Jari Kylmä

Russian nursing students’ knowledge level and attitudes in the context of human immunodeficiency virus (HIV) – a descriptive study

BackgroundThe purpose of this study was to describe the knowledge of Russian nursing students regarding HIV and Acquired Immuno-Deficiency Syndrome (AIDS), and their attitudes towards caring for people/patients living with HIV or AIDS (PLWHA - People Living With HIV/AIDS) and their possible homophobic attitudes. The HIV epidemic in Russia is substantial and increasing rapidly. Hence this study provides important new information regarding this phenomenon.MethodsThe data was collected by questionnaire from students in three nursing schools (n = 102, response rate 95.3%). The data was analyzed using PASW Statistics version 18. For computing the level of the students’ AIDS knowledge, all correct answers were recorded as equal to (1), while all incorrect and “Don’t know” answers were recorded as equal to (0). Each respondent’s scores were totaled and individual scores were analyzed using regression analysis. The effect of demographic variables on the average scores of attitudes was also subjected to regression analysis.ResultsOverall, students’ knowledge level regarding HIV and AIDS was moderate (range 5–26). Of a maximum score of 33, the mean of correct answers was 19.8 (SD = 3.70). Nursing students’ attitudes were quite negative and they also demonstrated homophobic attitudes. The mean scale score for nursing students’ general attitude was 2.75, and for homophobic attitudes it was 3.3 (min = 1, max = 5). Only the background factor of gender correlated with the homophobic level demonstrated (p = .05, β = −.67). Nursing students’ overall willingness to provide care for PLWHA was associated with their attitudes (p = .003, β = −.534).ConclusionsGiven that the HIV epidemic in Russia is both substantial and increasing, it is essential to improve HIV nursing education to provide sufficient and up-to-date information about HIV and also to prepare nursing students for caring for PLWHA. In doing so, this may help to address both the deficits in student knowledge, and also modify their attitude towards PLWHA.

Advanced nursing roles: A systematic review

In this systematic literature review, we analyzed and synthesized the literature on one specialized advance practice nursing role in three countries for the purpose of describing and comparing these roles, as well as discussing whether an international consensus of the advance practice nursing definition is possible. A systematic search on CINAHL and PubMed Medline was conducted in 2011 to search the literature on the nurse consultant in the UK, the clinical nurse specialist in the USA, and the clinical nurse consultant in Australia. The studies (n = 42) were analyzed and combined using qualitative content analysis method. The roles of the nurse consultant, clinical nurse specialist, and clinical nurse consultant were similar. The variation in the roles appears to derive from organizational or individual choices, not the country in question. The study process comprised a synthesized representation of one specialized advance practice nursing role. More work is needed to further define the concept of the advance practice nursing, as well as its implementation on other cultures beyond this review. Based on this review, an international consensus regarding the definition of advance practice nursing and its subroles is possible.

Gender differences in the association of adult hopelessness with adverse childhood experiences

Abstract.Background: The impact of childhood traumatic events on long-term psychological development has been widely studied. Nevertheless, little research has been carried out on possible associations between adverse childhood experiences (ACEs) and hopelessness in adulthood, and whether any gender differences exist. Aim: The aim of this study was to examine the association between ACEs (poor relationship between parents, unhappiness of childhood home, hard parenting, physical punishment, domestic violence, alcohol abuse in primary family) and current hopelessness without any mental disorder in a general population sample. Method: 1598 adults (43 % were men), aged 25–64 years, completed self-report measures to assess ACEs and hopelessness by means of the Beck Hopelessness Scale (HS). Logistic regression was used to adjust for the effects of sociodemographic factors on the association between the cumulative number of ACEs and hopelessness. Results: Whereas several bivariate associations were found between ACEs and hopelessness, none of them remained significant in multivariate analysis. However, men who reported three or more ACEs were 2.79 times (95 % CI 1.17–6.63) and women 2.19 times (95 % CI 1.04–4.65) more likely to be hopeless compared with those without any ACEs. In women (OR 2.25, 95 % CI 1.01–5.00), but not in men, this relationship remained significant after adjusting for several current covariates. Conclusion: Clustering of ACEs may have long-lasting effects by increasing the risk of hopelessness in adulthood, especially in women. Increased awareness of the frequency of ACEs and their subsequent consequences, such as hopelessness, may encourage health care professionals to undertake preventive work in primary and mental health care.

Life events are important in the course of hopelessness—a 2-year follow-up study in a general population

Abstract. Background: The association between life events and hopelessness in a general population is unknown. Aim: The aim of this study was to examine the course of hopelessness and how positive and negative life events are associated with it. Method: This was a 2- year follow-up study among general population adults, excluding any with a mental disorder. The impact of 15 occasional life events during the follow-up was assessed and the course of hopelessness measured with the Beck Hopelessness Scale (HS). Results: Four percent of the study subjects with no hopelessness at baseline and 56% of those with hopelessness at baseline reported hopelessness on follow-up. In multiple logistic regression analyses, a notable worsening of the subjective financial situation was revealed as the most important life event, both in becoming hopeless during the follow-up (OR 5.07; 95% CI 2.20–11.7) and in continued hopelessness (OR 7.51, 95% CI 2.19–25.8). Moreover, considerable interpersonal conflicts at work (OR 3.29, 95% CI 1.17–9.27) were associated with becoming hopeless. However, a notable positive change in common living conditions (OR 0.16, 95% CI 0.04–0.74) was found to be a protective factor against becoming hopeless. All these variables remained significant even when adjusted for change in depression scores (BDI). Conclusion: Hopelessness may be persistent in a general population. The impact of life events, especially a notable worsening of the subjective financial situation, is important in becoming or remaining hopeless.

Dissociation in a general population of Finnish adolescents.

Only a few studies have been published concerning dissociation in general population adolescents. We assessed dissociation using the Adolescent Dissociative Experiences Scale (A-DES) in a sample of Finnish adolescents aged 13 to 18 years (n = 4019). The A-DES had good internal reliability and factor analysis suggested a 1-factor solution to be optimal. The younger participants had somewhat higher A-DES scores, but there were no differences between the genders. The mean A-DES score of 0.88 in the whole sample was lower than that in previous studies in other countries. A high level of dissociation was associated with an age of 15 or less, daily smoking, frequent use of alcohol, abuse of legal drugs, cannabis use, social isolation, and poor school performance in mathematics.

A brief intervention is sufficient for many adolescents seeking help from low threshold adolescent psychiatric services

BackgroundThere has been a considerable increase in the need for psychiatric services for adolescents. Primary health care practitioners have a major role in detecting, screening and helping these adolescents. An intervention entitled SCREEN is described in this article. The SCREEN intervention was developed to help practitioners to detect and screen adolescent needs, to care for adolescents at the primary health care level and to facilitate the referral of adolescents to secondary care services in collaboration between primary and secondary health care. Secondly, the article presents the background and clinical characteristics of youths seeking help from the SCREEN services, and compares the background factors and clinical characteristics of those patients referred and not referred to secondary care services.MethodsThe SCREEN intervention consisted of 1 to 5 sessions, including assessment by a semi-structured anamnesis interview, the structured Global Assessment Scale, and by a structured priority rating scale, as well as a brief intervention for each adolescents chosen problem. Parents took part in the assessment in 39% of cases involving girls and 50% involving boys. During 34 months, 2071 adolescents (69% females) entered the intervention and 70% completed it. The mean age was 17.1 years for boys and 17.3 years for girls.ResultsFor 69% of adolescents, this was the first contact with psychiatric services. The most common reasons for seeking services were depressive symptoms (31%). Self-harming behaviour had occurred in 25% of girls and 16% of boys. The intervention was sufficient for 37% of those who completed it. Psychosocial functioning improved during the intervention. Factors associated with referral for further treatment were female gender, anxiety as the main complaint, previous psychiatric treatment, self-harming behaviour, a previous need for child welfare services, poor psychosocial functioning and a high score in the priority rating scale.ConclusionsA brief intervention carried out by a team including professionals from both primary and secondary level services was sufficient for a considerable proportion of adolescents seeking help for their psychiatric problems. Referral practices and counselling in special level services can be standardized. In the future, it will be important to develop and assess psychiatric services for adolescents using randomised controlled trials.

Clinical decision making involved in secluding and restraining an adult psychiatric patient: an integrative literature review

The purpose of this integrative literature review was to describe different factors involved in the decision-making process of using seclusion or restraint, and to discuss the process in practice. The data used in this review were systematically retrieved from the following databases: CINAHL, Medline and PsycINFO. Manual data retrieval was conducted from the reference lists of the papers that came up in the original database search. A total of 32 studies were selected. Results suggest that the situations that lead to the use of seclusion or restraint are always dynamic and circumstantial. During the decision-making process staff observe a patients behaviour, assesses risk and chooses and uses interventions that aim to de-escalate the situation. This process is affected by the previous experiences and history of staff as well as the behaviour and previous experience of the patient.

Sociocultural factors influencing HIV/AIDS caregiving in Addis Ababa, Ethiopia.

The sociocultural factors that influence care and caregiving vary from place to place, with both beneficial and harmful effects on the health of the caregivers. Therefore, this article presents the cultural and social structural factors that influence care and caregiving from the perspectives of the family caregivers of people living with HIV/AIDS in Addis Ababa, Ethiopia. Using semistructured interviews and participant observation, a purposive sample of six key participants and 12 general participants were interviewed in their home between December 2005 and January 2006. Four important sociocultural factors that influence care and caregiving have been identified: religious beliefs, economic issues, education, and social stigma and discrimination. The findings of our study underscore the importance of understanding the cultural and social structural factors that influence care and caregiving from the perspectives of family caregivers in order to provide culturally congruent care to those in need.

Psychiatric Nurses’ Emotional and Ethical Experiences Regarding Seclusion and Restraint

The purpose of this study was to describe psychiatric nurses’ emotional and ethical experiences regarding seclusion and restraint, and factors associated with these experiences. The data (n = 165) was collected in southern Finland, using the electronic version of the Seclusion and Restraint Experience Questionnaire (SREQ) and analyzed with statistical methods. We found that the experiences of control and duty were strongly emphasized in responses, especially among nurses with short work experience or temporary employment. These results offer new information about psychiatric nurses’ experiences regarding seclusion and restraint. These results can be utilized both in the teaching and in management of the nursing.

Knowledge, Attitudes and Risk Behaviour Related to HIV and AIDS: The Case of International Students in a Finnish University

The purpose of this pilot study was to illustrate international university students’ knowledge of HIV and AIDS, attitudes towards HIV and AIDS and risk behaviours in relation to HIV and AIDS. Questionnaires were posted to 140 students, and 32 responded. Data were analysed statistically. The results indicated a fairly good knowledge level of HIV and AIDS. The majority of students were well aware of the general facts about HIV and AIDS, modes of transmission and main risk groups, and they were also aware of the universal precautions. The majority of students had positive attitudes towards persons with HIV and AIDS and were willing to care for them. The students identified well with risk behaviours. Most agreed that their knowledge level of HIV and AIDS did affect their risk behaviours, while others felt it was a matter of choice, personal attitude and practice. Choice is a determining factor for decisions made by students in relation to HIV and AIDS. Future research focusing on factors influencing these choices that put them at risk of contracting the HIV virus is recommended. Students also need to be enlightened on matters concerning symptoms of HIV and AIDS.