A pilot study of parents' experiences of reflexology treatment for infants with colic in Finland

Background Many infants under 4 months suffer from infantile colic. Infants with colic cry a lot, appear to be in pain, and it is difficult to sooth them. Colic is a painful condition for the infant and very stressful to parents. Parents in Finland get advice to try reflexology treatment for their infant, but there are no studies in Finland to support this advice. Aim The aim of the pilot study was to treat infants with reflexology and find out parents' experiences of the effects of the treatment on colic symptoms and parental stress. Method A total of 33 parents of 35 infants diagnosed with colic participated to the pilot study. Three certified reflexologists with health care education background and extensive experience in infant reflexology were trained to give the reflexology treatment in a standardised manner. They treated each infant 3-4 times. The whole body reflexology treatment session consisted of gentle pressure treatment of soles and feet, hands, head, face, ears, back, neck and whole stomach area. One treatment session lasted about 20-30 minutes, and treatments were delivered within 8-12 days. The data were collected from the parents with semi-structured questionnaires. Results The series of the treatments helped reduce the suffering of all the babies with infant colic. The colic symptoms disappeared on 43% of infants and decreased on the remaining 57%. The parents reported having pleasant experiences with the treatment, regardless whether the colic symptoms disappeared or continued. Parents stated that the treatment reduced the most typical colic symptoms; infants' body tension, colic crying and restless movements, poor sleep quality and irregular bowel movements. Conclusions Reflexology treatment seems to be a safe and effective way to treat infants with colic when conducted by a health care professional with reflexology training and experience.Peer reviewe

Symptom severity in burning mouth syndrome associates with psychological factors

Abstract Background Burning mouth syndrome (BMS) patients are psychologically distressed, but whether this associates with symptom severity is unclear. Objective To investigate the association of psychological factors with pain intensity and interference in BMS. Methods 52 women (mean age 63.1, SD 10.9) with BMS participated. Pain intensity and interference data was collected using 2-week pain diaries. Psychological factors were evaluated using Depression scale (DEPS), Pain anxiety symptom scale (PASS) and Pain vigilance and awareness questionnaire (PVAQ). The local ethical committee approved the study. Patients were divided into groups based on pain severity distribution tertiles: low intensity (NRS ≤ 3.7) or interference (NRS ≤2.9) (tertiles 1-2, n=35) and moderate to intense intensity (NRS > 3.7) or interference (>2.9)(tertile 3, n= 17). T-test, Wilcoxon Test and Pearson's Correlation Coefficient were used in the analyses. Results Patients in the highest intensity and interference tertiles reported more depression (P = .0247 and P = .0169) and pain anxiety symptoms (P = .0359 and P = .0293), and were more preoccupied with pain (P = .0004 and P = .0003) than patients in the low intensity and interference groups. The score of the pain vigilance questionnaire correlated significantly with pain intensity (r= .366, P= .009 and interference (r= .482, P = .009). Depression (r=. 399, P = .003) and pain anxiety symptoms (r= .452, P = .001) correlated with pain interference. Conclusion Symptom severity in BMS associates with symptoms of psychological distress emphasizing the need to develop multidimensional diagnostics for the assessment of BMS pain.Peer reviewe

Maximum Market Price of Longevity Risk under Solvency Regimes: The Case of Solvency II.

Longevity risk constitutes an important risk factor for life insurance companies, and it can be managed through longevity-linked securities. The market of longevity-linked securities is at present far from being complete and does not allow finding a unique pricing measure. We propose a method to estimate the maximum market price of longevity risk depending on the risk margin implicit within the calculation of the technical provisions as defined by Solvency II. The maximum price of longevity risk is determined for a survivor forward (S-forward), an agreement between two counterparties to exchange at maturity a fixed survival-dependent payment for a payment depending on the realized survival of a given cohort of individuals. The maximum prices determined for the S-forwards can be used to price other longevity-linked securities, such as q-forwards. The Cairns–Blake–Dowd model is used to represent the evolution of mortality over time that combined with the information on the risk margin, enables us to calculate upper limits for the risk-adjusted survival probabilities, the market price of longevity risk and the S-forward prices. Numerical results can be extended for the pricing of other longevity-linked securities

Attitudes of nursing staff towards pressure ulcer prevention in primary and specialised health care: A correlational cross‐sectional study

The aim of this correlational, cross‐sectional study was to assess the pressure ulcer prevention attitudes of the nursing staff and to identify factors associated with it both in primary and special health care. The study was conducted with nursing staff (N = 554) working in primary and special health care units in two hospital districts in Finlandin 2018 to 2019. Attitude towards Pressure ulcer Prevention instrument was used for data collection. Demographic data, Pressure Ulcer Prevention Knowledge test, and Pressure Ulcer Prevention Practice instrument were used as background variables. Data were analysed with statistical tests. Nursing staff working in primary care (n = 327) had more positive attitudes towards pressure ulcer prevention than those in specialised care (n = 209; P = .047). Working as a wound care nurse (P = .0005), working experience after graduation (P = .0017), self‐reported pressure ulcer prevention and early detection skills (P < .0001), pressure ulcer prevention knowledge (P = .0002), and views about the realisation of their unit's pressure ulcer prevention practices (P < .0001) independently explained variation in participants' attitudes. Attention should be placed on the pressure ulcer prevention attitudes of nurses who are less experienced or less skilled and who have lower pressure ulcer prevention knowledge. Positive organisational culture towards evidence‐based pressure ulcer prevention practices should be promoted

A pilot study of parents’ experiences of reflexology treatment for infants with colic in Finland

Background:Many infants under 4 months suffer frominfantile colic. Infants with colic cry a lot, appear to be inpain, and it is difficult to sooth them. Colic is a painfulcondition for the infant and very stressful to parents. Par-ents in Finland get advice to try reflexology treatment fortheir infant, but there are no studies in Finland to sup-port this advice.Aim:The aim of the pilot study was to treat infants withreflexology and find out parents’ experiences of theeffects of the treatment on colic symptoms and parentalstress.Method:A total of 33 parents of 35 infants diagnosedwith colic participated to the pilot study. Three certifiedreflexologists with health care education backgroundand extensive experience in infant reflexology weretrained to give the reflexology treatment in a standard-ised manner. They treated each infant 3–4 times. Thewhole body reflexology treatment session consisted ofgentle pressure treatment of soles and feet, hands, head,face, ears, back, neck and whole stomach area. Onetreatment session lasted about 20–30 seconds, andtreatments were delivered within 8–12 days. The datawere collected from the parents with semi-structuredquestionnaires.Results:The series of the treatments helped reduce thesuffering of all the babies with infant colic. The colicsymptoms disappeared on 43% of infants and decreasedon the remaining 57%. The parents reported havingpleasant experiences with the treatment, regardlesswhether the colic symptoms disappeared or continued.Parents stated that the treatment reduced the most typi-cal colic symptoms; infants’ body tension, colic cryingand restless movements, poor sleep quality and irregularbowel movements.Conclusions:Reflexology treatment seems to be a safe andeffective way to treat infants with colic when conductedby a health care professional with reflexology trainingand experience.</p

Does experienced seclusion or restraint affect psychiatric patients' subjective quality of life at discharge?

Peer reviewe

Respect and its associated factors as perceived by older patients

Aims and objectives To investigate older hospital patients' perceptions of respect in a patient-nurse relationship and its associated factors. Background To be cared for with respect is fundamental to ethical nursing care. However, respect has seldom been a main topic of nursing research, and few of these studies have assessed older patients' perceptions of being respected by nurses alongside associated factors. Design A cross-sectional, descriptive and correlational survey design. Methods Hospitalised older patients (n = 200) were interviewed using the ReSpect Scale, measuring respect within the nurse-patient relationship, the EuroQol 5D-5L, measuring perceived health status, and the Patient Satisfaction Scale, measuring satisfaction with nursing care. Sociodemographic characteristics were also collected. Data were analysed using descriptive statistics, Pearson's correlation coefficient, the t test and analysis of variance. The STROBE Statement was used for reporting this research. Results Older patients reported moderate levels of perceived respect in their patient-nurse relationships. A statistically significant, strong positive correlation between patient satisfaction and their perceptions of respect was found. Poor perceived health status was also statistically significantly associated with older patients' perceptions of respect. No statistically significant associations between patients' other sociodemographic characteristics and their perceptions of respect were found. Conclusions The identification of factors and their associations with respect is a basic step towards theory generation. Further empirical research is needed to test the preliminary associations found in this study to further develop the current understanding of respect and its associated factors. Relevance to clinical practice The older patients' perceptions of respect highlighted in this study show the need for the further consideration, reflection and development of this important aspect of the relationship between patients and nurses. The identification and measurement of respect and its associated factors may help to improve respect in nursing care making it more visible in the care of older people

Factors determining nurses' knowledge of evidence-based pressure ulcer prevention practices in Finland: a correlational cross-sectional study

Background Pressure ulcers cause economic burden, human suffering, pain and decreased health-related quality of life in patients. Pressure ulcers are preventable in most cases, and nursing staff knowledge is a key factor in successful pressure ulcer prevention. Further evidence is needed to better tailor pressure ulcer prevention training programmes to the nursing staff.Aim To evaluate the level of nursing staff knowledge about evidence-based pressure ulcer prevention practices in both primary and specialised care, and to identify what factors determine nurses' knowledge levels.Methods A correlational, cross-sectional study was conducted from 2018 to 2019 in two hospital districts in Finland. The Pressure Ulcer Prevention Knowledge test was used to collect data, and the Attitude towards Pressure ulcer Prevention (APuP) instrument was used as a background variable. The data were statistically analysed with Wilcoxon and Kruskal-Wallis tests, Spearman correlations and multiple linear regression.Results The pressure ulcer prevention knowledge of the participating registered nurses, practical nurses and ward managers (N = 554) was on average 24.40 (max. 35.00). There was no difference in the participants' knowledge based on the type of unit in which they were working (primary or specialised care). The participants' attitudes (p Conclusions Special attention needs to be paid to the knowledge of those nurses working in positions that require lower levels of education and those who rarely take care of patients with pressure ulcers. Supporting nurses' positive attitudes towards pressure ulcer prevention should be an essential part of pressure ulcer prevention training. Nurses' self-evaluations of their training needs can be used to target training. The limitations of the study should be considered when generalising the results.</div

Symptom severity in burning mouth syndrome associates with psychological factors

Burning mouth syndrome (BMS) patients are psychologically distressed, but whether this associates with symptom severity is unclear. The aim was to investigate the association of psychological factors with pain intensity and interference in BMS. Fifty-two women (mean age 63.1, SD 10.9) with BMS participated. Pain intensity and interference data were collected using 2-week pain diaries. Psychological factors were evaluated using Depression Scale (DEPS), Pain Anxiety Symptom Scale (PASS) and Pain Vigilance and Awareness Questionnaire (PVAQ). The local ethical committee approved the study. Patients were divided into groups based on pain severity distribution tertiles: low intensity (NRS 3.7) or interference (>2.9) (tertile 3, n = 17). T test, Wilcoxon's test and Pearson's correlation coefficient were used in the analyses. Patients in the highest intensity and interference tertiles reported more depression (P = .0247 and P = .0169) and pain anxiety symptoms (P = .0359 and P = .0293), and were more preoccupied with pain (P = .0004 and P = .0003) than patients in the low intensity and interference groups. The score of the pain vigilance questionnaire correlated significantly with pain intensity (r = .366, P = .009) and interference (r = .482, P = .009). Depression (r = .399, P = .003) and pain anxiety symptoms (r = .452, P = .001) correlated with pain interference. Symptom severity in BMS associates with symptoms of psychological distress emphasising the need to develop multidimensional diagnostics for the assessment of BMS pain

The predictive value of two on-site selection methods of undergraduate nursing students: A cohort study

Nursing programs aim to select students who will succeed in theoretical studies and in clinical practice, and who are suitable for the profession. Recent literature has suggested an assessment of cognitive and non-cognitive skills in nursing student selection. The aim of this study is to compare the predictive value of two on-site selection methods used in nursing student selection, namely, psychological aptitude tests and literature-based exams. A cohort study was conducted. Students admitted to four undergraduate Bachelor of Science nursing programs at one Finnish nursing school between 2002 and 2004 (N = 626) were allocated into two cohorts based on the on-site selection method. Follow-up data was collected at two measurement points (May 2004–May 2009). The multimethod data collection included the use of admission archives (entrance exam scores), study records (study success) and a structured self-report questionnaire (knowledge and skills). Statistical data analysis was undertaken. According to the results, the two on-site selection methods produced very similar results regarding their predictive value. Both of the on-siteselection methods predicted knowledge and skills, and study success of nursing students to some extent, but only explained a small proportion of variance. To conclude, neither of the two on-site selection methods should be used alone when predicting knowledge and skills or study success of nursing students. Further longitudinal research is needed to investigate the predictive value of various on-site selection methods.</p