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Aims and objectives: The aim of this study was to explore the associations between patients' gender, education, health status in relation to assessments of patient-centred quality and individuality in care and trust in nurses for those

Aim and objectives. To examine the association between caregivers’ work satisfaction and individualised care in different care settings for older people. Background. Work satisfaction in older people care settings has been associated with absenteeism, staff turnover and the quality of care delivered. The management of individuality is an important quality of care issue. Although these two issues are important there is little evidence about the possible association between them. Design. An exploratory and correlational survey design. Methods. Data were collected using three questionnaires, the Individualised Care Instrument the Individualised Care Scale-Nurse and the Index of Work Satisfaction from a sample of professional nursing caregivers (n = 263, response rate 71%) in care settings for older people in one health care area in Finland in 2010. Statistical analysis included descriptive statistics, correlations, analysis of variance and multiple regression analysis. Results. Caregivers support the patient’s individuality through specific activities, perceiving that they maintain individuality in care provision whilst reporting moderate work satisfaction. The ratings of individuality assessments were the lowest in nursing homes followed by long-term care in in-patient wards. There were statistically significant correlations between work satisfaction and specific perceptions in the support of individuality. The sub-scales of the instruments used were: the Support of Individuality in general, Individuality in the Care Provided, Knowing the Person, Staff-to-Resident Communication and Staff-to-Staff Communication. Significant statistical differences in the results were found between staff working in home care, primary health care, in-patient wards and nursing homes. Conclusions. Low job satisfaction can affect the provision of individualised care emphasising the need to promote individualised care at an organisational level as a means of improving work satisfaction. Relevance to clinical practice. Instruments to measure work satisfaction and individualised care can be used to improve care quality.

Aims. The aims of this study were to explore nurses’ assessments of individualised care in long-term care wards and to examine how their sociodemographic variables were associated with their views of such care. Background. Although the importance of individualised care is highlighted both by nurses and by older people, there is a limited amount of research about individualised care, especially in the long-term care of older people. Design. An exploratory design was employed. Methods. Data were collected using questionnaires [Individualised Care Scale (ICS)-Nurse] from nurses (n = 283, n = 215, response rate 76%) working in the long-term care wards (n = 19) of four institutions in 2009. Data were analysed statistically. Results. Overall, nurses perceived that they supported patient individuality during nursing activities but the care they provided was not so individualised. Nurses perceived that they supported older peoples’ individuality in the clinical situation and in decisional control over care well but supported older peoples’ individual life situation to a lesser extent. The higher the nurses’ age, the longer the working experience in health care or experience in the current ward, the more positive views they had about the support of individuality. Conclusions. This study identified some shortcomings in the realisation of individuality in the care of older people. Nurses seem to think they generally provide individualised care but this was not necessarily realised in the current evaluations of the care they delivered. Relevance to clinical practice. There is need to identify issues that may help in developing individualised care in clinical practice. Nurses’ attitude to older people in the geriatric care settings needs exploration. Nurses may focus on physiological needs that may hinder the recognition of older patient’s individuality.

Aims and objectives. This study compared the pre-admission education received by two groups of rheumatoid arthritis (RA) patients scheduled for hip arthroplasty. The specific aim was to compare these patients’ knowledge about care-related issues and sense of certainty about that knowledge, empowering learning experience, length of admission discussion, length of hospital stay and number of health problems. Background. Previous studies have shown that surgical pre-admission education is beneficial, but there is no evidence on the relative effectiveness of different methods of education. Design. We used a pre–post-test design with two groups of surgical RA patients (Group I pre-admission education via telephone and standard written educational material, n = 29; Group II standard written educational material, n = 30). Methods. The data were collected with previously used instruments (OPKQ, MEQ), and demographic and clinical variables were asked. Results. The mean score for knowledge about care-related issues and sense of certainty about that knowledge for Group I and for Group II showed no statistically significant differences at baseline and at admission. At discharge, however, a significant difference was seen between the scores – in favour of Group II. On the other hand, patients in Group I were found to be more empowered in all areas than patients in Group II. Conclusions. Written educational material seems to be a good choice for pre-admission patient education compared with telephone counselling, particularly when patients are knowledgeable about care-related issues before admission. However, education via telephone is experienced by patients as more empowering than written educational material. Relevance to clinical practice. To increase patient’s knowledge written educational material can be recommended for use, but to increase patient’s empowerment telephone education is better.

Aim. To compare English, Finnish, Greek and Swedish orthopaedic and trauma patients' perceptions of nursing care received during hospitalisation. Background. Patient perceptions are important when evaluating nursing care delivery. Evaluations usually take place sub-nationally though European citizens may be treated throughout the European Union. International comparative studies are possible because of the universal nature and philosophical roots of quality in nursing care. They are needed to assist in improving care outcomes. Design. A cross-sectional, comparative study design was used. Method. The Schmidt Perception of Nursing Care Survey was used to obtain data from orthopaedic and trauma patients in acute hospitals in four countries: Finland (n = 425, response rate 85%), Greece (n = 315, 86%), Sweden (n = 218, 73%) and UK (n = 135, 85%). Data were first analysed using descriptive statistics, then between-country comparisons were computed inferentially using a one-way analysis of variance and a univariate analysis of covariance. Results. Between-country differences were found in patients' perceptions of the nursing care received. Over the whole Schmidt Perception of Nursing Care Survey the Swedish and Finnish patients gave their care the highest assessments and the Greek patients the lowest. The same trend was seen in each of the four sub-scales: Seeing The Individual Patient, Explaining, Responding and Watching. Responding was given the highest assessments in each participating country and Seeing the Individual Patient the lowest except in Greece. Conclusions. Further research is needed to consider whether the between-country differences found are caused by differences between cultures, nursing practices, roles of healthcare personnel or patients in the different countries. The Schmidt Perception of Nursing Care Survey is suitable for the assessment of European orthopaedic and trauma patients' perceptions of nursing care received during hospitalisation. Relevance to clinical practice. The results are useful in evaluating and developing nursing care in hospitals from different European countries. © 2009 Blackwell Publishing Ltd.

Aim. The study examines whether individual factors of healthcare staff are associated with computer use in psychiatric hospitals. In addition, factors inhibiting staff's optimal use of computers were explored. Background. Computer applications have developed the content of clinical practice and changed patterns of professional working. Healthcare staff need new capacities to work in clinical practice, including the basic computers skills. Computer use amongst healthcare staff has widely been studied in general, but cogent information is still lacking in psychiatric care. Methods. Staff's computer use was assessed using a structured questionnaire (The Staggers Nursing Computer Experience Questionnaire). The study population was healthcare staff working in two psychiatric hospitals in Finland (n = 470, response rate = 59%). The data were analysed with descriptive statistics and manova with main effects and two-way interaction effects of six individual factors. Results. Nurses who had more experience of computer use or of the implementation processes of computer systems were more motivated to use computers than those who had less experience of these issues. Males and administrative personnel who were younger had also participated more often than women in implementation processes of computer systems. The most significant factor inhibiting the use of computers was lack of interest in them. Conclusions. In psychiatric hospitals, more direct attention should focus on staff's capacities to use computers and to increase their understanding of the benefits in clinical care, especially for women and ageing staff working in psychiatric hospitals. Relevance to clinical practice. To avoid exclusion amongst healthcare personnel in information society and to ensure that they have capacities to guide patients on how to use computers or to evaluate the quality of health information on the web, staff's capacities and motivation to use computers in mental health and psychiatric nursing should be ensured.

• This paper reports the findings of a study exploring the provision of individualized care in a regional hospital in Finland. • Individualized care was defined in terms of how patient individuality was taken into account and how patient participation in decision-making was facilitated. • The data were collected from hospitalized patients (n = 203) using a questionnaire specially developed for this study. The response rate was 89%. • A strong support to facilitate patient participation in decision-making was reported. Most shortcomings concerning the provision of individualized care related to consideration of the patient’s cultural background and the involvement of the patient’s family in the planning of care. • Patients’ age and the type of ward were associated with the provision of individualized care: patients aged 65 or over were more satisfied than younger age groups with the way in which their personal life situation had been taken into account. Patients from the gynaecological ward thought, more than patients from the surgical ward, that their situation had been taken into account during hospitalization.

The aim of this study was to investigate, using Rasch model analysis, the measurement invariance of the item ratings of the Individualised Care Scale.Evidence of reliability is needed in cross-cultural comparative studies. To be used in different cultures and languages, the items must function the same way.A methodological and comparative design.Secondary analysis of data, gathered in 2005-2006 from a cross-cultural survey using the Individualised Care Scale from Finnish, Greek, Swedish and English predischarge hospitalised orthopaedic and trauma patients (n = 1093), was used. The Rasch model, which produces calibrations (item locations and rank) and item fit statistics, was computed using the Winstep program.The rank of average Individualised Care Scale item calibrations (-2·26-1·52) followed a generally similar trend (Infit ≤ 1·3), but slight differences in the item rank by country were found and some item misfit was identified within the same items. There was some variation in the order and location of some Individualised Care Scale items for individual countries, but the overall pattern of item calibration was generally corresponding.The Rasch model provided information about the appropriateness, sensitivity and item function in different cultures providing more in-depth information about the psychometric properties of the Individualised Care Scale instrument. Comparison of the four versions of the Individualised Care Scale - patient revealed general correspondence in the item calibration patterns although slight differences in the rank order of the items were found. Some items showed also a slight misfit. Based on these results, the phrasing and targeting of some items should be considered.The Individualised Care Scale - Patient version can be used in cross-cultural studies for the measurement of patients' perceptions of individualised care. Information obtained with the use of the Individualised Care Scale in clinical nursing practice is important, and valid measures are needed in evaluating patients' assessment of individualised care, one indicator of care quality.

Aims and objectives: The aim of this study was to investigate, using Rasch model analysis, the measurement invariance of the item ratings of the Individualised Care Scale. Background. Evidence of reliability is needed in cross-cultural comparative studies. To be used in different cultures and languages, the items must function the same way. Design: A methodological and comparative design. Methods: econdary analysis of data, gathered in 2005-2006 from a cross-cultural survey using the Individualised Care Scale from Finnish, Greek, Swedish and English predischarge hospitalised orthopaedic and trauma patients (n = 1093), was used. The Rasch model, which produces calibrations (item locations and rank) and item fit statistics, was computed using the Winstep program. Results: The rank of average Individualised Care Scale item calibrations (-2·26-1·52) followed a generally similar trend (Infit ≤ 1·3), but slight differences in the item rank by country were found and some item misfit was identified within the same items. There was some variation in the order and location of some Individualised Care Scale items for individual countries, but the overall pattern of item calibration was generally corresponding. Conclusions: The Rasch model provided information about the appropriateness, sensitivity and item function in different cultures providing more in-depth information about the psychometric properties of the Individualised Care Scale instrument. Comparison of the four versions of the Individualised Care Scale - patient revealed general correspondence in the item calibration patterns although slight differences in the rank order of the items were found. Some items showed also a slight misfit. Based on these results, the phrasing and targeting of some items should be considered. Relevance to clinical practice. The Individualised Care Scale - Patient version can be used in cross-cultural studies for the measurement of patients' perceptions of individualised care. Information obtained with the use of the Individualised Care Scale in clinical nursing practice is important, and valid measures are needed in evaluating patients' assessment of individualised care, one indicator of care quality.

To examine the association between caregivers' work satisfaction and individualised care in different care settings for older people.Work satisfaction in older people care settings has been associated with absenteeism, staff turnover and the quality of care delivered. The management of individuality is an important quality of care issue. Although these two issues are important there is little evidence about the possible association between them.An exploratory and correlational survey design.Data were collected using three questionnaires, the Individualised Care Instrument the Individualised Care Scale-Nurse and the Index of Work Satisfaction from a sample of professional nursing caregivers (n=263, response rate 71%) in care settings for older people in one health care area in Finland in 2010. Statistical analysis included descriptive statistics, correlations, analysis of variance and multiple regression analysis.Caregivers support the patient's individuality through specific activities, perceiving that they maintain individuality in care provision whilst reporting moderate work satisfaction. The ratings of individuality assessments were the lowest in nursing homes followed by long-term care in in-patient wards. There were statistically significant correlations between work satisfaction and specific perceptions in the support of individuality. The sub-scales of the instruments used were: the Support of Individuality in general, Individuality in the Care Provided, Knowing the Person, Staff-to-Resident Communication and Staff-to-Staff Communication. Significant statistical differences in the results were found between staff working in home care, primary health care, in-patient wards and nursing homes.Low job satisfaction can affect the provision of individualised care emphasising the need to promote individualised care at an organisational level as a means of improving work satisfaction.Instruments to measure work satisfaction and individualised care can be used to improve care quality.

The aims of this study were to explore nurses' assessments of individualised care in long-term care wards and to examine how their sociodemographic variables were associated with their views of such care.Although the importance of individualised care is highlighted both by nurses and by older people, there is a limited amount of research about individualised care, especially in the long-term care of older people.An exploratory design was employed.Data were collected using questionnaires [Individualised Care Scale (ICS)-Nurse] from nurses (n = 283, n = 215, response rate 76%) working in the long-term care wards (n = 19) of four institutions in 2009. Data were analysed statistically.Overall, nurses perceived that they supported patient individuality during nursing activities but the care they provided was not so individualised. Nurses perceived that they supported older peoples' individuality in the clinical situation and in decisional control over care well but supported older peoples' individual life situation to a lesser extent. The higher the nurses' age, the longer the working experience in health care or experience in the current ward, the more positive views they had about the support of individuality.This study identified some shortcomings in the realisation of individuality in the care of older people. Nurses seem to think they generally provide individualised care but this was not necessarily realised in the current evaluations of the care they delivered.There is need to identify issues that may help in developing individualised care in clinical practice. Nurses' attitude to older people in the geriatric care settings needs exploration. Nurses may focus on physiological needs that may hinder the recognition of older patient's individuality.

This study compared the pre-admission education received by two groups of rheumatoid arthritis (RA) patients scheduled for hip arthroplasty. The specific aim was to compare these patients' knowledge about care-related issues and sense of certainty about that knowledge, empowering learning experience, length of admission discussion, length of hospital stay and number of health problems.Previous studies have shown that surgical pre-admission education is beneficial, but there is no evidence on the relative effectiveness of different methods of education.We used a pre-post-test design with two groups of surgical RA patients (Group I pre-admission education via telephone and standard written educational material, n = 29; Group II standard written educational material, n = 30).The data were collected with previously used instruments (OPKQ, MEQ), and demographic and clinical variables were asked.The mean score for knowledge about care-related issues and sense of certainty about that knowledge for Group I and for Group II showed no statistically significant differences at baseline and at admission. At discharge, however, a significant difference was seen between the scores--in favour of Group II. On the other hand, patients in Group I were found to be more empowered in all areas than patients in Group II.Written educational material seems to be a good choice for pre-admission patient education compared with telephone counselling, particularly when patients are knowledgeable about care-related issues before admission. However, education via telephone is experienced by patients as more empowering than written educational material.To increase patient's knowledge written educational material can be recommended for use, but to increase patient's empowerment telephone education is better.

Aim. To study relatives’ views on how the integrity of older patients is maintained in long-term institutions in Finland. Background. Maintaining patient integrity is considered a key prerequisite for good quality care and treatment and a characteristic of ethical care. Institutionalization, dependence on others and vulnerability may all threaten the integrity of the older patient and, in this sense, pose ethical problems. Design/methods. The data for this descriptive and explorative survey were collected by questionnaires from 213 relatives of older patients in four long-term institutions in Finland. The response rate was 78%. Data were analysed using statistical methods. Results. Relatives rated the maintenance of patient integrity quite highly. The highest ratings were recorded for the maintenance of physical integrity and the lowest to the maintenance of psychological integrity. The main source of problems were patients’ and/or relatives’ wishes concerning elimination. There were also shortcomings in the provision of intimacy. Relatives who thought that admission to the long-term institution had been problematic, either for the patient or for themselves, felt that patient integrity was poorly maintained. Conclusion. The findings highlight the importance of nurses’ efforts in long-term care facilities to preserve the integrity of patients and to maintain close contact and cooperation with relatives. Although relatives generally were quite pleased with how patient integrity was maintained, the results also provide evidence on problems that may threaten patient integrity. Relevance to clinical practice. Greater emphasis should be placed on the need for cooperation between older patients, their relatives and nursing staff, especially before admission to long-term care. Furthermore, increased efforts are needed in maintaining the integrity of older patients and in reducing ethically problematic situations.