School Nurses' Experiences of Health Promotion for School-Age Asylum Seekers

The number of school-age asylum seekers and refugees worldwide is increasing. Health promotion provided by school nurses can be crucial for the well-being of young asylum seekers, yet research on these nurses' experiences is limited. This qualitative study aims to describe school nurses' experiences of providing health promotion to school-age asylum seekers. Semistructured interviews were conducted with 12 school nurses, and inductive content analysis was then used. The results were grouped under the following themes: (1) difficulties in providing health services to school-age asylum seekers, (2) considering the vulnerable circumstances of asylum seekers, (3) the importance of family-centered health promotion, and (4) the importance of time management. School nurses face challenges that stem from individual asylum seekers' unique circumstances, nursing competency, and the school health care system. To deepen the existing knowledge, further research is needed from the perspective of asylum seekers.</p

Empowering Healthcare Through User Feedback: A Multidimensional Analysis of the Knowledge

Minna Richards,1 Saija Inkeroinen,1 Jouko Katajisto,2 Sasu Muje,1 Heli Virtanen,1 Helena Leino-Kilpi1,3 1Department of Nursing Science, University of Turku, Turku, Finland; 2Department of Mathematics and Statistics, University of Turku, Turku, Finland; 3Turku University Hospital, Turku, FinlandCorrespondence: Saija Inkeroinen, Department of Nursing Science, University of Turku, Medisiina B, Kiinamyllynkatu 10, Turku, 20520, Finland, Email [email protected]: Feedback from service users is a valuable source for improving the quality of care and services, potentially reflecting the successes and failures in providing empowering healthcare. In supporting empowerment, the multidimensionality of knowledge of service users is assumed to be a crucial factor, yet feedback has not been explored from the perspective of empowering knowledge. In this study, the aim was to analyze the knowledge areas expressed in the service users’ feedback from the point of view of empowering knowledge.Patients and Methods: This was a retrospective study utilizing systematically collected service-user feedback from a feedback register of one university hospital district in Finland. Free-form feedback (n = 26,374) along with structured evaluative feedback was given by the patients themselves or their significant others, either by text message or using a feedback form, in 2019. The content of the feedback was analyzed according to the empowering knowledge areas (biophysiological, cognitive, functional, experiential, ethical, social, and financial), quantified, and analyzed statistically in relation to the background characteristics of service users.Results: Service users gave multidimensional free-form feedback about the knowledge and educational practices in care and services. In the free-form feedback, the most common empowering knowledge areas were biophysiological and cognitive ones, whilst experiential, ethical, social, and financial areas were the least common. The highest ratings of structured evaluative feedback were associated with the cognitive and ethical areas.Conclusion: Register-based feedback is systematic data for quality evaluation. In this study, service users seem to actively evaluate the knowledge procession in care and services, and therefore, they can be actors involved in developing the quality of educational practices. It does, however, indicate a need to add multidimensionality and improve the quality of the knowledge, and by that, advance the potential of empowerment among diverse service users.Keywords: empowerment, feedback, health information, hospitals, district, knowledge, patient satisfaction, service user

Instruments for patient education: Psychometric evaluation of the expected knowledge (EKHP) and the received knowledge of hospital patients (RKHP)

Purpose: In patient education, there is a need for valid and reliable instruments to assess and tailor empowering educational activities. In this study, we summarize the process of producing two parallel instruments for analyzing hospital patients’ expectations (Expected Knowledge of Hospital Patients, EKhp) and received knowledge (Received Knowledge of Hospital Patients, RKhp) and evaluate the psychometrics of the instruments based on international data. In the instruments, six elements of empowering knowledge are included (bio-physiological, functional, experiential, ethical, social, and financial). Patients and Methods: The original Finnish versions of EKhp and RKhp were tested for the first time in 2003, after which they have been used in several national studies. For international purposes, the instruments were first translated into English, then to languages of the seven participating European countries, using double-checking procedure in each one, and subsequently evaluated and confirmed by local researchers and language experts. International data collection was performed in 2009–2012 with a total sample of 1,595 orthopedic patients. Orthopedic patients were selected due to the increase in their numbers, and need for educational activities. Here we report the psychometrics of the instruments for potential international use and future development. Results: Content validities were confirmed by each participating country. Confirmatory factor analyses supported the original theoretical, six-dimensional structure of the instruments. For some subscales, however, there is a need for further clarification. The summative factors, based on the dimensions, have a satisfactory internal consistency. The results support the use of the instruments in patient education in orthopedic nursing, and preferably also in other fields of surgical nursing care. Conclusion: EKhp and RKhp have potential for international use in the evaluation of empowering patient education. In the future, testing of the structure is needed, and validation in other fields of clinical care besides surgical nursing is especially warranted. © 2020 Leino-Kilpi et al

Success and failure in turnaround attempts. An analysis of SMEs within the Finnish Restructuring of Enterprises Act

This study focuses on the success and failure of small and medium sized enterprises (SMEs) attempting turnaround within Finland’s Restructuring of Enterprises Act. In doing so, it aims to shed light on (1) how successful and unsuccessful SME turnarounds differ; and, (2) the effectiveness of the Finnish regime in promoting SME recovery. A preliminary review of the turnaround literature revealed 23 decline and recovery variables. Data on these variables were collected via a questionnaire sent to the Administrators of failing SMEs that entered restructuring. Data from the sample of 228 returns were subjected to factor and logit analysis. The factor analysis finds four decline categories: poor management, high debt in adverse macroeconomy, an adverse microeconomic environment, and one-off causes of decline. It also finds three recovery action categories: management change and cash generation, market reorientation, and cost cutting and retrenchment. The logit analysis finds that one-off causes of decline, management change and cash generation, and cost cutting and retrenchment are more important in successful turnarounds and that poor management and an adverse microeconomic environment are more important in unsuccessful turnarounds. The study also finds that the Finnish Restructuring of Enterprises Act has resulted in good rates of business survival. 54% of SMEs in our sample turnaround and survive