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ObjectivesTo assess, in terms of self-efficacy in weight management, the effectiveness of the SLIM lifestyle intervention among overweight or obese women during pregnancy and after delivery, and further to exploit machine learning and event mining approaches to build personalized models. Additionally, the aim is to evaluate the implementation of the SLIM intervention.MethodsThis prospective trial, which is a non-randomized, quasi-experimental, pre-post intervention, includes an embedded mixed-method process evaluation. The SLIM Intervention is delivered by public health nurses (n = 9) working in maternity clinics. The public health nurses recruited overweight women (n = 54) at their first antenatal visit using convenience sampling. The core components of the intervention i.e. health technology, motivational interviewing, feedback, and goal setting, are utilized in antenatal visits in maternity clinics starting from gestational week 15 or less and continuing to 12 weeks after delivery. Mixed effect models are used to evaluate change over time in self-efficacy, weight management and weight change. Simple mediation models are used to assess calories consumed and moderate to vigorous physical activity (MVPA) as mediators between self-efficacy and weight change. Signal processing and machine learning techniques are exploited to extract events from the data collected via the Oura ring and smartphone-based questionnaires.DiscussionThe SLIM intervention was developed in collaboration with overweight women and public health nurses working in maternity clinics. This study evaluates the effectiveness of the intervention among overweight women in increasing self-efficacy and achieving a healthy weight; thus, impacting the healthy lifestyle and long-term health of the whole family. The long-term objective is to contribute to women's health by supporting weight-management through behavior change via interventions conducted in maternity clinics.Trial registrationThe trial was registered at the Clinicaltrials.gov register platform (ID NCT04826861) on 17 March 2021.

Background: Stroke causes ethically challenging changes in the lives of individuals with stroke (IwS). However, it is unclear whether the changes are stable or dynamic. In this study, a novel concept 'ethical pathway' is used to describe the potential changes in the perceived realisation of IwS' values in temporal passage post-stroke. Ethical pathway includes three central values of nursing: dignity, privacy and autonomy. Aim of the study was to analyse the perceived ethical pathway of IwS over a non-limited post-stroke period, with the purpose to understand the existence of the IwS' ethical pathway in theoretical level. Design: A descriptive and correlational design. Methods: The volunteer participants were recruited via the Finnish Brain Association. Data were collected with questions of background variables and the Ethical Pathway of Individuals with Stroke (EPIS) instrument and analysed statistically. The Ethics Committee of the University approved the study and permission for data collection was obtained from the association. Results: Sixty-one IwS participated in the study. The ethical pathway varied during the post-stroke time. Of the values, dignity and privacy were realised lower with longer post-stroke time. The life situational factors were associated with the realisation of the values, but not consistently. [ABSTRACT FROM AUTHOR]

Background: Professional values create a basis for successful collaboration and person-centred care in integrated care and services. Little is known about how different health and social care workers assess their professional values. Research aim: To describe and compare professional value orientation among different health and social care workers in Finland. Research design: A quantitative cross-sectional study. Participants and research context: We carried out an online survey of health and social care workers from 8 March to 31 May 2022, using the Finnish version of the Nurses' Professional Values Scale-3. The data were analysed using descriptive and advanced statistics. Ethical considerations: Permission was received from all participating organizations and those who completed the survey provided informed consent. Results: A total of 1823 health and social care workers, representing seven professional groups and students, took part. The overall level of professional values among the participants was relatively high. Commitment to providing patients and clients with equal care was more important than engaging with society and professional responsibilities in the work environment. Professional values were strongest among professionals with higher educational degrees and training in professional ethics. The same was true for workers who received organizational support for ethical practice, were satisfied with their work and had shorter work experience. Discussion: Our results showed shared professional values among different health and social care workers and students. These results are meaningful for integrated care and services. At the same time, a clear need for strengthening engagement with society and professional responsibilities for developing work environments were identified. Conclusions: Health and social care workers and students need training in professional ethics and organizational support for ethical practice and work satisfaction to maintain their professional values at different stages of their career. [ABSTRACT FROM AUTHOR]

Smoking poses a significant threat to adolescent health because of its immediate and long-term detrimental health effects. Smoking refusal self-efficacy predicts smoking behavior in adolescence. In adolescents' health education, digital interventions are potential tools to support smoking refusal self-efficacy. The aim of this two-arm cluster randomized controlled trial was to evaluate the effectiveness of a digital health game intervention compared with a no-intervention control group on smoking refusal self-efficacy in 10- to 13-year-old Finnish early adolescents. The early adolescents (n = 781) were randomized to the control group (n = 394) and the health game intervention group (n = 387). Smoking refusal self-efficacy, sources of smoking and snus refusal self-efficacy, and motivation to decline smoking and snus use in the future were measured at baseline, 2-week postintervention, and 3-month follow-up. Data were analyzed using linear mixed model and Wilcoxon rank-based test for clustered data. According to the results, the intervention group made improvements in sources of smoking and snus refusal self-efficacy between baseline and postintervention, and in sources of snus refusal self-efficacy between baseline and follow-up, compared with the control group. The intervention group showed improvements in smoking refusal self-efficacy among 12-year-olds between baseline and follow-up, and postintervention and follow-up compared with the control group. Similar improvements were also found among those with a smoking friend or a smoking parent between postintervention and follow-up. The results were promising for the use of digital health game interventions to promote early adolescent smoking refusal self-efficacy and preventing smoking experimentation. Further research can evaluate the long-term effects for adolescents. [ABSTRACT FROM AUTHOR]

Copyright of Hoitotiede is the property of Hoitotieteiden Tutkimusseura HTTS r.y. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Hoitotiede is the property of Hoitotieteiden Tutkimusseura HTTS r.y. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Based on previous evidence person‐centred care (PCC) as a quality indicator is important in long‐term care (LTC) settings for older people. Effective ways to increase nurses' person‐centred care competence are missing. Aim: To evaluate the effectiveness of a continuing education (CE) intervention named 'Person First—Please' (PFP) for improving nurses' PPC competence and its connection to PPC climate. Methods: Quasi‐experimental cluster design with intervention and control groups was carried out in LTC settings for older people. The intervention group (n = 77) received a 10‐week CE intervention, with control group (n = 123) working as usual. The primary outcome was professional nurses' PCC competence. Secondary outcome was the PCC climate as perceived by nurses and, residents with their next of kin. Measurements were conducted pre−/post‐intervention and after 6 weeks using the validated, Person‐centred Care Competence scale and the Person‐centred Care Climate questionnaire, staff and patient versions. Data was analysed with descriptive and inferential statistics. Results: PCC competence was significantly increased in the intervention group and remained after 6 weeks of follow‐up. PCC climate increased in the intervention group in total score and also in all sub‐scales, across residents with their next of kin. The control group did not show any significant change. Comparisons of PCC competence and PCC climate in time between intervention and control groups confirmed that changes seen between groups were statistically significant in intervention group. Limitations: Measurements were self‐assessments, which may have been affected by bias, especially in context of competence assessment. Conclusion: The intervention was effective in increasing professional nurses' PCC competence and on person‐centred care climate in long‐term care settings for older people. [ABSTRACT FROM AUTHOR]

The desire to work in the nursing profession has recently been identified as an important aspect to consider in the selection process of nursing students but very little is known about nursing applicants' or students' desire to work in nursing. The study aimed to describe and explain the desire of undergraduate nursing applicants to work in nursing. A cross-sectional study design. The Desire to Work in Nursing Instrument was used to collect the data. All nursing applicants (N = 974) who took part in an entrance examination organised in six Universities in October 2018 were eligible to participate. Eight Hundred and Forty-one applicants (response rate 86%, 102 males) participated in the study. Statistical analysis included the use of descriptive statistics and linear regression was used to assess if dependent variables explained the observed outcomes. A strong desire to work in nursing was demonstrated in all the four areas. The most common reason to desire this work was suitability to nursing and the nature of work, and the least common was the career opportunities. Gender, previous education, and a realistic image best explain the desire. The assessment of desire to work in nursing may assist career choice of nursing applicants, and may enhance recruitment and retention in nursing education. Applicants need to be more aware of the career development possibilities. Further studies are needed to investigate if the desire to work in nursing is different to men than to women to inform recruitment strategies. [ABSTRACT FROM AUTHOR]

To analyse longitudinally patient- and proxy-perceptions on stroke survivors'(SSs') functioning using the 12-item WHO Disability Assessment Schedule 2.0 (WHODAS) after subacute inpatient stroke rehabilitation. Sixty-five SSs and their significant others(proxies) responded to WHODAS questionnaire at discharge and 9 to 50 months later. Self-WHODAS ratings were compared with corresponding proxy-perceptions and informal ratings on self-reported functional recovery. On average, SSs' functioning improved after discharge, except according to self-WHODAS ratings of those with severe stroke. Individual changes were, however, notable. Association between time and change was statistically insignificant. SSs perceived greatest improvements in walking, household tasks, community life and working ability. The only items showing slight deterioration were emotions and relationships. In parallel, proxies rated all items except emotions and relationships improved. At discharge, proxies rated SSs' functioning more impaired than SSs themselves, mostly regarding those with severe stroke. Still, inter-rater reliability was very strong and increased significantly with time (ICC 0.799 vs. 0.979 at follow-up). Ninety percent of SSs with improved functioning according to self-WHODAS reported better functioning also in the informal questionnaire. WHODAS showed improvements in SSs' functioning 9-50 months after discharge from subacute stroke rehabilitation. Improvements were in line with proxy-perception and self-reported functional recovery. Stroke survivors' functioning improved significantly during the 9-50 months follow-up after subacute inpatient stroke rehabilitation. Stroke survivors perceived slightly less difficulties in their functioning compared to evaluations by proxies. Strong correlation between patient- and proxy-perceptions on stroke survivors' functioning strengthened from subacute to chronic phase of stroke recovery. The 12-item WHODAS 2.0 seems to be a valuable patient- and proxy-reported outcome measure to assess longitudinal changes in stroke survivors' functioning after stroke. [ABSTRACT FROM AUTHOR]

Aims: To evaluate associations of age, transition readiness and anxiety in adolescents with chronic conditions and to compare perceptions of adolescents and their parents regarding health self‐management and transition readiness. Design: Cross‐sectional international study, reported following STROBE guidelines. Methods: Adolescents and young adults (N = 512, mean age 17.7) with a chronic medical condition and their parents (N = 322) from Finland and Australia. Data were collected through surveys (between September 2017 and December 2020). Adolescents reported the duration of their condition. Age at survey was defined by the response date of the questionnaires. Validated questionnaires were used to measure transition readiness (Am I ON TRAC? for Adult Care) and anxiety related to transition of care (State–Trait Anxiety Inventory short form). Perceptions of health self‐management and transition readiness were compared in adolescent/parent dyads. Associations were explored using Spearman's correlation. Results: Duration of condition and age at survey correlated weakly with transition readiness knowledge and behaviour. Higher transition readiness knowledge scores correlated with higher behaviour scores. Higher transition readiness behaviour scores were associated with lower levels of anxiety. Adolescents were less anxious than their parents and adolescents and parents mostly agreed about health self‐management and transition readiness. Conclusion: Transition readiness should be determined by an assessment of knowledge, self‐management and psychosocial skills instead of age alone. Further research should address how well transition readiness predicts positive health outcomes after the transfer of care. Implications for Patient Care: Transition readiness and self‐management skills should be formally assessed because positive feedback may decrease the anxiety of both adolescents and their parents regarding the transfer of care. Reporting Method: We have adhered to the STROBE statement, using STROBE checklist for cross‐sectional studies. Patient or Public Involvement Statement: No patient or public involvement. Trial and Protocol Registration: ClinicalTrials.org NCT04631965. [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]

Background: Occupational well-being supports the retention of the nurse educator workforce and their ability to manage workload. There is a research gap regarding interventions promoting occupational well-being. Purpose: To evaluate the effectiveness of an 8-workweek digital occupational well-being intervention using self-conducted exercises among nurse educators in secondary vocational nursing schools in Finland. Methods: A quasi-experimental study design was applied using an intervention group (n = 37) and a control group (n = 40). Data were collected at baseline, post, and 1-month follow-up using a questionnaire and a heart rate sensor to assess the resource-workload-balance and its associating and promoting factors. Results: This study found no statistical effects on the resource-workload-balance. Positive effects were found on associating factors (general well-being) and promoting factors (recovery experiences and self-regulation). Conclusions: Self-Help INtervention for Educators (SHINE) has the potential to promote recovery experiences during working hours; however, the intervention needs more investigation. [ABSTRACT FROM AUTHOR]

Background and Rationale: Comprehensive care and service planning in home care is tailored to older people's individual needs and resources in order to support them living at home. However, little is known about how these individual resources and home‐care‐specific tasks are recognised in older people's care and service plans. Aims: To describe the content of care and service plans in older people's home care with special attention to their individual resources and home‐care‐specific tasks. Design: This was a document‐based cross‐sectional study with mixed‐methods analysis, carried out in Eastern Finland during Spring 2018. Methods: A document analysis using the deductive Finnish Care Classification (FinCC), and an inductively developed framework of older people's care and service plans (n = 71). The data were analysed with descriptive statistical methods. Results: Altogether, 1718 notes were relevant to the FinCC main categories: 707 (41%) focused on older people's needs and 1011 (59%) on nursing interventions. We identified 1104 notes based on the 26 inductively developed main categories: the majority (n = 628, 57%) focused on individual resources and the remainder (n = 476, 43%) on home‐care‐specific tasks. Increasing age resulted in fewer notes on safety and sensory functions. There were fewer notes on resources related to sleeping and wakefulness after longer care and service periods. An increased number of home visits resulted in more documentation on tasks related to pharmaceutical issues, including repeat prescriptions. Discussion Individual resources for older people were documented, to some extent, in their care and service plans. It is necessary to review these alongside home‐care‐specific tasks that support older people's independence and safety at home. Conclusion: Individual resources need to be recognised in order to enable home‐care professionals to provide tailored, high‐quality home care services. Home‐care‐specific tasks should be supported by documentation with updated, sensitive home care classifications. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate changes in anxiety, care experiences and condition impact among adolescents with chronic health conditions in two countries as they transfer to adult healthcare and to assess factors influencing anxiety levels., Design: A longitudinal international study. Data was collected by questionnaires before (2017-2021) and a year after (2018-2022) transfer of care., Setting: Two specialist hospitals in Finland and Australia., Participants: 440 adolescents with chronic health conditions were recruited from Finland (FIN n=237; mean age 17.2) and Australia (AUS n=203; mean age 18.3) with the answering percentage FIN 68.8% and AUS 55.2% of the first time point., Main Outcome Measures: The validated State-Trait Anxiety Inventory short form (STAI) was used to measure care-related anxiety. Care experiences were measured using eight questions from the Adolescent-Friendly Hospital Survey. Self-reported condition impact was measured by a Visual Analogue Scale. Care experiences, condition impact, country and age were included in regression analyses as predictors of care-related anxiety., Results: At baseline, there were few clinically meaningful differences between participants at the two sites. Adolescents reported positive care experiences both before and after the transfer of care. In regression analyses after the transfer of care, adolescents with lower condition impact experienced lower anxiety levels than adolescents with higher condition impact (beta -9.00, 95% CI -13.85 to 4.16, p<0.001). After the transfer of care, adolescents who reported negative care experiences also reported higher anxiety (median STAI score 40.0 (IQR 30.0-50.0) versus 33.3 (IQR 23.3-41.6), p<0.001)., Conclusion: Across two different healthcare systems, most adolescents with chronic health conditions reported low anxiety and positive care experiences before and after transfer to adult healthcare. Beyond efforts to generally enhance positive care experiences, focusing on adolescents with higher-impact chronic conditions may reduce disease-related anxiety., Trial Registration Number: ClinicalTrials.org NCT04631965, submitted 21 October 2020., Competing Interests: Competing interests: All authors will complete the ICMJE uniform disclosure form at http://www.icmje.org/disclosure-of-interest/., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)