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Actors involved in the regulation of clinical research: comparison of Finland to England, Canada, and the USA.

https://arctichealth.org/en/permalink/ahliterature269574
Source
Health Res Policy Syst. 2015;13:20
Publication Type
Article
Date
2015
Author
Elina Hemminki
Source
Health Res Policy Syst. 2015;13:20
Date
2015
Language
English
Publication Type
Article
Keywords
Administrative Personnel
Biomedical Research - legislation & jurisprudence
Canada
Conflict of Interest
Drug and Narcotic Control
England
Ethics Committees, Research
Finland
Government Regulation
Interviews as Topic
Qualitative Research
United States
Abstract
The relevance and quantity of clinical research has caused concern and regulation is claimed to hinder clinical research. This paper compares clinical research regulations in Finland to those of England, Canada, and the USA around 2010-2011.
Several approaches and data sources were used, including semi- or unstructured interviews of experts. For the analysis, a theoretical framework was made, data from various sources was synthesized, and features of the systems were simplified and classified. The various specific names and terms used in the data were changed into general ones.
Common structures for the regulation existed in all four countries, but the details and scope varied. The research regulated within the main system was determined by research type (Finland), the financer of the health system (England), or research site (Canada, USA). Only Finland had specific legislation on medical research. The overriding impression of the regulatory systems was one of complexity. All countries had extra regulation for drug research. The types of drug research covered varied from trials with unlicensed (new) products or new indications (USA and Canada), to all types of interventional drug research (England), where 'interventional' was interpreted broadly (Finland). The complexity of regulations had led to the creation of various big and small businesses to help researchers and sponsors. There was notable variation in the role played by the public research funder. The role played by health care was difficult to study and seemed to involve varying interests as researchers were also health care employees. Research ethics committees were important and their tasks also included aspects other than ethics.
This study revealed that a comparison between countries can provide useful insights into the distinctive aspects of each country's system, as well as identifying common features that require international action.
Notes
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Cites: Milbank Q. 2011 Dec;89(4):599-62722188349
Cites: Clin Pharmacol Ther. 2012 Mar;91(3):535-4122318614
Cites: Trials. 2012;13:2722452964
Cites: Trials. 2012;13:5322540886
Cites: Int J Risk Saf Med. 2012;24(4):233-4223135338
Cites: Health Res Policy Syst. 2013;11:1723680289
Cites: Lancet. 2014 Jan 11;383(9912):176-8524411646
Cites: Health Res Policy Syst. 2014;12:1524666735
Cites: J Med Ethics. 2014 Jun;40(6):409-1323665856
PubMed ID
25888977 View in PubMed
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Act with respect: Views of supportive actions for older workers after completion of comprehensive vocational rehabilitation services.

https://arctichealth.org/en/permalink/ahliterature302114
Source
Work. 2019; 62(4):585-598
Publication Type
Journal Article
Date
2019
Author
Stina Wallin
Anncristine Fjellman-Wiklund
Author Affiliation
Faculty of Education and Welfare Studies, Health Sciences, Åbo Akademi University, Vaasa, Finland.
Source
Work. 2019; 62(4):585-598
Date
2019
Language
English
Publication Type
Journal Article
Keywords
Adult
Aging - psychology
Chi-Square Distribution
Female
Finland
Focus Groups - methods
Humans
Male
Middle Aged
Qualitative Research
Rehabilitation, Vocational - methods - standards
Respect
Social Support
Surveys and Questionnaires
Workplace - psychology - standards
Abstract
The number of older workers will expand during the next decades. Older workers have more long-term health problems and related limitations.
This study examined supportive actions provided in occupational healthcare services to older workers after vocational rehabilitation. An additional purpose was to explore occupational healthcare professionals' views on how to realize and improve adequate support activities.
Qualitative and quantitative methods were used, including a postal questionnaire and focus group discussions. Sixty-seven occupational healthcare service units participated in the postal questionnaire. Eight occupational healthcare professionals participated in two focus group discussions. The qualitative data was analyzed using qualitative content analysis.
The qualitative analysis resulted in one theme (Act with respect), and four categories (Need for cooperation, Collaborative resources of involved stakeholders, Individual needs for support, and Gender as homogenous and separate groups). Quantitative results revealed that the workers' initiative strongly influenced the support carried out. Recommendations from the rehabilitation clinic were almost always considered when deciding on supportive actions. Focus group discussions brought up gender differences especially highlighted in the category Gender as homogenous and separate groups.
Appropriate support of older workers requires cooperation between involved stakeholders, including occupational healthcare services. Provided support should be based on individual needs, but a mutual practice of determining needed support is requested.
PubMed ID
31104047 View in PubMed
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Adolescents' sense-making of alcohol-related risks: The role of drinking situations and social settings.

https://arctichealth.org/en/permalink/ahliterature273764
Source
Health (London). 2015 Sep;19(5):542-58
Publication Type
Article
Date
Sep-2015
Author
Anu Katainen
Anna-Sofia Lehto
Antti Maunu
Source
Health (London). 2015 Sep;19(5):542-58
Date
Sep-2015
Language
English
Publication Type
Article
Keywords
Adolescent
Adolescent Behavior - psychology
Alcohol Drinking - psychology
Female
Finland
Humans
Male
Psychology, Adolescent
Qualitative Research
Risk
Risk-Taking
Social Behavior
Abstract
The article explores how young people understand the risks of alcohol use and how these understandings are associated with differing drinking situations and social settings. By taking account of situational factors, the aim is to demonstrate how young people have highly nuanced notions of drinking styles that suit different drinking situations and of associated risks. The data for the research were gathered in 18 group interviews with Finnish ninth graders aged 14-15 years. Short film clips portraying young people in different drinking situations were used as stimulus material for the interviews. Data analysis focussed on the risk factors related to the social situations illustrated in the film clips. The results show that young people's risk assessments are not based on alcohol itself, but the magnitude of risk is estimated in relation to the social setting of the drinking situation. What is relevant for young people is whether the social situation allows them to make choices with which they feel comfortable. At the opposite pole of problem drinking was social drinking for the purpose of having fun together with other people in such a way that one remains in control of the drinking situation. From a prevention point of view, a key implication is that awareness of the risks is closely associated with situational and social factors. However, the awareness of those risks does not necessarily prevent young people from drinking because they may be accepted as part of the drinking experience.
PubMed ID
25411165 View in PubMed
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Adolescents with cancer: experience of life and how it could be made easier.

https://arctichealth.org/en/permalink/ahliterature178966
Source
Cancer Nurs. 2004 Jul-Aug;27(4):325-35
Publication Type
Article
Author
Hannele Hokkanen
Elina Eriksson
Outi Ahonen
Sanna Salantera
Author Affiliation
Helsinki Polytechnic Stadia, Tukholmankatu 10, 00290 Helsinki, Finland. hannele.hokkanen@stadia.fi
Source
Cancer Nurs. 2004 Jul-Aug;27(4):325-35
Language
English
Publication Type
Article
Keywords
Adaptation, Psychological
Adolescent
Adolescent Psychology
Attitude to Health
Decision Making
Female
Finland
Focus Groups
Goals
Health Knowledge, Attitudes, Practice
Helping Behavior
Humans
Life Change Events
Male
Morale
Needs Assessment
Negativism
Neoplasms - nursing - psychology
Nurse's Role
Nursing Methodology Research
Patient Education as Topic
Qualitative Research
Questionnaires
Self Concept
Social Support
Abstract
This study is about what adolescents with cancer think about their life situation, the support they get, and the information they receive about their illness. The data for this qualitative and descriptive study were collected in 3 focus group interviews with 20 adolescents aged 13 to 18 years attending a cancer adjustment camp. Interpretation was based on the method of inductive content analysis. The adolescents' experiences of their current situation were analyzed into 5 categories: views on life here and now, negative experiences of self because of the illness, resources recognized in self, difficulties caused by the illness in relation to life around them, and resources identified in the world around. They made very little, if any, conscious effort to plan ahead for the future. The information received by the adolescents concerned their illness and its treatment here and now, various practical matters, as well as the future impacts of the illness and its treatments. Most of this information focused on the here and now, whereas the adolescents' information needs were mainly oriented to the future. As for the adolescents' chances to take part in making decisions about their care and life, the analysis yielded 6 categories: joint decision making, inadequate chances for decision making, independent decision making, illusion of decision making, reluctant to make decisions, and excluded from decision making. Finally, the adolescents' hopes for improvement were focused on staff activities, physical care facilities, chances to discuss and work through their experiences of the illness, and the support received from society.
PubMed ID
15292729 View in PubMed
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Applying a phenomenological method of analysis derived from Giorgi to a psychiatric nursing study.

https://arctichealth.org/en/permalink/ahliterature71610
Source
J Adv Nurs. 2002 Aug;39(3):258-65
Publication Type
Article
Date
Aug-2002
Author
Kaisa Koivisto
Sirpa Janhonen
Leena Väisänen
Author Affiliation
Social and Health Care, Oulu Polytechnic, Oulu, Finland. kaisa.koivisto@oamk.fi
Source
J Adv Nurs. 2002 Aug;39(3):258-65
Date
Aug-2002
Language
English
Publication Type
Article
Keywords
Adult
Attitude to Health
Female
Finland
Hospital-Patient Relations
Hospitals, University
Humans
Middle Aged
Nurse-Patient Relations
Nursing Evaluation Research
Personal Autonomy
Psychiatric Department, Hospital
Psychiatric Nursing
Psychotic Disorders - nursing - psychology
Qualitative Research
Research Design - standards
Self Efficacy
Abstract
BACKGROUND: The experience of mental ill health is fundamentally disempowering. The processes of psychiatric hospital care and treatment may also add to the personal feeling of disempowerment. This disempowerment is partly due to the failure of others to afford a proper hearing to the person's story of his/her experiences and problems in life. Hence, there is a need to investigate patients' experiences of being mentally ill with psychosis and being helped in a psychiatric hospital. AIM: This paper describes the application of a phenomenological method of analysis derived from Amadeo Giorgi to an investigation of psychiatric patients' experiences about being mentally ill with psychosis and being helped in a psychiatric hospital ward in Northern Finland. METHOD: This phenomenological study was conducted with nine voluntary adult patients recovering from psychosis. In 1998, patients were interviewed regarding their experiences of psychosis and being helped. The verbatim transcripts of these interviews were analysed using Giorgi's phenomenological method. Giorgi's method of analysis aims to uncover the meaning of a phenomenon as experienced by a human through the identification of essential themes. Patients' experiences of psychosis and being helped were clustered into a specific description of situated structure and a general description of situated structure. FINDINGS: The Giorgian method of phenomenological analysis was a clear-cut process, which gave a structure to the analyses and justified the decisions made while analysing the data. A phenomenological study of this kind encourages psychiatric nurses to focus on patients' experiences. CONCLUSION: Phenomenological study and Giorgi's method of analysis are applicable while investigating psychiatric patients' experiences and give new knowledge of the experiences of patients and new views of how to meet patients' needs.
PubMed ID
12121526 View in PubMed
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Attention to nurses' rewarding - an interview study of registered nurses working in primary and private healthcare in Finland.

https://arctichealth.org/en/permalink/ahliterature281734
Source
J Clin Nurs. 2017 Apr;26(7-8):1042-1052
Publication Type
Article
Date
Apr-2017
Author
Jaana Seitovirta
Katri Vehviläinen-Julkunen
Lasse Mitronen
Sara De Gieter
Tarja Kvist
Source
J Clin Nurs. 2017 Apr;26(7-8):1042-1052
Date
Apr-2017
Language
English
Publication Type
Article
Keywords
Adult
Attitude of Health Personnel
Cross-Sectional Studies
Employee Incentive Plans
Female
Finland
Humans
Job Satisfaction
Male
Nurse's Role - psychology
Nursing Staff, Hospital - psychology - statistics & numerical data
Qualitative Research
Reward
Abstract
To identify meaningful types of rewards and the consequences of rewards as expressed by Finnish registered nurses working in primary and private healthcare.
Previous studies have found significant associations between nurses' rewards and both their commitment and job satisfaction. Furthermore, appropriate rewards can have beneficial effects on factors including workforce stability and occupational satisfaction that are highly important in times of nurse shortages.
A cross-sectional, qualitative interview study.
Data were collected via individual semi-structured interviews (n = 20) with registered nurses working in Finland's primary and private healthcare, and subjected to qualitative content analysis.
Six meaningful types of rewards were identified by the registered nurses: Financial compensation and benefits, Work-Life balance, Work content, Professional development, Recognition, and Supportive leadership. Rewards encouraged respondents to perform their work correctly and reinforced occupational satisfaction, but also caused feelings of envy and stress.
It is essential to pay attention to nurses' preferences for particular rewards and to reward management. When designing effective reward systems for registered nurses, it is not sufficient to provide financial rewards alone, as various kinds of non-financial rewards are both meaningful and necessary.
When trying to improve registered nurses' commitment and job satisfaction through reward management, it is important to listen to nurses' opinions to create a reward system that integrates financial and non-financial rewards and is fair from their perspective. Healthcare organisations that offer registered nurses a holistic reward system are more likely to retain satisfied and committed nurses at a time of increasing nursing shortages.
PubMed ID
27346394 View in PubMed
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Back pain and the resolution of diagnostic uncertainty in illness narratives.

https://arctichealth.org/en/permalink/ahliterature184355
Source
Soc Sci Med. 2003 Sep;57(6):1045-54
Publication Type
Article
Date
Sep-2003
Author
Annika Lillrank
Author Affiliation
Department of Social Policy, University of Helsinki, P.O. Box 18, 00014 Helsinki, Finland. annika.lillrank@helsinki.fi
Source
Soc Sci Med. 2003 Sep;57(6):1045-54
Date
Sep-2003
Language
English
Publication Type
Article
Keywords
Adaptation, Psychological
Adolescent
Adult
Attitude of Health Personnel
Back Pain - diagnosis - physiopathology - psychology
Chronic Disease
Female
Finland
Humans
Middle Aged
Narration
Physician-Patient Relations
Qualitative Research
Self Concept
Trust
Uncertainty
Women's health
Abstract
In this paper I consider 30 Finnish women's written narratives about the process of getting back pain diagnosed. From the beginning of the early discomfort of back pain, the women were sure of its bodily and subjective reality. They struggled repeatedly to be taken seriously, and only after years of medical disparagement did they encounter medical professionals who were able solve the riddle and give it a name, a diagnosis. Since back pain is a baffling problem and challenges the central biomedical epistemology-objective knowledge and measurable findings separate from subjective experience-it allowed the doctors to show a disrespectful attitude toward back pain sufferers. The moral essence of the women's common story was the stigmatizing experience when doctors did not take subjective pain seriously. Instead, doctors' neglectful attitudes became part of the prolonged problem. During the long-lasting uncertainty, women tried multiple coping strategies to ease their lives and developed mental attitudes to endure the pain. Since the protagonists did not give up the lived certainty of back pain they were gradually able to challenge medical uncertainty and to demand a thorough medical examination, and/or through random circumstance they encountered doctors who were willing to take their symptoms seriously. This triggered turning points that immediately or very soon resulted in solving the riddle of the puzzling pain. To be finally diagnosed was a great relief. However, to be taken seriously as a person was considered to be the greatest relief.
PubMed ID
12878104 View in PubMed
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Barriers and facilitators influencing the implementation of an interactive Internet-portal application for patient education in psychiatric hospitals.

https://arctichealth.org/en/permalink/ahliterature159811
Source
Patient Educ Couns. 2008 Mar;70(3):412-9
Publication Type
Article
Date
Mar-2008
Author
Marita Koivunen
Heli Hätönen
Maritta Välimäki
Author Affiliation
Satakunta Hospital District and University of Turku, Department of Nursing Science, Turku, Finland. mhkoivu@utu.fi
Source
Patient Educ Couns. 2008 Mar;70(3):412-9
Date
Mar-2008
Language
English
Publication Type
Article
Keywords
Adult
Attitude of Health Personnel
Attitude to Computers
Computer Literacy
Computer User Training
Female
Finland
Hospitals, Psychiatric
Humans
Inpatients - education - psychology
Internet - organization & administration
Male
Middle Aged
Multicenter Studies as Topic
Nursing Methodology Research
Nursing Staff, Hospital - education - organization & administration - psychology
Patient Education as Topic - organization & administration
Qualitative Research
Questionnaires
Randomized Controlled Trials as Topic
User-Computer Interface
Abstract
The purpose of this study was to identify barriers and facilitators influencing the implementation of an interactive Internet-portal application for patient education in psychiatric hospitals.
The data were collected from nurses by means of a questionnaire with thematic open-ended questions. The data was analysed using qualitative content analysis.
Four main categories were formed to describe barriers and facilitators of portal implementation in psychiatric wards. These categories were organisational resources, nurses' individual characteristics, patient-related factors and portal-related factors. Some major barriers were identified restricting the use of the portal in patient education: lack of computers, lack of time for patients, nurses' negative attitudes towards computer use and lack of education. The main facilitators for portal use were appropriate technological resources, easy Internet access, enough time for portal use, and level of motivation among staff to use computers.
The specific challenge in achieving patient education with the computer in psychiatric care is to ensure technological resources and that the staff are motivated to use computers. At the same time, attention should be paid the relationship between patient and nurse.
It is important to examine the patient-nurse relationship in the education process and also to define the usability of the application from the patients' point of view.
PubMed ID
18079085 View in PubMed
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Being a preceptor-a Nordic qualitative study.

https://arctichealth.org/en/permalink/ahliterature266951
Source
Nurse Educ Today. 2014 Dec;34(12):1420-4
Publication Type
Article
Date
Dec-2014
Author
Yvonne Hilli
Hanna-Leena Melender
Marita Salmu
Elisabeth Jonsén
Source
Nurse Educ Today. 2014 Dec;34(12):1420-4
Date
Dec-2014
Language
English
Publication Type
Article
Keywords
Adult
Attitude of Health Personnel
Clinical Competence
Female
Finland
Humans
Interprofessional Relations
Longitudinal Studies
Male
Middle Aged
Preceptorship - ethics
Qualitative Research
Students, Nursing - psychology
Sweden
Abstract
Positive preceptor experiences enhance learning and even affect the decisions of students to remain in nursing. In light of this, nurse managers have a responsibility, besides maintaining staff competence, to assess whether preceptors live up to their professional obligations.
The aim of this Nordic qualitative study was to gain a deeper understanding of the perceived experiences of preceptorship used to support undergraduate student nurses during their clinical education.
Data was collected through narrative interviews with 31 preceptors in Finland and Sweden before being analysed using a hermeneutical approach.
Preceptorship is all about teaching in a supportive environment with ethical dimensions uniting theory and praxis. A caring relationship is essential and the basis for student learning and development.
The preceptors emphasise a caring relationship as the foundation for student learning. Moreover, preceptorship is an ethical issue, a responsibility that should be recognised by all stakeholders. The findings suggest that preceptorship should be examined from a new perspective. The ethical dimension must be recognised and linked to the further education of preceptors. Nurse managers are in a key position to lead for change.
PubMed ID
24801746 View in PubMed
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Caring and Uncaring Encounters between Assistant Nurses and Immigrants with Dementia Symptoms in Two Group Homes in Sweden-an Observational Study.

https://arctichealth.org/en/permalink/ahliterature301157
Source
J Cross Cult Gerontol. 2018 Sep; 33(3):299-317
Publication Type
Journal Article
Observational Study
Date
Sep-2018
Author
Mirkka Söderman
Sirpa Rosendahl
Christina Sällström
Author Affiliation
School of Health, Care and Social Welfare, Mälardalen University, Box 325, SE-63105, Eskilstuna, Sweden. mirkka.soderman@mdh.se.
Source
J Cross Cult Gerontol. 2018 Sep; 33(3):299-317
Date
Sep-2018
Language
English
Publication Type
Journal Article
Observational Study
Keywords
Aged
Aged, 80 and over
Attitude of Health Personnel - ethnology
Communication
Communication Barriers
Cultural Competency
Dementia - diagnosis - nursing - psychology
Emigrants and Immigrants - psychology - statistics & numerical data
Female
Finland
Geriatric Nursing
Group Homes - organization & administration
Homes for the Aged
Humans
Interviews as Topic
Male
Middle Aged
Professional-Patient Relations
Qualitative Research
Sweden
Abstract
The total number of people with dementia symptoms is expected to double every 20 years and there will also be an increase in the number of older immigrants in several countries. There are considerable deficiencies in the present knowledge of how to conduct well-functioning health care for immigrants with dementia symptoms. The aim of this study was to explore caring and uncaring encounters between assistant nurses and immigrants in two group homes for persons with dementia symptoms in Sweden: a Finnish-speaking as well as a Swedish-speaking context. In addition, this study aims to describe how caring and uncaring encounters are manifested in these two contexts according to Halldórsdóttir's theory of "Caring and Uncaring encounters".
Descriptive field notes from 30 separate observations were analyzed using qualitative deductive content analysis.
The main category "caring encounters" focused on reaching out to initiate connection through communication, removing masks of anonymity by acknowledging the unique person, acknowledgment of connection by being personal. Reaching a level of truthfulness by being present and showing respect, raising the level of solidarity by equality and true negotiation of care, based on the residents' needs. The main category, uncaring encounters, focused on disinterest in and insensitivity towards the other, coldness in the connection and lack of humanity in care situations. The observations showed that caring encounters occurred more in the Finnish-speaking context and uncaring encounters more often in the Swedish context.
Encounters could be caring, uncaring, and carried out using a person-centered approach. Communication and relationships could be facilitated using the same language but also through learning to interpret residents' needs and desires.
PubMed ID
29931458 View in PubMed
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164 records – page 1 of 17.