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BACKGROUND: Work done in the emergency departments is one stressful aspect of physicians' work. Numerous previous studies have highlighted the stressfulness of on-call work and especially of night on call. In addition, previous studies suggest that there may be individual differences in adjusting to changes in circadian rhythms and on-call work. OBJECTIVE: The objective of this study was to examine whether physicians' on-call work is associated with perceived work-related stress factors and job resources and whether there are groups that are more vulnerable to on-call work according to sex, age, and specialization status. METHODS: This was a cross-sectional questionnaire study among 3230 Finnish physicians (61.5% women). The analyses were conducted using analyses of covariance adjusted for sex, age, specialization status, and employment sector. RESULTS: Physicians with on-call duties had more time pressure and stress related to team work and patient information systems compared with those who did not have on-call duties. In addition, they had less job control opportunities and experienced organization as less fair and team climate as worse. Older physicians and specialists seemed to be especially vulnerable to on-call work regarding stress factors, whereas younger and specialist trainees seemed vulnerable to on-call work regarding job resources. CONCLUSIONS: Focusing on team issues and resources is important for younger physicians and trainees having on-call duties, whereas for older and specialists, attention should be focused on actual work load and time pressure. [ABSTRACT FROM AUTHOR]

Abstract: Background: Elderly care systems have undergone a lot of changes in many European countries, including Finland. Most notably, the number of private for-profit firms has increased. Previous studies suggest that employee well-being and the quality of care might differ according to the ownership type. Objective: The present study examined whether the ownership type and the staffing level were associated with organisational commitment, job involvement, and job satisfaction. In addition, we examined the potential moderating effect of organisational justice on these associations. Design: Cross-sectional questionnaire study. Participants and setting: 1047 Finnish female staff members aged 18–69 years working in sheltered housing or nursing homes (units n =179). Methods: The relationships were studied with analyses of covariance (ANCOVA), adjusting for the effects of age and case-mix. Results: Organisational commitment and job satisfaction levels were low in for-profit sheltered homes when justice levels were low, but when justice levels were high, for-profit sheltered homes did not differ from other ownership types. Similarly, organisational justice acted as a buffer against low commitment resulting from low staffing levels. Staffing levels were lowest in public sheltered homes and highest in not-for-profit sheltered homes. Conclusion: The results show that organisational justice can act as a buffer against low organisational commitment that results from low staffing levels and working in for-profit sheltered homes. Increasing justice in regard to the management, outcomes, and procedures in the organisation would thus be important. [Copyright &y& Elsevier]

Abstract: Background: The use of fixed-term employment has increased lately, particularly in Europe and in the health care sector. Previous studies have shown that especially among the health care sector employee''s organizational justice perceptions and job control are important factors that are directly related to the welfare and attitudes of employees and may also help to buffer the negative impacts of many detrimental factors. Objective: The present study examined the association of employment type (fixed-term vs. permanent) with work interference with family (WIF) and sleeping problems. In addition, we examined whether organizational justice and job control were able to moderate above-mentioned associations. Design: Cross-sectional study design. Setting: A random sample of registered nurses in Finland from the Central Register of Health Care Professionals. Participants: 1767 Finnish registered nurses (1676 women and 91 men) aged 23–60 years (mean=42.6, SD=10.0) formed a final study sample. Methods: The relationships were studied by linear regression analyses and the effects of gender, age, marital status, employment sector, work shift, number of children, and overtime work hours were adjusted for. Results: Our results showed that organizational justice moderated the association between employment type and WIF. That is, those employees who were employed in fixed-term contracts and experienced low levels of organizational justice had higher levels of WIF than others. Employment type was not directly associated with WIF or sleeping problems. High justice levels were directly associated with less WIF and less sleeping problems, and high job control levels with less sleeping problems. Conclusion: According to our results it would be important to promote fair organizational procedures and management in the health care sector especially for those who are employed with fixed-term contracts and in organizations with a lot of fixed-term employees. [Copyright &y& Elsevier]

Abstract: Objective: The aim of this longitudinal study was to examine (a) the causal effect of unemployment 1990–1997 on health 1998–2001 (in-patient periods) and (b) the selection effect of health 1996–1999 on unemployment 2000–2002. We examined the effects of different diagnoses, namely, all causes, circulatory diseases, diseases of the digestive system, musculoskeletal diseases, and mental disorders. Methods: The data from the Central Register of Health Care Professionals of persons born 1945–1970 were linked to data from employment statistics and Finnish Hospital Discharge Register including 78,195 women and 12,455 men aged 31 to 56 in 2001. The associations were analyzed with logistic regression analyses and expressed as odds ratios (OR) and their 95% confidence intervals (CI). Results: After adjustments, existence of unemployment periods was associated with lower odds for in-patient periods due to musculoskeletal diseases for both women (OR=0.82, 95% CI=0.76–0.89) and men (OR=0.74, 95% CI=0.60–0.89). Unemployment periods were more likely among women (OR=1.65, 95% CI=1.33–2.04) and men (OR=2.54, 95% CI=1.44–4.48) having had in-patient periods due to mental diseases and among women also due to diseases of the digestive system (OR=1.17, 95% CI=1.04–1.31). Conclusion: The present study found evidence for selection to unemployment according to mental diseases and diseases of the digestive system among health care professionals. In addition, our results show that unemployment periods may protect health care workers from musculoskeletal diseases. [Copyright &y& Elsevier]

Abstract: This 14-year longitudinal study examined the independent association between perceived social support and the 5-year progression of depressive tendencies while taking into account the potential effects of childhood/adolescent anger and later hostility. From the on-going population based study of “Cardiovascular Risk in Young Finns”, 553 male and 860 female participants responded to a revised version of Beck''s Depression Inventory in 1992 and 1997. Hostility and perceived social support were assessed by self-rated questionnaires in 1992. Childhood/adolescent anger was assessed by parent-reports in 1983. Our results showed that higher levels of perceived social support were associated with the decrease of depressive tendencies after 5 years and lower levels of depressive tendencies prospectively and after 5 years. This association persisted after adjusting for childhood/adolescent anger and later hostility. In addition, hostility was strongly related to the 5-year increase of depressive tendencies and higher levels of depressive tendencies. Social support may therefore be a long-term protective factor from depression irrespective of personality characteristics, such as hostility and anger. [Copyright &y& Elsevier]

Sensitivities of behavioral inhibition and behavioral approach as related to dispositions to experience emotions in laboratory induced stress were examined among 95 randomly selected 21–36-year-old healthy men (n=49) and women (n=46). Gray‘s temperament theory was used to define behavioral inhibition (BIS) and behavioral approach (BAS) with Carver and White’s BIS/BAS scales. The circumplex model of affect was used to structure the self-reported affects. Stressors used were the aversive startle task, the appetitive mental arithmetic task, and the aversive choice-deadline reaction time task. The main finding was that BAS sensitivity was generally associated with pleasant affects with an especially great increase of Activated Pleasant Affect during the appetitive task. BIS sensitivity was, on the other hand, associated with unpleasant affects with a great increase of Activated Unpleasant Affect during aversive tasks. A conclusion was that BIS sensitivity could predispose a person to emotional distress in stressful situations and, probably, to a higher stress vulnerability with its somatic endpoints. [Copyright &y& Elsevier]

Nursing informatics competences (ie. knowledge and skills in electronic and structured documentation) have become a necessary prerequisite for nurses to carry out their professional roles. Therefore, there is a global need to integrate nursing informatics into nursing curricula. In Finland, the requirements to increase nursing informatics education were noted in eHealth strategies in 2015. However, it is not known whether these educational initiatives have succeeded in increasing nursing informatics competences of recent nursing graduates. To examine whether nurses who graduated after the Finnish educational initiatives have higher nursing informatics competences than nurses who graduated before the initiatives. Additionally, the associations of age, gender, work setting and geographical area with the nurses' informatics competences were examined. Cross-sectional study. The study was carried out between October–December 2018 in Finland. Registered nurses who graduated before (n = 931) and after (n = 712) the 2015 educational initiatives. Nursing informatics competences were measured by four items: (1) terminology-based documentation, (2) patient-related digital work, (3) general IT competency and (4) electronic documentation according to structured national headings. The associations of the year of the graduation and demographic background variables with nurses' overall nursing informatics competence and also separately with four specific competence items were examined with analysis of covariance. Nurses' graduation year was associated with their overall nursing informatics competence and the specific competence related to terminology-based documentation. Nurses who had graduated after the initiatives had higher competence than nurses with earlier graduation years. Associations were also found between age and work setting with the nursing informatics competences. Younger nurses and nurses working in specialised healthcare and elderly care had the highest competence. The national eHealth strategies with educational initiatives seem to have affected favorably on nursing informatics education in Finnish nursing programs and have potentially led to increased nursing informatics competences of recent nursing graduates. The results of this study highlight the importance of educational policies stating the directions and objectives of education programs. [ABSTRACT FROM AUTHOR]

Cultural diversity in healthcare settings requires that care professionals are able to provide culturally competent care. This means that educational institutions have a crucial role to play in equipping students with the skills to deal with diversity in cross-cultural and multicultural contexts. Ensuring that cultural competence is part of the educational curriculum is therefore essential. This study aims to examine what elements influence the implementation of cultural competence content in nursing education from a nurse teacher's perspective. A descriptive qualitative design was used consisting of semi-structured interviews with nurse teachers (n = 12). Inductive content analysis was applied to explore their perceptions on teaching cultural competence at a University of Applied Sciences (UAS) in Southern Finland. Analysis from the open coding of interviews indicated that there are three main categories of importance regarding students' cultural competence education: exposure to diversity in the teaching environment; teacher's experience and understanding of cultural competence; and integrating cultural competence into the curriculum. The findings suggest that more transparency and cooperation between nurse teachers and the university administration is necessary to ensure the inclusion of cultural competence in nursing education. For instance, teachers should receive training related to cultural competence and evidence-based teaching methods. The curriculum should include a course or workshop about cultural competence with clear learning objectives and evaluation criteria for the purpose of grading. Finally, the educational institution should commit to developing a culturally competent organisation through internationalization and the maintenance of a diverse environment. • Cultural competence content needs to be discussed by staff to include learning objectives and criteria for evaluation. • There should be a course or workshop dedicated to cultural competence in the curriculum focusing on exploring the concept. • Staff should receive training in cultural competence and be introduced to evidence-based teaching methods and pedagogies. • Cultural competence should be supported through internationalization and the maintenance of a diverse environment. [ABSTRACT FROM AUTHOR]

• We studied non-reporting of information system-related patient safety incidents. • Non-reporting of safety incidents was less common in a just work environment. • Fair treatment may encourage the reporting of patient safety incidents. Factors influencing the reporting of patient safety incidents that result from health information technology (HIT) failure are poorly understood. We examined whether organizational justice is associated with the non-reporting of HIT system-related safety incidents among registered nurses. Cross-sectional survey data were collected from nurses (N = 1399) who reported encountering a HIT system-related patient safety incident within the past 12 months. Selecting one or more reasons for not filing an incident report from a predefined list of potential reasons was used as an indicator for non-reporting. Logistic regression models were fit to predict the reason-specific likelihood of non-reporting with organizational justice. High organizational justice was associated with a reduced likelihood of non-reporting if non-reporting occurred because reporting was too hard or took too much time (OR = 0.81, 95% CI 0.67 to 0.96), because the reporting had no impact on the organization's processes (OR = 0.63, 95% CI 0.53 to 0.76), because the respondent was worried about the consequences (OR = 0.61, 95% CI 0.43 to 0.87), or because the respondent was not required to file a report (OR = 0.67, 95% CI 0.51 to 0.89). Justice was not associated with non-reporting if it occurred due to the lack of access to a reporting system, because no actual harm was caused to the patient, or some other, non-specified reason. The associations were robust to adjustment for several nurse and work characteristics. The results suggest that non-reporting of HIT system-related safety incidents is less common in a high-justice work environment. Fair treatment of nurses may encourage their reporting of safety incidents. [ABSTRACT FROM AUTHOR]

Abstract: Background: This study examined whether temperament dimensions, as indicated by Cloninger''s psychobiological model [Cloninger, C.R., Svrakic, D.M., Przybeck, T.R., 1993. A psychobiological model of temperament and character. Arch. Gen. Psychiatry 50, 975–990.], predicted depressive symptoms across a 4-year follow-up. Methods: Nine hundred ninety-three women and 583 men from the on-going population-based study of “Cardiovascular Risk in Young Finns” completed the Temperament and Character Inventory (TCI) [Cloninger, C.R., Svrakic, D.M., Przybeck, T.R., 1993. A psychobiological model of temperament and character. Arch. Gen. Psychiatry 50, 975–990.], a revised version of Beck''s Depression Inventory [Beck, A.T., Steer, R.A., 1987. Manual for the Revised Beck Depression Inventory. Psychological Corporation, San Antonio, TX; Katainen, S., Räikkönen, K., Keltikangas-Järvinen, L., 1999. Adolescent temperament, perceived social support and depressive tendencies as predictors of depressive tendencies in young adulthood. Eur. J. Pers. 13, 183–207] and the Perceived Social Support Scale-R [Blumenthal, J.A., Burg, M.M., Barefoot, J., Williams, R.B., Haney, T., Zimet, G., 1987. Social support, type A behavior, and coronary artery disease. Psychosom. Med. 49, 331–340]. Results: Results of hierarchical linear regression models showed that the temperament subscales impulsiveness, shyness with strangers, fatigability, sentimentality, and persistence increased the risk of depressive symptoms independently of a wide variety of known risk factors for depression. The association between fatigability and depressive symptoms was stronger for participants with low social support than for those reporting high social support. Limitations: The sample was restricted to men and women aged 20–35 at baseline and no clinically significant cut-point for depression was defined. Conclusions: Our results strengthen the view that depressive symptoms are independently influenced by temperamental dispositions. [Copyright &y& Elsevier]