Hyvinvointia hoitotyöhön : hoitajien kokemuksia työn voimavaratekijöistä

TIIVISTELMÄ Mäkelä, Anni & Turunen, Laura. Hyvinvointia hoitotyöhön: Hoitajien kokemuksia työn voimavaratekijöistä. Helsinki, syksy 2012, 52 s. 3 liitettä. Diakonia-ammattikorkeakoulu, Sosiaali- ja terveysalan koulutusohjelma, hoitotyön suuntautumisvaihtoehto, terveydenhoitaja (AMK)/ sairaanhoitaja (AMK). Tämän opinnäytetyön tavoitteena on kuvata hoitohenkilökunnan työhyvinvointia positiivisten työn voimavaratekijöiden näkökulmasta. Tavoitteena on myös verrata hoitohenkilökunnan korostamia positiivisia työn voimavaratekijöitä ja kirjallisuudesta nousevia työn voimavaratekijöitä toisiinsa. Opinnäytetyön tutkimusaihe perustuu käytännön hoitotyön tarpeeseen ja työhyvinvointitutkimuksen ajankohtaisuuteen. Opinnäytetyö perustuu laadulliseen tutkimusperinteeseen ja tutkimusaineiston keruumenetelmänä on teemahaastattelu. Opinnäytetyötä varten haastateltiin viittä hoitotyöntekijää työn voimavaratekijöistä keväällä 2012. Haastateltavat hoitotyöntekijät työskentelivät opinnäytetyön yhteistyötahona toimivan pääkaupunkiseudulla sijaitsevan sairaalan sisätautiosastolla. Litteroidut haastattelut analysoitiin laadullisen sisällön analyysin avulla. Hoitohenkilökunnan haastattelujen perusteella esille nousi neljä työn voimavaratekijää, joita ovat työilmapiiri ja yhteistyö, esimiehen tuki, hoitotyön kehittäminen ja potilastyö. Haastateltavat kuvasivat hyvää työilmapiiriä avoimeksi ja suvaitsevaksi, tällöin työntekijät ovat samanarvoisia ja yhteistyö heidän välillään on sujuvaa. Lisäksi työntekijöiden välillä vallitsee luottamus ja kunnioitus. Yhteistyön merkitys korostuu sekä hoitohenkilökunnan keskinäisissä suhteissa että suhteissa muihin alan ammattiryhmiin kuten lääkäreihin. Teemahaastatteluissa todettiin tärkeäksi, että hoitohenkilökunta tulee toimeen potilaiden kanssa ja ajaa potilaiden etuja. Esimieheltä saatua tukea ja palautetta pidettiin myös tärkeänä. Haastateltavat kokivat positiivisena asiana sen, että esimies ottaa huomioon kaikki työntekijät ja antaa positiivista palautetta ja kiitosta onnistuneiden hoitotilanteiden yhteydessä. Tärkeäksi koettiin myös se, että esimiehen kanssa voi keskustella sekä työasioista että henkilökohtaisista asioista. Haastatteluista ilmeni, että haastateltavien työtehtävät ovat lisääntyneet viime vuosina ja hoitotyö on muuttunut luonteeltaan kuormittavammaksi. Hoitotyö koettiin siitä huolimatta tärkeäksi ja merkitykselliseksi ja sitä kohtaan koettiin vahvaa kutsumusta. Opinnäytetyön avulla voidaan edistää hoitohenkilökunnan työhyvinvointia kiinnittämällä huomiota niihin työn voimavaratekijöihin, jotka vaikuttavat positiivisesti hoitohenkilökunnan kokemaan työhyvinvointiin. Opinnäytetyön tuloksien avulla voidaan kartoittaa myös muiden hoitotyön erikoisaloilla työskentelevien ammattihenkilöiden työn voimavaratekijöitä, jolloin saataisiin laajempi käsitys hoitotyöntekijöiden työhyvinvoinnin nykytilasta ja siihen myönteisesti vaikuttavista tekijöistä. Asiasanat: sairaanhoitajat, lähihoitajat, työhyvinvointi, työilmapiiri, esimiestyö, hoitotyö, työn organisointi, vaikuttaminen, tiedonkulkuABSTRACT Mäkelä, Anni & Turunen, Laura Welfare to Nursing: Nurses’ Experiences on Their Work Resources. 52 p. 3 appendices. Language: Finnish. Helsinki, Autumn 2012 Diaconia University of Applied Sciences. Degree Programme in Nursing, Option in Health Care. Degree: Public Health Nurse. / Degree Programme in Nursing. Degree: Nurse. This thesis aims at describing the occupational wellbeing of nurses from the viewpoint of positive resources in their work. Also, the purpose is to compare the positive resources expressed by the nurses with the literature and research on occupational wellbeing. The subject of this study stems from the practical needs of nursing, and the theme is contemporary in the field of occupational wellbeing, too. This is a qualitative research. Thematic interviews were used as a method of data collection. Five nurses who work in a Finnish metropolitan hospital’s medical ward were interviewed in the spring 2012. The interviews were transcribed and analysed by using content analysis. The interviews show the following four positive resources for work: work atmosphere and cooperation, support from the superior, patient work and development of care work. The interviewees expressed that a good work atmosphere is open and tolerant, the staff is equivalent and cooperation is smooth. Thus, there should be trust and respect between staff. Cooperation within the nurses is emphasised not only in the mutual but also in other relationships related to the profession. The results show that the staff should communicate well with the patients and advocate the benefit of the patients. Also, the feedback and support from the superior were considered important. The interviewees regarded important that the superior takes all employees into account and provides positive feedback after successful work performance. In addition, they expressed that it is essential to have the possibility to discuss both work related issues and personal matters with the superior. The results also indicate that the amount of work load has become more demanding during the last few years. However, nursing was considered important and significant, and the nurses have a strong mission for it. This thesis can be applied to promote job satisfaction of nursing staff by concentrating on the positive resources in the work. On the basis of this study it is possible to map the work resources of different branches of nursing. Hence, it will be possible to gain a more in-depth understanding of the current state of the medical staff and the factors that have an impact on it. Keywords: wellbeing, medical staff, resources for work, qualitative research, superior support, work atmosphere, communication, development of work communit

The role of attachment in recovery after a school-shooting trauma (vol 4, 22728, 2014)

Peer reviewe

Clinical and microbiological characterization of Aerococcus urinae bacteraemias at Helsinki metropolitan area, Finland

Our objective was to assess the incidence of bacteraemic Aerococcus urinae cases at Helsinki metropolitan area, Finland, from a 6-year study period (2013 to 2018) and to further characterize available cases. The study evaluates the outcome of commonly used cefuroxime treatment and determinate a set of A. urinae in vitro antimicrobial susceptibilities for benzylpenicillin, cefuroxime, and ceftriaxone. Clinical records of A. urinae bacteraemic patients were reviewed retrospectively. Antimicrobial susceptibility testing was performed by disk diffusion, gradient test, and broth microdilution for 139-141 clinical A. urinae isolates. Clinical data of 72/77 patients were combined with the in vitro susceptibilities. We found an increasing number of bacteraemic A. urinae cases within 6-year study period (p = 0.01). The patients were mainly elderly males, and all suffered from underlying conditions. A total of 27.3% of cases (21/77) showed polymicrobial blood cultures. Thirty-day mortality was 22.1%. Cefuroxime was the initial empiric antimicrobial agent given for 66/76 of the patients and treatment outcome was favorable for 20/22 patients who received cefuroxime at least up to day 5. All isolates were susceptible to benzylpenicillin and cefuroxime interpreted by EUCAST breakpoints for Aerococci and PK-PD breakpoints, respectively. MIC determinations gave variable results for ceftriaxone, 2.1-2.9% of the isolates were resistant. To conclude, it seems that the number of bacteraemic Aerococcus urinae cases is increasing at Helsinki metropolitan area, Finland, reflecting the growing blood culture sampling. Clinical A. urinae isolates were susceptible to cefuroxime in vitro. Treatment data indicate that empirical cefuroxime started for possibly urinary tract -derived community-acquired bacteraemia covers A. urinae.Peer reviewe

Psychotherapy and change in mental health-related work disability : a prospective Finnish population-level register-based study with a quasi-experimental design

Background Mental disorders are a major cause of work disability among the working-age population. Psychotherapy has shown to be an effective treatment for mental disorders, but the evidence is mainly based on small-scale randomised trials with relatively short follow-ups. We used population-based register data to examine the association between statutory rehabilitative psychotherapy and change in depression or anxiety-related work disability. Methods We drew a nationally representative sample of the working-age population (aged 18-55 in 2010). The study group comprised all those who started rehabilitative psychotherapy in 2011-2014. A total of 10 436 participants who were followed from 3 years prior to 4 years after the onset of rehabilitative psychotherapy. This resulted in 83 488 observations. The annual total number of mental health-related work disability months (0 to 12) was calculated from the total number of annual compensated sickness absence and disability pension days. A quasi-experimental interrupted time series analysis was applied. Results The onset of rehabilitative psychotherapy marked a decline in work disability in comparison to the counterfactual trend. Specifically, a 20% decrease in the level (incidence rate ratio, IRR 0.80; 95% CI 0.76 to 0.85) and a 48% decrease in the slope (IRR 0.52; 95% CI 0.50 to 0.54) of work disability were detected in comparison to the counterfactual scenario. No significant gender differences were observed. The decline in work disability was the steepest in the oldest age group. Conclusions This study suggests that statutory psychotherapy may decrease work disability at the population level. However, further evidence of causal inference and the potential heterogeneity of the association is required.Peer reviewe

Impacts of supplementary drainage on the water balance of a poorly drained agricultural field

In northern clay soils, field drainage is needed to ensure suitable moisture conditions for crop growth and farming operations. Supplementary drainage installations improve the efficiency of old drainage systems, but the hydrological impacts of the drainage procedures are not comprehensively understood or quantified. The objective was to simulate the hydrological behavior of a clay field section and to quantify the effects of a supplementary drainage on the water balance of the field section. The study site, in southern Finland, was originally subsurface drained in 1952 with 32 m drain spacing. Supplementary drainage was installed in 2014, decreasing the drain spacing to 10.7 m. Simulations were carried out with a dual-permeability hydrological model and two model parametrizations describing the field hydrology (1) before and (2) after the supplementary drainage installation. The parameterizations were used for simulations of a nine-year period to quantify the hydrological impacts of the supplementary drainage. For the periods without snow on the ground, the modified Nash-Sutcliffe efficiency for daily drain discharge and topsoil layer runoff values ranged from 0.43 to 0.53 and from 0.44 to 0.53, respectively. During the original drainage setup scenario, the average annual drain discharge was lower (7.8% of precipitation) than topsoil layer runoff and groundwater outflow (10.3% and 26.4%, respectively). For the supplementary drainage scenario, most of the water outflow was through drain discharge and groundwater outflow (20.4% and 21.9%, respectively). The supplementary drainage installation increased the average annual drain discharge by a factor of 2.6, while the annual average topsoil layer runoff and groundwater outflow decreased by 75% and 18%, respectively. The supplementary drainage setup was found to expedite the drying of the field section in spring by 8 days on average compared to the original drainage setup.Peer reviewe

Orexin/hypocretin receptor chimaeras reveal structural features important for orexin peptide distinction

AbstractWe wanted to analyze the basis for the distinction between OX1 and OX2 orexin receptors by the known agonists, orexin-A, orexin-B and Ala11, d-Leu15-orexin-B, of which the latter two show some selectivity for OX2. For this, chimaeric OX1/OX2 and OX2/OX1 orexin receptors were generated. The receptors were transiently expressed in HEK-293 cells, and potencies of the agonists to elicit cytosolic Ca2+ elevation were measured. The results show that the N-terminal regions of the receptor are most important, and the exchange of the area from the C-terminal part of the transmembrane helix 2 to the transmembrane helix 4 is enough to lead to an almost total change of the receptor’s ligand profile

A heterozygous p.S143P mutation in LMNA associates with proteasome dysfunction and enhanced autophagy-mediated degradation of mutant lamins A and C

Lamins A and C are nuclear intermediate filament proteins that form a proteinaceous meshwork called lamina beneath the inner nuclear membrane. Mutations in the LMNA gene encoding lamins A and C cause a heterogenous group of inherited degenerative diseases known as laminopathies. Previous studies have revealed altered cell signaling pathways in lamin-mutant patient cells, but little is known about the fate of mutant lamins A and C within the cells. Here, we analyzed the turnover of lamins A and C in cells derived from a dilated cardiomyopathy patient with a heterozygous p.S143P mutation in LMNA. We found that transcriptional activation and mRNA levels of LMNA are increased in the primary patient fibroblasts, but the protein levels of lamins A and C remain equal in control and patient cells because of a meticulous interplay between autophagy and the ubiquitin-proteasome system (UPS). Both endogenous and ectopic expression of p.S143P lamins A and C cause significantly reduced activity of UPS and an accumulation of K48-ubiquitin chains in the nucleus. Furthermore, K48-ubiquitinated lamins A and C are degraded by compensatory enhanced autophagy, as shown by increased autophagosome formation and binding of lamins A and C to microtubule-associated protein 1A/1B-light chain 3. Finally, chaperone 4-PBA augmented protein degradation by restoring UPS activity as well as autophagy in the patient cells. In summary, our results suggest that the p.S143P-mutant lamins A and C have overloading and deleterious effects on protein degradation machinery and pharmacological interventions with compounds enhancing protein degradation may be beneficial for cell homeostasis.Peer reviewe

Protocol for 3D drug sensitivity and resistance testing of patient-derived cancer cells in 384-well plates

Publisher Copyright: © 2022Establishment of drug testing of patient-derived cancer cells (PDCs) in physiologically relevant 3-dimensional (3D) culture is central for drug discovery and cancer research, as well as for functional precision medicine. Here, we describe the detailed protocol allowing the 3D drug testing of PDCs - or any type of cells of interest - in Matrigel in 384-well plate format using automation. We also provide an alternative protocol, which does not require supporting matrices. The cancer tissue is obtained directly from clinics (after surgery or biopsy) and processed into single cell suspension. Systematic drug sensitivity and resistance testing (DSRT) is carried out on the PDCs directly after cancer cell isolation from tissue or on cells expanded for a few passages. In the 3D-DSRT assay, the PDCs are plated in 384-well plates in Matrigel, grown as spheroids, and treated with compounds of interest for 72 h. The cell viability is directly measured using a luminescence-based assay. Alternatively, prior to the cell viability measurement, drug-treated cells can be directly subjected to automated high-content bright field imaging or stained for fluorescence (live) cell microscopy for further image analysis. This is followed by the quality control and data analysis. The 3D-DSRT can be performed within a 1-3-week timeframe of the clinical sampling of cancer tissue, depending on the amount of the obtained tissue, growth rate of cancer cells, and the number of drugs being tested. The 3D-DSRT method can be flexibly modified, e.g., to be carried out with or without supporting matrices with U-bottom 384-well plates when appropriate for the PDCs or other cell models used.Peer reviewe

Human Tumor–Derived Matrix Improves the Predictability of Head and Neck Cancer Drug Testing

In vitro cancer drug testing carries a low predictive value. We developed the human leiomyoma–derived matrix “Myogel” to better mimic the human tumor microenvironment (TME). We hypothesized that Myogel could provide an appropriate microenvironment for cancer cells, thereby allowing more in vivo–relevant drug testing. We screened 19 anticancer compounds, targeting the epidermal growth factor receptor (EGFR), MEK, and PI3K/mTOR on 12 head and neck squamous cell carcinoma (HNSCC) cell lines cultured on plastic, mouse sarcoma–derived Matrigel (MSDM), and Myogel. We applied a high-throughput drug screening assay under five different culturing conditions: cells in two-dimensional (2D) plastic wells and on top or embedded in Matrigel or Myogel. We then compared the efficacy of the anticancer compounds to the response rates of 19 HNSCC monotherapy clinical trials. Cancer cells on top of Myogel responded less to EGFR and MEK inhibitors compared to cells cultured on plastic or Matrigel. However, we found a similar response to the PI3K/mTOR inhibitors under all culturing conditions. Cells grown on Myogel more closely resembled the response rates reported in EGFR-inhibitor monotherapy clinical trials. Our findings suggest that a human tumor matrix improves the predictability of in vitro anticancer drug testing compared to current 2D and MSDM methods

Human Tumor–Derived Matrix Improves the Predictability of Head and Neck Cancer Drug Testing

In vitro cancer drug testing carries a low predictive value. We developed the human leiomyoma–derived matrix “Myogel” to better mimic the human tumor microenvironment (TME). We hypothesized that Myogel could provide an appropriate microenvironment for cancer cells, thereby allowing more in vivo–relevant drug testing. We screened 19 anticancer compounds, targeting the epidermal growth factor receptor (EGFR), MEK, and PI3K/mTOR on 12 head and neck squamous cell carcinoma (HNSCC) cell lines cultured on plastic, mouse sarcoma–derived Matrigel (MSDM), and Myogel. We applied a high-throughput drug screening assay under five different culturing conditions: cells in two-dimensional (2D) plastic wells and on top or embedded in Matrigel or Myogel. We then compared the efficacy of the anticancer compounds to the response rates of 19 HNSCC monotherapy clinical trials. Cancer cells on top of Myogel responded less to EGFR and MEK inhibitors compared to cells cultured on plastic or Matrigel. However, we found a similar response to the PI3K/mTOR inhibitors under all culturing conditions. Cells grown on Myogel more closely resembled the response rates reported in EGFR-inhibitor monotherapy clinical trials. Our findings suggest that a human tumor matrix improves the predictability of in vitro anticancer drug testing compared to current 2D and MSDM methods