Validation of Finnish Neecham Confusion Scale and Nursing Delirium Screening Scale using Confusion Assessment Method algorithm as a comparison scale

Peer reviewe

Nurse competence provides more individuality in the care of older hospitalized people

Aim: The aim of the study was to assess Registered Nurses' perceptions of general nurse competence, patient-centred care competence, and individuality in the care of older patients and to explore their associations. Design: A descriptive correlative survey. Methods: Data were collected using questionnaires at one Finnish university hospital during winter 2016-2017 amongst Registered Nurses (n = 223) and analyzedd statistically using descriptive and inferential statistics (ANOVA, Pearson's correlations coefficients) and path analysis. Results: Registered Nurses assessed their general competence, patient-centred care competenc,e and individuality in the care of older patients at a good level. The Path model confirmed general nurse competence was a predictor of patient-centred care competence, which in turn was a predictor of individuality in the nursing care of older patients. The novelty lies in empirical confirmation of the association between nurse competence and individuality in the care. Increasing competence may enhance individuality in the care of older people and enable interventions to support care outcomes.Peer reviewe

Nursing student-patient relationship-a 10-year comparison study in Finland

ObjectiveThis study aimed to describe and compare the group-level findings from 2005–2006 and 2015–2016 regarding students’ and patients’ views of the nursing student-patient relationship and associated factors.MethodsThe data were in both cases collected using Student-Patient Relationship Scales. The data were analysed statistically.ResultsIn both student cohorts, authoritative and facilitative student-patient relationships were reported by the students more frequently than mechanistic relationships. Authoritative relationships were most common in both patient cohorts, whereas facilitative relationships had become more frequent than mechanistic relationships. A positive change of views in the student and patient cohorts was found in factors associated with the relationship.ConclusionIn order to strengthen a clinical learning culture that reflects a facilitative student-patient relationship, further research is needed on the processes and outcomes of that relationship.</p

Construct validity and internal consistency of the revised Mental Health Literacy Scale in South African and Zambian contexts

Aim: The aim of this study was to evaluate the construct validity and internal consistency of the revised Mental Health Literacy Scale (MHLS) in South Africa (SA) and Zambia.Design: This cross-sectional study was conducted between October 2018 and December 2019.Methods: The study population comprised PHC workers (n = 454) in five districts in SA and Zambia. Principal component analysis (PCA) was used to explore the construct validity, and Cronbach's alpha was applied to measure the internal consistency of the MHLS.Results: Cronbach's alpha values for three attributes were below the appropriate level, but the value was strong (0.804) for the whole scale. The study found nine components explaining similar to 59% of the total variance of variables. All MHLS items loaded to main attributes based on the theory of MHL. The results stated that the revised version of the MHLS is a construct valid instrument with strong internal consistency.</p

Impact of a Web Program to Support the Mental Wellbeing of High School Students: A Quasi Experimental Feasibility Study

Little effort has been made to investigate the potential of web programs aimed to support the mental wellbeing of adolescents in school environments in middle-income countries. A quasi-experimental feasibility study was conducted in Thailand with adolescents (N = 180) in three conveniently sampled high schools and with teachers (N = 12) who acted as program tutors. The web program was used in small groups, independently, or it was not used at all. No statistically significant changes were found between the groups regarding depression, stress, or satisfaction. Differences between program users (n = 61) and non-users (n = 48) were not significant. Acceptance was higher among adolescents who used the program independently (n = 40, 73% vs. n = 21, 39%; p= 0.001). Usability feedback did not differ between the groups. Support should be provided in order for programs to be potentially used. More information is needed regarding factors associated with the use of web programs.</p

Self-assessed foot health in older people with rheumatoid arthritis-A cross-sectional study

Background: Foot and ankle problems are especially common in patients with RA, causing significant disability and limitation in daily activities. Previous studies have mainly focussed on foot problems in the adult population whilst the evidence of foot health in the older population is scarce.Objectives: The aim of the study was to analyse self-assessed foot health and associated factors in older people with rheumatoid arthritis (RA).Methods: The study applied a descriptive cross-sectional survey design and recruited older people with RA from the member register of one patient association. We collected the data in January 2019 with the Self-administered Foot Health Assessment Instrument, and sociodemographic and foot-related background questions and analysed the data with descriptive and inferential statistics.Results: Older people with RA had many self-reported foot problems. The most common problems were foot pain, dry skin and thickened toenails. In addition, structural deformities of the foot were prevalent. The level of foot health associated with the amount of daily walking or standing, and using walking or running shoes outdoors. Individuals who had consulted a physician due to their foot problems had more structural deformities in the foot. Foot problems limited their ability to perform daily activities.Conclusions: This study demonstrates that older people with RA not only live with a long-term health condition, but they also live with complex foot problems. Older people with RA need healthcare services due to their foot problems. There is a need to develop and implement care practices to alleviate foot pain and support and promote foot health and functional ability in older people with RA.Implication for practice: Understanding the nature and consequences of foot problems in older people with RA allows healthcare professionals to perform more accurate clinical foot evaluations and develop effective interventions to prevent further foot problems.</div

Nursing student‐patient relationship and related factors – A self‐assessment by nursing students

Aims and objectivesTo describe the nursing student–patient relationship in terms of three types of relationships—mechanistic, authoritative and facilitative—and analyse the factors related to the type of relationship.BackgroundAs future professionals, nursing students have a central role in facilitating patient autonomy while working in partnership with patients. Supporting student–patient relationship throughout the nursing education may result in positive outcomes for both students and patients.DesignA cross-sectional study.MethodsThe data were collected from a convenience sample of Finnish nursing students using a structured web survey. Statistical data analysis was performed using chi-square test, two-sample t test, one-way analysis of variance and multinomial logistic regression. The STROBE Statement — Checklist for cross-sectional studies was used (Appendix S1).ResultsStudents most often assessed their relationship with the patients as facilitative, followed by authoritative and mechanistic relationships. The results revealed three predictors for facilitative relationship: students’ older age, long enough contact time with the patient and higher competence in ensuring quality. In authoritative and facilitative relationships, students had significantly more positive perceptions of the contextual factors and consequences of the relationship and higher ratings of self-assessed competence levels than students in a mechanistic relationship.ConclusionsIt seems that the facilitative student–patient relationship is connected to the professional competence of nursing students, especially in the area of ensuring the quality of patient care. Therefore, sustaining clinical learning environments and pedagogical approaches that value and support facilitative relationships in students’ clinical learning should be enhanced.Relevance to clinical practiceEfforts aimed at contributing to facilitative student–patient relationships have a crucial role in shaping students’ competency and in promoting high-quality patient care. Thus, supervision of students organised around establishing mutual student–patient relationships with the preceptors acting as facilitators will benefit both students and patients.</p

Nurses' self-assessed moral courage and related socio-demographic factors

Background: Nurses need moral courage to ensure ethically good care. Moral courage is an individual characteristic and therefore it is relevant to examine its association with nurses' socio-demographic factors.Objective: To describe nurses' self-assessed level of moral courage and its association with their socio-demographic factors.Research design: Quantitative descriptive cross-sectional study. The data were collected with Nurses' Moral Courage Scale and analyzed statistically.Participants and research context: A total of 482 registered nurses from a major university hospital in Southern Finland completed the Finnish language version of Nurses' Moral Courage Scale in autumn 2017.Ethical considerations: Ethical approval was obtained from the university ethics committee and permission for the data collection from the participating hospital. Ethical principles and scientific guidelines were followed throughout the research process.Findings: Nurses' self-assessed level of moral courage was rather high. On Visual Analogy Scale (0-10), the mean value was 8.20 and the mean score of the four dimensional, 21-item Nurses' Moral Courage Scale was 4.09 on a 5-point Likert-type scale. Respondents' gender, present work role, ethical knowledge base, additional ethics education, self-study as a means to acquire ethical knowledge, and frequency of work situations needing moral courage were statistically significantly associated with nurses' moral courage.Discussion: Strongest association was found between nurses' higher moral courage level and formal and informal ethics education. Honesty and patient's humane and dignified encounter received the highest scores indicating respondents' internalization of the core values of nursing.Conclusion: Although nurses were fairly morally courageous, moral courage should be a part of nurses' basic and continuing education thus covering its theoretical and practical learning. Since moral courage is a virtue that can be taught, learnt, and practiced, education is a relevant way to maintain and further strengthen nurses' moral courage.</p

Meta-information censorship and the creation of the Chinanet Bubble

The question of who controls meta-information online has become a hot-button issue with profound political implications. The present article explores how state-led online censorship in the People’s Republic of China can create information bubbles, and how it is possible to analyze them. The article is based on a systematic comparison between 3,000 Google.com and Baidu.com image search results on a series of selected, potentially sensitive, keywords. This allows us to discern how censorship and information bubbles are connected, and how it is possible to detect and analyze them. To facilitate this, we offer a typology for conceptualizing the different dimensions of internet censorship. Our analysis points to the importance of censorship on metainformation and suggests that generally censored internet contents can also spill over to a liberal context through the Sinophone internet.</p

Finnish graduating nursing students' research utilization competence

In nursing, research utilization (RU) is a core competence for evidence-based practice (EBP). During the past fifteen years, a great deal of effort has been expended worldwide in nursing higher education to promote EBP. This study explores graduating nursing students’ RU competence in Finland using a descriptive cross-sectional, long-term survey design with two cohorts of nursing students in 2003 (n = 529) and 2012 (n = 259). Data were collected with a Competence in Research Utilization instrument, and analyzed statistically. In both cohorts, students’ attitudes towards RU were positive, but their knowledge and skills were low to moderate. Students’ RU competence was higher in 2003 compared to 2012. There is a need to develop nursing education strategically, and by seeking suitable pedagogical methods and curriculum contents to support the learning of RU. In higher education, educational cooperation and longitudinal learning outcome evaluations are recommended.</p