Maija Hupli

Perioperative documentation in Finland.

In Finland, research studies about perioperative documentation are few, and there are no professional recommendations for perioperative documentation, such as AORN s Standards, Recommended Practices, and Guidelines. Exploring current documentation practices and contents used in Finland is the first step to establishing a standard for perioperative documentation. The need for this type of exploration resulted in a study that found that the aim of nursing documentation is not always clear, and current documentation practice does not necessarily reveal the decision making that directs patient care, demonstrate nursing resources needed, or provide data for evaluating and developing perioperative practice. Education, motivation, and computerization generally were mentioned as a means to develop documentation.

Do Nurses Exercise Power in Basic Care Situations

Power is a matter of authority and control. It can be wielded either consciously or unconsciously, and it can be either overt or latent. Using a structured questionnaire, this study set out to describe nurses’ opinions about the exercise of power in basic care situations in both acute and long-term care. The questionnaire was organized into four categories in which items concerned: power in obligatory daily activities; power in activities necessitated by obligatory activities; power in voluntary activities; and power in activities that take into account the patient’s characteristics. The samples consisted of 228 nurses from five medical and surgical wards of district hospitals, and 233 nurses from five geriatric units of a community health centre and from one nursing home in Finland. The final response rate was 65% (acute care 76%; long-term care 55%). Data analysis was based on statistical methods. The results showed that, in the nurses’ own opinion, negative power is exercised only in certain situations and in the patient’s best interest, when for instance there are concerns that something may happen to the patient.

The association between physical dependency and the presence of neuropsychiatric symptoms, with the admission of people with dementia to a long-term care institution: A prospective observational cohort study.

BACKGROUND Dementia is a progressive neurological disorder that causes a high degree of dependency. This dependency has been defined as an increased need for assistance due to deterioration in cognition and physical functioning, and changes in behavior. Highly dependent people with dementia are more likely to be institutionalized. OBJECTIVES To investigate the association between specific categories of physical dependency and the presence of neuropsychiatric symptoms in people with dementia admitted to a long-term care institution. DESIGN A prospective observational cohort study. SETTINGS Home care and long-term care institutions in eight European countries. PARTICIPANTS People with dementia living at home but at risk of institutionalization and recently institutionalized people with dementia. METHOD Baseline and 3-month follow-up interviews were performed between November, 2010 and April, 2012. The sample consisted of 116 recently institutionalized dementia sufferers and 949 people with dementia still living at home. Physical dependency was measured using the Katz Activity of Daily Living index, and neuropsychiatric symptoms were assessed through The Neuropsychiatric Inventory. Specific categories of dependency were analyzed by performing a logistic regression analysis. This followed examination of baseline characteristics to define the degree of physical dependency, as factors associated with institutionalization, and evaluation of the same characteristics at 3-month follow-up to detect changes in the degree of physical dependency and neuropsychiatric symptoms associated with recent admission to a long-term care institution. RESULTS Toileting, dressing and continence dependency was higher in institutionalized people than in those receiving home-care. Delusion, hallucination, agitation, anxiety, apathy, motor-disturbances, night-time behavior and eating disorders were also worse in the institutionalized. Logistic regression analysis showed that independent factors significantly associated with being recently institutionalized were toileting (odds ratio=2.3; 95% confidence interval=1.43-3.71) and motor disturbances (odds ratio=1.81; 95% confidence interval=1.15-2.87). CONCLUSIONS This study supports the association between type and degree of physical dependency in people with dementia and long-term institutionalization. Institutionalization is associated with physical dependency and the presence of neuropsychiatric symptoms.

Somali asylum seekers’ perceptions of privacy in healthcare

Background: Privacy has been recognized as a basic human right and a part of quality of care. However, little is known about the privacy of Somali asylum seekers in healthcare, even though they are one of the largest asylum seeker groups in the world. Objectives: The aim of the study was to describe the content and importance of privacy and its importance in healthcare from the perspective of Somali asylum seekers. Research design: The data of this explorative qualitative study were collected by four focus group interviews with 18 Somali asylum seekers with the help of an interpreter. The data were analysed by inductive content analysis. Ethical considerations: Research permissions were obtained from the director of the reception centre and from the Department of Social Services. Ethical approval was obtained from the Ethics Committee of Turku University. Findings: The content of privacy includes visual privacy, physical privacy and informational privacy. All contents can be shared with healthcare professionals. The importance of privacy includes respect, dignity and freedom. Discussion: Privacy is strongly connected to the collectivism of Somali culture and religion. Unlike the Western cultures, privacy is not important only for the individual; most of all, it is seen to support collectivism. Conclusion: Even though all contents of privacy can be shared with healthcare professionals, it is important to recognize the cultural aspect of privacy especially when using interpreters with Somali background.

Interdisciplinary engineering education - Practice based case

Multiple disciplines approach, which includes interdisciplinarity, has been discussed in the engineering education context from the early 21st Century [1]. There is very little disagreement about its importance for the engineers. The key question has been how? How to implement theory into practice both in the curriculum and in the actual learning enhancement phase? Both Problem-based learning [2] and CDIO framework [1] are constructivist learning approaches [3] that emphasize these issues. In this paper, we discuss and elaborate some of the learning results of two interdisciplinary masters level student teams that were structurally organized as Capstone project courses [4]. The course projects had ill-defined and openended problem setting. The coaching for students was organized from the departments of Information Technology and Nursing Science at University of Turku. Students that participated in the project represented 3 higher education institutions and 8 disciplines. The disciplines were nursing science, engineering, sustainable development, computer science, social science, educational science, business and administration as well as futures studies. Altogether there were fifteen (15) students from two (2) different nationalities in this study. The results show that in a teamwork and problem oriented and project based setting [5] the learning of professional skills of the students can be enhanced both at the team and the individual level. Interdisciplinary and multidisciplinary learning happens inside the teams and it depends on the time used, structure of the facilitation process and the general team dynamics. This is, however, not always the case and the possible reasons for this will be discussed.

Planning focus group interviews with asylum seekers: Factors related to the researcher, interpreter and asylum seekers

The aim of this article was to discuss factors related to the researcher, interpreter and asylum seekers when planning focus group interviews with asylum seekers. Focus group interview is one of the basic data collection methods in descriptive nursing and health research. It has been used in multicultural research, allowing an opportunity to participate without literacy and to have linguistic and cultural support from other participants. Asylum seekers form a specific, vulnerable group, and the growing number of asylum seekers increases the need for research related to them. A culturally, methodologically and ethically high-quality focus group interview is based on the researchers special knowledge and skills, acknowledgement of asylum seekers as both individuals and part of cultural and communal groups, and careful planning of the interpreters role during the interviews.