Improving the delivery of care for patients with diabetes through understanding optimised team work and organisation in primary care

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The association between cross-cultural competence and well-being among registered native and foreign-born nurses in Finland

Background A growing body of research indicates that cross-cultural competence in nurses can improve migrant patients’ health-related outcomes, but little is known about the potential benefits of cross-cultural competence on the nurses’ own well-being. Objective To examine whether cross-cultural competence (empathy, skills, positive attitudes, and motivation) is associated with perceived time pressure at work, psychological distress, and sleep problems among registered nurses in Finland, and whether there are differences in these potential associations between native and foreign-born nurses. Methods The present cross-sectional study was based on a sample of 212 foreign-born nurses licensed to practice in Finland and a random sample of 744 native Finnish nurses. Data were collected with a questionnaire and analyzed using multiple linear regression and structural equation modeling (SEM). Results Of all four dimensions of cross-cultural competence, only empathy was associated with perceived time pressure (β = –0.13, p = .018), distress (β = –0.23, p .05). Conclusions Cross-cultural empathy may protect against perceived time pressure, distress, and sleep problems in both native and foreign-born nurses. Thus, the promotion of this component of cross-cultural competence among nursing personnel should be encouraged. © 2018 Wesołowska et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.Peer reviewe

Association of social isolation, loneliness and genetic risk with incidence of dementia: UK Biobank Cohort Study

BACKGROUND: Social isolation and loneliness have been associated with increased risk of dementia, but it is not known whether this risk is modified or confounded by genetic risk of dementia. METHODS: We used the prospective UK Biobank study with 155 070 participants (mean age 64.1 years), including self-reported social isolation and loneliness. Genetic risk was indicated using the polygenic risk score for Alzheimer's disease and the incident dementia ascertained using electronic health records. RESULTS: Overall, 8.6% of participants reported that they were socially isolated and 5.5% were lonely. During a mean follow-up of 8.8 years (1.36 million person years), 1444 (0.9% of the total sample) were diagnosed with dementia. Social isolation, but not loneliness, was associated with increased risk of dementia (HR 1.62, 95% CI 1.38 to 1.90). There were no interaction effects between genetic risk and social isolation or between genetic risk and loneliness predicting incident dementia. Of the participants who were socially isolated and had high genetic risk, 4.4% (95% CI 3.4% to 5.5%) were estimated to developed dementia compared with 2.9% (95% CI 2.6% to 3.2%) of those who were not socially isolated but had high genetic risk. Comparable differences were also in those with intermediate and low genetic risk levels. CONCLUSIONS: Socially isolated individuals are at increased risk of dementia at all levels of genetic risk

Structural and functional aspects of social support as predictors of mental and physical health trajectories: Whitehall II cohort study

BACKGROUND: Social support is associated with better health. However, only a limited number of studies have examined the association of social support with health from the adult life course perspective and whether this association is bidirectional. METHODS: Participants (n=6797; 30% women; age range from 40 to 77 years) who were followed from 1989 (phase 2) to 2006 (phase 8) were selected from the ongoing Whitehall II Study. Structural and functional social support was measured at follow-up phases 2, 5 and 7. Mental and physical health was measured at five consecutive follow-up phases (3–8). RESULTS: Social support predicted better mental health, and certain functional aspects of social support, such as higher practical support and higher levels of negative aspects in social relationships, predicted poorer physical health. The association between negative aspects of close relationships and physical health was found to strengthen over the adult life course. In women, the association between marital status and mental health weakened until the age of approximately 60 years. Better mental and physical health was associated with higher future social support. CONCLUSIONS: The strength of the association between social support and health may vary over the adult life course. The association with health seems to be bidirectional

The relationship of dispositional compassion with well-being : a study with a 15-year prospective follow-up

We investigated the associations of individual's compassion for others with his/her affective and cognitive well-being over a long-term follow-up. We used data from the prospective Young Finns Study (N = 1312-1699) between 1997-2012. High compassion was related to higher indicators of affective well-being: higher positive affect (B = 0.221, p <.001), lower negative affect (B = -0.358, p <.001), and total score of affective well-being (the relationship of positive versus negative affect) (B = 0.345, p <.001). Moreover, high compassion was associated with higher indicators of cognitive well-being: higher social support (B = 0.194, p <.001), life satisfaction (B = 0.149, p <.001), subjective health (B = 0.094, p <.001), optimism (B = 0.307, p <.001), and total score of cognitive well-being (B = 0.265, p <.001). Longitudinal analyses showed that high compassion predicted higher affective well-being over a 15-year follow-up (B = 0.361, p <.001) and higher social support over a 10-year follow-up (B = 0.230, p <.001). Finally, compassion was more likely to predict well-being (B = [-0.076; 0.090]) than vice versa, even though the predictive relationships were rather modest by magnitude.Peer reviewe

The associations between the final clinical practicum elements and the transition experience of early career nurses: A cross-sectional study

The final clinical practicum before graduation prepares nursing students for the transition from a student to a nurse, but the essential elements of the final clinical practicum that enhance successful transition are not known. We examined the associations of five elements of the final clinical practicum with four indicators of the transition experience in new nurses. We also tested whether psychosocial work characteristics modified these associations. The study sample comprised 712 Finnish nurses who had graduated within the previous two years before the data collection (response rate: 18%). The data were collected using a questionnaire survey in 2018. The elements of the final clinical practicum included (1) the systematicness of the practicum, (2) teacher involvement, (3) the quality of supervision, (4) preparing for the demands of a nurse's work and (5) being part of a professional team. Our results, based on linear regression analysis, showed that all the elements except the quality of supervision were associated with indicators of the transition experience (beta range: from 0.08 to 0.35). Job demands modified several of these associations. The findings of this study highlight the potential for well-implemented final clinical practicums to promote a smoother transition for new nurses.</p

Final clinical practicum, transition experience and turnover intentions among newly graduated nurses: A cross sectional study

BackgroundThe shortage of nurses is a global issue, and turnover rates are especially high for newly graduated nurses. The transition from student to nurse is often described as challenging, and the final clinical practicum before graduation is suggested to be important in preparing graduating students for the transition. However, little is known about the actual relationships between the final clinical practicum, transition and turnover intentions.ObjectivesTo examine whether the final clinical practicum experience is associated with the transition experience and turnover intentions of newly graduated nurses, and whether the transition experience mediates the potential relationship between the practicum and turnover intentions.DesignCross-sectional survey study.SettingsThe study was carried out in Finland (October–December 2018).ParticipantsRegistered nurses graduated within the past two years (n = 712).MethodsA new survey instrument with five subscales was developed for measuring the final clinical practicum experience. Transition experience was measured on four scales that demonstrated the emotional, physical, socio-developmental and intellectual domains of the transition: Psychological distress, sleep quality, role conflict/ambiguity, perception of transition and educational preparation. Turnover intentions from job and profession were asked about with two questions. Structural equation modelling was used to explore the associations between the variables. The models were adjusted for multiple potential confounders.ResultsFinal clinical practicum experience was associated with all domains of the transition experience and turnover intentions. The association between the practicum and turnover intentions was partly mediated by the emotional (psychological distress) and socio-developmental (role conflict and ambiguity) domains of the transition.ConclusionsOur findings provide new evidence about the associations between the specific final clinical practicum dimensions and turnover intentions and the specific mechanisms linking this association. These results highlight the importance of final clinical practicums and suggest targets for improving nurses' transition processes during their first years in practice.</div

Subjective mental well-being among higher education students in Finland during the first wave of COVID-19

Aims: Increased mental health problems during the COVID-19 pandemic have become a major concern among young adults. Our aim was to understand which COVID-19-related questions predicted mental well-being during the outbreak. Methods: Two cross-sectional datasets were used. The primary dataset was collected in May 2020 (n = 1001), during the initial COVID-19 outbreak, and the secondary in April 2019 (n = 10866), before the pandemic. Mental well-being was assessed with the Short Warwick-Edinburgh Mental Well-Being Scale. Relationships between mental well-being and COVID-19-related questions were investigated with lasso regression. As an exploratory analysis, two-way ANOVAs were used to compare mental well-being before and during the outbreak. Results: Higher levels of mental well-being were associated with lower levels of academic stress and COVID-19-related worry, along with a higher satisfaction with the procedures and information provided by the higher education institutions and the government. COVID-19-related symptoms and infections did not have an impact on students' mental well-being during the outbreak. Small to moderate effect sizes across the time points were detected, indicating an overall decrease in mental well-being across age and gender during the outbreak. Conclusions: COVID-19 had an impact on higher education students' mental well-being. Higher education institutes may play a crucial role in protecting their students' well-being during uncertain times.Peer reviewe