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Scand J Caring Sci; 2010; 24; 638-647 Intimate partner violence (IPV) is seen as a serious health risk factor for women with significant acute and long-term health consequences and it affects women from all ethnic and socioeconomic groups. Knowledge of these consequences of IPV may help emergency department (ED) professionals to identify these women and provide them with appropriate care, including information on a variety of community services, and refer those women to such services if necessary. The study aimed to describe the frequency of ED visits by women exposed to physical intimate partner violence as estimated by ED professionals (nurses, practical nurses, emergency medical technicians) and identification of acute IPV. In this study 'partner' is defined as a woman's husband, former husband, current or former cohabitant or partner. This design was used as part of a larger, descriptive, cross-sectional multi-centre and multi-method study. Data were collected from 28 EDs in 13 Finnish hospital districts. Altogether 488 questionnaires were returned, which yielded a response rate of 51%. The data were analysed using descriptive statistics and quantitative content analysis. Findings showed that 48% (n = 231) of the ED professionals reported that they encountered women in IPV relationships at least once a month. Over one-fifth of the ED professionals reported having repeatedly encountered the same women visiting the ED for IPV related injuries. Over half of the participants reported having problems 'often' or 'now and then' when identifying women exposed to IPV. Those with training on IPV estimated that they had identified women exposed to IPV more often. To conclude, the research suggests that improvement of identification of acute IPV requires that training be arranged and jointly agreed written procedures for handling IPV be introduced. [ABSTRACT FROM AUTHOR]

Scand J Caring Sci; 2010; 24; 734-745 During hospitalization patients need support from nursing staff. To improve the delivery of support during hospitalization, it is necessary to know more about how patient background factors and organizational factors are associated with patients` perceived access to support. This study describes hospital patients' perceived access to emotional and informational support from nursing staff. A further concern is with the associations of patient background factors (e.g. age, education, mode of admission) and various organizational factors (e.g. nurse to bed ratio, skill mix) with support. A quantitative research approach was applied. The data were collected from patients (n = 731) at a Finnish university hospital using a specially developed scale. The sample of hospital patients was drawn from the population by stratified random sampling. In addition, data were retrieved from the hospital's electronic database. During their stay in hospital, patients felt they received more emotional than informational support. Outpatients and elective inpatients reported receiving more support than inpatients and emergency patients. Having a named nurse was also positively associated with access to support. Staffing levels showed a positive association with patient access to support. On the other hand, the availability of support deteriorated when the number of emergency inpatients and the unit workload increased. Steps are needed to improve the provision of informational support to nursing care patients and to assess the methods of support provision. Patient support can also be improved by adopting the named nurse system. There is a significant association between organizational factors and patient access to support, which warrants further investigation. [ABSTRACT FROM AUTHOR]

Introduction: Low income correlates with increased health risks. The well-being of low-income families has received only limited attention in nursing research and most of the work has focused on unearthing their problems rather than on identifying their strengths. This article describes the well-being of mothers with children in Finnish low-income families, from a family health point of view.Aims: The aim of this study was to generate description of the well-being of mothers with children in lowincome families in their everyday life and interpret and understand it from the perspectives of low-incomes mothers.Methods: This study is based on the phenomenological method and the informants consisted of 15 mothers of low-income families with children. The data were collected in 2004--2005. The mothers were recruited from three municipalities by means of purposive sampling from amongst families in receipt of income support. Ethical approval was obtained.Findings: Well-being appears as a complex and multifaceted phenomenon which, in addition to health, is understood as the opposite of illness and experienced health involves dimensions related to the family's everyday life and situation. Mothers' well-being is described in terms of the flow of everyday life, meaningful family activities, everyday health, the existence of a network of significant others, internal family functioning, the strength received from motherhood and being in the position to influence the well-being of one's family.Conclusions: The results suggest that for purposes of supporting family well-being on the family's own terms, it is important to have a clear understanding of the everyday life of families in different situations and understand the meanings that grow out of their everyday life. This information helps nurses to take into account the social aspect of family health and understand low-income mothers' point of health, in different health situations in nursing practice where they meet one another. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Cooperation between pupils' parents and school nurses is an important part of health promotion in primary schools. Developing frank and trusting relationships contributes to easy and uninhibited cooperation. Cooperation between parents and school nurses has not been widely researched internationally. AIMS: This article reports on parents' views on cooperation with school nurses in primary schools. The study aims at contributing to school nurses' work so that instead of focusing only on the children, family nursing approaches could be improved. METHODS: Nineteen parents from 13 families from southern Finland were interviewed for the study in 2004. The data were analysed by grounded theory and the constant comparative method was utilized. FINDINGS: Six concepts describing parents' views on cooperation were generated on the basis of the data. Cooperation consists of supporting the child's well-being. School nurses take children's and parents' concerns seriously and intervene effectively if the child's health is threatened. School nurses' expertise is not very visible within school communities. Hoping to receive information and desiring parental involvement are important concepts of cooperation with the school nurse. The child's family is not sufficiently known or taken holistically into consideration when the child's health is promoted. Parents are the initiators of cooperation within school health care and parents describe this by the concept of one-sided communication. CONCLUSIONS: Parents do not know about school nurses' work and school health services. They would like to be more involved in school nursing activities. When developing children's health services, parents' expertise in their children's well-being should be paid more attention. This study enhances the knowledge of family nursing by describing Finnish parents' perceptions of cooperation with school nurses. The findings facilitate the understanding of cooperation in school health services. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Background: Knowledge of the experiences of coping in patients with incurable cancer is essential for high-quality palliative and end-of-life care., Aim and Objective: To describe the coping experiences of patients with incurable cancer in hospice care to better develop patient-centred care., Methods: The data for this qualitative study were collected through semi structured interviews, with patients with incurable cancer in hospice care (N = 20) and analysed with inductive content analysis. Ethical and organisational approvals were obtained, and the participants received both verbal and written information before consenting to participate., Results: The patients' coping was enhanced with their involvement in treatment-related decisions. Valuing day-to-day living and coping with emotional stressors helped them accept their own life situations. Accepting their increasing fragility was enhanced by their self-reappraisal. The patients found security in the possibility of receiving support when they needed it. Although the ordinariness of dying in hospice care settings was sometimes too much to bear, they understood dying to be a part of the natural cycle of life. They questioned the responsiveness of healthcare services because they felt that they were not always heard., Study Limitations: Because this study was limited to a specific population of cancer patients in hospice care, the results might not be generalised to other patient groups with chronic diseases or other palliative care settings., Conclusions: The experiences of patients in hospice care of coping with incurable cancer were reminiscent of the common coping process descriptions. Surprisingly, even though participants voiced that they had accepted their situation, dying itself was something they did not find crucial to discuss. The crucial aspects - without being in denial - dealt more with focusing on positive thinking and facing life., (© 2023 The Authors. Scandinavian Journal of Caring Sciences published by John Wiley & Sons Ltd on behalf of Nordic College of Caring Science.)

Objective: This study evaluates how extended childbirth education intervention affects first-time mothers' fear of childbirth and its manifestation during pregnancy., Method: A randomised controlled trial was conducted. A total of 659 first-time mothers were recruited before week 14 of gestation during the first ultrasound screening at the hospital's maternity outpatient clinic. The mothers were randomly assigned into an intervention group (n = 338) or a control group (n = 321). The control group received all available regular childbirth education. In addition, the intervention group received an enhanced 2-hour childbirth education at the maternity hospital., Outcome Measurements and Statistical Analysis: The objects of childbirth fears (childbirth-related fear, fear for the mother's and the child's well-being, fear related to Caesarean section) were the primary outcomes. The manifestations of childbirth fears (everyday life, stress symptoms and the wish to have a Caesarean section) were the secondary outcomes. These outcomes were measured over 34 weeks of gestation using two parts of the instrument 'Feelings of Fear and Security Associated with Pregnancy and Childbirth'. Logistic and ordinal linear regression models were used to model the effect of the intervention on the outcomes., Findings: The mothers in the intervention group had less childbirth-related fear than those in the control group [odds ratio (OR) 0.58, 95% confidence level (CL) 0.38-0.88]. Also, fear influenced the mothers in the intervention group less in everyday life than it did the mothers in the control group [OR 0.64, 95% CL 0.44-0.94]., Conclusion: The effectiveness of the intervention can be considered moderate: one of three objects and one of three manifestations of fears were reduced. The intervention proved most efficient in alleviating relatively limited objects of fears., (© 2016 Nordic College of Caring Science.)

Background: Parental empowerment is known to increase parents' resources and to reduce stress, and therefore to improve family well-being. Professionals working in family services (child health clinics, school health care, day care, preschool and primary school) encounter families in various everyday settings and can significantly support parental empowerment., Aim: This study aimed (i) to identify associations between parental empowerment and demographic and family service characteristics (i.e. parents' participation and perceived influence, decision-making and access to information) and (ii) to identify predictors of maternal and paternal empowerment., Method: Study design was cross-sectional. Participants were mothers (n = 571) and fathers (n = 384) of children aged 0-9 who were selected by stratified random sampling in 2009. Associations were analysed by t-test, one-way analysis of variance and multiple linear regression analysis., Results: Sufficient perceived influence and joint decision-making by family and professionals on family service appointments emerged as significant variables of increased parental empowerment. Access to adequate information about municipal services was also associated with high empowerment. These family service characteristics were associated with parents' sense that they were able to manage in everyday life and had influence on specific service situations and family services in general. Mothers with a child aged under 3 or a child in home care or primary school, and fathers with a lower education feel less empowered in family services than other parents., Conclusion: Knowledge about the factors associated with parental empowerment can contribute to further reinforce parental empowerment, help identify parents who need special attention and contribute to the development of family services., (© 2015 Nordic College of Caring Science.)

Nurses are an important source of support for patients and family members during hospitalization. It is unclear, however, what kinds of support methods are used in hospitals and how the support affects the patient and family member(s). This study describes methods of nursing support in hospital and adult patients' and their family members' experiences of this support. The data were collected in spring 2009 through essays written by and group interviews with nurses (n = 11) working at a Finnish university hospital. The data from patients (n = 9) and family members (n = 7) were collected in individual and group interviews. The material was interpreted by inductive content analysis. In their interaction with patients and family members, the hospital nurses used the methods of emotional and informational support. Patients' and family members' experiences of the effectiveness of this support were related to the establishment of a care relationship, their future outlook, mental well-being and experiences of getting well. The evidence from this research will be useful in developing methods of nursing support for patients and family members and family-oriented care in hospital., (© 2013 Nordic College of Caring Science.)

Background: The foundation of the health and well-being of a child in primary school age is the family. To promote the child's comprehensive health, we must develop the cooperation between the family and the primary school nurse., Aim: The aim of the study was to develop a family nursing oriented substantive theory of cooperation between primary school nurses and families., Method: The study used grounded theory based on Straussian principles. Data were collected from sixth-graders (N = 22) using group discussions. Interviews were conducted with parents (N = 19), and the views of school nurses (N = 20) on their cooperation with families were obtained via free form essays., Findings: The core concept of the theory describing cooperation between primary school nurses and families is problem-based communication. As a result of the analysis, nine-2-dimensional concepts were formed to describe this cooperation. The theory is structured further by four dimensions, which contain concepts explaining them and which also describe the relationships between the different concepts. These dimensions are the meeting between the school nurse and the family, mutual exchange of information, attending to the child's health monitoring and being at school for the child and family. The substantive theory describing cooperation between the primary school nurse and family entails the concepts formed in the analysis, their interrelationships, as well as, the core concept., Conclusions: Primary school nurses can apply the resulting theory while working with families and while developing this cooperation. This theory can also be implemented in developing nursing education., (© 2012 The Authors. Scandinavian Journal of Caring Sciences © 2012 Nordic College of Caring Science.)