Gerontologisen hoitotyön osaamisalueet ja valmistumisvaiheessa olevien sairaanhoitajaopiskelijoiden itsearvioitu gerontologisen hoitotyön osaaminen

Abstract The world’s population is aging and more and more nurses are facing older people at their work. Gerontological nursing challenges nursing staff with heterogeneity in the older people, different health care settings, and a variety of competence challenges. The purpose of this study was to describe and explain the areas of competence in gerontological nursing, to develop and evaluate the reliability of a new instrument GeroNursingCom and the competence in gerontological nursing produced by UAS’s. The aim was to form an overall picture of the skills required in gerontological nursing in order to develop and evaluate nursing education. The study consisted from three phases including three sub-studies; I a qualitative study, II development and evaluation of the instrument and III a quantitative cross-sectional study. The research material of the first phase was collected and pilot-tested (n=36) in five focus group interviews from gerontological nursing experts (n=27). In the second phase, the instrument GeroNursingCom instrument was developed and tested, with collected quantitative data from Finnish UAS’s (n=9) from 274 students which were used in phase III describing the gerontological competence areas. Qualitative data were analyzed by inductive content analysis and quantitative data by statistical methods using exploratory factor analysis, K-mean cluster analysis, non-parametric tests and descriptive statistics. The results of phase I identified the four competence areas of gerontological nursing; clinical nursing competence; competence in promoting health and well-being; interaction competence; and ethical competence. The instrument was developed in phase II based on phase I results and includes 53 questions from 11 different factors. The phase III results showed that the self-assessed competence in gerontological nursing of graduate nursing students is on intermediate level and in the three profiles identified, the competence varied between intermediate and high levels. The best competence was in the area of appreciative encounter and interaction and the worst the area of supporting the sexuality of older people. In conclusion, the current nursing education produces nurses with intermediate skills in gerontological nursing, which have been positively influenced by previous education and work experience in healthcare.Tiivistelmä Maailman väestö ikääntyy, ja yhä useampi sairaanhoitaja kohtaa työssään ikääntyneitä potilaita ja asiakkaita. Gerontologinen hoitotyö haastaa hoitohenkilökuntaa ikääntyneiden heterogeenisyydellä, erilaisilla terveydenhuollon toimintaympäristöillä ja moninaisilla osaamisen haasteilla. Tämän tutkimuksen tarkoituksena oli kuvata ja selittää gerontologisen hoitotyön osaamista ja sen osa-alueita sekä ammattikorkeakoulutuksen tuottamaa gerontologisen hoitotyön osaamista. Tavoitteena oli muodostaa kokonaiskuva gerontologisessa hoitotyössä vaadittavasta osaamisesta, jotta koulutusta voidaan kehittää ja arvioida. Tutkimus koostui kolmesta vaiheesta sisältäen kolme osatutkimusta: I laadullinen haastattelututkimus, II mittarin kehittäminen ja III määrällinen poikkileikkaustutkimus. Ensimmäisen vaiheen tutkimusaineisto kerättiin viidessä fokusryhmähaastattelussa gerontologisen hoitotyön asiantuntijoilta (n=27). Toisessa vaiheessa kehitettiin ja esitestattiin (n=36) gerontologisen hoitotyön osaamista mittaava mittari GeroNursingCom, jolla kerättiin määrällinen aineisto suomalaisista ammattikorkeakouluista (n=9) 274 opiskelijalta. Laadullinen aineisto analysoitiin induktiivisella sisällönanalyysillä ja määrällinen aineisto tilastollisin menetelmin käyttäen eksploratiivista faktorianalyysia, K-keskiarvo ryhmittelyanalyysiä, ei-parametrisia testejä sekä kuvaavia tilastoja. Vaiheen I tulokset osoittivat gerontologisen hoitotyön neljäksi osaamisalueeksi kliinisen hoitotyön osaamisen, terveyden ja hyvinvoinnin edistämisen osaamisen, vuorovaikutusosaamisen sekä eettisen osaamisen. Vaiheessa II kehitetyn mittarin sisältö perustuu vaiheen I tuloksiin ja sisältää 53 kysymystä 11 eri kategoriasta. Vaiheen III tutkimus osoitti, että valmistumisvaiheen sairaanhoitajaopiskelijoiden gerontologisen hoitotyön itsearvioitu osaaminen on kaikkiaan keskitasoista, ja laadituissa kolmessa osaamisprofiilissa osaaminen vaihteli keskitason ja korkean tason välillä. Parasta osaaminen oli arvostavan kohtaamisen ja vuorovaikutuksen osaamisalueella ja huonointa ikääntyneiden seksuaalisuuden tukemisen osaamisalueella. Johtopäätöksenä todetaan, että tämänhetkinen sairaanhoitajakoulutus tuottaa keskitasoista gerontologisen hoitotyön osaamista, johon on positiivisella tavalla vaikuttanut opiskelijan aiempi koulutus ja työkokemus terveydenhuollossa

Future palliative competence needs:a qualitative study of physicians’ and registered nurses’ views

Abstract Background: Globally, the need for palliative care will increase as a result of the ageing of populations and the rising burden of cancer, non-communicable diseases as well as some communicable diseases. Physicians and registered nurses working in palliative care should have a sufficient level of education and competence in managing the changing needs and requirements of palliative care. There is, however, need for evidence-based palliative care training and education of physicians and registered nurses. The purpose of this study was to describe the views of physicians and registered nurses regarding future competence needs within palliative care. Methods: The study was conducted through use of a cross-sectional qualitative design. A total of 54 physicians and 110 registered nurses completed an open-ended questionnaire about the future competence needs of palliative care. The data were analyzed using inductive content analysis. Results: The results revealed four main competence needs within palliative care for the coming decade: palliative care competence at all levels within healthcare and social welfare services; individualized palliative care competence; person-centered encounters competence; and systematic competence development within palliative care. Conclusions: The results offer cues for education and professional development, which can be used to support physicians and registered nurses when future palliative care competences are included in educational programs. Seamless cooperation between palliative care services and educational institutions is recommended to ensure that undergraduate and postgraduate education is based on a continuous assessment of competence requirements within the field of palliative care. Therefore, online multi-professional simulations, for example, could be used to enhance future competencies within palliative care; undergraduate medical, nursing and allied healthcare students as well as postgraduate palliative care professionals and experts of experience could work together during simulations

Competencies relevant for gerontological nursing:focus-group interviews with professionals in the nursing of older people

Abstract Older people are present in a variety of nursing settings and have distinct care needs. Evidence about the competencies required is crucial when developing the profession. The aim of the study was to describe competence areas relevant in gerontological nursing. A qualitative, descriptive study design was used with 27 participants included. Finnish gerontological nursing professionals who worked at several healthcare organizations and in education were interviewed in five focus-group interviews. The interviews were carried out between October 2017 and February 2018 and were analyzed using inductive content analysis. The study is reported according to SRQR guidelines. Analysis indicated four main competence areas for gerontological nursing: clinical nursing competence; competence in promoting health and well-being; interaction competence; and ethical competence. Registered nurses (RNs) must possess multiple competencies when caring for older people which should be taken into account in nursing and education

Development and psychometric testing of the Gerontological Nursing Competence (GeroNursingCom) instrument

Abstract Aim: To develop and psychometrically test an instrument — GeroNursingCom — that measures gerontological nursing competence of nursing students. Design: An instrument development guided by COSMIN guidelines. Methods: The development and testing of the GeroNursingCom instrument proceeded according to four distinct phases: (a) establishing a theoretical background; (b) testing face and content validity; (c) examining structural validity; and (d) testing internal consistency. The items of instrument were based on a theoretical framework developed from a comprehensive literature review and focus group interviews with experts (N = 27) in spring 2018. Content validity was assessed by nine experts in gerontological nursing, while face validity was tested in a pilot study including 36 nursing students. Structural validity was examined with exploratory factor analysis with 267 nursing students from nine universities of applied sciences. The internal consistency was established with Cronbach’s alpha. The data were collected in spring and autumn 2019. The data analysis was conducted with multivariate statistical methods. Results: The GeroNursingCom development and testing process yielded an instrument that includes 53 items across 11 factors: (a) appreciative encounters and interactions with older people; (b) medication for older people; (c) nutrition for older people; (d) safe living environment for older people; (e) supporting the functioning of older people; (f) end-of-life care; (g) developing one’s competencies; (h) supporting an older person’s mental well-being; (i) supporting an older person’s sexuality; (j) guiding self-care among older people; and (k) responding to challenging situations. The instrument was able to explain 66.15% of the total observed variance, while Cronbach’s alpha values for individual items varied from 0.75–0.89. Conclusion: TheGeroNursingCom instrument can be used to measure gerontological nursing competence among nursing students to improve gerontological nursing education and/or geriatric care. Impact: Graduating nursing students must develop versatile competencies to face the multiple needs of older patients and curriculums need to be further developed to ensure students are prepared for gerontological nursing

Palliatiivisen hoidon osaamisen kehittäminen edellyttää tutkimus-, kehittämis- ja innovaatiotoimintaa:EduPal-hanke kehittäjänä

Tiivistelmä Laadukas, näyttöön perustuva palliatiivinen hoito on jokaisen ihmisoikeus. Tämä edellyttää riittävän koulutuksen ja osaamisen omaavaa henkilöstöä palliatiivisen hoidon eri tasoille. Palliatiivisen hoidon koulutuksessa tutkimus- kehittämis- ja innovaatiotoiminta (TKI) on saumattomasti integroitu koulutuksen sisällölliseen ja pedagogiseen kehittämistoimintaan. Tässä artikkelissa kuvataan palliatiivisen hoidon koulutuksen kehittämiseen liittyvää TKI-toimintaa EduPal-hankkeessa, joka on toteutunut monialaisesti tiiviissä yhteistyössä ammattikorkeakoulujen, yliopistojen sekä keskeisten työelämän sidosryhmien kanssa. EduPal-hanke on kansallisesti ja kansainvälisesti merkittävä, sillä hankkeessa tarkastellaan mittavasti ja moniammatillisesti palliatiivisen hoidon opetuksen nykytilaa ja kehitetään perus- ja erityistason osaamisen kuvauksia, opetussuunnitelmasuosituksia sekä yhteistyötä ammattikorkeakoulujen ja yliopistojen välillä

Nursing students’ competence profiles in gerontological nursing:a cross-sectional study

Abstract Aim: The study aimed to describe and explain the self-assessed gerontological nursing competence levels of Finnish nursing students and factors relating to it. Design: A cross-sectional study design, reported by The Strengthening the Reporting of Observational studies in Epidemiology guidelines. Methods: Data were collected with the GeroNursingCom instrument, which features 53 items relating to 11 competence factors. The K-clustering technique and the Chi-squared, Kruskal-Wallis and Mann Whitney tests were used to analyse the data. Results: Seven hundred and ninety-nine nursing students from nine randomly selected higher education institutions were invited to participate in 2019. Three distinct student profiles were identified according to the data (N = 274): Profile A—lower intermediate competence (23.1% of students), Profile B—intermediate competence (45.8%) and Profile C—high competence (31.1%). The strongest competence area for all students was appreciative encounter and interaction, and the weakest was supporting the older person’s sexuality. Nursing students have diverse backgrounds and their overall competence in gerontological nursing is shaped in part by their previous education, motivations and work experience. Relevance to clinical practice: Recognizing students’ different gerontological nursing competence profiles enables the implementation of targeted education to improve competence in clinical practice

Palliatiivisen hoidon opettajien osaamisen vahvistaminen

Tiivistelmä Sosiaali- ja terveysalan opettajilla tulee olla riittävä osaaminen palliatiivisesta hoidosta. Osaamisen päivittäminen opetussuunnitelma- ja kansainvälisten suositusten mukaiseksi on ajankohtaista. Näin taataan koulutuksessa oleville opiskelijoille riittävä osaaminen toimia palliatiivisen potilaan ja hänen läheisensä tukena sairauden eri vaiheissa. EduPal-hankkeessa palliatiivisen hoidon opettajille suunniteltiin viiden opintopisteen laajuinen verkkokurssi, jonka tavoitteena on vahvistaa opettajien osaamista palliatiivista hoidosta sekä pedagogista osaamista.Abstract Strenghtening competencies of palliative care teachers Teachers of future healthcare professionals should have adequate expertise in palliative care, and they should update their expertise in accordance with curriculum- and international recommendations. In this way, students in education are guaranteed sufficient skills to act as support for the palliative patient and their loved ones at different stages of the disease. A fivecredit online course for palliative care teachers was designed to strengthen the teachers’ competence in palliative care and pedagogical competence