Informational Privacy in the Recovery Room-Patients' Perspective

Purpose: To describe patients' perceptions of informational privacy and factors promoting it in the recovery room. Design: A descriptive semistructured qualitative interview study. Methods: The study was conducted in 2013, and the data were analyzed with inductive content analysis. Adult surgical recovery room patients (n = 17) were recruited with purposive sampling at the Department of Ear, Nose and Throat diseases in a university hospital in Finland. Findings: Informational privacy was described as control of patients' health information maintained by the health care professionals and the patients. Informational privacy was especially important in relation to other patients. Health care professionals and patients' attitude, behavior, and knowledge of informational privacy, barriers of hearing and seeing, societal rules, and the electronic patient data system promoted informational privacy. Conclusions: Informational privacy in relation to other patients could be improved in the recovery room, for example, by developing patient health information transmission and architectural solutions.Peer reviewe

Ethical climate and nurse competence - newly graduated nurses' perceptions

Background: Nursing practice takes place in a social framework, in which environmental elements and interpersonal relations interact. Ethical climate of the work unit is an important element affecting nurses' professional and ethical practice. Nevertheless, whatever the environmental circumstances, nurses are expected to be professionally competent providing high-quality care ethically and clinically. Aim: This study examined newly graduated nurses' perception of the ethical climate of their work environment and its association with their self-assessed professional competence, turnover intentions and job satisfaction. Method: Descriptive, cross-sectional, correlational research design was applied. Participants consisted of 318 newly graduated nurses. Data were collected electronically and analysed statistically. Ethical considerations: Ethical approval and permissions to use instruments and conduct the study were obtained according to required procedures. Data were rendered anonymous to protect participant confidentiality. Completing the questionnaire was interpreted as consent to participate. Findings: Nurses' overall perception of the ethical climate was positive. More positive perceptions related to peers, patients and physicians, and less positive to hospitals and managers. Strong associations were found between perceived ethical climate and self-assessed competence, turnover intentions in terms of changing job, and job satisfaction in terms of quality of care. Nurses at a higher competence level with positive views of job satisfaction and low turnover intentions perceived the climate significantly more positively. Conclusion: Nursing management responsible for and having the power to implement changes should understand their contribution in ethical leadership, as well as the multidimensional nature of nurses' work environment and the interaction between work-related factors in planning developmental measures. Future research should focus on issues in nurse managers' ethical leadership in creating ethical work environments. There is also a need for knowledge of newly graduated nurses' views of factors which act as enhancers or barriers to positive ethical climates to develop. Interventions, continuing education courses, and discussions designed to promote positive ethical climates should be developed for managers, nurses, and multi-professional teams.Peer reviewe

Nursing student-patient relationship-a 10-year comparison study in Finland

ObjectiveThis study aimed to describe and compare the group-level findings from 2005–2006 and 2015–2016 regarding students’ and patients’ views of the nursing student-patient relationship and associated factors.MethodsThe data were in both cases collected using Student-Patient Relationship Scales. The data were analysed statistically.ResultsIn both student cohorts, authoritative and facilitative student-patient relationships were reported by the students more frequently than mechanistic relationships. Authoritative relationships were most common in both patient cohorts, whereas facilitative relationships had become more frequent than mechanistic relationships. A positive change of views in the student and patient cohorts was found in factors associated with the relationship.ConclusionIn order to strengthen a clinical learning culture that reflects a facilitative student-patient relationship, further research is needed on the processes and outcomes of that relationship.</p

Reasoning for whistleblowing in health care

Background Whistleblowing is recognised as part of solving wrongdoing. It requires individual reasoning as it is a potentially complicated process with a risk of possible negative consequences for oneself. Knowledge on how individuals reason for whistleblowing in healthcare context is lacking. Aim This study aimed to create a theoretical construct to describe individual reasoning for whistleblowing. Methods The methodology was grounded theory, with 244 nurses as informants. The data consisted of nurses' written narratives in response to a wrongdoing situation presented in a video vignette. To ensure the heterogeneity of the population and variation in nurses' professional expertise, experiences and geographical locations in health care to capture the multidimensionality of the responses, nurses were invited to participate, and data were collected electronically from the membership register of the Finnish Nurses' Association on a national level. Constant comparison was used to analyse the open data. Results The core category of the theoretical construct, 'The formation of morally courageous intervening', was discovered, reflecting individual's values and beliefs. It forms mentally as an integration of cognition and emotion for recognising one's own strengths and limits to act to do the right thing despite the risk of negative consequences for oneself. The core category consists of three dimensions of reasoning: (1) Reasoning Actors, (2) Reasoning Justifications and (3) Reasoning Activities, their categories and three patterns of reasoning connecting the dimensions and their categories with each other: (I) Individual Reasoning, (II) Collaborative Reasoning and (III) Collective Reasoning. Discussion and conclusion The theoretical construct indicate that reasoning is a multidimensional phenomenon. In future, a theoretical construct could be further developed. In health care, managers could use the theoretical construct to support employees in their whistleblowing.</p

Expectations of patients with colorectal cancer towards nursing care- a thematic analysis

PurposeThe purpose of this study was to explore comprehensively expectations of patients with colorectal cancer towards nursing care in the chemotherapy context.MethodsA purposive sample of patients with colorectal cancer (n = 15) was interviewed individually at the outpatient clinic in one university hospital chemotherapy unit. The data were analysed with thematic analysis.ResultsThree main themes were identified in the data. Firstly, patients expected to be empowered with knowledge of disease process, side effects and their self-management and peer support. Secondly, patients expected to be humanely encountered, which included being encountered with support, compassion and hope. Thirdly, patients expected to be skillfully cared for with systematic assessment, expertise, continuity and advocacy.ConclusionsBesides reliable knowledge of cancer treatment and care, patients expected the sympathetic presence of a nurse whose professional skills they can trust. The results may be utilised in intervention development by focusing on themes significant to these patients. The results may help nurses to enhance person-centred care as well as to encounter patients according to their expectations.</div

Phenomena of radiography science: A scoping review

IntroductionThe purpose of the study is to clarify the domain of radiography science. The main goal of science is building knowledge and developing ideas and theories that explain, predict, understand or interpret the phenomena investigated. Each discipline has its own perspective to view and study the phenomena of interest. The disciplinary perspective enables researchers in radiography science to reason and conceptualize phenomena, but it can also restrict them. The aim of this review was to investigate phenomena that are at the core of the discipline of radiography science.MethodsThis study used a scoping review as the method. A systematic search was carried out in the databases: Science Direct, Pubmed, Cinahl, and Scopus. The selection of articles was conducted by predetermined inclusion and exclusion criteria for the title, abstract and full text. After the exclusion process, fourteen articles were selected for a final review. The articles were analyzed with inductive content analysis.ResultsFrom the articles, 117 research interests were identified; these were merged into 17 categories and further into six main categories. The main categories represent the phenomena radiography science investigates. The phenomena are: the radiographers’ profession, clinical practices in diagnostic and therapeutic patient pathways, safe and high quality use of radiation, radiographic technology, discipline, management and leadership of radiography professionalsConclusionsRadiography science has a conceptual structure of its own that needs more investigation. Radiography science researches distinctive phenomena and specialized knowledge, common to researchers from different traditions and subspecialties thus justifying its existence.Implications for practiceInvestigating the core phenomena of interest in radiography science can support researchers in the field to focus their research and to develop the concepts of radiography.</p

Whistle-blowers - morally courageous actors in health care?

Background: Moral courage means courage to act according to individual's own ethical values and principles despite the risk of negative consequences for them. Research about the moral courage of whistle-blowers in health care is scarce, although whistleblowing involves a significant risk for the whistle-blower.Objective: To analyse the moral courage of potential whistle-blowers and its association with their background variables in health care.Research design: Was a descriptive-correlational study using a questionnaire, containing Nurses Moral Courage Scale((C)), a video vignette of the wrongdoing situation with an open question about the vignette, and several background variables. Data were analysed statistically and inductive content analysis was used for the narratives.Participants and research context: Nurses as healthcare professionals (including registered nurses, public health nurses, midwives, and nurse paramedics) were recruited from the membership register of the Nurses' Association via email in 2019. A total of 454 nurses responded. The research context was simulated using a vignette.Ethical considerations: Good scientific inquiry guidelines were followed. Permission to use the Nurses' Moral Courage Scale((C)) was obtained from the copyright holder. The ethical approval and permission to conduct the study were obtained from the participating university and the Nurses' Association.Findings: The mean value of potential whistle-blowers' moral courage on a Visual Analogue Scale (0-10) was 8.55 and the mean score was 4.34 on a 5-point Likert scale. Potential whistle-blowers' moral courage was associated with their socio-demographics, education, work, personality and social responsibility related background variables.Discussion and conclusion: In health care, potential whistle-blowers seem to be quite morally courageous actors. The results offer opportunities for developing interventions, practices and education to support and encourage healthcare professionals in their whistleblowing. Research is needed for developing a theoretical construction to eventually increase whistleblowing and decrease and prevent wrongdoing.</p

Informational Privacy in the Recovery Room—Patients' Perspective

Purpose: To describe patients' perceptions of informational privacy and factors promoting it in the recovery room.Design: A descriptive semistructured qualitative interview study.Methods: The study was conducted in 2013, and the data were analyzed with inductive content analysis. Adult surgical recovery room patients (n = 17) were recruited with purposive sampling at the Department of Ear, Nose and Throat diseases in a university hospital in Finland.Findings: Informational privacy was described as control of patients' health information maintained by the health care professionals and the patients. Informational privacy was especially important in relation to other patients. Health care professionals and patients' attitude, behavior, and knowledge of informational privacy, barriers of hearing and seeing, societal rules, and the electronic patient data system promoted informational privacy.Conclusions: Informational privacy in relation to other patients could be improved in the recovery room, for example, by developing patient health information transmission and architectural solutions.</div