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Abstract Purpose The purpose of this study was to explore changes in HRQoL (health-related quality of life) and identify the associated factors in patients with prostate cancer and their spouses during the year following their diagnosis of prostate cancer. Methods The longitudinal study design consisted of 179 patients and 166 spouses, using discretionary sampling, at five Finnish central hospitals. Participants completed a self-reported RAND-36-Item Health Survey at three time-points: time of diagnosis and 6 and 12 months later. Changes in HRQoL were analysed using descriptive statistics and non-parametric tests. Linear mixed-effects models were used to identify the factors associated with the changes in HRQoL in the patients and their spouses. Results On average, the HRQoL of patients with prostate cancer changed in physical functioning (p = 0.015), emotional well-being (p = 0.029) and general health (p = 0.038) were statistically significant over the 12-month study period. In spouses, statistically significant changes in HRQoL were not observed. Interaction between the age of participants and changes in HRQoL were statistically significant. Conclusions Findings in this study suggest that interventions aimed at improving the HRQoL of patients should support a few different dimensions of HRQoL for the patients themselves than for their spouses. Nurses should pay more attention to elderly couples. Highlights • A simultaneous follow-up of the HRQoL of these patients and their spouses is worth investigating. • Intervention aimed at improving the HRQoL of patients should support for the patients themselves than for their spouses. • Additional, nurses should pay more attention to elderly prostate cancer patients and their spouses. [ABSTRACT FROM AUTHOR]

The purposes of this study were to describe the coping processes and support needs of patients with incurable cancer. The study was conducted as a qualitative study. The research data were gathered by conducting thematic interviews with outpatients with incurable cancer (n = 16) and analyzed by means of inductive content analysis. The results of the study indicate that the lives of patients were temporarily interrupted by the incurable illness. A sympathetic family was perceived as strength, and after the initial shock, the patients began to rebuild their lives. They had conflicting thoughts about cancer treatment. The patients felt that theywere courageous, but fragile, in the face of their illness. They prepared for the approaching death by discussing the issue with their family members and friends and planning their own palliative care. The patients expected to be approached holistically. The results of this study are applicable in circumstances in which health care professionals are preparing to approach an incurable cancer patient as an individual, instead of simply as amedical case. The results can also be utilized to develop evidence-based, family-oriented palliative nursing for cancer patients and to better identify the expectations and needs of the patients while receiving treatment. [ABSTRACT FROM AUTHOR]

Older patients quite often arrive in an emergency department (ED) with a family member, but little is known about the family member’s health evaluated in ED. The aim of this study was to describe family health in EDs evaluated by family members and nurses. Data were collected from Estonian hospital EDs from 111 family members of older patients and from 93 nurses. Family health in EDs was evaluated as being at a moderate level. Family members reported that family health was better when older patients lived with the family. The more time the family spent in the ED, the worse the health-related activities were. Nurses reported that cardiovascular problems in older patients who presented in EDs disturbed the values of family health. We conclude that ED nurses should recognize the level of family health, in order to ensure that the family will be able to cope at home. Family health in EDs should be reviewed over time to help nurses meet the required needs of the family. [ABSTRACT FROM AUTHOR]

Background home births are quite rare and are not supported as part of mainstream health care services in most European countries. Women who choose home as the place of birth often do so because maternity services in hospitals do not offer the options that they want. The aim of the present study is to describe women's experiences of giving birth at home and to produce a comprehensive structure of meaning regarding giving birth at home. Design a phenomenological study based on analysis of open-interview transcripts using Colaizzi's approach. Participants women who gave birth at home Findings women who have given birth at home experience having control over their own body, the care they are given, and the practical arrangements surrounding the birth. However, they also experience negative attitudes from other people about their decision to give birth at home, and challenges because of worries about how they and their baby will cope. During the birth women feel a sense of connection to their own body, which they trust to tell them what to do. They experience great happiness on successfully giving birth and feel connected to nature and the circle of life. Being able to celebrate with family members and be pampered by them after the birth made the women feel ‘like queens’. Conclusions women's experience of childbirth at home is one of having control over the birthing process and its environment. The main challenge is exposure to negative attitudes from others, including health care professionals. Overall, the experience was full of happiness and good feelings. We conclude that more attention should be paid to the quality of birth experiences and women's individual needs and wishes within maternity care provision. [ABSTRACT FROM AUTHOR]

The present qualitative study used face-to-face and telephone interviews with service providers in the Tampere area in Finland to describe the provider viewpoint on barriers to care for people with co-occurring disorders. The core barrier concerns the definition and understanding of the problems: client and professional perspectives often differ, and both can be out of step with what the care system actually proposes. Professionals need to take into account contexts with potentially multiple barriers to care. Providers in each local area should examine possible barriers and find solutions together, integrating the client perspective at each step in the process. [ABSTRACT FROM AUTHOR]

This qualitative study investigated the mental health service users' (MHSUs') experiences of empowerment training and it was based on individual interviews with 24 MHSUs. Findings showed that MHSUs described the training environment through three dimensions: social interaction, learners' internal resources and the pedagogical execution of training. The training reinforced their positive internal resources, stimulated their inner mind activity and gave meaning to their lives. The knowledge of the training environment helps to build environment, which will support MHSUs' training. Empowerment training could be used to strengthen MHSUs' positive internal resources giving them also a possibility to train their cognitive activities. [ABSTRACT FROM AUTHOR]

Background: partners often participate in childbirth, and the effects on both partners have been intensively investigated, but children's participation is rare in western countries and less studied. Thus, the aim of this study was to explore and construct a comprehensive structure of meaning of Finnish children's experiences of participating in birth of a sibling at home. Design: a phenomenological study based on analysis of open-interview transcripts by Colaizzi's approach and drawings. Participants: seven children aged five to 17 years who participated in birth of a sibling at home. Findings: the children's experience of participating in a sibling's birth was multifaceted. Their feelings varied from joy to worry, they helped their mother and learned from the experience. They chose to participate. They experienced overwhelmingly strong and positive feelings, but were also worried about the well-being of other family members during the birth. Further, younger children were frustrated, especially if the birth took a long time and they were not allowed to do all they wanted, such as going to a birthing pool. It was important for the children to be able to help their mother and support younger siblings. They learned a lot about childbirth from their participation and information given by the adults. The children regarded home as safe, cosy and a better place to give birth than a hospital. The older children also regarded a home birth as a possible choice for them in the future. They celebrated the baby's arrival and remembered the birth day as being joyful and happy. Participation in the sibling's birth made relationships between the children closer and warmer. Children felt hurt when people outside the family were suspicious when told that the baby was born at home. Conclusions: the children's experience of participating in a sibling's birth at home included varying feelings, learning from their experience and helping mother. The findings could be utilised in parent education if they are going to have their children with them during the childbirth. [ABSTRACT FROM AUTHOR]

Introduction Older patients are a major patient group in emergency settings in Finland. Family members have a crucial part to play when older people are discharged home. Discharge education is common practice within discharge planning in emergency department (ED). Discharge planning is associated with patient outcomes, but little is known about discharge education as such. The purpose of this study was to examine the association of discharge education with discharge readiness among older patients and their family members in an emergency setting in Finland. Methods This cross-sectional study was performed in two EDs. Questionnaire data were collected from patients over 75 (N = 135) and their family members (N = 128) to examine the level of discharge education, and to see how discharge education was associated with discharge readiness. Descriptive and non-parametric methods were used. Results One in four older patients and 40 per cent of family members received no discharge education. Nevertheless, discharge education was associated with a higher level of discharge readiness, both among patients and family members. Discussion ED personnel should give more focus to discharge education when planning the discharge of older patients in order to facilitate better discharge readiness. [ABSTRACT FROM AUTHOR]

Objectives: The objective of this study was to describe parents' experiences of family functioning, health and social support provided by nursing personnel, while their child was in intensive care, and to determine how social support was associated with family functioning and family health. Design: Cross-sectional study. Setting: The data were collected by a self-administered questionnaire from 31 parents of critically ill children from 2010 to 2011. The data were analysed statistically. Main Outcome Measures: The parents considered their family functioning, health and social support provided by the nursing personnel to be good. Results: The sub-area of family functioning that rated the lowest was strengths of family, whereas the lowest rated sub-area of family health was ill-being. Child's previous hospital treatments were associated with family health. Parents, whose child had already been in hospital care, reported more well-being and less ill-being than parents with children hospitalised for the first time. Parents' education was associated with family functioning, family health and social support given by the nurses. Weak positive correlation was also found between social support given by nurses and family health experienced by parents. Conclusion: There is a need to discuss how nursing care can further support parental resources. [ABSTRACT FROM AUTHOR]

BACKGROUND : Social support is an important form of external support to patients and families. PURPOSE : Assessment of postoperative external support provided by staff to patients and family members at discharge from hospital and related factors. METHODS : Quantitative descriptive study conducted with surgical patients treated for disc herniation or spinal stenosis ( N = 92) and family members ( N = 55) in a central hospital in Finland in 2008–2010 to measure the importance of various forms of support and their association with respondents’ overall postoperative coping. RESULTS : Patient education atmosphere was the most important source of external support for both patients and family members. Better overall coping was reported by both groups if the patient’s behavior and intrafamilial emotions had changed in a positive way. Patients’ overall coping was promoted if they received adequate information from staff. CONCLUSIONS : Nurses’ role and competence are crucial in supporting the coping of patients and families. [ABSTRACT FROM AUTHOR]

Abstract: Background: the postpartum period presents several challenges related to learning infant care tasks, getting to know the infant and fulfilling self-expectations as parents. There is a need to evaluate the effectiveness of information-technology-based interventions that support parenting during this period. Objective: to evaluate the effectiveness of an internet-based intervention to support mothers’ and fathers’ parenting satisfaction and parenting self-efficacy (PSE). Design: a quasi-experimental design with a non-equivalent control group and repeated measures. Setting: two public maternity hospitals (intervention/control) in southern Finland. Participants: a convenience sample of mothers and/or fathers (n=1300 families). The inclusion criteria were primipara or multipara, and at least one parent willing to participate. Multiple birth, non-Finnish speaking and early discharge parents receiving home visits were excluded. A total of 500 mothers and 242 fathers returned complete sets of questionnaires. Intervention: the intervention offered online support for parenting, breast feeding and infant care beginning from the middle of pregnancy. It comprised an information database, a peer discussion forum and expert advice. Measurements: outcomes were measured by the Evaluation Subscale of the What Being the Parent of a New Baby is Like-Revised and parenting self-efficacy instruments after childbirth and six to eight weeks post partum. Findings: both intervention and control mothers’ parenting satisfaction and PSE increased significantly during the postpartum period. Fathers’ parenting satisfaction and PSE also increased, but this change was only significant in the case of PSE. Both parents felt that their affective skills related to PSE were the weakest after childbirth. During the postpartum period, affective skills improved more than cognitive and behavioural skills. Different groups of mothers and different groups of fathers showed an equally positive change in parenting satisfaction and PSE. Conclusion: both intervention and control mothers’ and fathers’ parenting satisfaction and PSE became more positive during the postpartum period. However, no intervention effects were found. In the future, it would be interesting to study longer-term effects and more specific groups of parents. The results indicate that online support has the potential to reach parents from diverse backgrounds. More research is needed on gender differences and user preferences. More interactive methods are needed to support parents’ affective skills related to PSE. [ABSTRACT FROM AUTHOR]

Abstract: Background: In the acute trauma caused by intimate partner violence (IPV), the emergency department (ED) and its staff are often the first contact for women. The failure to intervene in IPV situations may contribute to further injury and health problems for women, as well as to frequent visits to the ED. Aims: The aims of this study is to describe the history of IPV with its health consequences for women when seeking care for their acute injuries and what kinds of care experiences had the women had when visiting EDs. Methods: Data were collected via questionnaires from 35 women and after that seven semi-structured interviews were conducted. The data were analyzed using quantitative and qualitative methods. Results: Among the women the lifetime prevalence of physical IPV was 94%. Ninety-seven percent of past and 56% of acute cases of physical violence were accompanied by psychological violence. The surveyed women highlighted individual needs for care, including appropriate medical care of injuries, and psychological and tangible support. The women worried about their children and partners and regarded supporting the whole family as important. Conclusion: There is a need for ED professionals to develop family-oriented services, and a need for further training and research on how to deal with women exposed to IPV. [Copyright &y& Elsevier]

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

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

Objective: This study sought to identify the incidence of depression and its associations with demographic, lifestyle, perceived health, symptoms, treatment, and social support variables in patients 9 years after a coronary artery bypass graft. Methods: The questionnaire was mailed to 152 surviving patients who had undergone a coronary artery bypass graft 9 years earlier, and who had been respondents in an earlier study. Depressive symptoms were measured using the Zung Self-Rating Depression Scale, and social support was measured using Social Support from the Network Scale. Descriptive statistics and the linear regression method were used for analysis. Results: Depressive symptoms were reported by one fourth of the patients. The predictors for depressive symptoms included gender, perceived health, cardiac ischemic symptoms at rest, and emotional social support, which explained 24% of the variance. Controlling for gender revealed that the predictors for women and men were different. Conclusions: Depression is more difficult to predict in men than in women. [Copyright &y& Elsevier]

Aim. This paper is a report of a study of experiences of domestic violence and coping among ninth-grade (14-17 years old) adolescents. Background. Domestic violence is commonplace and adolescents are involved in it either as witnesses or victims. Research has shown that different degrees of domestic violence play a major role in adolescent well-being and coping. Method. A survey of ninth graders in one municipality in Finland was conducted in 2007. A total of 1393 adolescents participated, giving a 78% response rate. The survey included two validated scales, the Violence Scale and the Adolescent Coping Scale. Logistic regression analysis was performed to determine coping among adolescents with and without experience of domestic violence. Results. Sixty-seven per cent of adolescents had experienced parental symbolic aggression, 55% mild violence and 9% serious violence. The multivariate logistic regression model showed that experiences of violence were associated with deterioration in self-rated health, life satisfaction, adolescent giving in when in a conflict situation, approval of corporal punishment and coping by seeking to belong and self-blame. Those with experience of domestic violence did not seek professional help. Conclusion. Adolescents experiencing domestic violence do not seek help and care providers should therefore take active measures to help them. These adolescents reported that they were satisfied with life, which makes it difficult to identify their need for help. Resources should be developed to identify and help these adolescents. [ABSTRACT FROM AUTHOR]

Aims. To compare mothers' and fathers' parenting satisfaction; to identify factors contributing to their parenting satisfaction; and to evaluate the effect of these factors.Background. Parenting satisfaction is important for parents' motivation to care, nurture and interact with their child. Parenting is influenced by attributes of parent, infant and the environment. However, more research is needed to understand the contributing factors.Design. Parenting satisfaction and several parent, infant and environment attributes were measured at hospital or in one week of discharge. A total of 2600 questionnaires were handed out to a convenience sample of Finnish speaking parents in two hospitals during the winter of 2006. Multiple-birth and early-discharge parents receiving support at home were excluded. Responses were received from 863 mothers (66%) and 525 fathers (40%).Methods. Comparisons were made by percentages and means. Significances were determined by GEE models and One Way ANOVA tests. Pearson's and Spearman's correlations were used to determine correlations and multiple regression analysis to clarify the effect size.Results. Mothers were more satisfied than fathers with their parenting. Self-concept, depressive symptoms, infant centrality, state of mind on discharge and perception of infant contributed most to parenting satisfaction. Family functioning, health and advice from personnel were major contributory factors as well.Conclusion. Hospital practices and social support from personnel did not correlate with parenting satisfaction. More research is recommended to evaluate them, since they had an effect when combined with other attributes.Relevance to clinical practice. Our results will help professionals understand the experiences, resources and challenges faced by parents. Family-oriented care and sound advice have the potential to offer the most supportive environment for both parents. If professionals can identify mothers who are afraid, concerned or insecure during pregnancy, they can also offer them extra support before the child is born. [ABSTRACT FROM AUTHOR]

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

Title. Health-related quality of life after coronary artery bypass grafting.Aim. The purpose of this study was to monitor changes in health-related quality of life and to identify associated factors among patients having coronary artery bypass grafting and their significant others.Background. Heart disease and its treatment affects the lives of both patients and their significant others, and the early stage of recovery from surgery causes particular anxiety for both.Method. In this longitudinal study, three sets of questionnaire data were collected 1, 6 and 12 months after coronary artery bypass grafting surgery from patients and significant others at one university hospital in Finland in 2001-2005. We recruited all patients who had been admitted for elective coronary artery bypass grafting surgery during the period specified. The data consisted of the responses from those patients and significant others who had completed all three questionnaires and for whom patient-significant other pairs existed ( n = 163).Findings. Patients' and their significant others' health-related quality of life was at its lowest one month after the operation and improved during follow-up. The change in the mean health-related quality of life score differed between patients and significant others; the improvement in the patients' health-related quality of life was greater than that in the significant others. Neither the background variables used in the study nor social support were associated with change in health-related quality of life.Conclusion. Further research is needed to identify factors explaining the change in health-related quality of life to develop interventions to support patients and significant others. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To describe and compare the health-related quality of life (HRQoL) of patients (N = 367) and significant others (N = 367) and to identify factors associated with HRQoL after coronary artery bypass grafting (CABG). METHODS: HRQoL was measured by the 15D in 3 stages: 1, 6, and 12 months after CABG. The focus in this study is on HRQoL at the second (6 months) and third (12 months) stages of the recovery process. Stepwise linear regression analysis was used to identify the associations of independent variables with HRQoL. RESULTS: Patients had a lower HRQoL than significant others in both stages after CABG. The HRQoL of patients and significant others was explained by their HRQoL 1 month after the operation. Other significant explanatory factors among patients were cardiac symptoms on physical exertion and other additional diseases. Among significant others, chronic diseases were associated with HRQoL. CONCLUSION: The HRQoL of patients and significant others differed from each other at both 6 and 12 months after CABG. Previous HRQoL affects later HRQoL in both patients and significant others. [ABSTRACT FROM AUTHOR]

This paper describes how Hanna Maijala and Päivi Åstedt-Kurki developed a means of assessing interaction between staff and families of sick children while researching the provision of interactive nursing for families of children who required acute hospital care. [ABSTRACT FROM AUTHOR]

Aims. To describe informal carers' coping strategies and their experiences of the support provided by respite care. Background. The target set in the Finnish national old age policy strategy is that 90% of the population over 75 should be able to live at home. A major source of support for older people and their families is respite care in an institution. Design. Survey. Methods. The data were collected among informal carers who regularly use respite care services ( n = 143). Two structured questionnaires were used: the Carers' Assessment of Managing Index ( Nolan et al. 1995 ) and an index developed by the researchers. Results. Informal carers who provided care for younger individuals or people who needed less help had a better quality of life. Spouse carers and older informal carers were less satisfied with their quality of life than younger carers. Periods of respite care had a major influence on informal carers' quality of life: 93% said they felt invigorated. Care periods remained rather isolated episodes in the lives of the older patients in that there was hardly any discussion at the institution about the family's situation, the objectives of respite care, or about how the informal carer was coping. Altogether, 47% of the nurses remained fairly distant. The most useful coping strategies involved creating alternative perspectives in the caring relationship. Conclusions. The results strengthen the knowledge base of informal caregiving by showing how caregivers cope and what kind of support they need in their demanding caring role. Relevance to clinical practice. Respite care nurses should invest greater effort in supporting informal carers. The service should be developed as an integral part of home care for older people. Nurses and informal carers should see each other as partners who share a common goal, i.e. the well-being of the entire family. [ABSTRACT FROM AUTHOR]

Aim. The paper is a report of a review of the literature on the effects of school-based drama interventions in health promotion for school-aged children and adolescents. Background. Drama, theatre and role-playing methods are commonly used in health promotion programmes, but evidence of their effectiveness is limited. The educational drama approach and social cognitive theory is share the assumption that learning is based on self-reflection and interaction between environment and person. However, educational drama also emphasizes learning through the dialectics between actual and fictional contexts. Data sources. A search was carried out using 10 databases and hand searching for the period January 1990 to October 2006. Methods. A Cochrane systematic review was conducted. Results. Nine studies met the criteria for inclusion. Their topics included health behaviour (five studies), mental health (two) and social health (two). Actor-performed drama or theatre play followed by group activities was the intervention in five studies, and classroom drama in four studies. Four of the studies were randomized controlled trials and five were non-randomized controlled studies. Four reports gave the theory on which the intervention was based, and in eight studies at least some positive effects or changes were reported, mostly concerning knowledge and attitudes related to health behaviour. The diversity of designs and instruments limited comparisons. Conclusion. There is a need for well-designed and theory-based studies that address drama interventions in health promotion for children and families. The challenge is to find or develop a theory, which combines educational, drama and health theories with valid and reliable measurements to examine the effects of the intervention. [ABSTRACT FROM AUTHOR]

Aim. To describe and compare the health-related quality of life of patients and their significant others and to identify factors associated with health-related quality of life one month after coronary artery bypass surgery. Background. Heart disease and coronary artery bypass surgery affect the life of patients and their significant others. Following surgery, some patients might feel their quality of life is poor. Significant others are a major source of support for patients; therefore, it is important to know how their health-related quality of life is affected. Methods. This study is part of a major longitudinal research project. The questionnaire data for the study were collected one month after the surgical procedure from 270 patients and 240 significant others at one Finnish university hospital. Data analysis was by descriptive and inferential statistics. Stepwise linear regression analysis was used as a multivariate method. Results. Coronary artery bypass grafting patients had a poorer health-related quality of life than both the age and gender-standardised general population and their significant others. Significant others, on the other hand, had the same health-related quality of life as the general population. In patients, health-related quality of life was associated with the occurrence of cardiac symptoms and New York Heart Association class; in significant others, it was explained by chronic illnesses, employment, gender and emotional support received from members of the support network. Conclusion. In the early stages of recovery, the health-related quality of life of coronary artery bypass grafting patients is inferior to that of the general population. There are also differences in the health-related quality of life of patients and their significant others. Relevance to clinical practice. Postcoronary artery bypass grafting rehabilitation programmes should provide support for both patients and significant others through networks that involve both professionals and peer supporters. [ABSTRACT FROM AUTHOR]

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

Background: In day surgery, the patients and their families bear more responsibility for their own care than in traditional ward care. Previous studies describe that preoperative information can alleviate the patient's fear and nervousness regarding surgery, but only a few studies exist revealing nurses' experiences of counselling adult patients and their families in the day surgical unit. Aims and objectives: The purpose of this study was to describe nurses' perceptions of counselling patients and families in the day surgical unit. Methods: The study utilized grounded theory methodology and the study took place in day surgical units of three hospitals in Finland. The data consisted of diaries written by 16 registered nurses and interviews with 10 registered nurses. The data were analysed using the constant comparative method. Findings: Counselling was conceptualized as five domains: (1) directive counselling, (2) nurse oriented counselling, (3) counselling the silent family unit, (4) counselling focusing on the family situation and (5) counselling involving reciprocal exchange of information and feelings. Conclusion: The study revealed that there were tensions between the demands of the day surgical nursing environment and the unique needs and expectations of adult patients and their family members. The concepts identified in this study have practical applications for day surgical nursing care and provoke the need for further research from patients' and families' points of view. [ABSTRACT FROM AUTHOR]

BACKGROUND: The role of family is central to the wellbeing and health of individuals. Family attitudes, habits and routines affect the way individuals promote their health. Family functioning and family health are threatened when one family member develops heart disease. AIMS: The aim of the study was to describe family functioning and to ascertain factors related to family functioning of families with heart patient as assessed by family members. METHODS: Data collection was done using a questionnaire (FAFHES) in 2000. The sample consisted of 161 family members of patients receiving treatment on two medical wards. The data were analysed by means and tested by parametric and non-parametric tests. The multivariate method used was stepwise regression analysis. RESULTS: The better the family values were materialized and the greater the family's contribution to family health, the better the family's functioning is. Concrete aid was also related to family health. The more concrete aid the family received from nurses, the better family functioning is. When the background variables were included, values and activities remained in the model, but two new variables explained family functioning: family member's age and knowledge of health issues. The older the family member is and the better the knowledge in the family is, the better is family functioning. CONCLUSION: Family functioning of families with heart patients can be supported and developed by family nursing, e.g. concrete aid from nurses. Other aspects of support, e.g. consideration of family member's age and knowledge of health issues also need to be further considered and studied as the basis of care. [ABSTRACT FROM AUTHOR]

The purpose of this study was to obtain a more complete understanding of which familial factors contribute to adolescent satisfaction and ill-being, the latter term originally developed by Alexander Grob. Semistructured interviews were conducted with 19 non-clinical adolescents from the 7th and 9th grades. The data were analysed using qualitative content analysis. Six themes concerning satisfaction arose from the analysis. Teenagers described familial contribution to their satisfaction in terms of experiences of a comfortable home, emotionally warm atmosphere, open communication, familial involvement, possibilities for external relations and a sense of personal significance in the family. Three themes related to ill-being emerged: familial hostility, ill-being or death of a family member, as well as excessive dependency. The findings expand our understanding of the diversity of familial contribution to adolescent life and subjective well-being. They challenge nurses to focus on the adolescent's self-perception of familial effects on well-being and on promotion of familial factors in adolescent health issues. [ABSTRACT FROM AUTHOR]

AIMS AND OBJECTIVES: The study set out to describe women's experiences of intimate partner violence, the consequences of such violence, the help they received and women's experiences of their survival. BACKGROUND: Social and health professionals do not have sufficient ability to identify and help families who suffer from intimate partner violence. Methods for identifying and treating partner violence not have been developed adequately. METHOD: The study was conducted in Finland by loosely formulated open-ended interviews with seven battered women. The data were analysed by inductive qualitative content analysis. FINDINGS: Women had past experience of maltreatment and a distressing climate at their parental home. Women experienced both themselves and their spouse as having weak identities; their ideals, patterns of marriage and sexuality were different. Violence occurred in situations of disagreement. Women tried to strike a balance between independence and dependence in the relationship. The different forms of couple violence were interlinked. The women sought help when their health and social relationships got worse. An awareness of the problem, taking action, counselling and social relationships helped them survive. Religiousness was a factor that involved commitment to the couple relationship, made religious demands on women and promoted the recovery of integrity. CONCLUSIONS: Intimate partner violence was associated with the family model, childhood experience of maltreatment, the partners' weak identity and conflicts between individualism and familism. Social and healthcare professionals need competence in early intervention and skills to discuss moral principles, sexuality, and violence in a way that is free of prejudice and condemning attitudes. Spiritual approaches in the context of interventions should be taken into consideration. RELEVANCE TO CLINICAL PRACTICE: In a clinical context, nurses should be aware of the symptoms of violence, and they should have skills in dealing with intimate moral and spiritual issues. [ABSTRACT FROM AUTHOR]