Salo, Finland
Salo, Finland

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PubMed | Hospital District of Helsinki and Uusimaa, Statcon Ltd and University of Turku
Type: Journal Article | Journal: Nursing ethics | Year: 2015

Nursing practice takes place in a social framework, in which environmental elements and interpersonal relations interact. Ethical climate of the work unit is an important element affecting nurses professional and ethical practice. Nevertheless, whatever the environmental circumstances, nurses are expected to be professionally competent providing high-quality care ethically and clinically.This study examined newly graduated nurses perception of the ethical climate of their work environment and its association with their self-assessed professional competence, turnover intentions and job satisfaction.Descriptive, cross-sectional, correlational research design was applied. Participants consisted of 318 newly graduated nurses. Data were collected electronically and analysed statistically.Ethical approval and permissions to use instruments and conduct the study were obtained according to required procedures. Data were rendered anonymous to protect participant confidentiality. Completing the questionnaire was interpreted as consent to participate.Nurses overall perception of the ethical climate was positive. More positive perceptions related to peers, patients and physicians, and less positive to hospitals and managers. Strong associations were found between perceived ethical climate and self-assessed competence, turnover intentions in terms of changing job, and job satisfaction in terms of quality of care. Nurses at a higher competence level with positive views of job satisfaction and low turnover intentions perceived the climate significantly more positively.Nursing management responsible for and having the power to implement changes should understand their contribution in ethical leadership, as well as the multidimensional nature of nurses work environment and the interaction between work-related factors in planning developmental measures. Future research should focus on issues in nurse managers ethical leadership in creating ethical work environments. There is also a need for knowledge of newly graduated nurses views of factors which act as enhancers or barriers to positive ethical climates to develop. Interventions, continuing education courses, and discussions designed to promote positive ethical climates should be developed for managers, nurses, and multi-professional teams.


PubMed | Statcon Ltd. and University of Turku
Type: | Journal: Aging clinical and experimental research | Year: 2016

Identification of predictive factors on institutionalization provides the basis for the development and application of preadmission assessment. There is a lack of evidence for predictors of institutionalization for older people.To examine the effect of predictive factors on institutionalization in home-dwelling 70-year-old people.The data were collected in 1991 by the clinical examinations, a postal questionnaire and an interview from the residents of Turku, Finland, born in 1920 (n=1032). Institutionalization was defined as entry into a nursing home or sheltered housing at any time during a 22-year follow-up.A rate of institutionalization was 22.0%. In multivariable Cox regression analysis, impaired cognitive function (MMSE 18-26) (hazard ratio 1.37, confidence interval 1.17-1.62), low BMI (<25kg/mWe conclude that impaired cognitive function, frequent falling, low and high BMI and lack of help when needed predicted institutionalization during the 22-year follow-up. In order to reduce or postpone institutionalization, interventions should target risk factors, such as physical limitations and falling. Also community-based services according to the needs and functional ability of the home-dwelling older people should be developed.


PubMed | Hospital District of Helsinki and Uusimaa, Statcon Ltd and University of Turku
Type: Journal Article | Journal: Journal of clinical nursing | Year: 2016

To explore newly graduated nurses occupational commitment and its associations with their self-assessed professional competence and other work-related factors.As a factor affecting nurse turnover, newly graduated nurses occupational commitment and its associations with work-related factors needs exploring to retain adequate workforce. Nurses commitment has mainly been studied as organisational commitment, but newly graduated nurses occupational commitment and its association with work-related factors needs further studying.This study used descriptive, cross-sectional, correlation design.A convenience sample of 318 newly graduated nurses in Finland participated responding to an electronic questionnaire. Statistical software, NCSS version 9, was used in data analysis. Frequencies, percentages, ranges, means and standard deviations summarised the data. Multivariate Analyses of Variance estimated associations between occupational commitment and work-related variables. IBM SPSS Amos version 22 estimated the model fit of Occupational Commitment Scale and Nurse Competence Scale.Newly graduated nurses occupational commitment was good, affective commitment reaching the highest mean score. There was a significant difference between the nurse groups in favour of nurses at higher competence levels in all subscales except in limited alternatives occupational commitment. Multivariate analyses revealed significant associations between subscales of commitment and competence, turnover intentions, job satisfaction, earlier professional education and work sector, competence counting only through affective dimension.The association between occupational commitment and low turnover intentions and satisfaction with nursing occupation was strong. Higher general competence indicated higher overall occupational commitment.Managers recognition of the influence of all dimensions of occupational commitment in newly graduated nurses professional development is important. Follow-up studies of newly graduated nurses commitment, its relationship with quality care, managers role in enhancing commitment and evaluation of the impact of interventions on improving commitment need further studying.


PubMed | Hospital District of Helsinki and Uusimaa, Statcon Ltd and University of Turku
Type: Comparative Study | Journal: International journal of nursing practice | Year: 2015

Research indicates significant differences between nurse cohorts in many work-related factors. This study compared nurse competence between three generational cohorts comprising the current nursing workforce. The Nurse Competence Scale was used to collect data for this cross-sectional study from 2052 nurses in a university hospital in Finland. Data were analysed statistically. Significant differences were found between nurse cohorts in their competence. The length of work experience had a significant impact on the development of competence. The oldest cohort, with the longest work experience, had the highest competence scores (70.1 on a visual analogue scale), and the youngest had the lowest (59.0). All cohorts were most competent in patient-related nursing tasks, in maintenance of professional competence and in ethical care. Nurses were weakest in the development of nursing practice and the use of evidence-based knowledge. Targeted interventions in teaching-coaching for different nurse generations are needed to ensure the maintenance of nurse competence and high-quality patient care.


PubMed | University of Turku, Statcon Ltd and Karolinska University Hospital
Type: Comparative Study | Journal: Age and ageing | Year: 2016

to compare cardiovascular morbidity and risk factor profiles of two 70-year-old cohorts of Finns examined in 1991 and 2011 and to describe prevalence of statin use according to cardiovascular risk in the later cohort.1920-born cohort of community-dwelling 70-year-old persons (n = 1032) participated in comprehensive health surveys, physical and laboratory examinations in the Turku Elderly Study (TUVA) during 1991-92. In 2011, identical examination pattern was performed, in a 1940-born cohort of 70-year-old persons (n = 956) from the same area. Prevalence of cardiovascular diseases (CVD) and risk factors in the two cohorts was compared. Further, each cohort was divided into three cardiovascular risk groups (high, moderate and low) based on their estimated risk. Prevalence of statin use was calculated among each risk group in the 1940 cohort.coronary heart disease (25 versus 11%) and peripheral artery disease (9 versus 2%) were more common in the 1920 than 1940 cohort, respectively. Lipid profile was worse and blood pressure higher in the earlier cohort, whereas use of statins and antihypertensives was more common in the later cohort. Forty-two per cent of the 1920 cohort and 29% of the 1940 cohort were estimated to have high cardiovascular risk. In the 1940 cohort, a total of 36% used statins. Statin use was most common among high-risk persons.seventy-year olds examined in 2011 had less CVD morbidity than their counterparts 20 years earlier, and their cardiovascular risk factors were better controlled which is reflected in higher use of preventive medications, such as statins and antihypertensives.


PubMed | Hospital District of Helsinki and Uusimaa, University of Helsinki, Statcon Ltd and University of Turku
Type: Journal Article | Journal: Journal of nursing management | Year: 2016

To explore newly graduated nurses (NGN) perception of their practice environment and its association with their self-assessed competence, turnover intentions and job satisfaction as work-related factors.The impact of practice environment on nurses work is important. Positive practice environments are associated with positive organisational, nurse and patient outcomes. How this applies to NGNs needs further exploration.A cross-sectional descriptive correlation design was used. Data were collected with PES-NWI and NCS instruments from 318 Finnish registered nurses, and analysed statistically.Newly graduated nurses perception of their practice environment was mainly positive. Most positive perceptions related to collegial nurse-physician relations, and the least positive to staffing and resource adequacy. Positive perceptions were also associated with higher professional competence, higher perceptions of quality of care and lower intentions to leave the job or profession.The findings revealed strong and significant associations between practice environment and work-related factors. Practice environment is an important element in supporting NGNs competence, retention and job satisfaction. Nursing management should pay attention to NGNs perceptions of their practice environment.Managements ability to create and maintain positive practice environments can foster NGNs professional development and job satisfaction, and consequently retain them in the workforce.


PubMed | Statcon Ltd., University of Eastern Finland, Finnish National Institute for Health and Welfare and State Budgetary Health Care Institution of the Republic of Karelia
Type: Journal Article | Journal: International journal of behavioral medicine | Year: 2016

Becoming a smoker usually starts during adolescence and is a dynamic process involving experimentation before the establishment of daily smoking. It has been suggested that adolescents who smoke differ from those who do not in their attitudes to smoking. The purpose of this study was to find out whether attitudes related to smoking legislation and restrictions, social pressures in smoking and image of smokers are associated with smoking experimentation, daily smoking and best friends smoking.The data were gathered with a self-administered questionnaire in North Karelia, Eastern Finland and in the Pitkyaranta district, Republic of Karelia, Russia. The respondents were 15-year-old 9th grade pupils in local schools. In Pitkyaranta, the data analyses covered pupils in all eight schools in the area (n=179). In North Karelia, the data analyses comprised of selected eight schools (n=601). Data were analysed with exploratory factor analysis.The models revealed that attitudes related to restrictions and social pressure were significantly associated with experimenting with smoking [OR (95% CI) 7.923 (5.787-10.847)], daily smoking [OR (95% CI) 9.575 (6.727-13.628)] and the likelihood of best friends smoking [OR (95% CI) 3.154 (2.579-3.858)]. The stronger the young peoples attitudes and opinions, for example, towards restrictions and with more difficulties in refusing smoking, the higher the likelihood for smoking experimentations, daily smoking as well as the likelihood for their best friends smoking. The country and factor interactions were not associated with smoking experimentations, daily smoking or best friends smoking.Regardless of cultural background, adolescents who smoke have more positive attitudes to smoking, and perceive more social support for smoking, than do adolescents who do not smoke. The study stresses the similarity of the results in both Karelias despite the enormous differences in culture, economy and public policy.


Salonen A.H.,University of Tampere | Kaunonen M.,University of Tampere | Astedt-Kurki P.,University of Tampere | Jarvenpaa A.-L.,Hospital District of Helsinki and Uusimaa | And 2 more authors.
Journal of Clinical Nursing | Year: 2010

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. © 2010 The Authors. Journal compilation © 2010 Blackwell Publishing Ltd.


Salonen A.H.,University of Tampere | Kaunonen M.,University of Tampere | Kaunonen M.,Pirkanmaa Hospital District | Astedt-Kurki P.,University of Tampere | And 4 more authors.
Midwifery | Year: 2011

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. © 2010 Elsevier Ltd.


PubMed | The City of Turku Welfare Division and Statcon Ltd
Type: Journal Article | Journal: Scandinavian journal of caring sciences | Year: 2015

A positive life orientation (PLO) is important for staying healthy physically, mentally and functionally. However, little is known about the factors connected with PLO in home-dwelling older people, even though it is an important topic.The aim of this study was to identify factors connected with positive life orientation among home-dwelling older people.An explorative, population-based cross-sectional study of the age cohort of 70-year-olds living at home at the age of 70, 80, 85 and 90.The data were collected in 1991 among all residents of Turku, Finland, born in 1920 (N = 1530). Follow-ups were conducted in 2001 (n = 656), 2006 (n = 304) and 2011 (n = 156). A multiple regression analysis was conducted to estimate a model of factors that connected with PLO.Several factors were significantly connected with PLO at ages 70, 80, 85 and 90. For example, if 70-year-old respondents perceived themselves as being in better health than others of the same age, it improved their PLO. We also observed that PLO was improved by good self-rated health during the past 12 months at 80, good self-rated health at 85 and good self-rated health compared to others of the same age at 90. The various explanatory models explained between 24 and 36% of the variance in outcomes.Overall, our results showed that the respondents own subjective views were significant independent factors of PLO in all four analyses (70, 80, 85 and 90 years). These subjective experiences remained significant even when objective indicators such as medication use, the presence of diseases and functional capacity were taken into account.

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