Marjaana Pelkonen

Participation of expectant mothers in decision making in maternity care: results of a population‐based survey

The purpose of the study was to acquire knowledge of the opportunities that expectant mothers had to participate in decision making regarding their care in maternity clinics during their last pregnancy. The study is a part of a larger national survey ‘Family planning services in Finland’ carried out by the National Research and Development Centre for Welfare and Health. The rationale for the study were the known benefits of participation in one’s care and its emphasis in health policy documents. The subjects were a random sample of women aged between 18 and 44. The response rate was 73% (n=1289). The data were gathered by a mailed questionnaire and analysed statistically. According to the results mothers had fairly good opportunities to participate in decision making. However, there were statistically significant differences in opportunities between the women. The mothers who were most satisfied were aged 25–29 years, lived in a permanent relationship, had 12 years of basic education and had three children. Opportunities to participate in care have improved from the 1970s to the 1990s. The results have many implications for the development of nursing practice in maternity clinics and the deepening of the knowledge base in nursing education. The study, being the first national survey on this topic, also gives suggestions for further studies.

MULTI-SECTORAL MODEL FOR CHECKING HEALTH, SAFETY AND COMMUNITY WELL-BEING IN SCHOOLS

Background The Health Care Act (1326/2010, sections 16–17) prescribes that school and student health services must carry out triennial checks on the health and safety of school environments and well-being in learning communities in co-operation both with various authorities and with pupils, students and guardians. National follow-up data show, however, that checks have not been made comprehensively and that national guidance is needed. Objective In 2013 preparations were started for a handbook and a model for the checks in order to promote health, safety and community well-being as well as multi-sectoral co-operation in schools and educational institutions. The steering group had representatives from the Ministry of Social Affairs and Health, the National Institute for Health and Welfare, the Finnish National Board of Education, the Finnish Institute of Occupational Health, the Association of Finnish Local and Regional Authorities and the Trade Union of Education in Finland. During the process the group received valuable feedback from nearly 40 experts, and the handbook and the check forms were piloted in six schools. Results The handbook presents a new multi-sectoral model for checking the health, safety and community well-being in schools, covering the different stages of the checks: planning, implementation, monitoring, documentation, and communication of the results. It also includes the necessary forms for the checks and defines the roles of different actors. The handbook was published in autumn 2015. Conclusions Multi-sectoral co-operation increases the health, safety and community well-being in schools and educational institutions as well as improves effectiveness, bringing savings and benefits to all parties. The handbook is primarily intended for national authorities, but it can also be used by pupils and students, by teachers and educators in different educational institutions, as well as by employees and other stakeholders in the relevant sectors.