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The Adult Social Care Outcomes Toolkit four response‐level interview schedule (ASCOT INT4) for service users was translated into Finnish. The aim of this paper was to investigate the construct validity and structural characteristics of the Finnish ASCOT. We used data from a face‐to‐face interview survey of older people receiving publicly funded home care services, which was conducted in 2016–2017 (n = 493), excluding missing values and proxy respondents (n = 334). Chi‐square tests, adjusted residuals and analyses of variance were used to examine hypothesised associations between each attribute and a number of relevant variables regarding health and well‐being, disabilities, living arrangements, social contact and support, experience of service use, and the nature of the locality and environment. Structural characteristics were explored using exploratory factor analysis and Cronbach's alpha test. The EQ‐5D‐3L and ASCOT were moderately correlated (r = 0.429; p < 0.001). The ASCOT attributes were statistically positively related to the overall quality of life. For other tested variables, we found a high number of significant associations with the control over daily life, occupation, social participation, and personal cleanliness attributes, but fewer significant associations with the other attributes. Cronbach's alpha was 0.697 and a single factor was extracted. This assessment provides evidence to support the construct validity of the Finnish ASCOT. The results support the introduction of the Finnish ASCOT into Finland for use in practical applications. Future research on its reliability would be useful. [ABSTRACT FROM AUTHOR]

We used a randomized controlled trial to investigate if a mobile game, GraphoLearn (GL), could effectively support the learning of first graders (N = 70), who have severe difficulties in reading and spelling. We studied the effects of two versions of the game: GL Reading, which focused on training letter‐sound correspondence and word reading; and GL Spelling, which included additional training in phonological skills and spelling. During the spring of first grade, the children trained with tablet computers which they could carry with them during the six‐week intervention. The average exposure time to training was 5 hr 44 min. The results revealed no differences in the development of reading or spelling skills between GL players and the control group. However, pre‐training self‐efficacy moderated the effect among GL Reading players: children with high self‐efficacy developed more than the control group in word reading fluency, whereas children with low self‐efficacy developed less than the control group in spelling. Lay Description: What is already known: Serious games can support children's reading achievement, but less is known about their effects in mobile learning.GraphoLearn (GL) is a serious game designed to support reading acquisition, but previous studies suggest its effect on word‐level reading is limited.Explicit training of phonological skills and spelling could facilitate transfer to word reading.Self‐efficacy predicts persistence and effort in achievement situations but its role in mobile game‐based learning is not well known. What this paper adds: A randomized controlled trial was used to study if mobile game‐based learning supports children with reading difficulties.A new GL version, training phonological and spelling skills, had no effect on the development of reading and spelling skills.Children with high self‐efficacy benefited from training with the standard GL. Implications for practitioners: When using mobile games as support tools, close attention should be paid to learner characteristics and game design.Children with high self‐efficacy may be better able to regulate their behaviour during independent training with mobile games, leading to better learning outcomes. [ABSTRACT FROM AUTHOR]

Purpose — Economic pressures and rising stakeholder expectations have led public sector organisations to measure their reputation. The paper aims to highlight the importance of reputation for the public sector, define sector reputation and report findings on a quantitative study of sector reputations of four different types of Finnish public sector organisations. Design/methodology/approach — Inspired by stakeholder theory and the value of organisational reputation, a quantitative survey of stakeholder assessments on reputation was carried out in the 12 organisations from the field of the Finnish Ministry of Social Affairs and Health in 2003. The organisations represented four sectors: research, authority-functions, semi-commercial functions and legislation. Survey data were first analysed with factor analysis to form five reputational factors for public sector organisations. Further analyses were carried out to compare differences between the organisational types and groups of stakeholders (analysis of variance) and to define the part of the different stakeholders (cluster analysis) for sector reputation. Findings — The paper distinguishes between two major sector reputations: flexible and bureaucratic public sector organisations. Those organisations with more traditional functions (legislation and authority functions) are by reputation labelled bureaucratic, whereas those with more modem functions (research and semi-commercial functions) are by reputation more flexible. These findings give insight into the strengths and weaknesses in the reputation of different types of public sector organisations, and hence contribute to the body of literature on strategic management of public sector organisations. Research limitations/implications — Though the concept of sector reputation is universal, the contents of sector reputations are culturally bound. The study was conducted on Finnish public sector organisations, so the results could best be generalised to other Nordic countries. Moreover, reputation is an artificial concept based on stakeholder assessments and perceptions, and does not measure reality as such, though it is associated with stakeholder behaviour. Practical implications — The results of the paper point toward rather stable, yet specific sector reputations. Knowing the reputational strengths and weaknesses of each type of public sector organisation provides a deeper understanding of how stakeholders perceive different types of organisations, and hence enables suitable allocation of public resources. Originality/value — The paper will contribute to both theory and practice by addressing the concept of reputation for public sector organisations as well as providing new results on sector reputation. The paper will be of interest to those searching for ways to measure the effectiveness of public sector organisations as well as to those interested in stakeholder relations and strategic management. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to explore Finnish adolescents’ subjective health literacy (HL) in association to school achievement, learning difficulties, educational aspirations, and family affluence.Design/methodology/approach Nationally representative data were collected in Finland as a part of the international Health Behaviour in School-aged Children study. The respondents consisted in total of 3,833 adolescents (7th and 9th graders) from 359 schools. The Health Literacy for School-aged Children instrument was applied to measure adolescents’ subjective HL, while the Family Affluence Scale was used to measure adolescents’ socioeconomic status. Information was gathered on school achievement, learning difficulties, and educational aspirations.Findings Approximately one-third of the adolescents manifested a high level of HL, around 60 per cent had a moderate level of HL, and about one-tenth had low HL. The HL level was lower for boys than for girls, and lower for 7th graders than for 9th graders. In the total sample, the strongest explanatory variables for HL were school achievement in the first language, and educational aspirations.Originality/value This study provides the first nationally representative examination of adolescents’ subjective HL levels, and how these vary across age and gender groups. In drawing conclusions and presenting suggestions for HL interventions, it is important to verify the nature of the HL examined in any given study, and how it was researched. [ABSTRACT FROM AUTHOR]

Aim: To test the psychometric properties of the Finnish version of the Dempster Practice Behaviour Scale and explore nurses' professional autonomy along with which characteristics are related to it. Design: An instrument validation and a descriptive cross‐sectional study. Methods: The web‐based survey was conducted in September 2021 at two university hospitals in Finland. Exploratory factor analysis (EFA) was used to explore the factor structure of the modified instrument, while Cronbach's α coefficients were calculated to determine the reliability of the scale. Descriptive univariate and multivariate analyses were conducted to examine Registered Nurses' professional autonomy. The study followed STROBE guidelines. Results: During the validation process, the 30 items of the Dempster Practice Behaviour Scale were reduced to 25 items. The S‐CVI/Ave for the translated scale was 0.94. When one additional item was omitted from the EFA, the results supported five factors, which explained 45.9% of the total variance. The mean overall autonomy score was 3.63 out of 5, with readiness and empowerment the subscales with the highest and lowest, respectively, mean values. The linear regression models showed that age, nursing experience, unit type, education, shift, and perceptions of the importance of professional autonomy were related to the subscales describing professional autonomy. Conclusion: The psychometric testing provided evidence that the translated instrument was reliable. Nurses assessed that they are skilled professionals who are accountable for their actions. However, they experienced rather low levels of professional autonomy in empowerment and valuation. Health care organizations should consider this through authentic leadership and, thus, possibly strengthen professional autonomy. [ABSTRACT FROM AUTHOR]

Aims: To examine (1) the association between healthcare workers' workplace ostracism and job satisfaction, stress and perceived health, and (2) whether this relationship is mediated by loneliness and self‐esteem. Design: A cross‐sectional study. Methods: Healthcare (N = 569) managers and employees (nurses, practical nurses, doctors and social workers) in Finland responded to a semi‐structured survey in January 2021 and evaluated their experiences of workplace ostracism, job satisfaction, stress, perceived health, loneliness and self‐esteem during the last year. To examine the association of these variables, linear regression and mediator model tests were performed. Results: Workplace ostracism had a clear direct association with job satisfaction, stress and perceived health. Loneliness fully mediated the relationship between workplace ostracism, stress and perceived health, and partly mediated the association between workplace ostracism and job satisfaction. Self‐esteem partly mediated the association between workplace ostracism, stress, job satisfaction and perceived health. Conclusion: The experience of workplace ostracism in organizations is a significant factor in job satisfaction, stress and perceived health. Healthcare organizations could strengthen job satisfaction and increase workers' well‐being by strengthening social relationships in the organization and, via that, reducing turnover intention. Implications for the profession and patient care: This study gives understanding and information to the healthcare profession on how workplace ostracism affects work well‐being and workplace relationships. Workplace ostracism decreases interaction, which can also endanger patient care if information is not openly exchanged. Impact: This study indicated that workplace ostracism weakened job satisfaction more than loneliness. More commonality and consideration for others at work are needed because these factors may help increase work well‐being and decrease exits from working life. Further research is needed on why workplace ostracism occurs in healthcare workplaces. Reporting Method: STROBE. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Kuninkaanniemi H, Villberg J, Vanhala M, Poskiparta M. International Journal of Nursing Practice 2011; 17: 470-477 Behaviour-change interventions in primary care: Influence on nutrition and on the metabolic syndrome definers The purpose of this paper was to examine whether interventions influenced patients' (i) consumption of fish; whole grain products; fruits and vegetables; (ii) overall nutrition, that is, the three former as an index; and (iii) clinical outcomes in terms of metabolic syndrome definers. A questionnaire was delivered to adult patients entering the nine health centres on November 2006 ( n = 1211). During the year the ward personnel conducted intervention on patients with unhealthy habits. The 12-month follow up was conducted by mailings. Also clinical data of pre- and post-intervention values of metabolic syndrome definers were collected. For the analyses, intervention was divided into brief (≤ 15 min, at most three visits) and extended (> 15 min, more than three visits) intervention. Logistic Regression and manova were used to measure changes in the outcomes. Nutrition-related intervention was conducted on 218 patients (brief intervention n = 179, extended intervention n = 39). In the extended intervention group it was three times more likely to have a positive change in the nutrition index than in the brief intervention group ( P = 0.017, confidence interval 1.223-7.773). In conclusion, brief interventions were commonly used in the primary care. However, they were not enough to produce changes in the patients' nutrition or in the clinical outcomes. [ABSTRACT FROM AUTHOR]

Purpose - The purpose of this paper is to determine the nature of the academic skills deficits in male offenders and their relation to neurocognitive deficits. Design/methodology/approach - In total, 72 Finnish male prisoners were tested with regard to reading, spelling, and mathematical abilities. Findings - Low academic skills, especially reading, were related to poor neurocognitive performance in verbal memory, visual memory, attention, and motor dexterity. The results showed a high number (29-36 percent) of reading and spelling disorders. In all, 15 percent of those with medium to severe problems in academic skills had marked difficulties in mathematics. In total, 88 percent of the participants with at least one problem area in literacy skills had neurocognitive deficits. In the present study, the pervasive neurocognitive deficits, occurring comorbidly with reading and spelling difficulties, seem to refer to a fundamental set of deficits which are only minimally explained by IQ, educational background or training. Research limitations/implications - Reading and spelling difficulties could be seen as functional illiteracy which, combined with a broad spectrum of neuropsychological function deficits, pose a challenging task for rehabilitation. Only after proper identification of deficits has been achieved is it possible to set goals and select the appropriate means for rehabilitation. One obvious limitation is the moderate number of subjects (n=72). Practical implications - It may not be enough just to train reading or develop literacy activities among prisoners; focussing intervention on comprehensive neurocognitive deficits is also necessary. Originality/value - Correlates and comorbidity between academic difficulties and neurocognitive deficits among offenders, especially in arithmetic difficulties, have been less studied. [ABSTRACT FROM AUTHOR]

Purpose - Deinstitutionalization has impacts also on direct care workers and their work. The purpose of this paper is to analyse the attitudes of direct care workers towards the closure of the institution, and these attitudes' relation to workers' occupational identity. Design/methodology/approach - Data were collected by postal questionnaire before the closure of the institution. The respondents consisted of two groups: direct care workers of the institution (n = 93) and direct care workers of community-based residential units run by the same organization (n = 117). Findings - The results clearly show that direct care workers in the institution, as a group, were against the closure of the institution. This is quite understandable, because the closure will irrevocably affect their work and also private life. Although this opposing is evident, there was also variance in the attitudes within this group: some were more willing to accept the change, some were more against it. Those opposing the closure seemed to be more reluctant in adopting the new kind of identity as supporters of the self-determination o f their clients and also they felt more insecure about their own competence. Originality/value - In deinstitutionalization research a staff perspective has not been very common. To successfully accomplish the change process it is important to take into account also the staff and how they experience the change. It would be far more beneficial to have staff promoting change than resisting it. [ABSTRACT FROM AUTHOR]

Aim This paper reports a study testing of the validity and reliability of the personnel version of the Family Empowerment Scale in family services in Finland. Background The role of family services in parental reinforcement is important, given their extensive reach to most families and their aim of promoting family welfare. No instruments applicable to this situation were available in Finland. The Family Empowerment Scale is a widely used instrument that measures parent's empowerment. The personnel version of the Family Empowerment Scale enables an evaluation of the reinforcement of empowerment. Design This study used a cross-sectional survey design. Methods The Family Empowerment Scale was modified to measure how family services personnel evaluate reinforcement of parental empowerment. In May 2009, a questionnaire was sent to unit heads ( n = 457) in public social, health and educational services for families with children aged 0-9 years. The construct, convergent and discriminant validities, reliability and responsiveness of the personnel version of the Family Empowerment Scale were assessed. Results According to confirmatory factor analysis, the personnel version of the Family Empowerment Scale comprised three subscales (family, service system and community) as in the original Family Empowerment Scale. Confirmed convergent and discriminant validities supported the same construct. The reliability of the personnel version of the Family Empowerment Scale was acceptable. The reinforcement level of parental empowerment was high. Parental empowerment was reinforced most in health and least in educational services. Conclusion The psychometric properties of the personnel version of the Family Empowerment Scale were acceptable. It can serve as a generic instrument for assessing reinforcement of empowerment in family services in Finland. [ABSTRACT FROM AUTHOR]

Evidence-based nursing requires carefully designed interventions. This paper discusses methodological issues and explores practical solutions in the use of music intervention in pain management among adults after major abdominal surgery. There is a need to study nursing interventions that develop and test the effects of interventions to advanced clinical nursing knowledge and practice. There are challenges in carrying out intervention studies in clinical settings because of several interacting components and the length and complexity of the causal chains linking intervention with outcome. Intervention study is time-consuming and requires both researchers and participants' commitment to the study. Interdisciplinary and multiprofessional collaboration is also paramount. In this study, patients were allocated into the music group, in which patients listened to music 30 minutes at a time, or the control group, in which patients did not listen to any music during the same period. [ABSTRACT FROM AUTHOR]

papastavrou e., efstathiou g., tsangari h., suhonen r., leino-kilpi h., patiraki e., karlou c., balogh z., palese a., tomietto m., jarosova d. & merkouris a. (2011) A cross-cultural study of the concept of caring through behaviours: patients' and nurses' perspectives in six different EU countries. Journal of Advanced Nursing 68(5), 1026-1037. Abstract Aim. This paper is a report of an international study of patients' and nurses' perceptions of nurse caring behaviours. Background. Current economic constraints on healthcare systems, demand to increase the quality of care and the incorporation of the consumers' perspective into care, have created a need to develop a clear understanding of nursing behaviours which convey caring. Patients in different areas of the world report different expectations of nurses' caring actions when compared to nurses' views. Method. A descriptive comparative survey design was used to analyse a sample of surgical patients ( n = 1659) and their nurses ( n = 1195) in 88 wards of 34 hospitals in Cyprus, the Czech Republic, Finland, Greece, Hungary and Italy. Data were collected in autumn 2009 using the Caring Behaviours Inventory-24. Nurses' and patients' responses were compared using both inferential and descriptive statistics. Results. Independent samples t-tests showed important differences between nurses' and patients' views. Although both groups perceived knowledge and skill as being the most important sub-scale, the nurses' responses were higher compared to patients ( P < 0·05) with important differences in the 'assurance of human presence' ( P < 0·001) and the 'respectful deference to others' ( P < 0·001) sub-scales. Cross-country comparisons showed important differences between the nurses' ( F = 24·199, P < 0·001) and patients' views on caring ( F = 26·945, P < 0·001). Conclusions. Important differences were observed between patient-nurse perceptions in the participating countries. The results form a foundation for future research into the development of a common international perspective about caring behaviours between patients and their nurses. [ABSTRACT FROM AUTHOR]

koivu a., saarinen pi. & hyrkas k. (2012) Journal of Nursing Management 20, 401-413 Does clinical supervision promote medical-surgical nurses' well-being at work? A quasi-experimental 4-year follow-up study Aim The aim of the present paper is to report results of a quasi-experimental study exploring the effects of clinical supervision (CS) on the development of medical-surgical nurses' well-being at work over a 4-year period. Background Effective workplace interventions are needed to prevent stress and burnout. More robust scientific evidence is needed to confirm the restorative effects of CS in nursing. Methods A questionnaire survey on the perceptions of work and health was conducted in 2003 and 2007 on 14 units of a Finnish university hospital where 19 CS group processes had been completed between 2004 and 2007. Results Improvement in job resources as well as reduction in professional inefficacy and psychological distress were found among nurses who received effective CS ( n = 41), but were not present among the nurses who found their CS less effective ( n = 43) or who did not attend CS ( n = 82). Conclusions The results provide robust evidence for the positive effects of CS on medical-surgical nurses' well-being at work. Implications for nursing management Stress is a developmental challenge in the professional growth of individual nurses. One option for management to sustain nurses' well-being at work is to develop a learning organization in the workplace making use of CS. [ABSTRACT FROM AUTHOR]

Drama, theater and role-playing methods are commonly used in health promotion programs, but evidence of their effectiveness is limited. This paper describes the development, implementation and evaluation of a school-based drama program to enhance social relationships and decrease bullying at school in children in grades 4–5 (mean age of 10.4 years). Students (n = 190) were recruited from two primary schools with similar demographics and socio-economics in the Southern Finland and purposively allocated either to an intervention group or a control group. The drama program included classroom drama sessions, follow-up activities at home and three parents’ evenings concerning issues of social well being during the school year September 2007–May 2008. Data on social relationships in the class room and experiences of bullying were obtained before and after the program using self-completed questionnaire from the same students (n = 134). The response rate was 71%. No differences in socio-demographics existed between intervention group and control group at pretest. The positive effect on social relationships resulting from the intervention approached statistical significance (p = 0.065). Moreover, the positive effect was found to be statistically significant in the high-intensity intervention classes (p = 0.011). Bullying victimization decreased 20.7 percentage units from pretest (58.8%) to posttest (38.1%) in the intervention group (p < 0.05). The study indicates that using applied drama and theater methods in the classroom may improve children's social relationships at school. [ABSTRACT FROM AUTHOR]

salmela s., eriksson k. & fagerström l. (2012) Leading change: a three-dimensional model of nurse leaders' main tasks and roles during a change process. Journal of Advanced Nursing 68(2), 423-433. Abstract Aim. This paper is a report of a qualitative study which explored how nurse leaders described and understood their main tasks and roles during a change process. Background. During a database search for literature, no actual research that highlighted the main tasks and roles of nurse leaders during a change process was found. Earlier research has indicated the need for different leadership styles and the importance of strategies and values. Method. In-depth interviews with 17 nurse leaders took place in 2004. A phenomenological-hermeneutical approach was used for data analysis. Results. The findings resulted in a model of leading change in health care that focuses on good patient care and consists of three dimensions: leading relationships, leading processes and leading a culture. In addition to leading relationships and processes, nurse leaders, as role models, greatly impact caring culture and its inherent ethical behaviour, especially about the responsibility for achieving good patient care. Nurse leaders are also instrumental in leading ward culture. Conclusion. Nurse leaders need guidance and knowledge of what is expected of them during a structural change process. They play different roles by directing, guiding, motivating, supporting and communicating without losing their cultural ethos of caring and use various leadership styles to bring about actual change, which, in turn, requires learning so that the thought patterns, values and attitudes of personnel can be changed. [ABSTRACT FROM AUTHOR]

meretoja r. & koponen l. (2012) A systematic model to compare nurses' optimal and actual competencies in the clinical setting. Journal of Advanced Nursing 68(2), 414-422. Abstract Aim. This paper is a report of a study to develop a model to compare nurses' optimal and actual competencies in the clinical setting. Background. Although future challenge is to focus the developmental and educational targets in health care, limited information is available on methods for how to predict optimal competencies. Method. A multidisciplinary group of 24 experts on perioperative care were recruited to this study. They anticipated the effects of future challenges on perioperative care and specified the level of optimal competencies by using the Nurse Competence Scale before and after group discussions. The expert group consensus discussions were held to achieve the highest possible agreement on the overall level of optimal competencies. Registered Nurses ( n = 87) and their nurse managers from five different units conducted assessments of the actual level of nurse competence with the Nurse Competence Scale instrument. Data were collected in 2006-2007. Results. Group consensus discussions solidified experts' anticipations about the optimal competence level. This optimal competence level was significantly higher than the nurses' self-reported actual or nurse managers' assessed level of actual competence. The study revealed some competence items that were seen as key challenges for future education of professional nursing practice. Conclusion. It is important that the multidisciplinary experts in a particular care context develop a share understanding of the future competency requirements of patient care. Combining optimal competence profiles to systematic competence assessments contribute to targeted continual learning and educational interventions. [ABSTRACT FROM AUTHOR]

suhonen r., papastavrou e., efstathiou g., lemonidou c., kalafati m., da luz m.d.a., idvall e., berg a., acaroglu r., sendir m., kanan n., sousa v.d., katajisto j., välimäki m. & leino-kilpi h. (2011) Nurses' perceptions of individualized care: an international comparison. Journal of Advanced Nursing 67(9), 1895-1907. Abstract Aim. This paper is a report of a study of internationally-based differences in nurses' perceptions of individualized care in orthopaedic surgical in-patient wards. Background. Individualized care is valued in healthcare policy, practice and ethical statements as an indicator of care quality. However, nurses' assessments of individualized care are limited and comparative cross-cultural studies on individualized nursing care are lacking. Methods. A descriptive comparative survey was used to sample orthopaedic surgical nurses ( n = 1163) working in 91 inpatient wards in 34 acute hospitals in Finland, Cyprus, Greece, Portugal, Sweden, Turkey and the United States of America. Data were collected between March and November 2009 using the Individualized Care Scale-Nurse and analysed using descriptive and inferential statistics. Results. Nurses in different countries perceived that they supported patients' individuality generally and provided individualized care during nursing activities. Although the highest scores were in support of patients' individuality in the clinical situation both through nursing provision and nurses' perceptions of individuality, there were between-country differences within these scores. Generally, the Greek and American nurses gave the highest scores and the Turkish, Cypriot and Portuguese nurses the lowest. Conclusions. Between-country differences found may be attributed to differing roles of nurses, care processes, healthcare systems and/or the ways nursing care is defined and organized. As this was the first time the Individualized Care Scale-Nurse was used in an international context, the results are formative and indicate the need to continue studies in this area. [ABSTRACT FROM AUTHOR]

Aim. This paper is a report of a study exploring possible external and inner sources of the sense of security felt by older people aged 65 and 75. Background. The concept of 'security' has been parsimoniously defined and explored, especially as pertains to older people, and previous research has primarily focused on risks in relation to individuals' declining health and functional ability. Methods. In 2005, population-based cross-sectional surveys were carried out in 15 municipalities in Våsterbotten, Sweden and 18 municipalities in Ostrobothnia, Finland. A 15-page questionnaire (84 questions) was distributed, with the final total response rate reaching 68⋅4% (n = 3370): 1825 Swedish-speaking Swedes, 926 Swedish-speaking Finns and 621 Finnish-speaking Finns. The statistical analysis was three-stage, including nominal stepwise regressions. Results. Older people who indicate that they are 'very secure' are more likely to consider life meaningful and are able to master various life crises. Moreover, they possess confidence in economic institutions and are more likely to feel economically secure. Weak trust in family and friends or neighbours and decreased functional ability seem to indicate a subjective feeling of 'insecurity'. Conclusion. Caregivers in health care should focus more on supporting older persons' meaningfulness in life and how their feelings of security can be strengthened by trusting relationships and activities. In nursing, there should be more focus on developing knowledge of inner health resources, including positive life orientation and meaningfulness in life. [ABSTRACT FROM AUTHOR]

Aim. This paper is a report of a pilot study to examine the relationship of nursing intensity, work environment intensity and nursing resources to nurse job satisfaction. Background. There is an ever increasing amount of information in hospital information systems; however, still very little of it is actually used in nursing management and leadership. Methods. The combination of a retrospective time series and cross-sectional survey data was used. The time series patient data of 9704 in/outpatients and nurse data of 110 nurses were collected from six inpatient units in a medical clinic of a university hospital in Finland in 2006. A unit-level measure of nurse job satisfaction was collected with a survey (n = 98 nurses) in the autumn of 2006. Bayesian networks were applied to examine a model that explains nurse job satisfaction. Results. In a hospital data system, 18 usable nurse staffing indicators were identified. There were four nurse staffing indicators: patient acuity from nursing intensity subgroup, diagnosis-related group volume from work environment subgroup, and skill mix and nurse turnover from nursing resources subgroup that explained the likelihood of nurse job satisfaction in the final model. The Bayesian networks also revealed the elusive non-linear relationship between nurse job satisfaction and patient acuity. Conclusion. Survey-based information on nurse job satisfaction can be modelled with data-based nurse staffing indicators. Nurse researchers could use the Bayesian approach to obtain information about the effects of nurse staffing on nursing outcomes. [ABSTRACT FROM AUTHOR]

The present paper reports on a study that investigated the role of procedural and declarative memory in the acquisition of Finnish past tense morphology. Two competing models were tested. Ullman's (2004) declarative/procedural model predicts that procedural memory supports the acquisition of regular morphology, whereas declarative memory supports the acquisition of irregular morphology. In contrast, single-route approaches predict that declarative memory should support lexical learning, which in turn should predict morphological acquisition. One-hundred and twenty-four (N=124) monolingual Finnish-speaking children aged 4;0-6;7 completed tests of procedural and declarative memory, tests of vocabulary knowledge and nonverbal ability, and a test of past test knowledge. The results best supported the single-route approach, suggesting that this account best extends to languages that possess greater morphological complexity than English. [ABSTRACT FROM AUTHOR]

There is a need to better understand the nature of work-family culture and its relationships with job-related outcomes. The main objective of this study was to investigate the associations between a supportive work-family culture and work attitudes (i.e., job satisfaction, work engagement, turnover intentions) at both the individual and work departmental level. Survey-based data were gathered from 52 Finnish work departments (1219 individuals) in the domains of health care, ICT, and the paper industry. Data were analysed via multilevel structural equation modelling. Work-family culture was assessed via managers' supportiveness, organizational time demands, and the expected career consequences of taking up work-family-related benefits. The results showed, first, that employees in the same work department shared similar perceptions of the department's work-family culture and work attitudes; second, the perceptions of the work-family culture shared within the work department as well as employees' individual perceptions of it were associated with work attitudes. Thus, the positive effects of a supportive work-family culture on work attitudes were established at both the individual and work departmental levels. [ABSTRACT FROM AUTHOR]

Aim. This paper is a report of a study conducted to describe nursing and social services students' ethical reasoning at the start of their studies. Background. Gilligan argued that there are two modes of moral reasoning -- the ethic of justice, focusing on individuals' rights, and the ethic of care, focusing on responsibilities in relationships. Recent research has established the ethic of care as a developmental phenomenon. It has been widely argued that the ethic of care is crucial for nursing, but there has been little international research in this area. Method. Participants were first-year nursing and social services students in Finland (N = 112). Their care-based moral reasoning was measured using the Ethic of Care Interview, and their ethical reasoning on an abortion-related dilemma was analysed by content analysis. Expressed ethical codes and principles were calculated according to levels. The data were collected over a 5-month period in 2007-2008. Findings. Students' level of care reasoning was varied. Their current level of care reasoning was reflected in their responses to the ethical dilemma. Ethical reasoning at each level and its specific premises constituted a distinct entity. Use of the principle of self-determination was positively related to levels of care development. Care-based moral reasoning constitutes the bedrock for ethical reasoning among these novice students. Conclusion. Educators should be sensitive to the variation in students' current developmental levels in care reasoning. Reflective discussion on real-life ethical conflicts should be an explicit part of education and clinical practice in caring professions. [ABSTRACT FROM AUTHOR]

Aim. This paper is a report of a study conducted to compare service users', nursing students' and Registered Nurses' evaluations of the usability of a patient education website intended for individuals with severe mental health problems. Background. There is an obvious need for reliable mental health information on the Internet. When evaluating the usability of Internet-based patient education methods, the opinions of all parties need to be ascertained. Methods. An explorative descriptive design was used. Twenty-one service users, 20 nursing students and 35 Registered Nurses were recruited for the study in 2003 and 2004. Data were collected using a self-developed questionnaire on the content, structure and visual appearance of the website. Results. Service users had positive attitudes towards computer and Internet use but they needed support when using the computer and Internet. According to the evaluations, the content, structure and visual appearance of the website were good and it could be adopted for clinical practise after minor revisions. There were some differences in the evaluations between participant groups. Nurses were the most critical group, and the service user group was the most satisfied, although they were less experienced with using both computers and the Internet. Conclusion. It is especially important to include service users' evaluations at the early stages of the development process of Web-based patient education systems. It is possible to produce an information technology-based patient education system for individuals with severe mental health problems. Nurses working in psychiatric services need to pay more attention to supporting service users in computer and Internet use. [ABSTRACT FROM AUTHOR]

Scand J Caring Sci; 2010; 24; 38-45 The objectives of this article are to present a measurement instrument for virtues, and to examine the link between virtues and health. The instrument was tested by the occupational health care at a large Finnish pulp and paper manufacturer and was shown to be consistent, valid and reliable. In developing the scale, we had two samples of employees and used factor analysis and partial least squares modelling (PLS) on both samples. Factor analysis showed that pride is the most important virtue, followed by love and generosity. In the PLS analysis, we found virtues to significantly reduce the number of sick days. In addition, we found significant relationships between virtues and fatigue, depression and happiness. Virtuous behaviour decreased sick leave and depression. The virtues had a positive influence on happiness and on improvement in one's health. The results show that by taking into account virtues in working life, companies can significantly improve their employees' well-being. The measurement instrument helps broaden the traditional view on health and is meant to be used by health care professionals in their daily practice. By addressing a person's physical, mental and virtual well-being, health care practitioners can take care of employees on a broader level than before. [ABSTRACT FROM AUTHOR]

This Finnish study examined the impacts of a group-form dance movement therapy intervention on the social functioning, attachment styles, and embodied experiences during social situations of its participants. The sample consisted of Finnish working-age adults with diagnosed depression who were randomised into intervention and control groups. Participants responded to surveys at three measurement points: pre- and post-intervention, and a follow-up 3 months later. The quantitative results showed that social functioning increased in the intervention group between the pre-intervention and follow-up measurement points but there was no change in attachment styles. The embodied experiences of participants during social situations were analysed qualitatively. The prevalence of avoidant reactions and insecurity decreased between the pre-intervention and follow-up measurement points. This study deepens understanding of the embodied experiences depression sufferers encounter in social situations, and provides insight into the ways in which dance movement therapy may be effective in decreasing depressive symptoms. [ABSTRACT FROM AUTHOR]

This study investigates assistant nurses' views on and needs for orientation to care robot use in three European countries. The use of care robots is gradually being incorporated into welfare services. Orientation to care robot use (in short, introduction to the use of the care robot technology) has thus become a key issue for care services. A survey was sent to assistant nurses in Finland, Germany, and Sweden, to which 302 participants responded (Finland n = 117; Germany n = 73; Sweden n = 112). Only 11.3% of assistant nurses had experience of giving orientation to care robot use to older adults or colleagues, but over 50% were willing to do so. Those with experience of using care robots should take part in orientation. Orientation to care robot use should be seen as part of care management and an issue that may affect the whole organisation. Management should, firstly, allow assistant nurses to get to know care robots by offering information, and secondly, consider with the assistant nurses the ways care robots can change their work and the implications of this change. Emphasising the social factors and practical orientation to care robot use extends the previous theories and perspectives of technology acceptance, adoption and diffusion. [ABSTRACT FROM AUTHOR]

If children in child protection cannot be cared for by their natural parents, should they be adopted or live in foster home? Results from a study of representative samples of populations (n = 12 330), in eight European countries—Austria, England, Estonia, Finland, Germany, Ireland, Norway and Spain—and California, USA, reveal that people would recommend adoption over foster care, if a child in public care cannot grow up with their natural parent(s). There are cross‐country differences between populations, and examining if institutional context such as type of child protection system explains differences, we find that child maltreatment‐oriented systems are more supportive of adoption than other types of systems. Citizens having little confidence in the child protection system were only weakly correlated with preference for adoption. In conclusion, people prefer adoption as placement options for children in care are more than foster homes, and possible this finding reflects a sort of refamalialization of children into the private sphere. [ABSTRACT FROM AUTHOR]

Nurses need moral courage in their ethical decision-making. As a personal characteristic, moral courage varies between individuals. The aim of this study was to analyse nurses’ self-assessed moral courage, morally courageous acts and associated individual factors in older people care in one large city in Finland. The data of this cross-sectional study were collected with the ‘Nurses’ Moral Courage Scale’ (NMCS) and the main analyses were conducted with multi-way ANOVA. A total of 205 nurses responded. Respondents’ self-assessed moral courage was 4.16 on a Likert scale of 1 to 5. Higher moral courage was associated with a higher knowledge base in ethics, more frequent encountering of ethical conflicts and having several sources for knowledge of ethics, suggesting that providing ethics education for nurses in the care of older people is important. The STROBE checklist was used as the reporting guideline for the manuscript. [ABSTRACT FROM AUTHOR]

Background: The role of medical emergency team (MET) in managing deteriorating patients and enhancing patient safety is greatly affected by teamwork. Aims: To identify teamwork‐related needs of the MET from MET nurses' perspectives. To assess the associations between MET nurses' perceptions of teamwork and their work experience and education. Study design: A quantitative, descriptive correlational design. Methods: Registered intensive care unit (ICU) nurses (n = 50) who were members of the MET in an acute tertiary care hospital answered a modified version of the team assessment questionnaire in 2017. Data were analysed using descriptive statistics, the Kruskal‐Wallis test, and the univariate analysis of variance method. The reporting of this study adheres to the strengthening the reporting of observational studies (STROBE) guidelines. Results: Participants showed least agreement with the items presenting leadership skills (mean = 2.6, SD = 0.68). Approximately 50% nurses disagreed that the MET had adequate resources, training, and skills. The majority of nurses (80%) felt that their responsibilities as a MET member interfered with taking care of their own ICU patients. Many nurses (64%) felt that they did not have a voice in MET's decision‐making process. Approximately 50% nurses felt that they were not recognized for their individual contribution, and they were uncertain regarding MET's policies for dealing with conflicts. The amounts of MET nurses' work experience and education were associated with MET skills and function, respectively. Conclusion: Key teamwork elements of the MET that need improvements include decision‐making and conflict resolution skills, valuing team members, and team leadership. Practicing shared mental models, implementing the TeamSTEPPS curricula at hospitals for training ICU nurses, and simulation‐based team‐training programmes may be beneficial in improving teamwork of MET members. Relevance to clinical practice: This study revealed key teamwork elements of the MET that need improvements. Our findings may contribute to improve teamwork, thereby optimizing MET function, and enhancing patient outcomes. [ABSTRACT FROM AUTHOR]

Aim: To identify and differentiate the practice patterns of generalist, specialist and advanced practice nursing roles in specialist and central hospital contexts. Background: In Finland, as in other Nordic countries, advanced practice nursing roles emerged around 2000. There are over 60,000 registered nurses/midwives in Finland and the clinical career pathway from a registered nurse to advanced practice nurse has been described yet not fully implemented in healthcare organizations. However, the number and activities of nonadvanced and advanced practitioner roles are not well known. Design: A descriptive comparative study. Methods: An online self‐report survey was conducted between August and October 2020 using an advanced practice role delineation tool. A census sample of registered nurses, registered midwives, specialist nurses and advanced practice nurses in five university hospitals and one central hospital was recruited. Descriptive statistics were used to summarize the characteristics of participants and group differences were compared using analysis of variance (ANOVA). The STROBE checklist was used as the reporting guideline. Results: A total of 1497 responses were obtained (response rate = 10%). Overall, nurses used comprehensive care and education activities most frequently. The least used activities were research and publication and professional leadership. Univariate analysis of variance test between role effects, when education and grouped age were taken into account, showed statistically significant difference in all of the observed five activities (p <.001). Conclusion: Identifying activities in different levels of nursing is a crucial first step in delineating nursing roles thus improving the governance of the human resource management. Impact: The study results add to the international literature, delineating nursing roles in the spectrum of generalist to advanced practice nursing. As these roles become more formalized, we may incorporate novel ways of promoting the career development and optimal use and assessment of nursing roles and practice in various career levels. [ABSTRACT FROM AUTHOR]

Knowledge sharing is an employee behavior, critical to organizational success in knowledge-intensive work environments. This study set out to empirically test the model of knowledge-sharing motivation designed and presented in this journal by Gagné (2009). The model combines two established behavioral theories, the theory of planned behavior and self-determination theory, and connects various human resource practices to it. This prospective survey study ( n = 200) in a large expert organization employed structural equation modeling. The results mainly supported the proposed model, with attitudes, autonomous motivation, and sharing norms predicting knowledge-sharing intentions ( R2 = .69), which predicted knowledge-sharing behavior ( R2 = .42). We also identified potential ways to modify the model to better suit typical knowledge-sharing contexts. Implications for practice, with the emphasis on how our findings can benefit and be used by human resource management, are discussed. © 2016 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

The aim of this correlational, cross‐sectional study was to assess the pressure ulcer prevention attitudes of the nursing staff and to identify factors associated with it both in primary and special health care. The study was conducted with nursing staff (N = 554) working in primary and special health care units in two hospital districts in Finlandin 2018 to 2019. Attitude towards Pressure ulcer Prevention instrument was used for data collection. Demographic data, Pressure Ulcer Prevention Knowledge test, and Pressure Ulcer Prevention Practice instrument were used as background variables. Data were analysed with statistical tests. Nursing staff working in primary care (n = 327) had more positive attitudes towards pressure ulcer prevention than those in specialised care (n = 209; P =.047). Working as a wound care nurse (P =.0005), working experience after graduation (P =.0017), self‐reported pressure ulcer prevention and early detection skills (P <.0001), pressure ulcer prevention knowledge (P =.0002), and views about the realisation of their unit's pressure ulcer prevention practices (P <.0001) independently explained variation in participants' attitudes. Attention should be placed on the pressure ulcer prevention attitudes of nurses who are less experienced or less skilled and who have lower pressure ulcer prevention knowledge. Positive organisational culture towards evidence‐based pressure ulcer prevention practices should be promoted. [ABSTRACT FROM AUTHOR]

Accessible summary [ABSTRACT FROM AUTHOR]

Salonen P, Tarkka M-T, Kellokumpu-Lehtinen P-L, Koivisto A-M, Åstedt-Kurki P, Kaunonen M. International Journal of Nursing Practice 2011; 17: 396-410 Individual face-to-face support and quality of life in patients with breast cancer Living with breast cancer significantly affects women's quality of life (QOL) creating a need for support that might persist throughout the breast cancer experience. The aim of this study was to assess the effect of individual face-to-face support on women's QOL and identify factors associated with their QOL. A two-group quasi-experimental design was used with a sample of 204 women who was assigned to the intervention ( n = 112) or the control group ( n = 92) in hospital after breast cancer surgery. Data of this study were collected 6 months after the surgery by structured questionnaires and analysed statistically using descriptive statistics and non-parametric tests. Factors predicting poor QOL were investigated using logistic regression models with enter-method. Women in the intervention group reported less arm symptoms and clinically better sexual functioning. Factors related to QOL were age, education, employment status, lymph node status, type of surgery, type of axillary surgery, received chemotherapy, hormonal therapy and ongoing therapy. Factors, predictive of poor QOL, included control group, age, education, type of surgery, type of axillary surgery, chemotherapy and ongoing therapy. Short-term face-to-face education and support intervention might have decreased arm symptoms and increased sexual functioning. Women with breast cancer should be offered systematic support and education, which is tailored to women's individual needs. [ABSTRACT FROM AUTHOR]

Heiskanen S, Vickrey B, Pietilä A-M. International Journal of Nursing Practice 2011; : 187-194 The aim of this study was to measure the health-related quality of life (HRQOL) of Finnish multiple sclerosis (MS) patients and importance and adequacy of existing psychosocial services as reported by MS patients. Data were collected with a structured questionnaire of 100 adults in Finland diagnosed with MS 2-4 years earlier. Response rate was 81%. The data were analysed using statistical analyses. Results show the need for psychosocial support related significant reduction in HRQOL at an early stage of MS. In addition, results indicated considerable gaps between MS patients' perceptions of the importance and perceived adequacy of support. [ABSTRACT FROM AUTHOR]

Montin L, Suominen T, Haaranen E, Katajisto J, Lepistö J, Leino-Kilpi H. International Journal of Nursing Practice 2011; : 19-26 This study was carried out to measure changes in health-related quality of life (HRQOL) in patients ( n = 100) undergoing total hip arthoplasty. The Sickness Impact Profile was used to measure patients' dysfunctions in 12 different categories post surgery. Improvement was observed in each category and dimension already at 3 months and at 6 months. Preoperative pain showed a statistically significant although declining correlation both with total, and with Physical and the Psychosocial dimensions of HRQOL. The greatest improvements were found in the categories Body Care and Movement, Ambulation, Alertness Behaviour, Social Interaction, Recreation and Pastimes and in Sleep and Rest. Patients' pain decreased, and 72% reported no pain at 6 months post the surgery. Patients' perceptions of their pain should be gathered carefully when deciding the need and timing for the surgery in order to minimize impairments into HRQOL. [ABSTRACT FROM AUTHOR]

The aims of this study were; 1) to identify different movement profiles in sixth graders, and 2) to investigate if there are differences in their mathematical basic (BasicMath) and problem solving (ProbSol) skills between existing movement profiles. The sample included 461 (223 girls, 238 boys) students with a mean age of 11.27 ±.32 years from southern and middle Finland. A latent profile analysis (LPA) revealed four movement profiles: "poor movers", "average movers", "skilled movers" and "expert movers". These profiles differed substantially in their motor competence (MC) and health-related fitness (HRF). A multivariate analysis of variance (MANOVA) also revealed that "poor movers" and "average movers" obtained lower results in BasicMath comparing with "skilled movers". The results of this study suggest that cardiorespiratory and muscular fitness, MC and BasicMath are interrelated. [ABSTRACT FROM AUTHOR]

Background: Consistent practice, an agreed clinical practice based on evidence, has been considered as a base for effective provision of quality and safety of care. As a result, patients have an equal quality of care regardless of the organisation or worker. However, despite the international guidelines, pressure ulcer prevention practices vary in long‐term older people care. Aim: To develop, implement and evaluate the impact of renewed, consistent practice for pressure ulcer prevention, in long‐term older people care. Design: A quasi‐experimental intervention study. Methods: Two long‐term older people care facilities chosen with convenience sampling were randomly allocated to intervention or comparison group. Registered and practical nurses, in total 141/112, participated in the study. The renewed consistent practice based on international guidelines for pressure ulcer prevention was developed and implemented using the Operational Model for Evidence‐Based Practices (OMEBP). Frequencies and agreement of PU prevention practices in line with international guidelines in the care facilities were measured using the PUPreP instrument. Results: In the intervention facility, improvement in line with international guidelines was seen in the frequency of PU prevention practices in risk assessment, nutrition, pressure‐relieving devices and documentation. Furthermore, improvement was seen in the intervention facility in all six areas of agreement on practices. Conclusions: The results of this study support the implementation of PU prevention guidelines in long‐term older people care (LOPC) and more widely in healthcare settings for older people to promote consistent practice, and safety and equal quality of care. [ABSTRACT FROM AUTHOR]

In this study, we examine the cross-cultural differences in human resource (HR) managers' beliefs in effective HR practices by surveying HR practitioners in Finland (N = 86), South Korea (N = 147), and Spain (N = 196). Similar to previous studies from the United States, the Netherlands, and Australia, there are large discrepancies between HR practitioner beliefs and research findings, particularly in the area of staffing. In addition, we find that interpersonal-oriented aspects of HR practices tend to be more culturally bound than technical-oriented aspects of HR practices. We interpret the differences using Hofstede's cultural dimensions (Power Distance, Individualism versus Collectivism, Masculinity versus Femininity, Long-Term Orientation versus Short-Term Orientation, and Uncertainty Avoidance). We discuss the overall nature of the science-practice gap in HR management, and the implications for evidence-based management. © 2014 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Our objective with this study was to investigate students' metacognitive awareness (MA) and its association with course grades in general upper secondary foreign languages, to foster reflective practices. A total of 267 foreign language students at Finnish schools answered an online survey, and the data were analysed quantitatively. Based on the results, the students' levels of MA were high in foreign languages, students at urban schools had higher levels than students at rural schools, and students with high course grades had higher levels of MA. Knowledge of cognition and attitudes about the language predicted the course grade the most. The results indicate that more emphasis should be put on the enhancement of MA at rural schools and with low-achieving students, to enhance their reflective practices. [ABSTRACT FROM AUTHOR]

This trial examined the effectiveness of an 8-week home meal service on protein and other nutrient intake, physical performance (PP) and health related quality of life (HRQoL) among older people living at home (≥65 years; home care clients, caregivers and care recipients). Participants were randomized into three groups; (1) protein-rich meal, snack, and bread (INT1), (2) regular meal (INT2) and (3) control group. Nutrient intake was assessed with 3-day food diaries, PP with Short Physical Performance Battery (SBBP) and HRQoL with 15 dimensional Health-related quality of life instrument. Total of 67 (59.7% women, mean age 78.2 years) participants (n = 22 INT1, n = 24 INT2, n = 21 CG) completed the trial. At baseline, mean protein intake was 0.92 (SD 0.32) g/kg adjusted body weight (aBW)/d. At 8 weeks, protein-rich home meal service in INT1 increased protein intake (+ 0.11 (95%CI −0.01 to 0.21) g/kg aBW/d, 9.4 (95%CI 1.0 to 17.8) g/d) compared to other groups. It also increased calcium intake (+169.9 (95%CI 26 to 314) mg/d) and improved results in Sit-to-Stand Test (-4.8 (95%CI −6.8 to −2.7) sec) in INT1 compared to CG. Both home meal services increased saturated fat intake (INT1; 4.6 (95%CI 1.0–8.2) g/d, INT2;7.8 (95%CI 1.9 to 13.7)g/d) and decreased salt intake (INT1;-2330.9 (95%CI −2998 to -1664) mg/d, INT2; −2371.9 (95%CI −3399 to -1345) mg/d) compared to CG. There was no effect on overall HRQoL. [ABSTRACT FROM AUTHOR]

Objectives: To assess the long-term efficacy of arthroscopic subacromial decompression (ASD) by comparing it with diagnostic arthroscopy (primary comparison), a placebo surgical intervention, and with a non-operative alternative, exercise therapy (secondary comparison).Methods: We conducted a multicentre, three group, randomised, controlled superiority trial. We included 210 patients aged 35-65 years, who had symptoms consistent with shoulder impingement syndrome for more than 3 months. 175 participants (83%) completed the 5 years follow-up. Patient enrolment began on 1 February 2005 and the 5-year follow-up was completed by 10 October 2018. The two primary outcomes were shoulder pain at rest and on arm activity measured with Visual Analogue Scale (VAS). Minimally important difference (MID) was set at 15. We used a mixed-model repeated measurements analysis of variance with participant as a random factor, the baseline value as a covariate and assuming a covariance structure with compound symmetry.Results: In the primary intention to treat analysis (ASD vs diagnostic arthroscopy), there were no between-group differences that exceeded the MID for the primary outcomes at 5 years: the mean difference between groups (ASD minus diagnostic arthroscopy) in pain VAS were -2.0 (95% CI -8.5 to 4.6; p=0.56) at rest and -8.0 (-17.3 to 1.3; p=0.093) on arm activity. There were no between-group differences in the secondary outcomes or adverse events that exceeded the MID. In our secondary comparison (ASD vs exercise therapy), the mean differences between groups (ASD minus exercise therapy) in pain VAS were 1.0 (-5.6 to 7.6; p=0.77) at rest and -3.9 (-12.8 to 5.1; p=0.40) on arm activity. There were no significant between-group differences for the secondary outcomes or adverse events.Conclusions: ASD provided no benefit over diagnostic arthroscopy (or exercise therapy) at 5 years for patients with shoulder impingement syndrome. [ABSTRACT FROM AUTHOR]

Background: Medication‐related errors are common in elderly care. Most are detected during the preparation and administration stages of the medication process. Nursing staff have a key role in preventing errors, and it is based on adherence to guidelines. Aim: The aim was to determine nursing staff's self‐assessments of how they adherence to guidelines on safe medication preparation, administration and asepsis in the medication process in long‐term elderly care and to identify factors affecting this adherence. Method: Cross‐sectional study was conducted by total sampling at the communal long‐term elderly care wards of one healthcare district in Finland in November 2016. Data were collected from nursing staff by using a previously developed web‐based questionnaire. The response rate was 39.4% (n = 492). Results: One‐third of the nurses stated that they do not always follow guidelines when preparing medication, and around a half deviate from them occasionally, when administering medication. The most serious deviation on preparation stage was crushing of sustained release and enteric‐coated tablets and mixing of crushed tablets together. On administration stage, the deviation of guidelines of giving medicine in recommended time or in relation to food was common. Associations were detected between the adherence to guidelines and the nurses' experience about the adequacy of their knowledge of pharmacology and infection control, and their skill at performing medication calculations. Conclusion: Deviation from guidelines often causes an error. There is a need to review the teaching of pharmacology, infection control and medication calculations during undergraduate and continuing education. In addition, nursing staff must be reminded about the ethical aspects of safe medication processes and the appropriate attitudes to these processes. Nurses must understand why it is important to follow guidelines when preparing and administering medications, in order to avoid errors. [ABSTRACT FROM AUTHOR]

Background: First‐line managers are links between an organizations' administration and the workforce. They transmit information from higher managers to workers and vice versa. Their management skills and especially their interaction with staff are a key point in successful management. Aim: To describe how first‐line managers realized appreciative management in their everyday management practice in health and social care. Method: A quantitative descriptive study was conducted by means of an electronic survey among social and healthcare managers in Finland. Results: Based on the self‐evaluations of the managers, appreciative management is well realized. The most recognition was given to equality and the least to appreciative know‐how. Connections were seen between appreciative management and gender, education, education level and managers with higher education, and those with fewer work units below them tended to have a better realization of appreciative management. Conclusion: The education level of first‐line nurse managers is meaningful when realizing appreciative management in social and healthcare settings. Implications for nursing management: More advanced education levels of first‐line managers help to promote appreciative management in social and health care, together with the amount of work units (meaning outpatient and inpatient wards). A first‐line manager is responsible for the needs of their workforce and needs to be critically assessed so that they might have more time for managing in an appreciative way. Appreciative management should be given increased focus when educating nurse managers. [ABSTRACT FROM AUTHOR]

Background: Being involved in an artistic intervention is related to employeesinterest to do work tasks in other ways and to develop new professional skills. These proactive changes, job crafting, that employees make to their work conditions increase work-related well-being, work engagement. Methods: This two-wave quasi-experimental intervention study investigated whether a visual art intervention enhanced the crafting of job resources (skill variety) and increased work engagement. The study was conducted among employees (n = 21) working in five comprehensive schools and in four day-care centers over a 1-month intervention. Employees not involved in the interventions served as the control group (n = 19). Results: Repeated measures ANOVAs showed no significant interaction effects. However, pre–post comparison tests showed that, unexpectedly, the participants' work engagement significantly decreased, and skill variety tentatively diminished. Qualitative feedback revealed some shortcomings in the implementation of the intervention. Conclusions: In the case of insufficient operation, the intervention may even have reverse effects. [ABSTRACT FROM AUTHOR]

Background: Research on employee satisfaction and rehabilitation care practice models in elderly care is scarce, and no previous studies exist regarding the effects of implementation of Kinaesthetics on psychosocial factors at work. Aim: This study aimed to describe job satisfaction among employees in elderly care after implementation of Kinaesthetics as a patient mobility support model in rehabilitation care. The target organisation was a joint collaboration area of four municipalities in Finland. Methodology: A descriptive cross-sectional design was used. The data were part of a larger occupational wellbeing survey, the Hospital Personnel Study. Psychosocial factors at work, including job characteristics, team climate and organisational justice, among elderly care staff were examined in 2012 (N=336), 2014 (N=326) and 2017 (N=370). At the end of 2012, a development project was implemented and during 2013 all employees of geriatric wards underwent basic training in Kinaesthetics. The geriatric ward employees were compared with employees in home care and nursing home in the same organisation. Results: In general, job satisfaction was rather good in all units, and the differences between the units were minor regardless of statistical significance. The change was different between the units only regarding relational justice. Between the baseline and the first follow-up measurement, relational justice improved in all work units, and improvement was more pronounced in geriatric wards where Kinaesthetics was implemented than in other elderly care units. Innovation increased among geriatric ward staff, but not statistically significantly. Conclusion: The study indicated that the implementation of Kinaesthetics seems to effect relational justice positively in elderly care. The implementation of Kinaesthetics possibly gave managers an opportunity to maintain a presence in everyday work. During the study, a nation-wide health and social services reform was being prepared and a larger scale effect of the intervention may have been overridden by other changes in the organisation. [ABSTRACT FROM AUTHOR]

Background: Observing a patient's clinical condition is an important responsibility of critical care nurses and an essential component of their competence. Critical care nurses' patient observation skills contribute to patient safety and quality of care. These observation skills have not been assessed or measured previously. Aim: The aim of this study was to measure the self‐assessed level of critical care nurses' patient observation skills and to explore the factors associated with these skills. Study design This was a multicentre cross‐sectional survey conducted in Finland. Methods: The sample consisted of critical care nurses working at Finnish university hospitals. The data were collected between September 2017 and January 2018 using an instrument developed for the study – Patient Observation Skills in Critical Care Nursing (visual analogue scale 0–100). Descriptive and inferential statistics were used to analyse the data. Results: A total of 372 critical care nurses (49%) responded. Finnish critical care nurses assessed their patient observation skills overall as excellent. The bio‐physiological foundation was assessed as good, whereas skills in using observation methods and skills in recognizing changing clinical condition were assessed as excellent. Education for special tasks in intensive care units, information searching in scientific journals, working experience in critical care nursing and critical care nurses' perception of critical care as a preferred field of nursing were factors promoting patient observation skills. Conclusions and relevance to clinical practice: The study provided a novel instrument for measuring critical care nurses' patient observation skills. The instrument may be used as an assessment tool in clinical practice and education. Developing orientation and on‐the‐job training in intensive care units are essential in assuring critical care nurses' adequate patient observation skills. Patient observation skills could be developed during nursing education by providing students with opportunities for clinical training and applying patient cases in virtual learning environments. [ABSTRACT FROM AUTHOR]

While physical activity is beneficial for youth with developmental disabilities, little is known about those individuals' fitness profile and levels of activity. Therefore the purpose of this study was to investigate the physical fitness profile and physical activity level of 30 adolescents with and without Asperger syndrome (AS). Evaluations were done using the Eurofit physical fitness test and the Baecke Habitual Physical Activity questionnaire. A 2 × 2 MANOVA indicated that adolescents with ASscored significantly lower than the comparison group on all physical fitness subtests, including balance, coordination, flexibility, muscular strength, running speed, and cardio-respiratory endurance (p < .001). Adolescents with AS were also less physically active (p < .001). Engagement in physical activities is therefore recommended. [ABSTRACT FROM AUTHOR]

Eighteen young (23 ± 4 yr) and 25 older (70 ± 4 yr) male sprinters were examined for ground reaction force (GRF) and temporal-spatial variables. The data were collected during maximum-speed phase, and variability and symmetry indices were calculated from a total of 8 steps. There was little variation (CV < 6%) in vertical and resultant GRF and kinematic variables, while impact loading had high variability (CV: 10-21%). Overall, the pattern of variability was similar in both groups. Yet, a small but significant age-related increase in CV was evident in horizontal GRFs. There was a variable-specific asymmetry between legs but it was not related to leg dominance. No age differences existed in the symmetry indices. Results indicate that only selected force platform variables are symmetric and repeatable enough so that their use for comparison purposes is appropriate. Data also suggest that aging may increase variability in certain biomechanical measures, whereas symmetry is not affected by age. [ABSTRACT FROM AUTHOR]

Aim: To characterize registered nurses' (RNs') perceptions of nurse leaders' transformational leadership (TL) qualities in Finnish university hospitals and identify predictors of positive and negative evaluations. Background: Transformational leadership can improve health care but requires development. Information on TL is typically derived from survey results, which are vulnerable to confounders. Method: Cross‐sectional survey. Registered nurses' perceptions of nurse leaders were measured with the TL scale. Kohonen's self‐organizing map was used to cluster the data based on RNs' opinions and questionnaire items. Logistic regression explained background characteristics' effects on cluster formation. Results: A total of 1,970 RNs participated and evaluated their nurse leaders' TL qualities as moderate. Giving feedback and rewarding clustered separately from other TL qualities. Females and permanent workers evaluated nurse managers more negatively but nurse directors positively. Positive perceptions of nurse managers' TL predicted better TL among nurse directors. Vice nurse managers gave the most positive evaluations. A total of 197 RNs had no opinions about nurse directors' TL. Conclusions: Registered nurses evaluated nurse managers' TL qualities as moderate and were unfamiliar with nurse directors. Background characteristics affecting evaluations differed between leader types. Implications for Nursing Management: Giving feedback and rewarding should be more closely associated with other TL qualities. Transformational leadership requires transformational approaches from both nurse managers and directors. [ABSTRACT FROM AUTHOR]