Osteoarthritis in a hip not only causes pain and decreases physical function, which are the most common reasons for total hip arthroplasty, but also causes anxiety and reduces patients' health-related quality of life (HRQoL). The objective of this study was to evaluate patients' anxiety and its possible relationship with HRQoL before and after surgery.
In this longitudinal follow-up study, the State Trait Anxiety Inventory was used to measure patients' (n = 100) level of anxiety before surgery and at 1 month, 3 months and 6 months post-operatively. The Sickness Impact Profile was used to measure patients' total HRQoL before surgery and post-operatively at 3 and 6 months.
Before surgery, patients' trait and state anxiety were moderate. Patients' pre-operative trait anxiety impaired HRQoL both before and after surgery. After surgery, state anxiety remained at a moderate level, although a few minor peaks were observed, but no relationship between state anxiety and HRQoL was found.
Patients' needs and characteristics should be carefully assessed when planning post-operative care and support. Nurses should be aware of factors that may relate to anxiety and also consider different methods of supporting patients' recovery.
Adolescents are an important target group for sexual health promotion, and there are numerous programs and interventions carried out in this field. The aim of this study is to describe adolescents' attitudes, knowledge and sexual behavior before and after a sexual health promotion intervention. The intervention was developed in the study and consisted of three elements: (i) class-room session, (ii) information materials and (iii) free condom distribution. The study was carried out in eight randomly selected vocational schools in Finland. The participants were first year students aged 15-19 years. The data were collected using an electronic questionnaire before intervention (intervention baseline n?=?500, control baseline n?=?183) and two times after the intervention (intervention first follow-up n?=?173/second follow-up n?=?202, control first follow-up n?=?115/second follow-up n?=?46). There were significant differences before and after the intervention concerning better knowledge and more frequent testing for sexually transmitted infections (STIs). Schools are an important environment to reach adolescents during the phase where their sexual health is developing and there is an increased risk of STI transmission. More school-based interventions are therefore needed, and the results of this study can be utilized when developing sexual health promotion interventions among adolescents.
The purpose of this study was to describe Finnish ICU nurses' (n=172) experiences of autonomy in their work. The research was carried out as part of a project concerned with empowerment in intensive care nursing. Viewed from a psychological perspective, empowerment is understood as referring to the ability to make goal-directed decisions and to take action towards meeting the goals set out. Autonomy, then, is seen as part of empowerment. The data were collected with a structured questionnaire specially designed for this study. The random sample was drawn from 31 Finnish adult intensive care units. The respondents were registered nurses working in eight adult intensive care units. The data were analysed using statistical methods. Autonomy was defined as being composed of three bases: knowledge base (independence, right and responsibility in decision-making), action base (independence, right and responsibility in actions) and value base (independence, right and responsibility in values). The majority of the respondents felt they had more autonomy in decision-making and actions concerning patient care than in decision-making and actions concerning the intensive care unit as a whole. Autonomy usually increased with work experience. Work will be continued to study the autonomy of nurses in different health care organisations in Finland.
This study describes the basic biological and physiological knowledge and skills of graduating nurse students in Finland against the requirement of their being able to practice safely and effectively in intensive care. The study describes also their interest and willingness to work in intensive care. Measurements were based on the Basic Knowledge Assessment Tool (BKAT-5) developed by Toth in the United States. The sample consisted of 130 nursing students graduating in December 2001 and January 2002. The data were analysed statistically. The students were most knowledgeable in the areas of appropriate precautions, living will and medical calculation, followed by neurology and endocrinology. Scores were poorest for pulmonary, gastrointestinal and cardiovascular knowledge. Intensive care studies and the desire to work in intensive care correlated significantly with the respondents' basic intensive care knowledge. It is important for nursing education to concentrate on developing those areas of intensive care studies where the performance of students is weakest.
This study was carried out to measure changes in health-related quality of life (HRQOL) in patients (n=100) undergoing total hip arthoplasty. The Sickness Impact Profile was used to measure patients' dysfunctions in 12 different categories post surgery. Improvement was observed in each category and dimension already at 3 months and at 6 months. Preoperative pain showed a statistically significant although declining correlation both with total, and with Physical and the Psychosocial dimensions of HRQOL. The greatest improvements were found in the categories Body Care and Movement, Ambulation, Alertness Behaviour, Social Interaction, Recreation and Pastimes and in Sleep and Rest. Patients' pain decreased, and 72% reported no pain at 6 months post the surgery. Patients' perceptions of their pain should be gathered carefully when deciding the need and timing for the surgery in order to minimize impairments into HRQOL.
This study describes experiences of work empowerment among staff members at the Rheumatism Foundation Hospital in Helsinki, Finland.
The data were collected on two occasions in 2004 and 2005 using a structured questionnaire with background variables and items concerning verbal, behavioural and outcome empowerment. The questionnaires were sent to all (n1=115, n2=112) members of multidisciplinary teams at the Rheumatism Foundation Hospital, with the exception of physicians, departmental secretaries and administrative personnel. The response rate at both data collections was 58%. The data were analysed by statistical methods.
No statistically significant differences were seen in work empowerment between the two data collections. Perceptions of work-related empowerment were relatively strong.
Work-related empowerment appears to be relatively constant and independent of changes in the organization. Indeed there is good reason to ask whether work empowerment is primarily a function of the individual employee's strengths and competencies.
This paper is a report of an exploration of the content of nursing advocacy from the point of view of patients and nurses in the context of procedural pain care.
Nursing advocacy is every nurse's professional duty, grounded in patients' legal and moral rights. Nevertheless, earlier research has approached advocacy as a whistle-blowing event from the nurse's perspective.
This cross-sectional study was conducted with a cluster sample of otolaryngology patients (n = 405) and nurses (n = 118) in 11 hospital units in Finland during 2007. The data were collected using an instrument measuring the content of advocacy and analysed statistically.
Advocacy in procedural pain care is a process which takes place in the patient-nurse relationship through role identification in decision-making about pain care. This prompts counselling and responding activities, which in turn lead to some degree of empowerment on the part of both patient and nurse. However, advocacy is partly dependent on the nurse's own role identification: in the context of pain care it seems that the nurse's pain care skills and influence over pain care plans are important factors in the decision to advocate or not. At best, patients have some role in decision-making about their care; at worst, they are subjected to paternalism.
Advocacy is an integral part of the nursing care process. It is important that this key ethical aspect of professional nursing is discussed in nursing education and systematically applied in nursing practice through on-the-job training, feedback and collaboration.
This study dealt with patients' experiences of the continuity of care through an ambulatory surgical critical pathway. Data were collected from theme interviews conducted with surgical patients 25 days after their procedures. Important factors in continuity of care were defined as time flow, coordination flow, caring relationship flow, and information flow.
This study describes moral judgment among first- and last-year nursing students in Finland and examines the effects of ethics teaching on the development of moral judgment. The data for this quantitative cross-sectional study were collected using the Defining Issues Test (DIT), which is based on Kohlberg's theory of moral reasoning stages. The questionnaires were sent to four polytechnics, which offer nursing education in southern Finland. A total of 52 first-year students and 54 last-year students participated. The results showed that students who had had to deal with ethical dilemmas in their practical training had higher moral judgment than students who did not. Last-year students had higher moral judgment than first-year students. Last-year students resorted to principle-based thinking more often than first-year students in resolving DIT dilemmas. The differences between the two groups were statistically significant. The results indicate that nursing education may has an effect upon students' moral judgment.
Power is a matter of authority and control. It can be wielded either consciously or unconsciously, and it can be either overt or latent. Using a structured questionnaire, this study set out to describe nurses' opinions about the exercise of power in basic care situations in both acute and long-term care. The questionnaire was organized into four categories in which items concerned: power in obligatory daily activities; power in activities necessitated by obligatory activities; power in voluntary activities; and power in activities that take into account the patient's characteristics. The samples consisted of 228 nurses from five medical and surgical wards of district hospitals, and 233 nurses from five geriatric units of a community health centre and from one nursing home in Finland. The final response rate was 65% (acute care 76%; long-term care 55%). Data analysis was based on statistical methods. The results showed that, in the nurses' own opinion, negative power is exercised only in certain situations and in the patient's best interest, when for instance there are concerns that something may happen to the patient.