Tarja Kettunen

Taciturn Patients in Health Counseling at a Hospital: Passive Recipients or Active Participators?

This study explored patients’ taciturnity as observed on videotape during hospital health counseling situations with a nurse. Health counseling sessions, 38 in number, were videotaped, transcribed verbatim, and analyzed by using an adaptation of conversation analysis. The data analysis included information on 18 selected patients who spoke little and did not introduce new topics, but rather supported the discussion on the theme chosen by the nurse. When we examined nurses’ and patients’ speech word by word, we discovered four participation frames that produced taciturnity: in the hands of professionals, compliant, guilty, and polite. These could fluctuate during interaction. The findings indicate that there is a need for a more extensive description of taciturn, or silent, patients. What has been interpreted as passivity in the literature can be interpreted more constructively. This insight can be useful for developing health counseling practice in hospitals.

Seasonal and daily variation in physical activity among three-year-old Finnish preschool children

The purposes of this study were to assess seasonal, daily, and gender variations in childrens physical activity (PA). ActiGraph GT3X accelerometers were used to record the three-year-old childrens PA levels for five consecutive days in autumn and winter. Complete data for both seasons were obtained for 47 children. Despite a significant difference in seasonal temperatures (p < .001), differences were only found for weekdays light PA (p = .021). No difference in PA was observed between weekdays and weekend days. Only 20% of the sample had ≥120 minutes light-to-vigorous PA (LMVPA), and 46% of children had ≥60 minutes moderate-to-vigorous PA (MVPA). Boys spent more minutes in LMVPA (p = .001) and MVPA (p = .004) than girls. The current findings indicated that season and day of the week only minimally influence childrens PA levels, whereas gender continues to be a significant factor.

A systematic concept analysis of mental health promotion

Abstract This study explored and clarified the nature and characteristics of the concept of mental health promotion. The study also investigated how these characteristics appear in current policies and strategies. A total of 30 scientific articles and policy documents were identified and analysed using Rodgers’s systematic evolutionary concept analysis method. The analysis provided valuable information on the attributes, related concepts, antecedents, consequences and references of mental health promotion, indicating that the concept is a distinct concept comprising a unique set of attributes and characteristics. A concept mapping of mental health promotion was subsequently developed. The analysis and the concept mapping provide health professionals, policy-makers and researchers with a framework, upon which well-grounded mental health promotion practice and evaluation research can be based.

Patients’ conceptions of preoperative physiotherapy education before hip arthroplasty

Abstract In Finland, over 7500 hip arthroplasties are performed annually. While the mean age of the patients has increased, the length of hospital stay has decreased, and this presents challenges for patient education. The aim of this study was to explore patients’ conceptions of preoperative physiotherapy education. This qualitative study included 10 hip arthroplasty patients. Data were collected using individual interviews at home before collecting preoperative information, and at the hospital after the operation. The interviews were tape-recorded and analysed using the phenomenographic method. Four hierarchically constructed categories of preoperative physiotherapy education were identified: readiness for the operation, preparing for the rehabilitation, actor within the hospital service system and independent actor. These categories were analysed through the following themes: knowledge about hip arthroplasty, action skills, body understanding and trusting encounter. According to the patients’ conceptions, in preoperative physiotherapy education gaining knowledge is the key element, which should be combined with practical elements. This requires a trusting relationship between the patient and the physiotherapist. Two critical aspects can be identified: how the readiness for the operation could shift towards preparation for rehabilitation, and widening the perspective from preparing for rehabilitation to being the actor within the hospital service system.

Public health nurses’ concerns in preschool-aged children’s health check-ups

The aim is to describe Finnish public health nurses’ concerns during regular health check-ups of preschool-aged children. In 2011, focus-group interviews were conducted with 12 public health nurses. The data were analysed using inductive content analysis. Public health nurses’ concerns dealt with the healthy growth and development of children and their ability to cope with difficult family situations, as well as the everyday reality of parenting. The concerns of public health nurses related to children’s health focused on their psychosocial development. Concerns also focused on the interaction between mother and baby, children’s behavioural problems and their cognitive development, parents’ mental health problems and families’ social circumstances. The everyday reality of parenting caused concern, including the lack of sufficient family time and conflicting parenting roles. Based on the available evidence, the role of public health nurses in child health care has broadened remarkably from the traditional physical follow-up of growth and development to support the well-being of the entire family. Children’s psychosocial problems and families’ difficult circumstances increasingly represent the challenges faced by public health nurses during preschool-aged children’s health check-ups. Public health nurses’ concerns revealed that, in order to respond to the needs of families, they may need to increasingly rely on multi-disciplinary cooperation with other professionals.

Patient education in physiotherapy in total hip arthroplasty (THA) - The perspective of physiotherapists

ABSTRACT Background and Purpose There is limited knowledge about patients’ and physiotherapists’ perceptions of patient education in physiotherapy in hip arthroplasty. The aim of this study was to describe physiotherapists’ conceptions of the patient education in physiotherapy needed by patients undergoing total hip arthroplasty. Methods The data for this qualitative study were collected using group and individual semi-structured interviews. Seven physiotherapists were interviewed. The research data were analyzed using a phenomenographic method. Results Three categories of patient education in physiotherapy in hip arthroplasty were produced and the categories formed a hierarchy. The narrowest descriptive category was Schematic physiotherapy complying with the protocol. Identifying individual rehabilitation needs was the second category, and the third, widest category was Coaching home rehabilitation. The differences between the categories were described in four themes: 1) Moving; 2) Exercising; 3) Interaction in relation to patient; and 4) Health care system. Conclusion According to the results, patient education in physiotherapy optimally aims to identify patients’ individual rehabilitation needs, advice on coping at home and especially helping patients to be prepared for and capable of long rehabilitation for which they are themselves responsible. These findings resulting from descriptive categories can be utilized in developing education methods and physiotherapists’ competence in patient education.

Mental health promotion competencies in the health sector in Finland: a qualitative study of the views of professionals:

Aims: In this study, we aimed to investigate what competencies are needed for mental health promotion in health sector practice in Finland. Methods: A qualitative study was carried out to seek the views of mental health professionals regarding mental health promotion-related competencies. The data were collected via two focus groups and a questionnaire survey of professionals working in the health sector in Finland. The focus groups consisted of a total of 13 professionals. Further, 20 questionnaires were received from the questionnaire survey. The data were analysed using the qualitative data analysis software ATLAS.ti Scientific Software Development GmbH, Berlin. A content analysis was carried out. Results: In total, 23 competencies were identified and clustered under the categories of theoretical knowledge, practical skills, and personal attitudes and values. In order to promote mental health, it is necessary to have a knowledge of the principles and concepts of mental health promotion, including methods and tools for effective practices. Furthermore, a variety of skills-based competencies such as communication and collaboration skills were described. Personal attitudes and values included a holistic approach and respect for human rights, among others. Conclusions : The study provides new information on what competencies are needed to plan, implement and evaluate mental health promotion in health sector practice, with the aim of contributing to a more effective workforce. The competencies provide aid in planning training programmes and qualifications, as well as job descriptions and roles in health sector workplaces related to mental health promotion.