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LBGTQ+ students often miss the support and information they need in the school nursing, but little is known about junior high school (JHS) nurses' work with LGBTQ+ students. 15 JHS nurses were interviewed in focus groups about their perceptions of supporting LGBTQ+ students. Four interconnected themes were identified with inductive thematic analysis: (1) JHS nurses' professional identity and practice; (2) Recognition of sexual and gender diversity in school; (3) Family acceptance process; and (4) LGBTQ+ students as school nursing clients. JHS nurses self-identified as accepting professionals, but having limited skills, knowledge, and education needed in supporting LGBTQ+ students. Supporting LGBTQ+ students is a complex phenomenon, and to enhance JHS nurses' competence in providing care for these students, sexual and gender diversity needs to be included in evidence-based nursing information sources, covered in nursing education, and the school needs to be secured as LGBTQ+ safe place. [ABSTRACT FROM AUTHOR]

Research indicates that refusal self-efficacy predicts adolescent smoking behavior and needs to be addressed in health education programs. Developing such programs requires examining the factors associated with smoking refusal self-efficacy in the target group. Thus, our study examined factors associated with smoking refusal self-efficacy among early adolescents in Finland and Portugal. Self-reported data on smoking refusal self-efficacy, smoking outcome expectations, smoking-related attitudes, motives, and motivations were obtained from 295 early adolescents, and analyzed using a logistic regression and correlation calculations. Experiences with tobacco, smoking-related attitudes and motives, the motivation to refrain from smoking in the future, and smoking outcome expectations were associated with smoking refusal self-efficacy. Gender, and the smoking behavior of relatives and friends were independent predictors of smoking refusal self-efficacy. The findings were similar in both countries. Our results strengthen the notion that parental smoking is not associated with smoking refusal self-efficacy of early adolescents but smoking by friends and relatives and gender favoring girls are. Thus, health education programs aiming to support early adolescent smoking refusal self-efficacy need to consider the role of peer influence and the social acceptance of smoking and place more emphasis on effectively supporting boys' smoking refusal self-efficacy. [ABSTRACT FROM AUTHOR]

Introduction and aims: The aim was to explore clinical decision support (CDS) use in the practice of primary healthcare nurses. The objectives were to recognize to what extent nurses (registered nurses, public health nurses, and practical nurses) use CDS, what factors were associated with the CDS used, what kind of organizational support nurses need, and what were nurses' views about CDS development needs. Methods: The study was conducted with a cross-sectional study design, using an electronic questionnaire developed for this purpose. The questionnaire contained 14 structured questions and nine open-ended questions. The sample consisted of randomly selected primary healthcare organizations (N=19) in Finland. Quantitative data were analyzed using cross-tabulation and Pearson's chi-squared test, and qualitative data with quantification. Results: A total of 267 healthcare professionals (age range 22-63 years) volunteered to participate. Participants were mainly registered nurses, public health nurses, and practical nurses (46.8, 24, and 22.9%, respectively). Overall, 59% of the participants had never used CDS. The majority (92%) found it necessary to develop nursing-specific content for CDS. The most commonly used features were medication recommendations and warnings (74%), reminders (56%), and calculators (42%). Half of the participants (51%) had not received training on the use of CDS. The older age of participants was associated with the feeling of not having enough training to use CDS (P=0.039104). Nurses felt that CDS was helpful in their clinical work and decision-making, promoting evidencebased practice, and narrowing the research-into-practice gap, improving patient safety and the quality of care, and helping those who are new in their work. Conclusion: CDS and its support structures should be developed from a nursing perspective to achieve the full potential of CDS in nursing practice. [ABSTRACT FROM AUTHOR]

Background: Pressure ulcers cause economic burden, human suffering, pain and decreased health‐related quality of life in patients. Pressure ulcers are preventable in most cases, and nursing staff knowledge is a key factor in successful pressure ulcer prevention. Further evidence is needed to better tailor pressure ulcer prevention training programmes to the nursing staff. Aim: To evaluate the level of nursing staff knowledge about evidence‐based pressure ulcer prevention practices in both primary and specialised care, and to identify what factors determine nurses' knowledge levels. Methods: A correlational, cross‐sectional study was conducted from 2018 to 2019 in two hospital districts in Finland. The Pressure Ulcer Prevention Knowledge test was used to collect data, and the Attitude towards Pressure ulcer Prevention (APuP) instrument was used as a background variable. The data were statistically analysed with Wilcoxon and Kruskal–Wallis tests, Spearman correlations and multiple linear regression. Results: The pressure ulcer prevention knowledge of the participating registered nurses, practical nurses and ward managers (N = 554) was on average 24.40 (max. 35.00). There was no difference in the participants' knowledge based on the type of unit in which they were working (primary or specialised care). The participants' attitudes (p < 0.0001), current position (p = 0.0042), frequency of taking care of patients with pressure ulcers (p = 0.0001) and self‐evaluated training needs (p < 0.0001) independently explained the variation in the knowledge scores. Conclusions: Special attention needs to be paid to the knowledge of those nurses working in positions that require lower levels of education and those who rarely take care of patients with pressure ulcers. Supporting nurses' positive attitudes towards pressure ulcer prevention should be an essential part of pressure ulcer prevention training. Nurses' self‐evaluations of their training needs can be used to target training. The limitations of the study should be considered when generalising the results. [ABSTRACT FROM AUTHOR]

Peers play a significant role in influencing adolescent self-efficacy. Self-efficacy, in turn, has been considered to influence health behavior. The purpose of this qualitative descriptive study was to describe adolescents' perceptions about their self-efficacy in peer interactions to strengthen the theoretical understanding about the sources of self-efficacy during adolescence. The sample comprised of 155 adolescents (13 − 17 years) in three upper comprehensive schools within two Finnish cities. The data were collected using the critical incident technique with an open-ended questionnaire. Adolescents were asked to describe two situations: one in which they had, and another in which they had not been able to act according to their own choice in peer interactions. Adolescents' written descriptions were analyzed using inductive thematic analysis. The data suggests that adolescents' perceptions about their self-efficacy in peer interactions manifests itself as a dynamic process characterized by debating with oneself and reflecting on information relevant for judging personal abilities. Debating with oneself consisted of five themes which influenced the adolescents' self-efficacy in peer interactions: adolescents' self-identity, social atmosphere, adolescents' cognitive and emotional aspects as well as evaluating the consequences of the intended action. Adolescents' self-identity, which included self-confidence and morals, appeared to be the most solid theme, whereas social atmosphere varied according to the situation. Social atmosphere often diminished the adolescents' self-efficacy in peer interactions. Although the findings are partly consistent with previous literature, they also put more emphasis on adolescents' own active role in the formation of self-efficacy in the context of peer interactions. [ABSTRACT FROM AUTHOR]

Aim: This article introduces the protocol of a study aiming to evaluate the effectiveness of digital WellWe intervention in supporting the participation of families with small children in the promotion of their health. Background: Early childhood is a meaningful period for building a strong base for good health. Parents play a key role in affecting the health behaviour and psychosocial development of their children. A family-centred approach makes it possible to support families' individual health literacy needs and empower them to take actions towards promoting healthier behaviour. However, there are a lack of family-centred digital health interventions intended for parents and their small children. Design: The study is designed as a two-arm cluster, randomized, controlled trial with a 4-month follow-up. Methods: The data are being collected from 200 families with a 4-year-old child. Cluster randomization is being performed at the municipality level. Municipalities (N = 4) located in Southwest Finland, comprising child health clinics (N = 15) with their family clients, were randomly allocated to either an intervention (WellWe intervention) or a control group (usual care). The outcome measures include parental self-efficacy for healthy behaviours, mindfulness in parenting and the family-centred approach of the extensive health examination. Data collection is being performed at baseline, after the intervention and at a 4-month follow-up. Discussion: The results from this study will make it possible to determine whether this new method can be recommended for implementation in child health clinic settings to support the participation of families with small children in promoting their health. [ABSTRACT FROM AUTHOR]

Aim To describe and explore health game interventions that enhance the physical activity self-efficacy of children and to evaluate the effectiveness of these interventions. Background Physical inactivity among children has increased globally. Self-efficacy is one of the key determinants of physical activity engagement in children. There is a need to explore new and innovative interventions to enhance physical activity self-efficacy that are also acceptable for today's children. Design Quantitative systematic review. Data sources MEDLINE (Ovid), CINAHL, PsychInfo, EMBASE and the Cochrane Library between 1996-2016. Review methods A review was conducted in accordance with the Cochrane Collaboration guidelines. A systematic search was done in June 2016 by two independent reviewers according to the eligibility criteria as follows: controlled trial, comparison of digital game intervention with no game intervention control condition, participants younger than 18 years of age and reported statistical analyses of a physical activity self-efficacy outcome measure. Results Altogether, five studies met the eligibility criteria. Four game interventions, employing three active games and one educational game, had positive effects on children's physical activity self-efficacy. An intervention, employing a game-themed mobile application, showed no intervention effects. The variation between intervention characteristics was significant and the quality of the studies was found to be at a medium level. Conclusion Although health game interventions seemingly enhance the physical activity self-efficacy of children and have potential as a means of increasing physical activity, more rigorous research is needed to clarify how effective such interventions are in the longer run to contribute to the development of game-based interventions. [ABSTRACT FROM AUTHOR]