The use of electronic communication for patient-professional interaction – nursing staff’s point of view

Patient care in hospital wards is decreasing dramatically; more and more often, it takes place at home and in outpatient clinics. New ways to communicate are thus needed between patients and professionals. The use of electronic devices is one possible solution to facilitate the communication and support modern care.The purpose of the study was to describe nursing staff’s skills and experiences on the use of electronic communication for interaction with patients. The study also looks at factors promoting and hindering the use of electronic communication. The study used a descriptive design including both qualitative and quantitative components. The data were collected among nursing staff (N=567, n=123) working in outpatient clinics in spring 2012 with an electronic questionnaire.Computer and electronic communication skills among nursing staff were at a moderately good level. They had most experience in the use of email and text messages. Electronic devices were used at all stages of the nursing process. Three main categories were formed to describe promoting and hindering factors for the use of electronic communication: user-related factors; technology- and organization-related factors; and nursing- and communication-related factors. According to the participants, electronic devices are necessary and useful tools in interacting with patients. Patients’ personal characteristics and information security problems were perceived as the most significant hindering factors.The use of technology benefited both the nursing staff and patients in communication. The nurses’ experiences on the use of electronic communication were not very extensive as emails and text messages were the most commonly used methods

Patient participation in shared decision-making in palliative care - an integrative review

Background Shared decision-making is a process where the decisions regarding patients' care are done in collaboration with the patient, the patient's family and a healthcare professional or an interdisciplinary team. Shared decision-making is considered to be a part of patient centred care, and it enables patient autonomy which is a cornerstone of palliative care. In the past, research on the experiences of palliative care patients' participation in shared decision-making involving a nurse has been limited as the focus has mainly been on specific medical interventions, rather than holistic palliative care. Objectives To synthesise research findings on patient participation in shared decision-making in palliative care. Research design An integrative literature review. Methods The literature search was conducted by searching computerised databases (CINAHL, PubMed, PsychINFO and COCHRANE). The search resulted in 12 articles. The quality of the included articles was evaluated with JBI checklist, and the data analysis was done using inductive content analysis. Reporting was done according to a PRISMA checklist. Findings Patients do participate in shared decision-making and desire to participate in everyday nursing care decisions, treatment-related medical decisions and end-of-life decisions. The prerequisites for patient participation in shared decision-making are interdisciplinary teamwork, open communication, good patient-healthcare professional relationship, a favourable environment and mutual information. Conclusion Palliative care patients do participate and desire to participate in decisions that cover a much broader range of topics than just medical interventions and this should be addressed in future research and in practise. The main responsibility for successful patient participation in shared decision-making lies with the healthcare professionals and the organisations providing palliative care. There is a need to conduct more research from the patient's perspective and explore the meaning of participating in shared decision-making from the patient's point of view.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

Patient participation in shared decision-making in palliative care - an integrative review

Background Shared decision-making is a process where the decisions regarding patients' care are done in collaboration with the patient, the patient's family and a healthcare professional or an interdisciplinary team. Shared decision-making is considered to be a part of patient centred care, and it enables patient autonomy which is a cornerstone of palliative care. In the past, research on the experiences of palliative care patients' participation in shared decision-making involving a nurse has been limited as the focus has mainly been on specific medical interventions, rather than holistic palliative care.Objectives To synthesise research findings on patient participation in shared decision-making in palliative care.Research design An integrative literature review.Methods The literature search was conducted by searching computerised databases (CINAHL, PubMed, PsychINFO and COCHRANE). The search resulted in 12 articles. The quality of the included articles was evaluated with JBI checklist, and the data analysis was done using inductive content analysis. Reporting was done according to a PRISMA checklist.Findings Patients do participate in shared decision-making and desire to participate in everyday nursing care decisions, treatment-related medical decisions and end-of-life decisions. The prerequisites for patient participation in shared decision-making are interdisciplinary teamwork, open communication, good patient-healthcare professional relationship, a favourable environment and mutual information.Conclusion Palliative care patients do participate and desire to participate in decisions that cover a much broader range of topics than just medical interventions and this should be addressed in future research and in practise. The main responsibility for successful patient participation in shared decision-making lies with the healthcare professionals and the organisations providing palliative care. There is a need to conduct more research from the patient's perspective and explore the meaning of participating in shared decision-making from the patient's point of view

The assessment of learning skills in nursing student selection: A scoping review

Higher education student selection has significant societal, institutional and individual impacts. Thousands of applicants apply only for nursing, one of the major higher education disciplines. As the nursing profession is characterised by cognitive requirements, higher education institutions assess the learning skills of nursing applicants. However, there has been no comprehensive analysis of learning skills assessment for nursing student selection. The purpose of this scoping review was to describe the assessment of learning skills in undergraduate nursing student selection. Five databases were systematically searched, and 24 studies published between 2006 and 2016 were included. Learning skills were most commonly assessed using standardised tests in the areas of language and communication, reasoning, mathematics and natural sciences. Overall scores of onsite selection methods were found to best predict future academic performance. The results indicate that higher education institutions may benefit from comprehensive assessment of learning skills in their selection processes. This assessment should focus on a wider range of cognitive aptitudes, including reasoning skills. This review focussed on nursing education, but the results may benefit other higher education disciplines due to the generic nature of learning skills and similar cognitive requirements of higher education studies. The results support the development of more comprehensive and valid methods for assessing learning skills

Identifying reasoning skills for the selection of undergraduate nursing students: a focus group study

Background: Reasoning is a cognitive skill crucial to making solid decisions. The assessment of reasoning skills in nursing student selection is studied scarcely. Aim: To identify which reasoning skills should be assessed when selecting undergraduate nursing applicants. Design: A qualitative descriptive design. Methods: Four focus group interviews (n = 25) were undertaken with nursing students (n = 16) and experts (n = 9). The Clinical Reasoning Model was used as a deductive framework for the main categories. Subcategories were formed inductively. Results: All eight steps of the clinical reasoning process were deductively identified including 15 subcategories and representing reasoning skills in the selection phase: Consider the situation, Collect cues and information, Process information, Identify the problem, Establish goals, Take action, Evaluate outcomes and Reflect on the process of action and new learning. The beginning of the clinical reasoning process was emphasised most. Conclusion: The assessment of applicants' reasoning skills should focus on the information processing skills. Impact statement: This study identifies reasoning skills which should be considered in the assessment of nursing applicants.</p

Emotional intelligence of nursing applicants and factors related to it: A cross-sectional study

Background: Emotions influence patient care decisions and professional relationships. Emotional intelligence has been proven to predict nursing students' success in clinical practice and academic performance. Scarce amount of studies have assessed the emotional intelligence in the nursing student selection context.Objectives: To assess the emotional intelligence of applicants to undergraduate (bachelor level) nursing education and the factors related to it.Design: Cross-sectional quantitative study.Settings: The data collection took place in four Universities of Applied Sciences in October 2016.Participants: Participants were nursing applicants (N = 529) who took part in the entrance exams of the four Universities. Overall, 430 applicants (response rate 81%, 75 males) gave permission to access their results for the study's purposes.Methods: The Rankein Scale measure of emotional intelligence was used. All of the nursing applicants undertook the same electronic entrance exam in supervised computer classrooms. Statistical analysis included the use of two independent samples tests to compare differences in emotional intelligence scores and ANCOVA models to investigate whether background variables explained the observed differences.Results: In this study, nursing applicants' level of emotional intelligence was found to be average (on a scale of below average, average, above average). However, total scores ranged between 102 and 160 (of 160). Approximately 4% of the applicants scored below the minimum score (Conclusions: Nursing applicants enter their studies with differing EI skills. This finding may have a major impact on how nursing students experience emotions during their studies. More research is needed to establish the use of EI in student selection context.</h3

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

Ikäneuvolan merkitys ikääntyneiden itsenäiselle toimimiselle: 70-vuotiaiden palvelunkäyttäjien kokemuksia

Tutkimuksen tarkoituksena oli kuvata ikäneuvolan ja siellä saadun palveluohjauksen merkitystä ikäneuvolan 70-vuotiaiden asiakkaiden itsenäiselle toimimiselle. Tutkimus oli kuvaileva ja toteutettiin haastattelututkimuksena. Tarkoituksenmukaisella otannalla rekrytoitiin 14 varsinaissuomalaisen kuntayhtymän 70-vuotiasta ikäneuvolan asiakasta. Aineisto kerättiin puolistrukturoituina teemahaastatteluina toteutetuilla yksilöhaastatteluilla keväällä 2021 ja analysoitiin aineistolähtöisellä temaattisella analyysillä. Ikäneuvolalla koettiin olevan ikääntyneiden itsenäiselle toimimiselle useita merkityksiä. Ikääntyneet kokivat ikäneuvolan tiedonlähteeksi ja sillä oli terveydenhoidollista sekä avun saamiseen liittyvää merkitystä. Lisäksi ikäneuvolalla koettiin olevan henkistä sekä yhteiskunnallista merkitystä. Tutkimuksen tulokset viittaavat siihen, että ikäneuvolan kaltaiselle toiminnalle ja palvelulle on ikääntyneiden kokemuksen perusteella tarvetta ja sen hyöty koetaan niin ikääntyneen itsensä kuin yhteiskunnan kannalta. Tutkimuksen tuloksia voidaan hyödyntää ikääntyneiden toimintakykyä ja terveyttä edistävien palveluiden sekä toimintakyvyn heikkenemistä ennaltaehkäiseviä palveluita suunniteltaessa.&nbsp