Nuorten Kompassi (Youth Compass): Menetelmä yläkouluikäisten nuorten hyvinvointitaitojen vahvistamiseen (1. arvio)

Ilmiöt: Hyvinvointitaidot Johdanto: Hyvä psyykkinen hyvinvointi on keskeistä nuoren kehittymisen sekä opintosuoriutumisen ja työelämävalmiuksien kannalta. Oppilaitoksilla on keskeinen asema nuorten psyykkisen hyvinvoinnin tukemisessa, ja niitä velvoitetaan myös laissa vahvistamaan opiskelijoidensa hyvinvointia. Nuorten Kompassi -menetelmän tavoitteena on tukea nuorten hyvinvointitaitoja, kuten psykologista joustavuutta ja sen osataitoja sekä ennaltaehkäistä mielenterveyden ongelmia. Menetelmä on täysin verkkopohjainen, ja sitä on mahdollista hyödyntää osana oppilaitosten toimintaa. Se on alun perin kehitetty yläkouluikäisille, mutta soveltuu myös toisen asteen opintojen alkuvaiheessa oleville nuorille. Aineisto ja menetelmät: Kirjallisuushaku tehtiin kartoittaville kirjallisuuskatsauksille tyypillisellä Population, Concept, Context (PCC) -hakustrategialla, joka kohdistui kysymykseen: Mitä tutkimusta Nuorten Kompassi -menetelmästä (Youth Compass) on tehty. Hakusanoina käytettiin: P = nuoret, yläkoulu, toinen aste, C = Youth Compass, Nuorten Kompassi, C = koulu, koti, terveydenhuolto. Ensisijaisena kiinnostuksenkohteena haussa olivat menetelmään liittyvät vaikuttavuustutkimukset, mutta mukaan otettiin kuitenkin myös muilla asetelmilla tehtyjä tutkimuksia. Systemaattinen haku kohdistui seuraaviin tietokantoihin: MEDLINE, APA PsycInfo, CINAHL, ERIC, Web of Science ja Scopus, ja sitä täydennettiin manuaalisella haulla. Tulokset: Kirjallisuushaun perusteella mukaan otettiin kahdeksan tutkimusta. Näistä viisi oli suomalaisia vaikuttavuustutkimuksia, joihin menetelmän vaikuttavuuden arviointi perustui. Lisäksi mukana oli kolme suomalaista tutkimusta, joissa ei arvioitu menetelmän vaikuttavuutta tai implementointia. Mukaan otettujen tutkimusten ja menetelmäoppaan perusteella Nuorten Kompassi -menetelmän kuvaus ja teoreettinen peruste on riittävä. Menetelmällä on todettu olevan myönteisiä vaikutuksia nuoren masennusoireisiin, ahdistusoireisiin, tyytyväisyyteen elämään, stressiin, akateemiseen joustavuuteen sekä urasuunnitteluun liittyvään epävarmuuteen. Lisäksi sen on todettu lisäävän kyvykkyyttä tehdä uravalintaan liittyviä päätöksiä. Vaikutukset olivat enintään pieniä vasteiden osalta yläkoulua käyvillä nuorilla (d = 0,03–0,48, NNT (Number­Needed­to­Treat) = 3,76–62,5). Vaikuttavuustutkimusten laatu vaihteli tyydyttävästä hyvään. Nuorten Kompassin implementointivalmius ei täyttynyt riittävästi käytettyjen osa-alueiden mukaan arvioituna. Menetelmä on tällä hetkellä valtakunnallisessa levityksessä stand­alone-periaatteella, eli menetelmästä kiinnostuneet voivat osallistua rekisteröitymällä sivustolle ja käydä sitä läpi itsenäisesti. Kokonaisarvio: Menetelmä saa kokonaisarvion 4/5, eli menetelmällä on kohtalainen dokumentoitu näyttö suomalaisessa kontekstissa. Kokonaisarvio perustuu vaikuttavuustutkimuksiin, joissa menetelmää toteutettiin verkkopohjaisella alustalla sekä kasvokkain ja digitaalisesti tapahtuvan ohjauksen avulla

How Adolescents and Parents See Their Moral Responsibilities With Regard to Adolescents Using Alcohol-A Deductive Secondary Analysis

Background: This study described how adolescents and the parents saw their moral responsibilities with regard to adolescents using alcohol.Methods: This was a deductive secondary analysis, based on Hart's taxonomy of moral responsibility. The primary studies were based on 19 group interviews with 87 adolescents aged 14-16 and 17 interviews with 20 parents. Voluntary participants were recruited by purposive sampling from two public schools in Finland.Results: Role responsibilities comprised of adolescents taking care of themselves and parents providing authority figures and helping adolescents to make rational decisions about alcohol. Capacity responsibilities referred to adolescents' abilities to make independent decisions on using alcohol and their developing abilities to control their actions. Parents required abilities to get involved in and show an interest in their children's everyday lives. Causal responsibilities focused on ensuring that adolescents did not cause harm when they used alcohol, and parents had to acknowledge and react to the consequences. Liability responsibilities were about the law on alcohol use and responsibilities for any legal consequences. The role schools could play was important.Conclusions: Adolescents and parents had wide-ranging responsibilities related to the adolescents' using alcohol and school nurses could play an important role in healthy decisions.</p

Adolescents’ Perceptions and Experiences of Their Responsibilities for Their Alcohol use—A Group Interview Study

Young people often experiment with alcohol during adolescence, which is a period of their life that is characterized by increasing responsibility. Knowing how adolescents perceive responsibilities with regard to their alcohol use could prevent their alcohol consumption and help them to take responsibility for this aspect of their lives. This study describes adolescents’ perceptions and experiences of their responsibilities for alcohol use. We used a qualitative descriptive method that focused on 87 adolescents aged 14–16 years, from two schools. They took part in semi-structured interviews in 19 groups in Finland in 2017. The data were analyzed using inductive content analysis. The adolescents described alcohol as harmful, but tempting, and said that they were developing a sense of responsibility for their alcohol use. They were responsible for their own wellbeing, behaving responsibly if they drank and intervening in peers’ alcohol use. They talked about how their parents had unquestionable responsibilities to care about whether adolescents drank alcohol. Their parents’ responsibilities related to the guidance they gave, how strict they were and how they responded to adolescents using alcohol. Anonymous and intense support from authorities encouraged adolescents to learn to take responsibility. Identifying and focusing on their responsibilities could help adolescents to develop into healthy individuals and increase their awareness of the need to avoid alcohol. Parents may also need support to meet their responsibilities.</p

Vanhemmuusohjelmien käytettävyys haavoittuvassa asemassa olevien vanhempien näkökulmasta - Integratiivinen kirjallisuuskatsaus

Integratiivisen kirjallisuuskatsauksen tarkoituksena oli kuvata lasten mielenterveys- ja käytösongelmien ennaltaehkäisyyn ja hoitoon tarkoitettujen vanhemmuusohjelmien käytettävyyttä haavoittuvassa asemassa olevien vanhempien näkökulmasta. Tavoitteena oli tuottaa kuvaus vanhemmuusohjelmista sekä lisätä tietoa niiden saavutettavuutta edistävistä ja estävistä tekijöistä. Systemaattinen haku tehtiin PubMed/Medline, CINAHL, PsychINFO, Cochrane Library ja ERIC-tietokantoihin. Tiedonhaku rajattiin koskemaan interventiotutkimuksia. Aineisto analysoitiin deduktiivisesti käytettävyyttä kuvaavien osa-alueiden (hyväksyttävyys, tarve, implementointi, käytännöllisyys, adaptiivisuus, integrointi, siirrettävyys, vaikuttavuuden testaus) mukaisesti sekä laatimalla kuvaus vanhemmuusohjelmista TIDieR-tarkistuslistan mukaisesti. Katsaukseen valittiin mukaan 13 tutkimusta, jotka käsittelivät viittä eri vanhemmuusohjelmaa. Osallistumista edisti muun muassa käytännön järjestelyissä tukeminen, vanhemmuusohjelman maksuttomuus sekä palvelun sopivuus perheen tarpeisiin. Osallistumista puolestaan esti esimerkiksi muutokset perheen taloudellisessa tilanteessa sekä aikatauluongelmat. Kaikilla vanhemmuusohjelmilla oli lyhytaikaista vaikutusta lasten käytöshäiriöoireisiin. Ohjelmien käytön havaittiin vahvistavan vanhemmuustaitoja ja vähentävän vanhempien kuormitusta. Johtopäätöksenä voidaan todeta, että haavoittuvassa asemassa olevien vanhempien vanhemmuusohjelmien käytettävyyttä lisää oikea-aikaisesti tarjottu palvelu, palvelun osuvuus lapsen ja perheiden tarpeisiin, osallistumisen tukeminen sekä palvelun joustavuus

Family members' participation in palliative inpatient care: An integrative review

Aim: To analyse how family members participate in hospital inpatient palliative care, and how their participation could be supported.Methods: This review followed a methodology outlined in the literature for integrative reviews. A literature search supplemented by a manual search was conducted on four electronic databases during 2020 to 2021: PubMed, CINAHL, PsycINFO, and Cochrane Library. A critical appraisal of the included studies was performed, and data were analysed using inductive content analysis.Results: The literature search resulted in 4990 articles, of which 14 articles were included in this review. Four main categories were identified concerning the participation of family members in hospital inpatient palliative care: participation in the physical care, provision of emotional support, promoting good patient care, and support provided by healthcare professionals for family members' participation. Family members' participation can be supported in different ways, including active communication and adequate information.Conclusion: Family members' participation in hospital inpatient palliative care has been an important part of palliative care in hospital settings. Family members should be offered the opportunity to participate in patient care, and their presence in the hospital should be accommodated. Research on the topic is still scarce, and future research is needed from different perspectives, including intervention research.</p

Nurses' and Patients' Perceptions about Psychiatric Intensive Care-An Integrative Literature Review

This integrative literature review describes nurses's and patients' perceptions of care in psychiatric intensive care units (PICU). The database search was conducted in April 2020. PRISMA checklist and Mixed Method Appraisal Tool guided the identification and evaluation of the studies (n = 21). Data was analyzed with qualitative content analysis. Nurses perceived PICU as a challenging work environment where their primary task was to ensure the unit's safety. Patients views on their treatment varied from positive to negative. Patients wished to have more privacy and supportive interaction. Findings can be used as a basis in developing care practices and staff's further education in PICUs

Comparison of new psychiatric diagnoses among Finnish children and adolescents before and during the COVID-19 pandemic : A nationwide register-based study

BackgroundCoronavirus Disease 2019 (COVID-19) restrictions decreased the use of specialist psychiatric services for children and adolescents in spring 2020. However, little is known about the pattern once restrictions eased. We compared new psychiatric diagnoses by specialist services during pandemic and pre-pandemic periods. Methods and findingsThis national register study focused on all Finnish residents aged 0 to 17 years from January 2017 to September 2021 (approximately 1 million a year). The outcomes were new monthly diagnoses for psychiatric or neurodevelopmental disorders in specialist services. These were analyzed by sex, age, home location, and diagnostic groups. The numbers of new diagnoses from March 2020 were compared to predictive models based on previous years. The predicted and observed levels in March to May 2020 showed no significant differences, but the overall difference was 18.5% (95% confidence interval 12.0 to 25.9) higher than predicted in June 2020 to September 2021, with 3,821 more patients diagnosed than anticipated. During this period, the largest increases were among females (33.4%, 23.4 to 45.2), adolescents (34.4%, 25.0 to 45.3), and those living in areas with the highest COVID-19 morbidity (29.9%, 21.2 to 39.8). The largest increases by diagnostic groups were found for eating disorders (27.4%, 8.0 to 55.3), depression and anxiety (21.0%, 12.1 to 51.9), and neurodevelopmental disorders (9.6%, 3.0 to 17.0), but psychotic and bipolar disorders and conduct and oppositional disorders showed no significant differences and self-harm (-28.6, -41.5 to -8.2) and substance use disorders (-15.5, -26.4 to -0.7) decreased in this period. The main limitation is that data from specialist services do not allow to draw conclusions about those not seeking help. ConclusionsFollowing the first pandemic phase, new psychiatric diagnoses in children and adolescents increased by nearly a fifth in Finnish specialist services. Possible explanations to our findings include changes in help-seeking, referrals and psychiatric problems, and delayed service access.Author summary Why was this study done? Healthcare emergencies and conflicts pose real threats to the availability of psychiatric services for children and adolescents.Previous studies compared limited pandemic and pre-pandemic periods or they did not cover the whole spectrum of psychiatric or neurodevelopmental disorders.This study was done to provide a comprehensive overview of the patterns of new diagnoses among children and adolescents during the pandemic. What did the researchers do and find? This study compared the predicted and observed new diagnoses from March 2020 to September 2021 based on pre-pandemic data and analyzed data from 2017 to 2021 among approximately 1 million children and adolescents per year.No significant changes in diagnoses were seen during the first phase of the pandemic, from March to May 2020, but new diagnoses increased by 18.5% from June 2020 to September 2021.Particularly high increases were observed in females, adolescents, and those living in areas with the highest Coronavirus Disease 2019 (COVID-19) rates. The highest increases in diagnoses related to eating disorders, depression and anxiety disorders, and neurodevelopmental disorders. What do these findings mean? The rapid increases in primary and secondary diagnoses by specialist services after the first 3 months of the pandemic raises concerns about gaps in services, accessibility, and continuity after the pandemic.Changes in supply and demand can pose serious challenges for psychiatric services, as they adapt to provide efficient services for children and adolescents.These data emphasize the importance of preparing for sudden changes in service use due to healthcare emergencies or crises, including the ongoing pandemic and the current conflict in Europe.Peer reviewe

Family members’ experiences of psychosocial support in palliative care inpatient units: A descriptive qualitative study

PurposeThe support for family members (FMs) during a patient's palliative hospital care has been rarely studied, creating a gap in how FMs can be better supported. Psychosocial support answers widely to FMs' needs. Therefore, this study aims to describe FMs’ experiences of psychosocial support in specialist palliative care inpatient units from the perspective of the FMs themselves.MethodsA qualitative descriptive study with individual semi-structured interviews and inductive content analysis was conducted. Data were collected in four specialist palliative care inpatient units in two large hospital districts in Finland. The 32-item checklist Consolidated Criteria for Reporting Qualitative Studies was used to ensure detailed reporting.ResultsA total of 19 FMs of cancer patients receiving palliative care participated in the study. Their experiences of psychosocial support focused on Support FMs hoped for, Support practices in the care unit, and Informational support for FMs.ConclusionsAccording to FMs' experiences, support focusing particularly on the FMs, safe quality patient care, proper access to information regarding the patient's care and condition, and genuine encounters with HCPs were the aspects that seemed to be the most important to the FMs. Systematic provision of support and information should be a routine model in palliative care. Additionally, a care environment that promotes FMs' presence, participation, and family-centred care is essential in FMs' support and should be considered when developing family involvement in palliative care. Furthermore, the importance of FMs receiving sufficient information, and FMs' dependence on HCPs to share the needed information, should be acknowledged. Hence, more attention should be paid to successful information sharing between the HCPs and FMs in palliative hospital care.</p

Supportive interventions for family members of very seriously ill patients in inpatient care: A systematic review

Aims and objectives To systematically review existing literature exploring supportive interventions for family members of very seriously ill patients in inpatient care.Background Being around a patient with a very serious illness in inpatient care setting is stressful and burdensome for family members. There is little information available on interventions that support family members of very seriously ill patients in inpatient care.Design A systematic review.Methods The literature review was conducted in May 2020 using four databases: PubMed (Medline), CINAHL, PsycINFO and Cochrane. A quality assessment was performed using the Quality Assessment Tool for Before-After (Pre-Post) Studies With No Control Group by the National Heart, Lung, and Blood Institute. The PRISMA checklist was used to support specific reporting and the TIDieR checklist to form detailed descriptions of the interventions.Results Of the 7165 identified studies, 11 studies were included in the review based on predetermined criteria. Interventions were based on meetings with family members, education or therapy. Mindfulness- and therapy-based interventions and multiple-session tailored interventions showed beneficial outcomes for psychological symptoms and educational interventions on preparedness and self-efficacy. Several different measuring instruments to evaluate similar outcomes, such as psychological symptoms and coping, were used.Conclusions Only a few supportive interventions for family members of very seriously ill patients in inpatient care were found, which made comparing the differences in the varying study methods and outcomes difficult. More studies on supportive interventions and their feasibility and effectiveness are essential. Further evaluation of instruments is necessary to identify the most valid and reliable ways of measuring symptoms and coping.Relevance to Clinical Practice The results of this study can be used in clinical practice when selecting effective interventions or assessing family members' need for support. Additionally, the results can be used for guidance when developing new, effective interventions.</div