Kerttu Tossavainen

Nurses' roles in health promotion practice: an integrative review

Nurses play an important role in promoting public health. Traditionally, the focus of health promotion by nurses has been on disease prevention and changing the behaviour of individuals with respect to their health. However, their role as promoters of health is more complex, since they have multi-disciplinary knowledge and experience of health promotion in their nursing practice. This paper presents an integrative review aimed at examining the findings of existing research studies (1998-2011) of health promotion practice by nurses. Systematic computer searches were conducted of the Cochrane databases, Cinahl, PubMed, Web of Science, PsycINFO and Scopus databases, covering the period January 1998 to December 2011. Data were analysed and the results are presented using the concept map method of Novak and Gowin. The review found information on the theoretical basis of health promotion practice by nurses, the range of their expertise, health promotion competencies and the organizational culture associated with health promotion practice. Nurses consider health promotion important but a number of obstacles associated with organizational culture prevent effective delivery.

The North Karelia Youth Programs

Two family-based and two community- and school-based studies have been done in the province of North Karelia in eastern Finland. In the two family-based studies it was possible to decrease serum cholesterol level among children by 15%, showing that to a great extent the extremely high blood cholesterol level among Finnish children can be explained mainly by the typical Finnish diet high in saturated fat. In the first North Karelia Youth Project it was possible to affect the onset of smoking among adolescents. Two years after the program, smoking was about 30% less common in the intervention school than in the reference schools. In the eighth-year follow up survey the effect of the teacher-delivered program was still seen. In the second North Karelia Youth Project it was possible to delay the onset of smoking during the seventh grade but no permanent effect was seen. Diet was changed more among the program school students than in the reference school. These studies, done during the last 10 years, show the cardiovascular risk factors can be reduced among children and adolescents. The next main question is how to use these findings in the normal school and health care system. We have started the National Healthy School Program in Finland to assess the extent to which these programs can be implemented on the national level.

Charactersistics of intercultural mentoring – a mentor perspective

Abstract This article reports a study of Finnish preceptors’ and British undergraduate nursing students’ mentor–student relationship during international placement in Finland from the mentors’ perspective. The study aimed to explore the characteristics of intercultural mentorship and the strategies used by the mentors to improve the students’ intercultural competence. Altogether 23 mentors and five students participated in this study. The data consisted of mentoring session observations, group interviews and research diary notes. Intercultural mentorship was characterised by concern about the students’ adjustment, pervasiveness of the relationship, sense of mutual learning, inadequate school–placement co-operation and concern about learning outcomes. The mentors used a variety of strategies to improve the students’ intercultural competence. Mentorship was both a rewarding and a frustrating experience.

Support for Traumatic Brain Injury Patients' Family Members in Neurosurgical Nursing: A Systematic Review

ABSTRACT This systematic literature review describes how adult traumatic brain injury (TBI) patients’ family members received support. The research question was “What in healthcare constitutes support for a TBI patient’s family members?” The data for this review were based on 22 empirical studies published in scientific journals in 2004–2010, which were found in the Cinahl, PsychINFO, and ISI Web of Knowledge databases. The review includes the study design, sample, method, and main results. The data were analyzed using content analysis. Social support for brain injury patients’ family members was divided into 3 main categories: informational, emotional, and practical support. The subcategories of informational support were information about the patient’s symptoms, information about care, quality of information, and information about the prognosis. The subcategories of emotional support were taking emotions into account, caring, listening, and respecting. The subcategories of practical support were support in decision making, promoting the welfare of the family, encouraging family members to participate in care, cooperation with the family members, and counseling services. The results are available for nurses in practical work. The review offers nurses a structure for supporting TBI patients’ families, and according to this review, supporting TBI patients’ families appears to have many dimensions. The results suggest that nurses should be informed that it is important for family members to know the facts about TBI to understand the condition and to receive practical advice on how to help their significant other with TBI with daily activities. In addition, the results provide a basis for further research and development of interventions that support brain injury patients and their family members.

Collaboration in the operating room: the nurses' perspective.

The operating room (OR) is a demanding, stressful, and complex working environment for staff. Collaboration holds the promise of easing environmental demands without interfering with the delivery of efficient patient care. 1,2Nonhierarchical in nature, collaborative work emphasizes development of wo

Pregnant families' discussions on the Net--from virtual connections toward real-life community.

The aim of this research was to analyze conversations between expectant families (N = 21) in Net Clinic, an Internet-based service designed for patients using public maternity care. The online conversations, shared opinions about experiences of pregnancy, and family life constituted the data for content analysis. The families developed a sense of virtual community, which gradually evolved into a real-life community, by discovering the similarity of their life situations and by giving parent-to-parent support for everyday life events. As a view of daily family life, Net Clinic offers maternity care professionals a deeper understanding of how to enhance safer pregnancy, birth, and growth of the family.

Ten year trends in chronic disease risk factors in the Republic of Karelia, Russia

BACKGROUND In Russia, non-communicable diseases are leading cause of death. The aim of this article is to describe changes in chronic disease risk factors (RFs) in Pitkäranta district in Russia during ten year period of time from 1992 to 2002. METHODS Study areas were Pitkäranta and Aunus districts in the Republic of Karelia, North-West Russia. The RF surveys were carried out in Pitkäranta every fifth year since 1992 and in Aunus in 2003. Independent random samples, age 25-64, were taken from the population registers. Blood pressure, weight and height were measured. Serum cholesterol, HDL-cholesterol, triglyceride and GGT values were determined from serum samples. Smoking and alcohol consumption were asked. The total number of respondents was 2766. RESULTS Systolic and diastolic blood pressure decreased in Pitkäranta from 1992 to 2002. Total serum cholesterol increased slightly. There was no significant change in BMI or in physical activity. Smoking did not change in males but increased among females. Self-reported alcohol use increased, as also mean GGT. CONCLUSIONS The study gives valuable information on developments of RFs in Russia. Some alarming tendencies in lifestyle were seen and chronic disease RF situation has generally worsened. The results also show how big is the challenge to change lifestyles deep in culture--and in the situation where preventive work and policies do not receive strong support. A reliable monitoring of RFs and behaviours is obviously a back bone for drawing necessary attention and to steer intervention.

Can There Be Such a Delightful Feeling as This? Variations of Sexual Scripts in Finnish Girls' Narratives.

This study examined what kinds of sexual scripts were found in Finnish girls’ narratives, what elements those scripts included and how different scripts were associated with sexually risky behavior. The data were comprised of the narratives of 173 14 - 15-year-old girls regarding their experiences in sexually motivating situations. The narratives were analyzed using inductive content analysis. Besides the traditional romantic script, there are rational and experience-seeking scripts as well as the scripts of desire and postponing available to young girls to weigh and adapt in their lives. Implementation of emotion-based scripts often included risks of unprotected intercourse and losing self-control. The variety of these scripts is challenging in sex education, and is discussed in this paper.

Improving health in the European Network of Health Promoting Schools in Finland

Reports on a study that examined the issues related to health promotion in the 30 Finnish comprehensive schools participating in the European Network of Health Promoting Schools (ENHPS). The data were collected from school representatives in January 1998, at a national ENHPS event, using a questionnaire developed for the study. The response rate was 100 per cent. The results show that the school representatives considered that a general infrastructure for health promotion existed in schools, and that the clarification of the mission of health promotion in schools was well developed. Networking within the communities that surrounded the schools was reported as being uncommon.

Did something change in health promotion practices? A three‐year study of Finnish European Network of Health Promoting Schools

In many countries, educational and health policies currently highlight the need to develop schools towards health promotion settings for pupils and school staff. The aim of this three‐year follow‐up study was to investigate teachers’ assessments of goal attainment and possible changes in health promotion practices in the Finnish schools that participated in the Programme of European Network of Health Promoting Schools. The data were collected by questionnaires from teachers who also worked as ENHPS coordinators at the school level. The data analysis was statistical. The results showed that, overall, the infrastructure for health promotion was good at the participating Finnish schools. Based on the results of this Finnish ENHPS study, it can be concluded that the progress towards health‐promoting schools is demanding and requires action at the administrative level, such as appropriate planning of responsibilities, resources and training. Additionally, it requires modification of everyday practices for a school to become a health‐promoting setting.