Hanna Hopia

Reviewing the methodology of an integrative review.

BACKGROUND Whittemore and Knafls updated description of methodological approach for integrative review was published in 2005. Since then, the five stages of the approach have been regularly used as a basic conceptual structure of the integrative reviews conducted by nursing researchers. However, this methodological approach is seldom examined from the perspective of how systematically and rigorously the stages are implemented in the published integrative reviews. PURPOSE To appraise the selected integrative reviews on the basis of the methodological approach according to the five stages published by Whittemore and Knafl in 2005. DESIGN A literature review was used in this study. CINAHL (Cumulative Index to Nursing and Allied Health), PubMed, OVID (Journals@Ovid) and the Cochrane Library databases were searched for integrative reviews published between 2002 and 2014. Papers were included if they used the methodological approach described by Whittemore and Knafl, were published in English and were focused on nursing education or nursing expertise. A total of 259 integrative review publications for potential inclusion were identified. RESULTS Ten integrative reviews fulfilled the inclusion criteria. Findings from the studies were extracted and critically examined according to the five methodological stages. The reviews assessed followed the guidelines of the stated methodology approach to different extents. The stages of literature search, data evaluation and data analysis were fairly poorly formulated and only partially implemented in the studies included in the sample. The other two stages, problem identification and presentation, followed those described in the methodological approach quite well. CONCLUSION Increasing use of research in clinical practice is inevitable, and therefore, integrative reviews can play a greater role in developing evidence-based nursing practices. Because of this, nurse researchers should pay more attention to sound integrative nursing research to systematise the review process and make it more rigorous.

Ethical concerns and dilemmas of Finnish and Dutch health professionals

Background: Healthcare professionals encounter ethical dilemmas and concerns in their practice. More research is needed to understand these ethical problems and to know how to educate professionals to respond to them. Research objective: To describe ethical dilemmas and concerns at work from the perspectives of Finnish and Dutch healthcare professionals studying at the master’s level. Research design: Exploratory, qualitative study that used the text of student online discussions of ethical dilemmas at work as data. Method: Participants’ online discussions were analyzed using inductive content analysis. Participants: The sample consisted of 49 students at master’s level enrolled in professional ethics courses at universities in Finland and the Netherlands. Ethical considerations: Permission for conducting the study was granted from both universities of applied sciences. All students provided their informed consent for the use of their assignments as research data. Findings: Participants described 51 problematic work situations. Among these, 16 were found to be ethical dilemmas, and the remaining were work issues with an ethical concern and did not meet criteria of a dilemma. The most common problems resulted from concerns about quality care, safety of healthcare professionals, patients’ rights, and working with too few staff and inadequate resources. Discussion: The results indicated that participants were concerned about providing quality of care and raised numerous questions about how to provide it in challenging situations. The results show that it was difficult for students to differentiate ethical dilemmas from other ethical work concerns. Conclusion: Online discussions among healthcare providers give them an opportunity to relate ethical principles to real ethical dilemmas and problems in their work as well as to critically analyze ethical issues. We found that discussions with descriptions of ethical dilemmas and concerns by health professionals provide important information and recommendations not only for education and practice but also for health policy.

Gamification in Healthcare: Perspectives of Mental Health Service Users and Health Professionals

The purpose of this descriptive qualitative study is to explore the perceptions and experiences that mental health service users (n = 10) and healthcare professionals (n = 32) have regarding the use of gamification in mental health care. Data was gathered by interviews. The mental health service users described promoting and retarding factors in the use of gamification, while professionals described the requirements for using gamification and changes occurring in the work culture. Additional research is needed on how game-playing elements could be integrated as a systematic part of mental health practice and how the digital skills of professionals could be effectively developed.

Mental health service users’ and professionals’ relationship with games and gaming

Background Games and elements of gamification can be utilized in mental healthcare to provide customized interventions for the service users. However, very little evidence exists as to what kind of experiences service users and professionals have towards games and gaming, and what their perceptions of the phenomenon are. This sort of information is needed to help professionals put game-based interventions actively into practice in mental health services. Research objectives The objective is to describe the experiences and perceptions of digital games and gaming from the perspectives of mental health service users and mental health professionals. Methods In this qualitative study, data consisted of interviews of 23 mental health service users and professionals working in the mental health field. We conducted altogether 39 interviews. Sixteen of the participants were interviewed twice. Main categories and subcategories were identified using qualitative content analysis. Results The analysis revealed four distinct orientations towards games and gaming: (a) compulsive gaming; (b) closet gaming; (c) gaming as a hobby; and (d) late bloomers. Each group was characterized by different personal histories, experiences, conceptions and attitudes regarding gaming and digital games. Conclusion When attempting to implement a game-based intervention in mental health services, it is essential to recognize the different attitudes that both service users and staff exhibit concerning games and gaming. The attitudes of service users and professionals described in this study can be utilized in the implementation of game-based methods as part of care and rehabilitation in mental health services.