatives said that they visited the patient in hospital, talked to the patient about their concerns and were near them whenever they felt they needed that. On the other hand, relatives did not take part in discussions about care, nor were they informed about such a possibility.

Journal Article↗

PubMed2000

Nursing students' knowledge of and views about children in pain.

It is important to evaluate the outcomes of the given education to gain knowledge about the abilities of our students to meet the needs of nursing practice. Pain associated with different illnesses and procedures is one of the most common symptoms that children experience in the hospital. The purpose of this study was to evaluate the views and knowledge base of graduating nursing students in the area of taking care of children in pain. The data were collected with a purpose-designed Likert-type instrument from all nursing students that graduated during one year from the child nurse specializing program in Finland (n = 85), with a response rate of 86%. Results indicate that students have mainly positive views and attitudes towards taking care of children in pain. The views and attitudes differ when older and younger students and students from different schools are compared. Students lack knowledge especially in the area of pain medications as well as in the assessment of pain. In the knowledge section, the results did not differ greatly when different schools, younger and older students or previous working experience and no working experience were compared. In some of the researched schools, many of the students felt a lack of confidence about their knowledge. There is a need for more detailed education in the area of taking care of children with pain.

Adult↗

PubMed2000

Clinical pathway of elderly persons with lowered mood in the health care services.

Elderly persons with mild depression are notable consumers of somatic health services. This study describes the typical clinical pathway including institutional care of two groups, depressed and non-depressed elderly persons, in different stages of the health care system, and compares possible changes in the use of health care services between the two groups. We also compare differences in morbidity and mortality between depressed and non-depressed persons. The depressed group of 50 persons in our follow-up study were selected randomly from among those persons who were diagnosed as having symptoms of depression, as shown in the Zung Self-Rating Depression Scale (n = 109). Persons (n = 50) who were not diagnosed as suffering from depression and who showed no signs of cognitive impairment (n = 833) were likewise chosen at random as a control group. We found that people suffering from symptoms of depression utilized institutional care, home health care and the outpatient clinics more than non-depressed people. Depressed people were more likely to suffer cardiovascular (p < 0.023) and pulmonary diseases (p < 0.04) than non-depressed controls. The mortality among depressed people was significantly higher than that in the control group. The results of our study give reason to believe that home-care staff are in a key position to identify depressed subjects. They have to understand the relationship between depression and the effect of various diseases on health and functional capacity. It is also important to ensure efficient communication between those responsible for health care.

Affect↗

PubMed1999

Fears associated with pregnancy and childbirth--experiences of women who have recently given birth.

OBJECTIVE: To describe fears associated with pregnancy and childbirth and to see whether women who have recently given birth feel that their fears were justified. DESIGN: A qualitative study. Data were collected by semi-structured interviews. Data interpretation was based on the method of content analysis. SETTING: The maternity units of two university hospitals in Finland. PARTICIPANTS: A convenience sample of 20 women, 10 primiparae and 10 multiparae. The interviews were held 2 or 3 days after childbirth. FINDINGS: The most common fears associated with pregnancy and childbirth were concerned with the baby's well-being, the course of pregnancy, and childbirth. The fears found expression in different kinds of behaviours, emotions and physical sensations. Many of the participants felt that their fears had not been justified, but some maintained that their fears had been justifiable. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: There was much inter-individual variation in the fears associated with pregnancy and childbirth. It is important that diagnosis during pregnancy is undertaken sensitively and that midwifery staff remember that pregnant women may have very serious fears associated with pregnancy and childbirth. The participants in this study felt that fears associated with pregnancy and childbirth also had positive meanings. It may not be essential to try to protect women against these fears or to remove them altogether, but to give every pregnant women the opportunity to deal with her own fears and to obtain the help she needs in her situation.

Adult↗

PubMed1999

Nursing activities and outcomes of care in the assessment, management, and documentation of children's pain.

This study describes how assessment and documentation of children's acute postoperative pain is managed by nurses in university hospitals in Finland. A survey was conducted of 303 nurses working in children's wards of university-affiliated hospitals, and at the same time a retrospective chart review of 50 consecutive cases of operation of acute appendicitis was carried out. Charts were analyzed by content analysis, and the results of the survey are reported with percentage distribution and nonparametric statistical calculations. The results indicate that nurses assess pain mainly by observing the child's behavior and changes in physiology. Pain measurement instruments are rarely used, and nurses do not recognize them. The documentation of pain care is unsystematic and does not support the continuity of care. There is a clear need for development of assessment and documentation practices in the studied hospitals. Future research should look at the postoperative care of pain at home as well as care in non-university-affiliated hospitals.

Adolescent↗

PubMed1999

Nurses' knowledge about pharmacological and nonpharmacological pain management in children.

The purpose of this study was to investigate the knowledge base and practices of Finnish nurses in the area of children in pain. The convenience sample consisted of 265 nurses working on children's wards in university hospitals. Data were collected using an instrument designed for the study. The results showed that there remain gaps in the knowledge base of nurses with regard to both pharmacological and nonpharmacological pain management in children. The education and the area of expertise were significant influences on knowledge scores. Nurses used a fairly wide range of nonpharmacological pain alleviation methods but most of these were such that the nurse was in an active role and the child was passive. There is a clear need for further education. Nurses should take a more active role in seeking new information and also should be encouraged to use nonpharmacological methods that let the children be active participants in their own care.

Adult↗

PubMed1999

Patients' and nurses' assessment of cancer pain.

The purpose of this study was to examine hospitalised cancer patients' and nurses' assessment of patients' cancer pain and to compare them. The data were collected from 51 patient-nurse pairs in two hospitals from oncological and medical clinics. Each nurse and patient took part in the study no more than once. The data were collected with a structured interview and the questionnaire. The intensity of pain was measured with a visual analogue scale (VAS) and the Finnish version of the McGill Pain Questionnaire (FPQ). The results showed that the differences between patients' and nurses' assessments were statistically significant for most intensive pain and for acceptable pain. In both cases nurses' assessments of the intensity of pain were lower than patients' assessments. The nurses identified 40 words in the verbal FPQ that the patients used in describing their experiences of pain. The words used most often by patients were agonizing, tender, wave-like and radiant. The word that the nurses used most often was that of intense. Nurses' knowledge about pain medication in general and morphine in particular was clearly associated with the differences observed in estimates of the intensity of pain. Nurses with poor knowledge underestimated the patients' most intensive experiences of pain. The difference was statistically significant.

Adult↗

PubMed1999

What asthma patients know about their illness and its treatment.

The purpose of this paper is to describe what adult asthma patients in Finland know about asthma and its treatment. The data were collected with a questionnaire specifically developed for this study. The response rate was 86.6% (n = 130). The respondents' knowledge scores were quite high: 34% had good knowledge, 51% had fairly good knowledge, and 15% had satisfactory knowledge of their disease and its treatment. Women knew more about asthma and its treatment than men (p = 0.043). The item on which there was most uncertainty related to whether it is possible to prevent asthma. The most surprising finding was that as many as 30% believed that the only way to reduce asthma symptoms is by effective medication.

Adolescent↗

PubMed1998

Decision-making models in different fields of nursing.

The purpose of this study was to identify the decision-making models used by nurses in different fields of nursing and to find out which variables explain the use of those models. The instrument for the project was developed on the basis of existing decision-making theories and earlier studies on nurses' decision making. The sample consisted of 483 Finnish nurses from five fields of nursing: long-term care, short-term medical-surgical care, critical care, health care, and psychiatric care. The statistical analyses consisted of factor analysis, factor scores, and correspondence analysis. Five different models of nursing decision making were identified. The nature of the nursing task and the nursing context showed associations with decision making on all models. The structure of knowledge and nurses' practical experience did not provide an explanation for nurses' decision making on any model.

Critical Care↗

PubMed1998

Developing the nursing care of breast cancer patients: an action research approach.

This study set out to develop the nursing care of breast cancer patients at the Central University Hospital in Turku, Finland, using the methods of action research and to evaluate the results of the development effort from the point of view of both patients and nursing staff. A theoretical model of the care of cancer patients was constructed on the basis of existing knowledge of how people react in stress and crisis situations or at different stages of a difficult illness. A specific care programme for breast cancer patients was also planned for the hospital's oncology and surgical units. Data were collected using questionnaires. Results indicated that our theoretical model of the care of cancer patients worked reasonably well. They also clearly highlighted the areas in which there is room for further improvement. Patients' experiences of the nursing staff were generally positive and the majority of the nursing staff also regarded the development project as a success.

Adult↗