1
|
Koivunen K, Kaakinen P, Päätalo K, Mattila O, Oikarinen A, Jansson M, Mikkonen K, Pölkki T, Meriläinen M, Kääriäinen M, Holopainen A, Tuomikoski AM, Kanste O. Frontline nurse leaders' competences in evidence-based healthcare: A scoping review. J Adv Nurs 2024; 80:1314-1334. [PMID: 38041585 DOI: 10.1111/jan.15920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 09/11/2023] [Accepted: 10/17/2023] [Indexed: 12/03/2023]
Abstract
AIM To identify evidence on frontline nurse leaders' competences in evidence-based healthcare (EBHC) and the instruments measuring these competences. DESIGN A scoping review. DATA SOURCES The search was conducted in June 2021 and complemented in June 2022. The CINAHL, ProQuest, Medline (Ovid), Scopus, Web of Science databases and MedNar along with the Finnish database Medic were searched. REVIEW METHOD The scoping review was conducted in accordance with the Joanna Briggs institute methodology for scoping reviews. Titles, abstracts and full-text versions were screened independently by two reviewers according to the inclusion criteria. Deductive-inductive content analysis was used to synthesize data. RESULTS A total of 3211 articles published between 1997 and 2022 were screened, which resulted in the inclusion of 16 articles. Although frontline nurse leaders had a positive attitude towards EBHC, they had a lack of implementing EBHC competence into practice. Part of the instruments were used in the studies, and only one focused especially on leaders. None of instruments systematically covered all segments of EBHC. CONCLUSION There is a limited understanding of frontline nurse leaders' competence in EBHC. It is important to understand the importance of EBHC in healthcare and invest in the development of its competence at all levels of leaders. Frontline nurse leaders' support is essential for direct care nurses to use EBHC to ensure the quality of care and benefits to patients. Leaders must enhance their own EBHC competence to become role models for direct care nurses. It is also essential to develop valid and reliable instruments to measure leaders' competence covering all EBHC segments. The results can be utilized in the assessment and development of frontline nurse leaders' EBHC competence by planning and producing education and other competence development methods.
Collapse
Affiliation(s)
- Kirsi Koivunen
- University of Applied Sciences, Oulu, Finland
- The Finnish Centre for Evidence-Based Health Care: A JBI Centre of Excellence, Helsinki, Finland
| | - Pirjo Kaakinen
- The Finnish Centre for Evidence-Based Health Care: A JBI Centre of Excellence, Helsinki, Finland
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Kati Päätalo
- University of Applied Sciences, Oulu, Finland
- The Finnish Centre for Evidence-Based Health Care: A JBI Centre of Excellence, Helsinki, Finland
| | - Outi Mattila
- Lapland University of Applied Sciences, Rovaniemi, Finland
| | - Anne Oikarinen
- The Finnish Centre for Evidence-Based Health Care: A JBI Centre of Excellence, Helsinki, Finland
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Miia Jansson
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Kristina Mikkonen
- The Finnish Centre for Evidence-Based Health Care: A JBI Centre of Excellence, Helsinki, Finland
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Tarja Pölkki
- The Finnish Centre for Evidence-Based Health Care: A JBI Centre of Excellence, Helsinki, Finland
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Merja Meriläinen
- Wellbeing Services County of North Ostrobothnia, Oulu University Hospital, Medical Research Centre (MRC), Oulu, Finland
| | - Maria Kääriäinen
- The Finnish Centre for Evidence-Based Health Care: A JBI Centre of Excellence, Helsinki, Finland
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Arja Holopainen
- The Finnish Centre for Evidence-Based Health Care: A JBI Centre of Excellence, Helsinki, Finland
- Nursing Research Foundation, Helsinki, Finland
| | - Anna-Maria Tuomikoski
- The Finnish Centre for Evidence-Based Health Care: A JBI Centre of Excellence, Helsinki, Finland
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
- Wellbeing Services County of North Ostrobothnia, Oulu University Hospital, Medical Research Centre (MRC), Oulu, Finland
| | - Outi Kanste
- The Finnish Centre for Evidence-Based Health Care: A JBI Centre of Excellence, Helsinki, Finland
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| |
Collapse
|
2
|
Hyvärinen S, Jarva E, Mikkonen K, Karsikas E, Koivunen K, Kääriäinen M, Meriläinen M, Jounila-Ilola P, Tuomikoski A, Oikarinen A. Healthcare professionals' experience regarding competencies in specialized and primary stroke units: A qualitative study. J Vasc Nurs 2024; 42:26-34. [PMID: 38555175 DOI: 10.1016/j.jvn.2023.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 10/20/2023] [Accepted: 11/18/2023] [Indexed: 04/02/2024]
Abstract
AIM To describe healthcare professionals' experience of needed competence in patient stroke care within specialist and primary healthcare. BACKGROUND Healthcare professionals who provide stroke care need multifaceted, multi-professional skills; ongoing training is important for competent stroke care. DESIGN A descriptive qualitative study. METHODS Six focus group interviews with semi-structured interviews were conducted in October and November 2020. Healthcare professionals (n = 25) working in stroke care units in both specialist and primary healthcare settings were interviewed. The interviews were recorded, transcribed and analyzed inductively by content analysis. The study was conducted, and results were reported according to the Consolidated Criteria for Reporting Qualitative Research. RESULTS Five main categories were identified: clinical competence; multiprofessional networking competence; competence in interaction skills; emotional and psychoeducational support competence; and self-management and development competence. CONCLUSION Competence in stroke care includes both in-depth and wide-ranging professional competences that require ongoing development. Utilizing various education models and collaborative learning approaches can help meet the requirements for developing competence in stroke care. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
Collapse
Affiliation(s)
- Satu Hyvärinen
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, P.O. Box 5000, FI- 90014 University of Oulu, Oulu, Finland.
| | - Erika Jarva
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, P.O. Box 5000, FI- 90014 University of Oulu, Oulu, Finland.
| | - Kristina Mikkonen
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland.
| | - Eevi Karsikas
- Oulu University Hospital, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.
| | | | - Maria Kääriäinen
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.
| | - Merja Meriläinen
- Oulu University Hospital, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.
| | | | | | - Anne Oikarinen
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, P.O. Box 5000, FI- 90014 University of Oulu, Oulu, Finland.
| |
Collapse
|
3
|
Karsikas E, Koivunen K, Meriläinen M, Kanste O. Health and social care managers' perceptions of factors affecting the competence of managers in knowledge management: A qualitative study. J Adv Nurs 2023. [PMID: 38012828 DOI: 10.1111/jan.15990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 10/19/2023] [Accepted: 11/11/2023] [Indexed: 11/29/2023]
Abstract
AIM To describe health and social care managers' perceptions of the factors affecting the competence of managers in knowledge management. DESIGN A qualitative descriptive study. METHODS A semi-structured interview was conducted with 15 managers from three public health and social care organizations in Finland. Data were collected in the spring of 2022 and analysed using inductive content analysis. RESULTS Health and social care managers perceived that the competence of managers working in knowledge management is affected by managers' behavioural and attitudinal characteristics, their interactive network competence in knowledge management, the dimensions of their competence in knowledge management, the knowledge management infrastructure with which they work and the organizational learning culture within which they work. CONCLUSIONS The competence of health and social managers in knowledge management is influenced by various factors, including their personal characteristics, management competence and the infrastructure and culture of the organization for which they work. However, their competence is constrained by an absence of clear processes, structures and resources in knowledge management as well as a lack of systematic support and training for managers working in knowledge management. IMPACT The study provides valuable information for improving the competence of managers working in knowledge management in health and social care organizations. The competence of managers working in knowledge management is instrumental for successful implementation and sustaining of knowledge management practices and thus, such competence has a positive impact on the overall performance of an organization. IMPLICATIONS Clarifying the roles and responsibilities of health and social care managers, as well as establishing organizational structures, is essential for effective knowledge management in organizations. REPORTING METHOD Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist has been used in the reporting. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
Collapse
Affiliation(s)
- Eevi Karsikas
- Research Unit of Health Sciences and Technology, University of Oulu, Oulu, Finland
- MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | | | - Merja Meriläinen
- MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Outi Kanste
- Research Unit of Health Sciences and Technology, University of Oulu, Oulu, Finland
- MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| |
Collapse
|
4
|
Koivunen K, Schaap LA, Hoogendijk EO, Schoonmade LJ, Huisman M, van Schoor NM. Exploring the conceptual framework and measurement model of intrinsic capacity defined by the World Health Organization: A scoping review. Ageing Res Rev 2022; 80:101685. [PMID: 35830956 DOI: 10.1016/j.arr.2022.101685] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 06/16/2022] [Accepted: 07/07/2022] [Indexed: 01/04/2023]
Abstract
WHO has defined intrinsic capacity (IC) as the composite of all physical and mental capacities of an individual covering five subdomains: cognition, locomotion, sensory, vitality, and psychological. Despite this well accepted definition, the conceptual and measurement model of IC remains unclear, which hampers a standardized operationalization of the construct. We performed a scoping review to give a comprehensive overview of the extent to which the current literature of IC addresses and assumes the conceptual framework and measurement model of IC as reflective or formative. For inclusion, we considered all types of articles that were published in peer-reviewed journals except for protocol articles. A systematic search of 6 databases from different disciplines led to the inclusion of 31 papers. We found inconsistency and gaps in the descriptions of IC. Most of the papers did not define the measurement model. In the conceptual background and validation articles, we identified descriptions of both reflective and formative measurement models while in empirical studies applying IC measurements the underlying assumptions remained mainly unclear. Defining a measurement model is not merely a theoretical matter but influences the operationalization and validation processes of the construct. This study raised questions about the most fundamental features of the IC construct and discusses whether IC should be considered as an underlying latent trait of all capacities (reflective construct) or an aggregate summary measure of the subdomain capacities (formative construct).
Collapse
Affiliation(s)
- K Koivunen
- Amsterdam UMC location Vrije Universiteit Amsterdam, Epidemiology and Data Science, De Boelelaan, 1117, Amsterdam, the Netherlands; Faculty of Sport and Health Sciences and Gerontology Research Center, University of Jyväskylä, Rautpohjankatu 8, P.O. Box 35, FI-40014, Finland.
| | - L A Schaap
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health Research Institute, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, De Boelelaan 1081, 1081 HV Amsterdam, the Netherlands
| | - E O Hoogendijk
- Amsterdam UMC location Vrije Universiteit Amsterdam, Epidemiology and Data Science, De Boelelaan, 1117, Amsterdam, the Netherlands; Amsterdam Public Health Research Institute, Aging & Later Life, Amsterdam, the Netherlands, De Boelelaan 1117, Amsterdam, the Netherlands
| | - L J Schoonmade
- Medical Library, Vrije Universiteit Amsterdam, De Boelelaan 1117, P.O. Box 7057, 1007 MB Amsterdam, the Netherlands
| | - M Huisman
- Amsterdam UMC location Vrije Universiteit Amsterdam, Epidemiology and Data Science, De Boelelaan, 1117, Amsterdam, the Netherlands; Amsterdam Public Health Research Institute, Aging & Later Life, Amsterdam, the Netherlands, De Boelelaan 1117, Amsterdam, the Netherlands; Department of Sociology, Vrije Universiteit Amsterdam, De Boelelaan 1105, 1081 HV Amsterdam, the Netherlands
| | - N M van Schoor
- Amsterdam UMC location Vrije Universiteit Amsterdam, Epidemiology and Data Science, De Boelelaan, 1117, Amsterdam, the Netherlands; Amsterdam Public Health Research Institute, Aging & Later Life, Amsterdam, the Netherlands, De Boelelaan 1117, Amsterdam, the Netherlands
| |
Collapse
|
5
|
Karsikas E, Meriläinen M, Tuomikoski AM, Koivunen K, Jarva E, Mikkonen K, Oikarinen A, Kääriäinen M, Jounila‐Ilola P, Kanste O. Healthcare managers’ competence in knowledge management: a scoping review. J Nurs Manag 2022; 30:1168-1187. [PMID: 35403311 PMCID: PMC9542587 DOI: 10.1111/jonm.13626] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 04/05/2022] [Indexed: 11/27/2022]
Abstract
Aim Background Evaluation Key issues Conclusion Implications for Nursing Management
Collapse
Affiliation(s)
- E. Karsikas
- Research Unit of Nursing Science and Health Management University Of Oulu Oulu Finland
- Oulu University Hospital Oulu Finland
| | - M. Meriläinen
- Oulu University Hospital, Medical Research Center Oulu Finland
| | - A. M. Tuomikoski
- Oulu University of Applied Sciences Oulu Finland
- The Finnish Centre For Evidence‐Based Health Care: A Joanna Briggs Institute Centre of Excellence; Research Unit of Nursing Science and Health Management University Of Oulu Oulu Finland
| | - K. Koivunen
- Oulu University of Applied Sciences Oulu Finland
| | - E. Jarva
- Research Unit Of Nursing Science And Health Management University Of Oulu Oulu Finland
| | - K. Mikkonen
- Research Unit Of Nursing Science And Health Management University Of Oulu Oulu Finland
- Medical Research Centre Oulu Oulu University Hospital and University Of Oulu Oulu Finland
- The Finnish Centre for Evidence‐Based Health Care: A Joanna Briggs Institute Centre of Excellence
| | - A. Oikarinen
- Research Unit of Nursing Science and Health Management University Of Oulu Oulu Finland
- Medical Research Centre Oulu Oulu University Hospital and University Of Oulu Oulu Finland
- The Finnish Centre for Evidence‐Based Health Care: A Joanna Briggs Institute Centre of Excellence
| | - M. Kääriäinen
- Research Unit of Nursing Science and Health Management University Of Oulu Oulu Finland
- Medical Research Centre Oulu Oulu University Hospital and University Of Oulu Oulu Finland
- The Finnish Centre for Evidence‐Based Health Care: A Joanna Briggs Institute Centre of Excellence
| | | | - O. Kanste
- Research Unit of Nursing Science and Health Management University Of Oulu Oulu Finland
- Medical Research Centre Oulu Oulu University Hospital and University Of Oulu Oulu Finland
- The Finnish Centre for Evidence‐Based Health Care: A Joanna Briggs Institute Centre of Excellence
| |
Collapse
|
6
|
Immonen K, Tuomikoski AM, Kääriäinen M, Oikarinen A, Holopainen A, Kuivila H, Männistö M, Mikkonen K, Mattila O, Vesterinen S, Päätalo K, Koivunen K, Ylimäki S, Mikkonen K. Evidence-based healthcare competence of social and healthcare educators: A systematic review of mixed methods. Nurse Educ Today 2022; 108:105190. [PMID: 34763223 DOI: 10.1016/j.nedt.2021.105190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 10/13/2021] [Accepted: 10/25/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Social and healthcare operating environments are constantly evolving, so educators have major responsibility for ensuring that Evidence-Based Healthcare is included in the education of future healthcare professionals and applied in their practice. A holistic understanding and implementation of evidence-based healthcare competence is critical to the delivery of appropriate, relevant, and effective healthcare. AIM To identify and describe social and healthcare educators' EBHC competence according to the five main components of the JBI model and associated factors to it. METHODS A mixed-methods systematic review was conducted, with inclusion and exclusion criteria identified according to PICo and PEO inclusion criteria for qualitative and quantitative studies, respectively. Five databases-the CINAHL (EBSCO), PubMed, Scopus, Medic and ProQuest databases- were searched in June 2020. In total, 12 original studies (qualitative and quantitative) were included for quality appraisal, data extraction and narrative synthesis. RESULTS Key competence areas addressed in the selected studies were integrated into the four components of the JBI model of EBHC (evidence generation, synthesis, transfer, and implementation, and focus on its ultimate goal: global health). In the majority of chosen studies', it was found that educators had a positive attitude towards EBHC and wanted to stay up-to-date in the areas of global health and collaboration. Educators demonstrated their abilities to locate, appraise, and interpret the best current relevant evidence. They knew how to integrate EBHC into their teaching and had strong communication skills in evidence transfer. Their EBHC competence was strongest in the educational context and educators could transfer evidence when teaching but were not able to translate it into how to implement EBHC in clinical care. In addition to higher academic education and work experience, organizational support and continuous education reportedly play essential roles in development of educators' EBHC competence. CONCLUSION Measures are needed to maintain and improve social and health educators' EBHC competence and develop robust methods to reliably assess it.
Collapse
Affiliation(s)
- Kati Immonen
- Research Unit of Nursing Science and Health Management, University of Oulu, Finland.
| | - Anna-Maria Tuomikoski
- Oulu University of Applied Sciences The Finnish Centre for Evidence-Based Health Care: a JBI Centre of Excellence, Helsinki, Finland; Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland.
| | - Maria Kääriäinen
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland; The Finnish Centre for Evidence-Based Health Care: A JBI Centre of Excellence, United States of America.
| | - Anne Oikarinen
- Research Unit of Nursing Science and Health Management, Faculty of Medicine/University of Oulu, Finland.
| | - Arja Holopainen
- Nursing Research Foundation, The Finnish Centre for Evidence-Based Health Care: a JBI Centre of Excellence, WHO Collaborating Centre for Nursing, Helsinki, Finland.
| | - Heli Kuivila
- Research Unit of Nursing Science and Health Management, University of Oulu, Finland.
| | - Merja Männistö
- Oulu University of Applied Sciences The Finnish Centre for Evidence-Based Health Care: a JBI Centre of Excellence, Helsinki, Finland.
| | - Kristina Mikkonen
- Research Unit of Nursing Science and Health Management, University of Oulu, Finland.
| | - Outi Mattila
- Lapland University of Applied Sciences, Finland.
| | | | - Kati Päätalo
- Oulu University of Applied Sciences The Finnish Centre for Evidence-Based Health Care: a JBI Centre of Excellence, Helsinki, Finland.
| | - Kirsi Koivunen
- Oulu University of Applied Sciences The Finnish Centre for Evidence-Based Health Care: a JBI Centre of Excellence, Helsinki, Finland.
| | - Saija Ylimäki
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland; Oulaskangas hospital, Ostrobothnia Hospital District, Finland.
| | - Kristina Mikkonen
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland.
| |
Collapse
|
7
|
Jarva E, Mikkonen K, Tuomikoski AM, Kääriäinen M, Meriläinen M, Karsikas E, Koivunen K, Jounila-Ilola P, Oikarinen A. Healthcare professionals' competence in stroke care pathways: A mixed-methods systematic review. J Clin Nurs 2021; 30:1206-1235. [PMID: 33350004 DOI: 10.1111/jocn.15612] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 11/30/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND The challenges of caring for stroke patients are growing due to population ageing and improved survival rates. Healthcare professionals' competence development in stroke care is a necessity to ensure high-quality patient care. OBJECTIVES To identify and describe the competence areas of healthcare professionals working in the stroke patient care pathway and factors influencing these competences. DESIGN A mixed-methods systematic review. METHODS The review was conducted according to the JBI guidelines and registered in the PROSPERO database (CRD42020204062). PRISMA checklist guided the review process. Relevant original studies were identified by searching four databases-CINAHL (EBSCO), PubMed, Scopus and Medic. After researcher consensus was reached, 32 studies were selected for inclusion and subjected to content analysis and data tabulation. RESULTS Competence in care processes, clinical competence, competence in using self-management strategies, interaction skills, skills in acknowledging family and competence in integrating the available evidence base into patient care were identified as key competence areas. Organisation of services, specialisation in stroke care, continuous development and education, family and carer and training in oral care and cognitive rehabilitation were identified as factors that influence healthcare professionals' competence. CONCLUSIONS Diverse clinical and interaction competencies are needed throughout the stroke care pathway, and various factors affect healthcare professionals' competence. Further research on healthcare professionals' stroke care competence will be needed to respond to changing healthcare demand. RELEVANCE TO CLINICAL PRACTICE We recommend organisational support and formulation of stroke care patient guidelines in line with healthcare competence requirements. Focus should be added for nursing professions in developing interactive communication competence since nurses spend the majority of the time providing individual patient care. Also, organisations should integrate continuing training in specialised stroke care for healthcare professionals' competence development.
Collapse
Affiliation(s)
- Erika Jarva
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland
| | - Kristina Mikkonen
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland
| | - Anna-Maria Tuomikoski
- Oulu University of Applied Sciences, Oulu, Finland.,The Finnish Centre for Evidence-Based Health Care: A Joanna Briggs Institute Centre of Excellence, Helsinki, Finland
| | - Maria Kääriäinen
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland.,The Finnish Centre for Evidence-Based Health Care: A Joanna Briggs Institute Centre of Excellence, Helsinki, Finland.,Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Merja Meriläinen
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.,Oulu University Hospital, Oulu, Finland
| | | | | | | | - Anne Oikarinen
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland
| |
Collapse
|
8
|
Liljamo P, Säilynoja H, Tuomikoski K, Henner A, Koivunen K. Patient-Centered Development of a Digital Care Pathway for Arrhythmia Patients. Stud Health Technol Inform 2020; 275:127-131. [PMID: 33227754 DOI: 10.3233/shti200708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/25/2023]
Abstract
Citizens are ready and willing to use various kinds of e-health services and Web-based portals. The purpose of this study was to describe the experiences of patients who underwent an arrhythmia procedure of the guidance they received as well as their needs and expectations for a future digital care path. The goal for the future is to utilize the results in other patient-centered digital service development activities. The research material was collected in a two-part thematic interview with patients who underwent an electrophysiology examination and supraventricular tachycardia catheter ablation procedure (n=7) or ablation treatment for atrial fibrillation (n=4). The preliminary digital care path was modified based on the results. The arrhythmia patient's digital care path was tested in a workshop using a test group consisting of patients (n=3) and nursing staff (n=6). As a result, a digital care pathway for arrhythmia patients was completed.
Collapse
Affiliation(s)
- Pia Liljamo
- Oulu University Hospital, Northern Ostrobothnia District, Oulu, Finland
| | - Hanna Säilynoja
- Oulu University Hospital, Northern Ostrobothnia District, Oulu, Finland
| | - Kirsi Tuomikoski
- Oulu University Hospital, Northern Ostrobothnia District, Oulu, Finland
| | - Anja Henner
- Oulu University of Applied Sciences, Oulu, Finland
| | | |
Collapse
|
9
|
Koivunen K, Lukkarinen H. One-Year Prospective Health-Related Quality-Of-Life Outcomes in Patients Treated with Conservative Method, Endovascular Treatment or Open Surgery for Symptomatic Lower Limb Atherosclerotic Disease. Eur J Cardiovasc Nurs 2008; 7:247-56. [DOI: 10.1016/j.ejcnurse.2007.12.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2007] [Revised: 09/17/2007] [Accepted: 12/04/2007] [Indexed: 10/22/2022]
Affiliation(s)
- Kirsi Koivunen
- Department of Nursing Science and Health Administration, Faculty of Medicine, University of Oulu, Finland
| | - Hannele Lukkarinen
- Department of Nursing Science and Health Administration, Faculty of Medicine, University of Oulu, Finland
| |
Collapse
|
10
|
Koivunen K, Sintonen H, Lukkarinen H. Properties of the 15D and the Nottingham Health Profile questionnaires in patients with lower limb atherosclerotic disease. Int J Technol Assess Health Care 2007; 23:385-91. [PMID: 17579943 DOI: 10.1017/s0266462307070444] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Objectives:The aim of this study was to compare the generic health-related quality of life (HRQoL) instruments, the 15D and the Nottingham Health Profile (NHP), in terms of feasibility, cross-sectional construct validity, discriminatory power, and responsiveness to the change in patients with lower limb atherosclerosis disease (LLAD).Methods:Patients who were treated conservatively (64 patients), scheduled for endovascular treatment (85 patients), or for elective surgery (31 patients) filled in the NHP and the 15D questionnaires before treatment and 12 months after. The methods of analysis included calculations of the completion rate, the multitrait–multimethod matrix, extreme group comparisons with thet-test, and calculations of “floor” and “ceiling” effects and effect sizes.Results:Both the 15D and the NHP instruments were feasible because full data were obtained at baseline from 84.1 percent of patients and 82 percent at 12 months with the 15D and, respectively, 75.8 percent and 79 percent with the NHP. The multitrait–multimethod matrix and extreme group comparisons provided a clear convergent and discriminant evidence of the cross-sectional construct validity of the instruments. The convergent validity correlations were quite high, ranging between .40 and .682. The tendency for higher percentages at the “ceiling” and “floor” for the NHP suggests that it has less discriminatory power than the 15D on roughly comparable dimensions. The 15D and the NHP were almost equally responsive to change.Conclusions:This study provided evidence that both the 15D and the NHP are appropriate for measuring HRQoL among patients with LLAD.
Collapse
Affiliation(s)
- Kirsi Koivunen
- Department of Nursing Science and Health Administration, University of Oulu, Finland.
| | | | | |
Collapse
|
11
|
Abstract
AIMS AND OBJECTIVES The purpose of this study was to describe the experience of rehabilitation reported by coronary artery disease patients who had undergone coronary artery bypass surgery. A further purpose was to describe the kind of guidance on rehabilitation that they were given during this period. METHODS The data consisted of thematic questionnaires completed by six women and eight men who had undergone coronary artery bypass surgery. They had recorded their experiences on these questionnaires at one-month intervals for a year after the surgery. The data were analysed using the method of content analysis. RESULTS On the basis of the results, women had experienced the most balanced period of physical, mental and social rehabilitation during the six months following surgery. Their recovery, however, suffered a setback after the first six months. On the basis of the results, men attained a better balance of physical, mental and social rehabilitation only after the six-month period following surgery. Even men had various problems in their rehabilitation, but their recovery proceeded more smoothly than that of women. Women hoped for more guidance throughout the process of rehabilitation. The support and help from wives had a positive impact on the process of men's recovery. Peer support was another significant source support. CONCLUSIONS A person undergoing rehabilitation needs special guidance from health care professionals, especially when his/her rehabilitation does not proceed optimally. The findings suggest that, especially, the guidance of women should be improved because women seemed to suffer from many problems during their process of rehabilitation, including loneliness, insecurity, uncertainty, fears, depression and anxiety. RELEVANCE TO CLINICAL PRACTICE Expanding the role of practical nurses to provide both preventive and rehabilitation guidance should be seen as an important strategy in health care. Individual needs, gender differences and support from families and peers should be taken into consideration when planning and implementing guidance.
Collapse
Affiliation(s)
- Kirsi Koivunen
- Department of Nursing Science and Health Administration, Faculty of Medicine, University of Oulu, Finland.
| | | | | |
Collapse
|
12
|
Koivunen K, Lukkarinen H. Lower limb atherosclerotic disease causes various deteriorations of patients’ health-related quality of life. Journal of Vascular Nursing 2006; 24:102-15. [PMID: 17141129 DOI: 10.1016/j.jvn.2006.06.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2006] [Revised: 06/20/2006] [Accepted: 06/20/2006] [Indexed: 11/17/2022]
Abstract
BACKGROUND Lower limb atherosclerotic disease (LLAD) is a worldwide health problem. Approximately 100,000 Finns have LLAD. Currently, a large number of health-related quality of life (HRQoL) studies are available, but we still have scant comprehensive information of HRQoL of patients with LLAD. OBJECTIVES The aim was to describe the HRQoL of women and men with LLAD in relation to the age- and sex-matched general population. In addition, the purpose was to study which demographic and relevant clinical and psychologic factors are connected with HRQoL of patients with LLAD. METHODS Patients with LLAD (N = 180, 62 women and 118 men) were recruited to participate in this study in the Clinic of Surgery, Oulu University Hospital, from 2001 to 2004. The control sample consisted of an age- and sex-matched general population (N = 2126; 1081 women and 1045 men). The HRQoL of the women and men with LLAD was evaluated using the Nottingham Health Profile (NHP) instrument, in relation to an age- and sex-matched general population (N = 2126) as well as demographic and relevant clinical and psychologic factors. RESULTS The HRQoL of men was significantly (P < .05) poorer on all dimensions of the NHP instrument in the age groups 55 to 74 years. HRQoL was also clearly affected in the youngest age group of men on the dimensions of pain (P < .05) and mobility (P < .05) and further in the oldest age group on the dimension of energy (P < .05). The HRQoL of women with LLAD was only significantly poorer (P < .05) on the dimension of pain in the age group of 65 to 74 years than the HRQoL of age-matched Finnish women. The most emphasized relationships between poor HRQoL and the demographic, relevant clinical and psychologic factors were male sex, lack of exercise, retirement, a short painless walking distance, other atherosclerotic disease, poor subjective health status, problems with ability to cope at home, problems with the treatment of illness, and sex life. Male patients with LLAD had poorer HRQoL than the corresponding female patients on the dimensions of energy (P = .023), emotional reaction (P = .050), social isolation (P = .028), and NHP total score (P = .023). Those who did not exercise regularly had poorer HRQoL on the dimensions of energy (P = .005), pain (P = .049), emotional reaction (P = .007), social isolation (P = .001), and physical mobility (P = .028) than those who did exercise regularly. CONCLUSIONS The HRQoL of middle-aged men was significantly poorer than that of controls. Male sex, retirement, asymptomatic walking distance, other atherosclerotic disease, lack of exercise, and feeling incapable of performing daily activities are important causes of impaired HRQoL. Health care professionals should pay extra attention to the development of rehabilitation programs aimed at preventing patients with LLAD from experiencing a myriad of problems.
Collapse
Affiliation(s)
- Kirsi Koivunen
- Department of Nursing Science and Health Administration, Faculty of Medicine, University of Oulu, Oulu, Finland.
| | | |
Collapse
|