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Attitudes toward guidelines in Finnish primary care nursing: a questionnaire survey.

https://arctichealth.org/en/permalink/ahliterature148823
Source
Worldviews Evid Based Nurs. 2009;6(4):229-36
Publication Type
Article
Date
2009
Author
Seija Alanen
Minna Kaila
Maritta Välimäki
Author Affiliation
Department of Nursing Science, University of Turku, and Tampere University Hospital, Pirkanmaa Hospital District, Tampere, Finland. seija.alanen@pshp.fi
Source
Worldviews Evid Based Nurs. 2009;6(4):229-36
Date
2009
Language
English
Publication Type
Article
Keywords
Adult
Age Distribution
Attitude of Health Personnel
Cross-Sectional Studies
Evidence-Based Nursing - statistics & numerical data
Female
Finland
Guideline Adherence - statistics & numerical data
Health Care Surveys
Humans
Male
Practice Guidelines as Topic
Primary Health Care - statistics & numerical data
Questionnaires
Specialties, Nursing - statistics & numerical data
Abstract
Evidence-based clinical guidelines have attracted international interest as tools for improving the quality of health care. Attitudes toward these guidelines are of great importance because attitudes are proven to be important predictors of guideline use. Attitudes are also believed to be shaped by perceptions of others, which makes the role of organizational implementation interventions interesting.
This article describes primary care nurses' attitudes toward guidelines among Finnish primary care nurses and the associations between attitudes, implementation interventions, and guideline use.
This study was a cross-sectional survey using postal questionnaires. Participants (N = 409) were primary care nurses working in outpatient services of primary health care centers in Finland. They were selected for the study from two groups of Finnish health centers representing contrasting implementation styles, for example, disseminator and implementer health centers (N = 32).
Responses were received from 327 nurses. In general, nurses' attitudes toward guidelines were positive, especially those concerning the reliability and usefulness of guidelines. The utilization of any implementation intervention included in the questionnaire was associated with more positive attitudes. In addition, nurses working in health centers that used an active implementation strategy as opposed to a disseminator strategy also felt that others in their organization rated the guidelines more positively and that guidelines were more easily available. Further, nurses who were familiar or very familiar with the guidelines had more positive attitudes toward them. Attitudes were also associated with self-reported guideline use.
The evidence-based guidelines were accepted as a reliable source of advice in patient care in Finnish primary care. It seems that implementation interventions improve attitudes toward guidelines and enhance guideline use. These interventions might also be important from another point of view; they presumably improve familiarity with guidelines, which was also associated with guideline use.
PubMed ID
19719463 View in PubMed
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Cost-effectiveness analysis of guidelines for antihypertensive care in Finland.

https://arctichealth.org/en/permalink/ahliterature160632
Source
BMC Health Serv Res. 2007;7:172
Publication Type
Article
Date
2007
Author
Neill Booth
Antti Jula
Pasi Aronen
Minna Kaila
Timo Klaukka
Katriina Kukkonen-Harjula
Antti Reunanen
Pekka Rissanen
Harri Sintonen
Marjukka Mäkelä
Author Affiliation
Tampere School of Public Health, University of Tampere, Tampere, Finland. neill.booth@uta.fi
Source
BMC Health Serv Res. 2007;7:172
Date
2007
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Antihypertensive Agents - economics - therapeutic use
Cost-Benefit Analysis
Decision Making
Drug Administration Schedule
Drug Utilization - economics - standards
Female
Finland - epidemiology
Guideline Adherence - economics
Humans
Hypertension - drug therapy - economics - epidemiology
Male
Middle Aged
Practice Guidelines as Topic
Quality-Adjusted Life Years
Registries
Abstract
Hypertension is one of the major causes of disease burden affecting the Finnish population. Over the last decade, evidence-based care has emerged to complement other approaches to antihypertensive care, often without health economic assessment of its costs and effects. This study looks at the extent to which changes proposed by the 2002 Finnish evidence-based Current Care Guidelines concerning the prevention, diagnosis, and treatment of hypertension (the ACCG scenario) can be considered cost-effective when compared to modelled prior clinical practice (the PCP scenario).
A decision analytic model compares the ACCG and PCP scenarios using information synthesised from a set of national registers covering prescription drug reimbursements, morbidity, and mortality with data from two national surveys concerning health and functional capacity. Statistical methods are used to estimate model parameters from Finnish data. We model the potential impact of the different treatment strategies under the ACCG and PCP scenarios, such as lifestyle counselling and drug therapy, for subgroups stratified by age, gender, and blood pressure. The model provides estimates of the differences in major health-related outcomes in the form of life-years and costs as calculated from a 'public health care system' perspective. Cost-effectiveness analysis results are presented for subgroups and for the target population as a whole.
The impact of the use of the ACCG scenario in subgroups (aged 40-80) without concomitant cardiovascular and related diseases is mainly positive. Generally, costs and life-years decrease in unison in the lowest blood pressure group, while in the highest blood pressure group costs and life-years increase together and in the other groups the ACCG scenario is less expensive and produces more life-years. When the costs and effects for subgroups are combined using standard decision analytic aggregation methods, the ACCG scenario is cost-saving and more effective.
The ACCG scenario is likely to reduce costs and increase life-years compared to the PCP scenario in many subgroups. If the estimated trade-offs between the subgroups in terms of outcomes and costs are acceptable to decision-makers, then widespread implementation of the ACCG scenario is expected to reduce overall costs and be accompanied by positive outcomes overall.
Notes
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PubMed ID
17958883 View in PubMed
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[Current care guidelines from trials to keystone].

https://arctichealth.org/en/permalink/ahliterature176258
Source
Duodecim. 2004;120(24):2949-54
Publication Type
Article
Date
2004
Author
Eeva Ketola
Minna Kaila
Marjukka Mäkelä
Author Affiliation
Käypä hoito-toimitus, Suomalainen Lääkäriseura Duodecim, Helsinki.
Source
Duodecim. 2004;120(24):2949-54
Date
2004
Language
Finnish
Publication Type
Article
Keywords
Female
Finland
Guideline Adherence
Humans
Male
National Health Programs - standards
Patient Care - standards
Practice Guidelines as Topic
Sensitivity and specificity
PubMed ID
15700595 View in PubMed
Less detail

Hypertension guideline implementation: experiences of Finnish primary care nurses.

https://arctichealth.org/en/permalink/ahliterature157305
Source
J Eval Clin Pract. 2008 Oct;14(5):830-5
Publication Type
Article
Date
Oct-2008
Author
Seija Alanen
Jarja Ijäs
Minna Kaila
Marjukka Mäkelä
Maritta Välimäki
Author Affiliation
Tampere University Hospital, Tampere, Finland. seija.alanen@pshp.fi
Source
J Eval Clin Pract. 2008 Oct;14(5):830-5
Date
Oct-2008
Language
English
Publication Type
Article
Keywords
Ambulatory Care - organization & administration
Attitude of Health Personnel
Chi-Square Distribution
Diffusion of Innovation
Evidence-Based Practice - education - organization & administration
Female
Finland
Humans
Hypertension - prevention & control
Information Dissemination
Male
Middle Aged
Nurse's Role - psychology
Nursing Methodology Research
Nursing Staff - education - organization & administration - psychology
Organizational Innovation
Patient Education as Topic
Practice Guidelines as Topic
Primary Health Care - organization & administration
Questionnaires
Workload - psychology
Abstract
Evidence-based guidelines on hypertension have been developed in many western countries. Yet, there is little evidence of their impact on the clinical practices of primary care nurses.
We assessed the style of implementation and adoption of the national Hypertension Guideline (HT Guideline) in 32 Finnish health centres classified in a previous study as 'disseminators' (n = 13) or 'implementers' (n = 19). A postal questionnaire was sent to all nurses (n = 409) working in the outpatient services in these health centres. Additionally, senior nursing officers were telephoned to enquire if the implementation of the HT Guideline had led to a new division of labour between nurses and doctors.
Questionnaires were returned from 327 nurses (80.0%), while all senior nursing officers (n = 32) were contacted. The majority of nurses were of the opinion that the HT Guideline has been adopted into clinical practice. The recommendations in the HT Guideline were adopted in clinical practice with varying success, and slightly more often in implementer health centres than in disseminator health centres. Nurses in implementer health centres more often agreed that multiple channels had been used in the implementation (P
PubMed ID
18462289 View in PubMed
Less detail
Source
Duodecim. 2016;132(9):850-7
Publication Type
Article
Date
2016
Author
Raija Sipilä
Taina Mäntyranta
Marjukka Mäkelä
Jorma Komulainen
Minna Kaila
Source
Duodecim. 2016;132(9):850-7
Date
2016
Language
Finnish
Publication Type
Article
Keywords
Finland
Guideline Adherence
Humans
Practice Guidelines as Topic
Translational Medical Research - trends
Abstract
Implementation research examines and promotes the uptake of research findings in various operational environments. The concepts of implementation research in Finnish are not yet established. In support of the research field we describe the Finnish equivalents of the central terms related to knowledge translation in healthcare and the frame of reference of Implementation research, with the national Current Care Guidelines as the starting point. The frame of reference is based on literature, experiences of the authors, iterative modification of the frame of reference on the basis of discussions, and results of expert inquiry. The frame of reference describes seven objects of evaluation, examples of research set-ups and methods as well as tools.
PubMed ID
27319083 View in PubMed
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Primary care guidelines: Senior executives' views on changing health centre practices in hypertension treatment.

https://arctichealth.org/en/permalink/ahliterature147241
Source
Scand J Prim Health Care. 2009;27(4):202-7
Publication Type
Article
Date
2009
Author
Jarja Ijäs
Seija Alanen
Minna Kaila
Eeva Ketola
Solja Nyberg
Maritta A Välimäki
Marjukka Mäkelä
Author Affiliation
Health Centre of the City of Järvenpää
Source
Scand J Prim Health Care. 2009;27(4):202-7
Date
2009
Language
English
Publication Type
Article
Keywords
Adult
Antihypertensive Agents - therapeutic use
Attitude of Health Personnel
Community Health Centers
Family Practice
Finland
Guideline Adherence
Humans
Hypertension - diagnosis - drug therapy
Middle Aged
Nursing, Supervisory
Physician Executives
Practice Guidelines as Topic
Questionnaires
Abstract
To describe the adoption of the national Hypertension Guideline in primary care and to evaluate the consistency of the views of the health centre senior executives on the guideline's impact on clinical practices in the treatment of hypertension in their health centres.
A cross-sectional telephone survey.
All municipal health centres in Finland.
Health centres where both the head physician and the senior nursing officer responded.
Agreement in views of the senior executives on the adoption of clinical practices as recommended in the Hypertension Guideline.
Data were available from 143 health centres in Finland (49%). The views of head physicians and senior nursing officers on the adoption of the Hypertension Guideline were not consistent. Head physicians more often than senior nursing officers (44% vs. 29%, p
Notes
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PubMed ID
19929184 View in PubMed
Less detail

[The execution of current treatment praxis recommendations in the specialized health care ].

https://arctichealth.org/en/permalink/ahliterature185727
Source
Duodecim. 2003;119(5):399-406
Publication Type
Article
Date
2003

7 records – page 1 of 1.