Katja Joronen

School-based drama interventions in health promotion for children and adolescents: systematic review.

AIM The paper is a report of a review of the literature on the effects of school-based drama interventions in health promotion for school-aged children and adolescents. BACKGROUND Drama, theatre and role-playing methods are commonly used in health promotion programmes, but evidence of their effectiveness is limited. The educational drama approach and social cognitive theory is share the assumption that learning is based on self-reflection and interaction between environment and person. However, educational drama also emphasizes learning through the dialectics between actual and fictional contexts. DATA SOURCES A search was carried out using 10 databases and hand searching for the period January 1990 to October 2006. METHODS A Cochrane systematic review was conducted. RESULTS Nine studies met the criteria for inclusion. Their topics included health behaviour (five studies), mental health (two) and social health (two). Actor-performed drama or theatre play followed by group activities was the intervention in five studies, and classroom drama in four studies. Four of the studies were randomized controlled trials and five were non-randomized controlled studies. Four reports gave the theory on which the intervention was based, and in eight studies at least some positive effects or changes were reported, mostly concerning knowledge and attitudes related to health behaviour. The diversity of designs and instruments limited comparisons. CONCLUSION There is a need for well-designed and theory-based studies that address drama interventions in health promotion for children and families. The challenge is to find or develop a theory, which combines educational, drama and health theories with valid and reliable measurements to examine the effects of the intervention.

Adolescents’ experiences of coping with domestic violence

AIM This paper is a report of a study of experiences of domestic violence and coping among ninth-grade (14-17 years old) adolescents. BACKGROUND Domestic violence is commonplace and adolescents are involved in it either as witnesses or victims. Research has shown that different degrees of domestic violence play a major role in adolescent well-being and coping. METHOD A survey of ninth graders in one municipality in Finland was conducted in 2007. A total of 1393 adolescents participated, giving a 78% response rate. The survey included two validated scales, the Violence Scale and the Adolescent Coping Scale. Logistic regression analysis was performed to determine coping among adolescents with and without experience of domestic violence. RESULTS Sixty-seven per cent of adolescents had experienced parental symbolic aggression, 55% mild violence and 9% serious violence. The multivariate logistic regression model showed that experiences of violence were associated with deterioration in self-rated health, life satisfaction, adolescent giving in when in a conflict situation, approval of corporal punishment and coping by seeking to belong and self-blame. Those with experience of domestic violence did not seek professional help. CONCLUSION Adolescents experiencing domestic violence do not seek help and care providers should therefore take active measures to help them. These adolescents reported that they were satisfied with life, which makes it difficult to identify their need for help. Resources should be developed to identify and help these adolescents.

Needs, expectations and consequences for children growing up in a family where the parent has a mental illness

The lack of pan-European guidelines for empowering children of parents with mental illness led to the EU project CAMILLE - Empowerment of Children and Adolescents of Mentally Ill Parents through Training of Professionals working with children and adolescents. The aim of this initial task in the project was to analyse needs, expectations and consequences for children with respect to living with a parent with mental illness from the perspective of professionals and family members. This qualitative research was conducted in England, Finland, Germany, Italy, Norway, Poland and Scotland with 96 professionals, parents with mental illness, adult children and partners of parents with mental illness. A framework analysis method was used. Results of the study highlighted that the main consequences described for children of parental mental illness were role reversal; emotional and behavioural problems; lack of parents attention and stigma. The main needs of these children were described as emotional support, security and multidisciplinary help. Implications for practice are that professionals working with parents with mental illness should be aware of the specific consequences for the children and encourage parents in their parental role; multi-agency collaboration is necessary; schools should provide counselling and prevent stigma.

Family dynamics in the United States, Finland and Iceland

Understanding the dynamics of contemporary, postmodern families and how these relate to health is critically important to nurses and other health care providers throughout the world. Much can be learned by studying not only ones own culture but also other countries. Thus, the purpose of this study was to compare family dynamics of families in the United States, Finland and Iceland. To date relatively little has been published related to families in these Nordic countries. Six family dimensions in Barnhills Family Health Cycle served as the theoretical framework. Adult respondents (n = 567) purposively selected from varied community groups, completed the Family Dynamics Measure II (FDM II) and a sociodemographic questionnaire. Main findings from the three countries were positive family dynamics, with mutuality contributing the strongest factor to partially confirm the theoretical propositions in Barnhills Family Health Cycle. Respondents from all countries reported (1) clear communication and flexibility that contribute to mutuality; (2) younger age of respondents and increased education that were associated with more positive family dynamics; and (3) larger families associated with more negative dynamics. Mixed reports occurred according to gender, with Nordic men tending to perceive some negative dimensions. Marriage was important for more positive family dynamics only in the United States. Families in the United States and in Iceland had in common more negative family dynamics during illnesses. Problems and changes affected mostly families in the United States. In general, families in Finland and Iceland had greater strengths than in the United States. This benchmark study offers information for health practitioners to assist families, as well as contribute to the improvement of family social policies, especially in the United States.

Subjective Well-Being in Finnish Adolescents Experiencing Family Violence

This article describes the relationship between adolescent subjective well-being and experiences of family violence reported by a sample of 14- to 17-year-old adolescents living in one Finnish municipality (N = 1,393). Survey results found that experiences of family violence were common. The logistic regression model showed that experiences of violence were associated with adolescents’ feeling of inner disequilibrium and markedly strong relationships with friends. In additional, adolescents who experienced family violence rated their health as poorer than adolescents from nonviolent homes. They also surprisingly reported being satisfied with their life and did not necessarily identify their need for help. Although adolescents are resilient and have some resources to cope with violence, nurses and other professionals should attend more carefully to adolescents’ reports of health and behavioral problems and assess for the presence of family violence and school bullying.

Nonphysical effects of exergames on child and adolescent well-being: a comprehensive systematic review.

BACKGROUND Exergames have the potential to promote physical activity among children and adolescents. They also have other important benefits, but knowledge about other than the physical effects of exergaming remains thin. AIM To report the findings of a review of ten studies on the nonphysical effects of exergames on child and adolescent well-being. DATA SOURCES A broad search strategy was employed to identify relevant studies in CINAHL Ebsco Host, Ovid MEDLINE, Psycinfo ProQuest, Eric ProQuest, Scopus and Cochrane Library. The search timeframe was from January 2004 to April 2015. REVIEW METHODS A comprehensive systematic review without meta-analysis was conducted on 10 quantitative, qualitative and mixed-methods intervention studies. The quality of these studies was assessed following the guidelines of the Joanna Briggs Institute. The data were analysed using a narrative synthesis approach. RESULTS Exergaming was found to have some positive effects on self-concept, situational interest and motivation, enjoyment, psychological and social well-being, symptomatology and different learning experiences. However, two studies reported no effect on self-efficacy, and one study showed no intervention effect on self-esteem. The only follow-up study indicated that the enjoyment effect lasted for a few months. CONCLUSION Most of the studies reviewed found that exergaming had positive effects. However, more research evidence is still needed. In particular, there is a need for better-validated instruments and follow-up research.

Self-rated health, symptoms and health behaviour of upper secondary vocational students by field of study

This article examines the self-rated health, symptoms and health behaviour of upper secondary vocational students in Finland. The data consist of the responses of first- and second-year vocational students (n = 34 554) to the 2013 School Health Promotion Survey. The data were analysed statistically and processed separately for girls and boys. Associations between self-rated health, symptoms and health behaviour and fields of study were examined by cross-tabulation. Statistical significance was measured using the chi-squared test. Self-rated health, symptoms and health behaviour were found to have a statistically significant association with field of study (p < 0.001). Vocational students in different fields had different experiences of health, different symptoms and different health behaviours. The results complement existing evidence about disparities in well-being among young people in the context of education.

Parents’ Experiences of Caring for a Ventilator-Dependent Child: A Review of the Literature

The purpose of this review was to describe parents’ experiences of caring for a ventilator-dependent child at home. The data consisted of 19 articles searched from Medic, Arto, Linda, Cinahl, Medline and PsycINFO databases and manually for the 1998–2016. The data were analysed using qualitative content analysis. Parents’ experience of caring for a ventilator-dependent child at home showed that caring for such a child made life a constant battle for survival. This constant battle for survival meant struggling with life management challenges, trying to maintain balance within the family and turning to everyday resources. The home became like a hospital because of the presence of technology and healthcare staff. Parenting of a ventilator-dependent child meant undertaking some nursing. The effects of this on parenting have not been given enough attention in paediatric care. The results of the review show that the life with a ventilator-dependent child is a constant struggle and balancing act, which the parents cannot manage without professional support. Further research on the topic is needed because more and more increasingly sick children are able to live at home with the help of medical technology.