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In this paper, we describe a geriatric rehabilitation nursing model developed on the basis of the nursing and rehabilitation literature. That literature comprised some 120 articles addressing the rehabilitation of elderly patients and the work done by nurses in that process, various philosophical questions and the results of geriatric rehabilitation. One-third of these articles has been evaluated on the strength of the articles' evidence, and these are discussed in this paper. The findings show that the main factors in geriatric rehabilitation nursing are the patient with health or functional problems and the nurse with professional values, knowledge and skills. The patient is part of a family and the nurse works as part of a multidisciplinary team. In the geriatric rehabilitation process, the patient and the nurse work in close interaction. The aims of rehabilitation depend upon the patient's commitment to the objective and upon the nurse's commitment to help the patient achieve that objective. A health orientation, goal-oriented work, nursing decision-making and a rehabilitative approach to work are all central to this effort. Work is organized in multidisciplinary teams where nurses have equal responsibilities with other professional staff. Testing and development of the model is ongoing.

This study examined and compared the processes of information collection and clinical judgement by nurses (n=107) and physicians (n=27) working with cancer patients. The data was collected in two university hospitals by means of a computer-simulated case description and the thinking-aloud method. Data interpretation was based on SPSS statistical software and the method of content analysis. Statistical differences between the two groups were tested with non-parametric Kruskal-Wallis Anova or the Mann-Whitney U-test. The Wilcoxon test was applied in pairwise comparisons. Independent questions were analysed by cross-tabulation and Pearson's chi(2). According to the results nurses and physicians apply different approaches to clinical judgement and problem-solving. On the basis of the status statement they received in the program both groups pointed to similar problems and sought a great deal of additional information. However the type of information required was different in the two groups. There were also significant differences in the knowledge base applied for purposes of clinical judgement: nurses tended to rely on personal knowledge, physicians on theory. Physicians were able to identify their patient's major clinical problems, but nurses had more difficulty doing this. On the other hand, nurses took a broader view on the general well-being of patients than physicians did., (Copyright 2002 John Wiley & Sons, Ltd.)

The aim of this study was to describe the sense of security associated with pregnancy and childbirth and to identify factors associated with it. Security was conceptualized in accordance with Kaufmann as a human need and as a human value. The instrument used was a questionnaire with a 4-point scale. The sample consisted of 481 pregnant Finnish women. The response rate was 69%. Rotated factor analysis was carried out and sum variables were produced. The effects of various background variables were calculated using the Kruskal-Wallis test and the Mann-Whitney U-test. The elements creating security were social support, knowledge, prenatal health-care experiences, support from the partner, livelihood, positive stories and, in multiparae, positive previous childbearing experiences. The most salient finding concerning factors related to security was that women who had no pregnancy-related problems in the current pregnancy reported social support, prenatal health-care experiences and support from the partner as security-creating elements more often than women with such problems. This was the only factor related to manifestation of security. The findings suggest that all pregnant women should be assisted by professionals to find security-creating elements in their particular situation to promote and strengthen the sense of security, paying special attention to women with pregnancy-related problems.

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.

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.

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.

Little is known about nurses' attitudes towards alternative medicine. The purpose of this study was to describe attitudes towards alternative medicine among nurses working on oncology wards in three university and one central hospital in Finland. The data were collected with a questionnaire specifically developed for this project. The response rate was 68.1% (n = 92). The nurses did not regard alternative medicine as a safe and natural method in the treatment of cancer. On the contrary, many nurses believed that alternative therapies are offered by quack doctors for financial gain. However, the nurses considered it important that cancer patients have the opportunity to talk about their use of alternative medicine both with nurses and physicians. Overall the results indicated that nurses' attitudes are for the most part negative. An interesting question that deserves further attention is whether this attitude is reflected in nursing practice.

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.