Disciplinary processes for nurses, from organizational supervision to outcomes: A document analysis of a regulatory authority's decisions

Aim: This study aims to explore the disciplinary processes for nurses, from organizational supervision to final decisions by the Finnish regulatory authority.Background: Regulatory authorities are responsible for protecting the public, by ensuring that they receive safe, competent and ethical nursing care, but little is known about the disciplinary processes for nurses.Methods: This is a retrospective document analysis of 296 disciplinary decisions by the Finnish regulatory authority from 2007 to 2016. The data were analysed using a quantitative design with descriptive statistics.Results: We studied 204 disciplined nurses (81.4% female) with a mean age of 43.5 years. The disciplinary process comprised organizational supervision, complaints, investigations and decisions. Nurses with substance abuse issues were more likely to face criminal investigations and receive temporary decisions. The process lasted from under 1 month to years and could have profound effects on nurses, col-leagues and nurse managers and compromise patient safety.Conclusion: This study identified key factors that could inform the disciplinary processes for nurses. More knowledge is needed about how organisations ensure patient safety when unprofessional conduct is suspected.Implications for Nursing Management: Retaining nursing professionals is vital due to global shortages, and more attention should be paid to organizational supervision and support for nurses during disciplinary processes.</p

Supporting lifestyle change in obese pregnant mothers through the wearable internet-of-things (SLIM) -intervention for overweight pregnant women : Study protocol for a quasi-experimental trial

ObjectivesTo assess, in terms of self-efficacy in weight management, the effectiveness of the SLIM lifestyle intervention among overweight or obese women during pregnancy and after delivery, and further to exploit machine learning and event mining approaches to build personalized models. Additionally, the aim is to evaluate the implementation of the SLIM intervention.MethodsThis prospective trial, which is a non-randomized, quasi-experimental, pre-post intervention, includes an embedded mixed-method process evaluation. The SLIM Intervention is delivered by public health nurses (n = 9) working in maternity clinics. The public health nurses recruited overweight women (n = 54) at their first antenatal visit using convenience sampling. The core components of the intervention i.e. health technology, motivational interviewing, feedback, and goal setting, are utilized in antenatal visits in maternity clinics starting from gestational week 15 or less and continuing to 12 weeks after delivery. Mixed effect models are used to evaluate change over time in self-efficacy, weight management and weight change. Simple mediation models are used to assess calories consumed and moderate to vigorous physical activity (MVPA) as mediators between self-efficacy and weight change. Signal processing and machine learning techniques are exploited to extract events from the data collected via the Oura ring and smartphone-based questionnaires.DiscussionThe SLIM intervention was developed in collaboration with overweight women and public health nurses working in maternity clinics. This study evaluates the effectiveness of the intervention among overweight women in increasing self-efficacy and achieving a healthy weight; thus, impacting the healthy lifestyle and long-term health of the whole family. The long-term objective is to contribute to women's health by supporting weight-management through behavior change via interventions conducted in maternity clinics.Peer reviewe

Validation of the Patient-Centred Care Competency Scale Instrument for Finnish Nurses

Patient-centredness in care is a core healthcare value and an effective healthcare delivery design requiring specific nurse competences. The aim of this study was to assess (1) the reliability, validity, and sensitivity of the Finnish version of the Patient-centred Care Competency (PCC) scale and (2) Finnish nurses' self-assessed level of patient-centred care competency. The PCC was translated to Finnish (PCC-Fin) before data collection and analyses: descriptive statistics; Cronbach's alpha coefficients; item analysis; exploratory and confirmatory factor analyses; inter-scale correlational analysis; and sensitivity. Cronbach's alpha coefficients were acceptable, high for the total scale, and satisfactory for the four sub-scales. Item analysis supported the internal homogeneity of the items-to-total and inter-items within the sub-scales. Explorative factor analysis suggested a three-factor solution, but the confirmatory factor analysis confirmed the four-factor structure (Tucker-Lewis index (TLI) 0.92, goodness-of-fit index (GFI) 0.99, root mean square error of approximation (RMSEA) 0.065, standardized root mean square residual (SRMR) 0.045) with 61.2% explained variance. Analysis of the secondary data detected no differences in nurses' self-evaluations of contextual competence, so the inter-scale correlations were high. The PCC-Fin was found to be a reliable and valid instrument for the measurement of nurses' patient-centred care competence. Rasch model analysis would provide some further information about the item level functioning within the instrument

Educators' occupational well-being in health and social care education

BackgroundThe occupational well-being (OW) of educators can be defined as a balance between resources and workload factors as seen from four aspects of working life: (i) individual, (ii) working conditions, (iii) professional competence and (iv) work community. The research in this study examined the individual aspect as particular importance to the physical and mental workability of educators. Aims To study the individual aspect of the OW of educators as well as the associating factors.MethodsA cross-sectional survey design was conducted among educators working in health and social care education in Finland. The data were collected with an electronic survey using the 'Occupational well-being of social and health care teachers-index questionnaire'. The data were analysed with an SPSS version 27 using descriptive statistics, explorative factor analysis and linear regression analysis.ResultsThe educators (n = 552, response rate 31%) assessed their resources for managing their mental workload as quite poor (2.41, standard deviation [SD] 0.98). In addition, workplace support promoting OW was assessed as being quite poor (2.37, SD 0.88), and as especially requiring more measures during working hours. Associations with the individual aspect of OW were found between the personal and work-related background variables as well as overall OW.ConclusionsThe perceptions of the educators indicated that resources to cope with workload factors should be promoted. Investing in educators' resources at work, enabling well-being actions during working hours and avoiding backlog situations would all help promote the educators' OW.</p

Health Promotion Actions and School Violence—A Cluster Analysis from Finnish Comprehensive Schools

(1) Schools have a significant role in violence prevention activities. This study aimed to first identify profiles of Finnish comprehensive schools based on school violence. The second aim was to examine the associations between profiles concerning health promotion actions, reactive or punitive actions, and school characteristics. (2) The study used the large-scale, nationally representative Benchmarking System of Health Promotion Capacity-Building (BSHPCB) data (n = 2057 schools) completed by the school’s principal together with a student welfare team. The data was analyzed by cluster analysis and Chi-squared and Kruskal–Wallis tests. For post hoc testing, Fisher’s exact test with odds ratios and Mann–Whitney U-test were used. (3) The cluster analysis yielded five profiles of school violence: “No violence”, “Adolescent violence” (violence both among pupils and from pupils towards staff, but not inappropriate behavior from school staff towards pupils), “Not known” (principals either did not respond to these questions or they did not know whether there had been any school violence incidents), “Peer violence” (school violence occurred among pupils but not from pupils towards staff, nor inappropriate behavior from school staff towards pupils), and “All violence” (all types of school violence and inappropriate behavior from school staff towards pupils). These clusters differed according to type of school and municipality. Additionally, both management and monitoring as health promotion actions were related to higher incidence of school violence whereas other actions, such as commitment, resources, common practices, and participation were not related to school violence. (4) The findings of this study indicate that schools have different profiles in terms of school violence and providing evidence and guidance for school violence prevention work.publishedVersionPeer reviewe

Health Promotion Actions and School Violence—A Cluster Analysis from Finnish Comprehensive Schools

(1) Schools have a significant role in violence prevention activities. This study aimed to first identify profiles of Finnish comprehensive schools based on school violence. The second aim was to examine the associations between profiles concerning health promotion actions, reactive or punitive actions, and school characteristics. (2) The study used the large-scale, nationally representative Benchmarking System of Health Promotion Capacity-Building (BSHPCB) data (n = 2057 schools) completed by the school’s principal together with a student welfare team. The data was analyzed by cluster analysis and Chi-squared and Kruskal–Wallis tests. For post hoc testing, Fisher’s exact test with odds ratios and Mann–Whitney U-test were used. (3) The cluster analysis yielded five profiles of school violence: “No violence”, “Adolescent violence” (violence both among pupils and from pupils towards staff, but not inappropriate behavior from school staff towards pupils), “Not known” (principals either did not respond to these questions or they did not know whether there had been any school violence incidents), “Peer violence” (school violence occurred among pupils but not from pupils towards staff, nor inappropriate behavior from school staff towards pupils), and “All violence” (all types of school violence and inappropriate behavior from school staff towards pupils). These clusters differed according to type of school and municipality. Additionally, both management and monitoring as health promotion actions were related to higher incidence of school violence whereas other actions, such as commitment, resources, common practices, and participation were not related to school violence. (4) The findings of this study indicate that schools have different profiles in terms of school violence and providing evidence and guidance for school violence prevention work.</p

Nurse educator competence in four European countries—A comparative cross-sectional study

Abstract Aim The aim of this article is to describe and compare the nurse educator competences in four European countries using three different evaluators: nurse educators (n = 329), heads of a nursing subject (n = 60) and student nurses (n = 1058). Design The study was conducted as a comparative cross‐sectional survey in Finland, Malta, Slovakia and Spain between May 2021 and February 2022. Methods The data were collected with an online survey. The instrument used was a 20‐item Tool for Evaluation of Requirements of Nurse Teachers, utilizing a 5‐point Likert‐type scale. The data were analysed statistically and reported according to STROBE guidelines. Results Nurse educators' competence evaluated positively in all the groups of evaluators, with a mean of >3.5. The self‐evaluation of nurse educators' competence was higher than the other evaluators' evaluations. Having a degree in nursing, having completed some pedagogical studies and longer work experience as a nurse educator had a positive association with higher self‐evaluated competence among nurse educators. Conclusions Nurse educator competence is at a good level in the selected European countries, but further studies are required to find the reasons behind the differences in evaluations. Public Contribution Each participating educational institution named a contact person who distributed the surveys to the participants and returned the study's metadata to the researchers

Professional competence, personal occupational well-being, and mental workload of nurse educators – A cross-sectional study in four European countries

BackgroundNurse educators need a high level of professional competence to educate future health care professionals. Professional competence supports occupational well-being whilst high mental workload can undermine it. There is little existing research into nurse educators' professional competence, occupational well-being, mental workload, and the relationships between them, particularly in the European context.ObjectivesTo describe the professional competence, personal occupational well-being, and mental workload of nurse educators in four European countries, and to explore how the professional competence and mental workload of nurse educators relate to their personal occupational well-being.DesignCross-sectional study design with quantitative survey data.SettingNurse educators from Finland, Spain, Slovakia, and Malta.MethodsThe data were collected from 302 nurse educators through an online questionnaire which used the Health and Social Care Educator's Competence (HeSoEduCo) instrument. This contains 43 items which measure areas of professional competence. Statistical analysis involved descriptive and multivariate analysis.ResultsNurse educators self-assessed their overall professional competence as high. Competence in evidence-based practice was assessed as the highest whilst cultural competence was perceived to be the lowest of the six competence areas. Nurse educators perceived their levels of personal occupational well-being and the balance of mental workload as moderate. However, these levels varied between the four countries. Professional competence, more specifically administrative and curriculum competence, and a balanced mental workload were positively related to personal occupational well-being.ConclusionsThe educators who perceive themselves to have very good professional competence and a balanced mental workload are more likely to report high occupational well-being. The findings suggest that nurse educators' cultural competence needs to be strengthened and intervention research is needed to determine ways of reducing mental workload and increasing the occupational well-being of nurse educators

Oligogenic basis of sporadic ALS The example of SOD1 p.Ala90Val mutation

Objective To characterize the clinical and neuropathologic features of patients with amyotrophic lateral sclerosis (ALS) with the superoxide dismutase 1 (SOD1) p.Ala90Val mutation, as well as the mutation frequency and the role of oligogenic mechanisms in disease penetrance. Methods An index patient with autopsy-proven ALS was discovered to have the SOD1 p.Ala90Val mutation, which was screened in 2 Finnish ALS cohorts (n = 453). Additional contributing variants were analyzed from whole-genome or whole-exome sequencing data. Results Seven screened patients (1.5%) were found to carry the SOD1 heterozygous mutation. Allele-sharing analysis suggested a common founder haplotype. Common clinical features included limb-onset, long disease course, and sensory symptoms. No TDP43 pathology was observed. All cases were apparently sporadic, and pedigree analysis demonstrated that the mutation has reduced penetrance. Analysis of other contributing genes revealed a unique set of additional variants in each patient. These included previously described rare ANG and SPG11 mutations. One patient was compound heterozygous for SOD1 p.Ala90Val and p.Asp91Ala. Conclusions Our data suggest that the penetrance of SOD1 p.Ala90Val is modulated by other genes and indicates highly individual oligogenic basis of apparently sporadic ALS. Additional genetic variants likely contributing to disease penetrance were very heterogeneous, even among Finnish patients carrying the SOD1 founder mutation

Oligogenic basis of sporadic ALS The example of SOD1 p.Ala90Val mutation

Objective To characterize the clinical and neuropathologic features of patients with amyotrophic lateral sclerosis (ALS) with the superoxide dismutase 1 (SOD1) p.Ala90Val mutation, as well as the mutation frequency and the role of oligogenic mechanisms in disease penetrance. Methods An index patient with autopsy-proven ALS was discovered to have the SOD1 p.Ala90Val mutation, which was screened in 2 Finnish ALS cohorts (n = 453). Additional contributing variants were analyzed from whole-genome or whole-exome sequencing data. Results Seven screened patients (1.5%) were found to carry the SOD1 heterozygous mutation. Allele-sharing analysis suggested a common founder haplotype. Common clinical features included limb-onset, long disease course, and sensory symptoms. No TDP43 pathology was observed. All cases were apparently sporadic, and pedigree analysis demonstrated that the mutation has reduced penetrance. Analysis of other contributing genes revealed a unique set of additional variants in each patient. These included previously described rare ANG and SPG11 mutations. One patient was compound heterozygous for SOD1 p.Ala90Val and p.Asp91Ala. Conclusions Our data suggest that the penetrance of SOD1 p.Ala90Val is modulated by other genes and indicates highly individual oligogenic basis of apparently sporadic ALS. Additional genetic variants likely contributing to disease penetrance were very heterogeneous, even among Finnish patients carrying the SOD1 founder mutation.Peer reviewe