The aim of this study was to adapt the instrument 'Good Nursing Care Scale for Patients' to Swedish conditions as a measure of patients' satisfaction, as well as estimating its reliability and validity. Following a pilot test, discussions in the author group, testing for readability among patients and judgement of content validity by a panel of experts, the final version was reduced to 72 items focusing on good caring. The refined instrument was assessed for internal consistency in 447 surgical in-patients, for 2 week test-retest reliability in 100 patients and subjected to orthogonal principal components factor analysis with varimax rotation, followed by second-order factor analysis. The internal consistency item-item correlation coefficient ranged from 0.15 to 0.91, correlation between each item and the total scale was >or=0.30 for 70 items, Cronbach's alpha coefficient for the final scale was 0.79 and test-retest reliability was 0.75. An orthogonal principal components factor analysis with varimax rotation was conducted on the final 71 items and the 15 first-order factors with eigenvalues >or=1 explained 66% of the total variance. A second-order factor analysis of these 15 factors as items resulted in a seven-factor solution. The total variance explained by the seven factors was 79%. Cronbach's alpha coefficient for the seven factors ranged between 0.32 and 0.95. The instrument seems reliable and valid to assess the patients' satisfaction with what happened during their hospital stay. To confirm the factor structure and improve factor consistency additional development and testing is suggested.
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.
Not much is known about how children perceive the quality of care that they receive in hospitals. This study set out to describe elements of quality in children's drawings of an ideal hospital. Thirty-five drawings were collected from children aged between 4 and 11 years during their stay in a university hospital in Finland. They were coded using the method of content analysis. The two main categories extracted from the analysis were the environment and the people of their ideal hospital. The emphasis was on the environment; patients, parents, and nurses appeared less frequently in the drawings. The findings showed that children are capable of offering valuable insights into the elements of quality through the medium of drawing.
This study compares nurse and manager assessments of nurse competence in a university hospital setting. Although managers carry out annual reviews, few studies have examined the agreement between the competence assessments made by practising nurses and their managers. Using a pretested 73-item questionnaire, consisting of seven competence categories, we compared self-assessments and manager assessments of the level of nurse competence on a Visual Analogue Scale of 0-100 and the frequency of using competencies by using statistical analyses. Managers assessed the overall level of competence (70.8 +/- 19.3 vs. 63.9 +/- 13.7) (mean +/- SD) and the level of competence in five competence categories significantly higher than the nurses themselves. A high degree of agreement was found between the assessments for the frequency of using competencies. These results can be used to encourage nurses and to improve the quality of care in different hospital work environments.
This study examines nurses' perceptions of competence in different university hospital work environments.
Nurses' self-recognition of own level of competence is essential in maintaining high standards of care. The demands for nurse competence may vary between work environments. However, there are very few studies that compare nurse competence in different hospital work environments.
We analysed self-assessments of competence of 593 Registered Nurses working in wards, emergency/outpatient or intensive care units or in operation rooms. The instrument used was a pretested 73-item questionnaire consisting of seven competence categories. The level of competence was assessed on a Visual Analogue Scale (VAS) scale of 0-100 and the frequency of using items of competencies in clinical practice was assessed on a four-point scale.
Nurses reported their overall level of competence as good. They felt most competent in the categories of Managing situations, Diagnostic functions and Helping role (VAS-means 68-69), and least competent in Ensuring quality category (VAS-mean 56). Operation room nurses compared with other nurses reported lower level of competence and lower frequency of using items of competencies in several competence categories. In general, the self-assessed level of competence was greater the higher the frequency of using of competencies. Correlations between both age and length of work experience and the self-assessed overall level of competence were positive.
Nurse competence profiles differed in both the level of and in frequency of using competencies between work environments. Context-specific knowledge of nurse competence from real work life situations provides direction on how to structure work environments and staff development interventions to provide qualified care.
The aim of this study was to evaluate how student nurse teachers meet the requirements of nurse teachers as they practice teaching in nurse education. The data was collected by the Evaluation of Requirements of Nurse Teachers (ERNT), as self-evaluations and peer evaluations answered by 40 student teachers over three years. The response rate was 82%. The total number of completed questionnaires received was 143. Data was analyzed by using descriptive statistics. The student teachers gained a high level of competence as teachers. The highest level of competence was reported in relationships with students, while the lowest level was associated with teaching skills. Of the single requirements, the weakest skills were related to teaching decision-making and encouraging students constantly to seek new knowledge. The nursing competence was mainly evaluated with high-level scores. Evaluations by the student teachers themselves and their peer students were in line.
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.
Dignity is seen as an important but complex concept in the healthcare context. In this context, the discussion of dignity includes concepts of other ethical principles such as autonomy and privacy. Patients consider dignity to cover individuality, patient's feelings, communication, and the behavior of healthcare personnel. However, there is a lack of knowledge concerning the realization of patients' dignity in hospital care and the focus of the study is therefore on the realization of dignity of the vulnerable group of patients with stroke.
The aim of the study was to create a theoretical construct to describe the dignity realization of patients with stroke in hospital care.
Patients with stroke (n = 16) were interviewed in 2015 using a semi-structured interview containing open questions concerning dignity. The data were analyzed using constant comparison of Grounded Theory.
Ethical approval for the research was obtained from the Ethics Committee of the University. The permission for the research was given by the hospital. Informed consent was obtained from participants.
The "Theory of Dignity Realization of Patients with Stroke in Hospital Care" consists of a core category including generic elements of the new situation and dignity realization types. The core category was identified as "Dignity in a new situation" and the generic elements as health history, life history, individuality and stroke. Dignity of patients with stroke is realized through specific types of realization: person-related dignity type, control-related dignity type, independence-related dignity type, social-related dignity type, and care-related dignity type.
The theory has similar elements with the previous literature but the whole construct is new. The theory reveals possible special characteristics in dignity realization of patients with stroke.
For healthcare personnel, the theory provides a frame for a better understanding and recognition of how dignity of patients with stroke is realized.
This paper is a report of a study exploring the use of ethical codes and obstacles to their use in nursing practice as perceived by Finnish, Greek and Italian nurses.
In all European countries nurses are responsible for the well-being of patients, for their own technical and ethical competence and, for their own part, for the high standard of health care in society. These points illustrate the central content areas of nursing codes of ethics. Recent advances in medical technology have added to the complexity of nursing. Nurses today are increasingly confronted with ethical dilemmas, underlining the role and meaning of ethical codes in their decision-making. However, there is only very limited research literature on codes of ethics, their use in nursing practice and obstacles to their use.
Twenty-three focus group interviews were conducted in 2003 with a total of 138 Registered Nurses: 35 in Finland, 54 in Greece and 49 in Italy. The data were content analysed.
Two main categories emerged from our analysis of the use of ethical codes: (1) conscious and (2) unconscious use. Seven main categories described the obstacles to the use of ethical codes: (1) the codes themselves, (2) nurses themselves, (3) multiprofessional teamwork, (4) patients' family members, (5) the organization, (6) the nursing profession and (7) society/healthcare policy. Participants in all three countries were firmly committed to the values expressed in ethical nursing codes. Nonetheless, continued efforts are needed in all these countries to remove the remaining obstacles so that nursing care can be provided in keeping with the requirements of ethical codes.
The use of codes is connected with the changes in nursing profession and in society at large. The core of nursing, however, has remained stable. Future studies should be conducted in order to generalize the findings to a broader population.