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Biomedical subjects

Tarja Suominen

Publications and source records attributed to Tarja Suominen.

17 recordsLinked to original sources

Nursing intensity and patient classification at an adult intensive care unit (ICU).

BACKGROUND: ICUs have been using patient information systems for several years now and a huge amount of data is recorded every day. Still nursing research has only limited evidence on how the data recorded in these systems are used. Two of the items systematically recorded in Finnish patient information systems are patient classification and nursing intensity. The aim of this pilot study was to: Use the systematically recorded data of one intensive care unit and discover which variables correlate with or have a statistical relationship to patient classification and nursing intensity. METHODS: The study uses a descriptive statistical approach and the material has been investigated, retrospectively. The material consisted of information system data on 1737 patients at one Finnish intensive care unit in 2003. FINDINGS: Altogether 15,866 patient classifications were made during 1 year. A statistically moderate dependence and a strong correlation (r=0.40) were found between nursing intensity, patient's age, sex and type of intensive care in the case of female emergency non-operative patients and between nursing intensity. That is, the older the female emergency non-operative patient, the higher the assessment of nursing intensity was. Also the correlation between Therapeutic Intervention Scoring System (TISS) scores and nursing intensity was found to be statistically strong (r=0.57). Despite the strong correlation the average TISS score in this study can only account for 32% of the patient's average nursing intensity during the period of treatment.

APACHE↗

Work-related empowerment of the multidisciplinary team at the Rheumatism Foundation Hospital.

Carried out as part of a staff development project, this study describes the experiences of work-related empowerment within a multidisciplinary team at the Rheumatism Foundation Hospital in Finland. The data were collected using a structured questionnaire consisting of background variables and questions concerning verbal, behavioural and outcome empowerment. The questionnaire was sent to all members of the multidisciplinary team at the Rheumatism Foundation Hospital, with the exception of physicians, departmental secretaries and administrative personnel. The response rate was 58%. The data were examined using statistical methods. The multidisciplinary team felt quite strong verbal and behavioural empowerment, but was less confident in terms of outcome empowerment. Several factors were found to be associated with the different fields of empowerment. In conclusion, the multidisciplinary team felt quite strong work-related empowerment.

Adult↗

Nursing advocacy: how is it defined by patients and nurses, what does it involve and how is it experienced?

UNLABELLED: THE STUDY'S RATIONALE: Advocacy is an integral part of nursing. However, there is a scarcity of empirical evidence on nursing advocacy process and most of that evidence concerns nurses' views on the care of certain vulnerable patient groups in acute care settings. Before nursing practice can truly adopt advocacy as an inherent and natural part of nursing, a clearer understanding is needed of how it is defined and what activities are needed to accomplish advocacy. AIMS AND OBJECTIVES: The aim was to describe the way that nursing advocacy is defined, the activities through which nursing advocacy is accomplished and the way that nursing advocacy is experienced by patients and nurses. METHODOLOGICAL DESIGN AND JUSTIFICATION: Based on a qualitative approach, the study was limited to adult patients experiencing procedural pain in somatic care. Interviews were conducted in a convenience sample of patients (n = 22) and nurses (n = 21) from four medical and four surgical wards in Finland. A qualitative content analysis of the tape-recorded data was then carried out. ETHICAL ISSUES AND APPROVAL: The appropriate ethical principles were followed. All the participants gave their informed consent and formal approval for conducting the research was obtained according to national and local directives. RESULTS: Nursing advocacy seems to integrate aspects of individuality, professionalism and experiences of empowering, exceptional care. It is not a single event, but a process of analysing, counselling, responding, shielding and whistleblowing activities in clinical nursing practice. CONCLUSIONS: In nursing practice the abstract concept of nursing advocacy finds expression in voicing responsiveness, which integrates an acknowledged professional responsibility for and active involvement in supporting patients' needs and wishes.

Adult↗

Nursing intensity and patient classification in a patient information system.

Patient information systems have been available and implemented in many intensive care units for several years and still nursing research has little evidence from the use of the recorded data. One of the focus areas in Finnish nursing research is the use of information technology in evidence based nursing. The nursing intensity and patient classification assessments are important part of intensive care units data in Finnish patient information systems. Our main goal was to conduct a pilot study concerning nursing intensity and patient classification together with patient records to find out if this will provide more information on the nursing intensity.

Critical Care↗

Work empowerment as experienced by head nurses.

BACKGROUND: Head nurses have in the past few decades gained both more power and more responsibilities in their job. Their experience of work empowerment is not known. AIM: The aim of this study was to describe the verbal, behavioural and outcome empowerment experienced by head nurses. METHODS: Data were collected using a structured questionnaire, which was sent to 259 head nurses. The data were analysed using statistical methods. RESULTS: The results suggest that head nurses experience quite strong verbal and behavioural empowerment. They feel less confident in terms of outcome empowerment. Various factors, including stress and the capacity to handle the head nurse's job, were found to correlate with the empowerment experience. CONCLUSION: It seems that head nurses do not have enough power to influence the effectiveness of their organization.

Adult↗

Biological and physiological knowledge and skills of graduating Finnish nursing students to practice in intensive care.

This study describes the basic biological and physiological knowledge and skills of graduating nurse students in Finland against the requirement of their being able to practice safely and effectively in intensive care. The study describes also their interest and willingness to work in intensive care. Measurements were based on the Basic Knowledge Assessment Tool (BKAT-5) developed by Toth in the United States. The sample consisted of 130 nursing students graduating in December 2001 and January 2002. The data were analysed statistically. The students were most knowledgeable in the areas of appropriate precautions, living will and medical calculation, followed by neurology and endocrinology. Scores were poorest for pulmonary, gastrointestinal and cardiovascular knowledge. Intensive care studies and the desire to work in intensive care correlated significantly with the respondents' basic intensive care knowledge. It is important for nursing education to concentrate on developing those areas of intensive care studies where the performance of students is weakest.

Adult↗

The development of moral judgment during nursing education in Finland.

This study describes moral judgment among first- and last-year nursing students in Finland and examines the effects of ethics teaching on the development of moral judgment. The data for this quantitative cross-sectional study were collected using the Defining Issues Test (DIT), which is based on Kohlberg's theory of moral reasoning stages. The questionnaires were sent to four polytechnics, which offer nursing education in southern Finland. A total of 52 first-year students and 54 last-year students participated. The results showed that students who had had to deal with ethical dilemmas in their practical training had higher moral judgment than students who did not. Last-year students had higher moral judgment than first-year students. Last-year students resorted to principle-based thinking more often than first-year students in resolving DIT dilemmas. The differences between the two groups were statistically significant. The results indicate that nursing education may has an effect upon students' moral judgment.

Adult↗

How delivery ward staff exercise power over women in communication.

BACKGROUND: Power is a central element in all social interactions. In order to act appropriately in different care situations, it is important to understand the meaning of power. AIM: This paper reports a study whose aim was to describe delivery ward staff opinions about the exercise of power over women in communications. METHODS: Data were collected in 2000 using a questionnaire developed for the study with a convenience sample of 155 midwifery and nursing professionals in delivery wards in four Finnish hospitals. RESULTS: The results showed that in respondents' opinions they worked for women's good and aimed at relationships based on a sense of equality and individuality. Negative power was used in situations where women's well-being was threatened. The power used was verbal or non-verbal. CONCLUSIONS: The exercise of power is not only negative in nature. There are times, such as in life-threatening situations, when it is crucial that the professional takes control and makes decisions immediately, and in that sense exercises power.

Adult↗

Recovery of Finnish short-stay surgery patients.

In order to counsel the surgical patient, the nurse needs to have a clear picture of home recovery based on the patient's biophysiologic health problems. The purpose of this study was to examine short-stay surgery patients' experiences of pain, nausea, vomiting, fatigue, and problems with elimination and wound healing during a 1-week recovery phase at home.

Ambulatory Surgical Procedures↗

Autonomy among intensive care nurses in Finland.

The purpose of this study was to describe Finnish ICU nurses' (n=172) experiences of autonomy in their work. The research was carried out as part of a project concerned with empowerment in intensive care nursing. Viewed from a psychological perspective, empowerment is understood as referring to the ability to make goal-directed decisions and to take action towards meeting the goals set out. Autonomy, then, is seen as part of empowerment. The data were collected with a structured questionnaire specially designed for this study. The random sample was drawn from 31 Finnish adult intensive care units. The respondents were registered nurses working in eight adult intensive care units. The data were analysed using statistical methods. Autonomy was defined as being composed of three bases: knowledge base (independence, right and responsibility in decision-making), action base (independence, right and responsibility in actions) and value base (independence, right and responsibility in values). The majority of the respondents felt they had more autonomy in decision-making and actions concerning patient care than in decision-making and actions concerning the intensive care unit as a whole. Autonomy usually increased with work experience. Work will be continued to study the autonomy of nurses in different health care organisations in Finland.

Adult↗

Men's experiences and their resources from cancer diagnosis to recovery.

This study describes the experiences and resources of male cancer patients in Finland during the trajectory of their illness. A semi-structured interview schedule was used to collect data on falling ill with cancer, on periods of treatment (surgery, chemotherapy, radiation therapy), and on convalescence. The participants (n=8), aged 42-64 (mean=53) were interviewed in a clinic setting in connection with a check-up visit. The interviews were tape-recorded and transcribed for qualitative content analysis. The male cancer patients described their experiences through the illness trajectory in terms of suspicions, their encounter with cancer, and the cancer becoming a reality. During treatment, men described their experiences in terms of changes in body image, individual illness experiences, and new social roles. Men's experiences during the convalescence period included physical restoration, anxiety following treatment regimes, reflection, and social roles at transition. The results also indicated that men did not consider their status as a chronic one, but rather as a passing and relatively short stage in their life. Both intra- and extrapersonal resources were described: the former included body image and capacity, self-understanding, social situation, and psychological resources; and the latter wives, children, colleagues, health-care personnel, fellow patients, health-care interventions and society. Extrapersonal resources included informational, emotional, and evaluative support, as well as concrete help.

Adult↗

Do nurses exercise power in basic care situations?

Power is a matter of authority and control. It can be wielded either consciously or unconsciously, and it can be either overt or latent. Using a structured questionnaire, this study set out to describe nurses' opinions about the exercise of power in basic care situations in both acute and long-term care. The questionnaire was organized into four categories in which items concerned: power in obligatory daily activities; power in activities necessitated by obligatory activities; power in voluntary activities; and power in activities that take into account the patient's characteristics. The samples consisted of 228 nurses from five medical and surgical wards of district hospitals, and 233 nurses from five geriatric units of a community health centre and from one nursing home in Finland. The final response rate was 65% (acute care 76%; long-term care 55%). Data analysis was based on statistical methods. The results showed that, in the nurses' own opinion, negative power is exercised only in certain situations and in the patient's best interest, when for instance there are concerns that something may happen to the patient.

Adult↗

What does information about referrals reveal about the service network?

OBJECTIVE: To identify the most important referring parties in the Finnish health care system. DESIGN: A record linkage study based on nationwide administrative registers. SETTING: The hospital discharge register during 1996 to 2000. SUBJECTS: The total Finnish population and the population of four hospital districts. MAIN OUTCOME MEASURES: Discharges of individuals by the most important referring parties. RESULTS: The five most important referring parties in order of magnitude are as follows: health centre, no referral, clinic/unit of the same hospital, hospital other than a health centre, and private health care. The five most important referring parties for those aged over 75 are the same mentioned above. There were regional differences in referral practices. CONCLUSIONS: Differences or changes in referral profiles as a function of time cannot be taken as a direct measure of the impact of possible interventions or as an indication of an actual difference between the areas compared. One should also always be aware about any related meta-knowledge.

Continuity of Patient Care↗

Early adolescents' HIV-related knowledge, attitudes and behaviour in Finland.

Finland had a relatively low rate of HIV infection during the first 17 years of the epidemic, which began in 1980. Similar to other developed countries around the world, information about the infection has been readily available, and this helped to reduce the occurrence of HIV contagion, particularly among adolescents, a group that is responsible for 50% of HIV infections worldwide. This small-scale study investigated HIV-related knowledge, attitudes, and behaviour among a group of 171 youths ageed 13-16 years in suburban schools in southern Finland. Knowledge levels were relatively low and the disease was somewhat stigmatized, but homosexuality was less stigmatized than in other developed countries. The results suggest that Finnish adolescents need to be better informed about HIV and AIDS. Schools and school nurses could play a crucial role in providing information about this incurable disease.

Adolescent↗

Critical pathways. A systematic review.

Critical pathways are care plans that detail the essential steps in patient care with a view to describing the expected progress of the patient. The authors' review of the literature suggest the use of critical pathways reduces the cost of care and the length of patient stay in hospital. They also have a positive impact on outcomes, such as increased quality of care and patient satisfaction, improved continuity of information, and patient education.

Benchmarking↗

Organizational ethics in Finnish intensive care units: staff perceptions.

The purpose of this study was to describe ethical problems that are influenced by organizational factors in Finnish intensive care units (ICUs). The goal was to help nurses and administrators to analyse intensive care work, and to improve nurses' work motivation. Through these means the ultimate goal is to improve the quality of patient care. Data were collected in 35 hospital ICUs by means of the Ethics Environmental Questionnaire (EEQ). This gained access to the population of 1047 Finnish intensive care nurses. The response rate was 77% (n = 814). Data analysis was carried out using SAS-6 statistical software. The results provided scores for the 20 EEQ items. Reliability according to Cronbach's alpha was 0.87. The results revealed that organizational factors in Finnish ICUs have both positive and negative dimensions. Positively, nurses have the opportunity to discuss ethical problems in their work units, whereas, negatively, respondents noted that there is much concern about earning money. Nurses' work in Finnish hospital ICUs is ethically challenging; it is similar to that found in other countries and thereby supports international application of these findings.

Adult↗

HIV/AIDS and its impact on student nurses.

This article describes components surrounding British nursing students' (n=138) knowledge base, attitudes towards HIV/AIDS, homophobia level, willingness to care for individuals with HIV/AIDS and attitudes to sexual risk behaviours. The data were collected by questionnaire and analysed by statistical methods. Out of the 33 knowledge questions, the mean value of correct answers was 22.2 (Min 13, Max 29, SD 3.27). Students who had taken care of people with AIDS and who were willing to take care of these people showed more positive attitudes to the disease and people with AIDS. Older age and reluctance to care for a person with AIDS were associated with a high level of homophobic attitudes. Students demonstrated a positive approach to carrying out general nursing tasks for a person with HIV/AIDS. Having been asked to care or having cared for a patient with HIV/AIDS, and being single were associated with a higher level of willingness to care for these patients. Female sex, older age and having children were associated with more cautious attitudes to sexual risk behaviours. The results underline the importance of providing education about HIV/AIDS and supporting student nurses who are afraid they might contract the disease in nursing tasks.

Adolescent↗