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Ahlstrand A, Mishina K, Elomaa-Krapu M, Joronen K. Consumer involvement and guiding frameworks in mental healthcare: An integrative literature review. Int J Ment Health Nurs 2024. [PMID: 38706160 DOI: 10.1111/inm.13343] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 03/26/2024] [Accepted: 04/14/2024] [Indexed: 05/07/2024]
Abstract
Perspectives of healthcare have, in past decades, focused more on active citizenship, human rights and empowerment. Healthcare consumer involvement as a concept is still unstructured and consumers have no apparent opportunities to participate in their care processes. The focus is often on the expertise of professionals, even if mental health consumers are willing to become involved and have sufficient decisional capacity. The aim of this integrative literature review was to construct an understanding of consumer perceptions and guiding frameworks of consumer involvement. There was no previous synthesis of mental health consumer perceptions combined with guiding frameworks. An integrative review methodology was employed, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The quality of the 18 studies included was analysed with the Whittemore and Knafl approach. By following Braun and Clarke's guidelines, an inductive thematic analysis was conducted to collate the themes from the selected papers. Mental health consumers' perceptions of involvement included expectations of person-centred care, such as respect, dignity, equal interaction, supportive environments and being part of a community. This research did not find any single established framework to give clear guidelines for consumer involvement in mental healthcare, but similar determinants describing various frameworks were uncovered. This review also shows how the terminology has changed throughout the years. The perceptions of mental health consumers need to be considered to enable the implementation of person-centredness from guidelines through to practice. Paying more attention to the education of professional mental health caregivers and the involvement of mental health consumers in their care provides better opportunities to co-develop successful mental health services and recovery processes.
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Affiliation(s)
- Anita Ahlstrand
- Department of Nursing Science, Faculty of Medicine, University of Turku, Turku, Finland
- Metropolia University of Applied Sciences, Helsinki, Finland
| | - Kaisa Mishina
- Research Centre for Child Psychiatry, University of Turku, Turku, Finland
- INVEST Research Flagship, University of Turku, Turku, Finland
| | - Minna Elomaa-Krapu
- Metropolia University of Applied Sciences, Helsinki, Finland
- Faculty of Social Sciences, Nursing Science, Tampere University, Tampere, Finland
| | - Katja Joronen
- Department of Nursing Science, Faculty of Medicine, University of Turku, Turku, Finland
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2
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Mishina K, Kronström K, Heinonen E, Sourander A. Body dissatisfaction and dieting among Finnish adolescents: a 20-year population-based time-trend study. Eur Child Adolesc Psychiatry 2024:10.1007/s00787-023-02327-0. [PMID: 38168825 DOI: 10.1007/s00787-023-02327-0] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 11/28/2023] [Indexed: 01/05/2024]
Abstract
Body image has an important role in the health and development of adolescents. Body dissatisfaction and dieting can become chronic and continue into adulthood. There is a lack of recent, comprehensive studies on ongoing trends on body dissatisfaction. This study assessed time-trend changes in self-reported body dissatisfaction and dieting among Finnish adolescents at four assessment points. Representative samples of adolescents (N = 6660) aged 13-16 years participated in school-based, cross-sectional studies in 1998 (N = 1458), 2008 (N = 2044), 2014 (N = 1809), and 2018 (N = 1349), respectively. The studies were similar in design, methodology, and geographical recruitment areas. Body dissatisfaction and dieting were assessed with a questionnaire including items derived from the DSM-IV criteria for anorexia and bulimia nervosa. From 1998 to 2018, dieting and fears related to gaining weight decreased among females. Body dissatisfaction reduced among females, and their wishes to become thinner became less prevalent. Consuming large amounts of food at one time consistently decreased among females and males and there were no changes in the rates of willful vomiting. The number of females in the 90th percentile with the most severe symptoms decreased. The results indicate that body dissatisfaction and disturbed dieting improved among females during the 20-year study. Despite these positive developments, the overall level of symptoms among females remained substantial, indicating that females have much higher levels of body dissatisfaction and dieting than males.
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Affiliation(s)
- Kaisa Mishina
- Department of Child Psychiatry, Research Centre for Child Psychiatry, University of Turku, Lemminkäisenkatu 3, 20014, Turku, Finland.
- INVEST Research Flagship, University of Turku, Turku, Finland.
| | - Kim Kronström
- Department of Adolescent Psychiatry, University of Turku, Turku, Finland
| | - Emmi Heinonen
- Department of Child Psychiatry, Research Centre for Child Psychiatry, University of Turku, Lemminkäisenkatu 3, 20014, Turku, Finland
- INVEST Research Flagship, University of Turku, Turku, Finland
| | - Andre Sourander
- Department of Child Psychiatry, Research Centre for Child Psychiatry, University of Turku, Lemminkäisenkatu 3, 20014, Turku, Finland
- INVEST Research Flagship, University of Turku, Turku, Finland
- Department of Child Psychiatry, Turku University Hospital, Turku, Finland
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3
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Saarinen J, Mishina K, Soikkeli-Jalonen A, Haavisto E. Family members' participation in palliative inpatient care: An integrative review. Scand J Caring Sci 2023; 37:897-908. [PMID: 34958141 DOI: 10.1111/scs.13062] [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: 08/25/2021] [Revised: 11/23/2021] [Accepted: 12/12/2021] [Indexed: 10/19/2022]
Abstract
AIM To analyse how family members participate in hospital inpatient palliative care, and how their participation could be supported. METHODS This review followed a methodology outlined in the literature for integrative reviews. A literature search supplemented by a manual search was conducted on four electronic databases during 2020 to 2021: PubMed, CINAHL, PsycINFO, and Cochrane Library. A critical appraisal of the included studies was performed, and data were analysed using inductive content analysis. RESULTS The literature search resulted in 4990 articles, of which 14 articles were included in this review. Four main categories were identified concerning the participation of family members in hospital inpatient palliative care: participation in the physical care, provision of emotional support, promoting good patient care, and support provided by healthcare professionals for family members' participation. Family members' participation can be supported in different ways, including active communication and adequate information. CONCLUSION Family members' participation in hospital inpatient palliative care has been an important part of palliative care in hospital settings. Family members should be offered the opportunity to participate in patient care, and their presence in the hospital should be accommodated. Research on the topic is still scarce, and future research is needed from different perspectives, including intervention research.
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Affiliation(s)
- Johanna Saarinen
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Kaisa Mishina
- Department of Nursing Science, University of Turku, Turku, Finland
- Department of Child Psychiatry, University of Turku, Turku, Finland
- INVEST Research Flagship Center, University of Turku, Turku, Finland
| | | | - Elina Haavisto
- Deparment of Health Sciences, Tampere University, Tampere, Finland
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Saarinen J, Mishina K, Soikkeli-Jalonen A, Konradsen H, Haavisto E. Participation in inpatient care from the perspective of family members of palliative care patients. Int J Palliat Nurs 2023; 29:446-454. [PMID: 37757806 DOI: 10.12968/ijpn.2023.29.9.446] [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] [Indexed: 09/29/2023]
Abstract
BACKGROUND The participation of family members in inpatient palliative care has been shown to be meaningful; it contributes to the wellbeing of the patient. Even so, little is known about the perspectives of family members regarding their participation in this type of care. AIM The aim of this study was to describe participation in inpatient care from the perspective of family members of palliative care patients. METHOD This study involved semi-structured individual interviews with family members (n=19) of patients receiving inpatient palliative care, as well as inductive thematic analysis. FINDINGS Four main themes describing the family members' perspectives of their participation in inpatient palliative care were identified: family members attending to everyday activities, importance of participation to family members, family members providing emotional support to patients and the role of family members in discussions and decision-making processes concerning patient care. CONCLUSION Family members participate in inpatient palliative care in different ways. Participation was experienced as important to patients and family members, and some family members felt that participation may have supported their coping process.
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Affiliation(s)
- Johanna Saarinen
- Student, Department of Nursing Science, University of Turku, Turku, Finland
| | - Kaisa Mishina
- Senior researcher, Department of Nursing Science; Department of Child Psychiatry; INVEST Research Flagship Centre University of Turku, Turku, Finland
| | - Anu Soikkeli-Jalonen
- Doctoral researcher, Faculty of Social Sciences, Health Sciences Unit, Tampere University, Tampere, Finland
| | - Hanne Konradsen
- Professor, Herlev and Gentofte University Hospital, Herlev, University of Copenhagen, Copenhagen, Denmark
| | - Elina Haavisto
- Professor, Department of Nursing Science, University of Turku, Turku, Finland, Faculty of Social Sciences, Health Sciences Unit, Tampere University, Tampere, Finland Satakunta Central Hospital, Pori, Finland
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Kauhanen L, Wan Mohd Yunus WMA, Lempinen L, Peltonen K, Gyllenberg D, Mishina K, Gilbert S, Bastola K, Brown JSL, Sourander A. A systematic review of the mental health changes of children and young people before and during the COVID-19 pandemic. Eur Child Adolesc Psychiatry 2023; 32:995-1013. [PMID: 35962147 PMCID: PMC9373888 DOI: 10.1007/s00787-022-02060-0] [Citation(s) in RCA: 80] [Impact Index Per Article: 80.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 07/27/2022] [Indexed: 11/29/2022]
Abstract
There is increasing knowledge that the COVID-19 pandemic has had an impact on mental health of children and young people. However, the global evidence of mental health changes before compared to during the COVID-19 pandemic focusing on children and young people has not been systematically reviewed. This systematic review examined longitudinal and repeated cross-sectional studies comparing before and during COVID-19 pandemic data to determine whether the mental health of children and young people had changed before and during the COVID-19 pandemic. The Web of Science, PubMed, Embase and PsycINFO databases were searched to identify peer-reviewed studies that had been published in English and focused on children and young people between 0 and 24 years of age. This identified 21 studies from 11 countries, covering more than 96,000 subjects from 3 to 24 years of age. Pre-pandemic and pandemic data were compared. Most studies reported longitudinal deterioration in the mental health of adolescents and young people, with increased depression, anxiety and psychological distress after the pandemic started. Other findings included deteriorated negative affect, mental well-being and increased loneliness. Comparing data for pandemic and pre-pandemic periods showed that the COVID-19 pandemic may negatively impact the mental health of children and young people. There is an urgent need for high-quality research to address the impact, risks and protective factors of the pandemic on their mental health, as this will provide a good foundation for dealing with future health emergencies and other crises.
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Affiliation(s)
- Laura Kauhanen
- Research Centre for Child Psychiatry, University of Turku, Turku, Finland
| | - Wan Mohd Azam Wan Mohd Yunus
- Research Centre for Child Psychiatry, University of Turku, Turku, Finland
- INVEST Research Flagship, University of Turku, Turku, Finland
- Department of Psychology, Faculty of Social Sciences and Humanities, Universiti Teknologi Malaysia, Johor, Malaysia
| | - Lotta Lempinen
- Research Centre for Child Psychiatry, University of Turku, Turku, Finland
- INVEST Research Flagship, University of Turku, Turku, Finland
| | - Kirsi Peltonen
- Research Centre for Child Psychiatry, University of Turku, Turku, Finland
- INVEST Research Flagship, University of Turku, Turku, Finland
| | - David Gyllenberg
- Research Centre for Child Psychiatry, University of Turku, Turku, Finland
- INVEST Research Flagship, University of Turku, Turku, Finland
- National Institute for Health and Welfare, Helsinki, Finland
- Department of Adolescent Psychiatry, Helsinki University Central Hospital, Helsinki, Finland
| | - Kaisa Mishina
- Research Centre for Child Psychiatry, University of Turku, Turku, Finland
- INVEST Research Flagship, University of Turku, Turku, Finland
| | - Sonja Gilbert
- Research Centre for Child Psychiatry, University of Turku, Turku, Finland
- INVEST Research Flagship, University of Turku, Turku, Finland
| | - Kalpana Bastola
- National Institute for Health and Welfare, Helsinki, Finland
| | - June S L Brown
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, England, London, UK
| | - Andre Sourander
- Research Centre for Child Psychiatry, University of Turku, Turku, Finland.
- INVEST Research Flagship, University of Turku, Turku, Finland.
- Department of Child Psychiatry, Turku University Hospital, Turku, Finland.
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Gyllenberg D, Bastola K, Wan Mohd Yunus WMA, Mishina K, Liukko E, Kääriälä A, Sourander A. Comparison of new psychiatric diagnoses among Finnish children and adolescents before and during the COVID-19 pandemic: A nationwide register-based study. PLoS Med 2023; 20:e1004072. [PMID: 36848384 PMCID: PMC10089356 DOI: 10.1371/journal.pmed.1004072] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 04/11/2023] [Accepted: 07/11/2022] [Indexed: 03/01/2023] Open
Abstract
BACKGROUND Coronavirus Disease 2019 (COVID-19) restrictions decreased the use of specialist psychiatric services for children and adolescents in spring 2020. However, little is known about the pattern once restrictions eased. We compared new psychiatric diagnoses by specialist services during pandemic and pre-pandemic periods. METHODS AND FINDINGS This national register study focused on all Finnish residents aged 0 to 17 years from January 2017 to September 2021 (approximately 1 million a year). The outcomes were new monthly diagnoses for psychiatric or neurodevelopmental disorders in specialist services. These were analyzed by sex, age, home location, and diagnostic groups. The numbers of new diagnoses from March 2020 were compared to predictive models based on previous years. The predicted and observed levels in March to May 2020 showed no significant differences, but the overall difference was 18.5% (95% confidence interval 12.0 to 25.9) higher than predicted in June 2020 to September 2021, with 3,821 more patients diagnosed than anticipated. During this period, the largest increases were among females (33.4%, 23.4 to 45.2), adolescents (34.4%, 25.0 to 45.3), and those living in areas with the highest COVID-19 morbidity (29.9%, 21.2 to 39.8). The largest increases by diagnostic groups were found for eating disorders (27.4%, 8.0 to 55.3), depression and anxiety (21.0%, 12.1 to 51.9), and neurodevelopmental disorders (9.6%, 3.0 to 17.0), but psychotic and bipolar disorders and conduct and oppositional disorders showed no significant differences and self-harm (-28.6, -41.5 to -8.2) and substance use disorders (-15.5, -26.4 to -0.7) decreased in this period. The main limitation is that data from specialist services do not allow to draw conclusions about those not seeking help. CONCLUSIONS Following the first pandemic phase, new psychiatric diagnoses in children and adolescents increased by nearly a fifth in Finnish specialist services. Possible explanations to our findings include changes in help-seeking, referrals and psychiatric problems, and delayed service access.
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Affiliation(s)
- David Gyllenberg
- Department of Child Psychiatry and INVEST Research Flagship Center, University of Turku and Turku University Hospital, Turku, Finland
- Finnish Institute of Health and Welfare, Helsinki, Finland
- Department of Adolescent Psychiatry, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
- * E-mail:
| | - Kalpana Bastola
- Department of Child Psychiatry and INVEST Research Flagship Center, University of Turku and Turku University Hospital, Turku, Finland
- Finnish Institute of Health and Welfare, Helsinki, Finland
| | - Wan Mohd Azam Wan Mohd Yunus
- Department of Child Psychiatry and INVEST Research Flagship Center, University of Turku and Turku University Hospital, Turku, Finland
- Faculty of Social Sciences and Humanities, Universiti Teknologi Malaysia, Malaysia
| | - Kaisa Mishina
- Department of Child Psychiatry and INVEST Research Flagship Center, University of Turku and Turku University Hospital, Turku, Finland
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Emmi Liukko
- Finnish Institute of Health and Welfare, Helsinki, Finland
| | - Antti Kääriälä
- Finnish Institute of Health and Welfare, Helsinki, Finland
| | - Andre Sourander
- Department of Child Psychiatry and INVEST Research Flagship Center, University of Turku and Turku University Hospital, Turku, Finland
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7
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Soikkeli‐Jalonen A, Mishina K, Virtanen H, Charalambous A, Haavisto E. Healthcare professionals' perceptions of psychosocial support for family members in palliative care inpatient units—A qualitative descriptive study. Nurs Open 2022; 10:3018-3027. [PMID: 36539588 PMCID: PMC10077415 DOI: 10.1002/nop2.1548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 11/18/2022] [Accepted: 11/25/2022] [Indexed: 12/24/2022] Open
Abstract
AIM This study aimed to describe the psychosocial support healthcare professionals in specialist palliative inpatient units provide to family members of palliative care patients. DESIGN A qualitative descriptive design. METHOD The data were collected with focus group interviews and analysed with inductive content analysis. RESULTS Altogether, 48 healthcare professionals, including physicians, registered nurses and practical nurses, participated in the study. Information sharing was recognised as an essential element of support. Methods to improve support of family members included an opportunity to allocate recourses to the families, systematic support and strengthening healthcare professionals' competence in family care. The healthcare professionals describe their perceptions of psychosocial support for family members primarily through patient care and the patient's situation rather than family needs. Direct support for the family members is realised principally by information sharing and conversations. Healthcare professionals express their opportunities to implement support focusing on family members' needs restricted by reason of organisational resources. The information can be used when developing and improving family care in palliative care context to recognise the most relevant needs from healthcare professionals' perspective and also when implementing healthcare professionals' education and training.
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Affiliation(s)
- Anu Soikkeli‐Jalonen
- Department of Health Sciences, Faculty of Social Sciences Tampere University Tampere Finland
| | - Kaisa Mishina
- Department of Nursing Science University of Turku Turku Finland
- Department of Child Psychiatry University of Turku Turku Finland
- INVEST Research Flagship Centre University of Turku Turku Finland
| | - Heli Virtanen
- Department of Nursing Science University of Turku Turku Finland
| | - Andreas Charalambous
- Department of Nursing Science University of Turku Turku Finland
- Cyprus University of Technology Limassol Cyprus
| | - Elina Haavisto
- Department of Health Sciences, Faculty of Social Sciences Tampere University Tampere Finland
- Satakunta Central Hospital Pori Finland
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8
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Mishina K, Kinnunen M, Heikkinen A, Saarinen S, Hinkka-Yli-Salomäki S, Sinokki A, Imberg T, Sourander A. Digital universal parent training program to promote positive parenting skills – A randomized waiting-list study. Eur Psychiatry 2022. [PMCID: PMC9567941 DOI: 10.1192/j.eurpsy.2022.1465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Introduction Parent training programs have high potential to promote positive parent-child relationships as well as reach and engage parents to participate. Digitally delivered programs may overcome the barriers associated with face-to-face interventions, such as stigma, logistic challenges and limited resources. Objectives To assess the effectiveness and feasibility of digital universal parent training program for families with 3 years-old children, focusing on parenting skills and child´s behavior. Methods A non-blinded randomized controlled trial (RCT) with two groups: (I) the intervention group, in which participants receive the parent training and (II) the waiting list group, in which participants are placed on a waiting list to receive the parent training intervention after the first follow-up measurement have been completed. Participants must meet the following inclusion criteria: a) guardians having a child age 3 years, b) participating to annual health checkup in child health clinic, c) at least one of the guardian is able to understand the languages that intervention is provided. Results Pilot study with feasibility assessment finished at early 2021. Recruitment of the wider RCT study is currently ongoing. The results from the pilot study and more detailed description about the intervention will be presented. Conclusions This study with good national geographical coverage is a unique possibility to evaluate universal parenting program on promoting parenting behaviors associated with the promotion of optimal child emotional development. This study also provides population level information about parenting skills and child´s behavior. Disclosure No significant relationships.
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Wan Mohd Yunus WMA, Kauhanen L, Sourander A, Brown JSL, Peltonen K, Mishina K, Lempinen L, Bastola K, Gilbert S, Gyllenberg D. Registered psychiatric service use, self-harm and suicides of children and young people aged 0-24 before and during the COVID-19 pandemic: a systematic review. Child Adolesc Psychiatry Ment Health 2022; 16:15. [PMID: 35216630 PMCID: PMC8874300 DOI: 10.1186/s13034-022-00452-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 02/11/2022] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has impacted on psychiatric symptoms of children and young people, but many psychiatric services have been disrupted. It is unclear how service use, self-harm and suicide has changed since the pandemic started. To gain timely information, this systematic review focused on studies based on administrative data that compared psychiatric service use, self-harm and suicide before and during the pandemic among children and young people. METHODS AND FINDING A systematic review of studies published in English from 1 January 2020 to 22 March 2021 was conducted, using the Web of Science, PubMed, Embase and PsycINFO databases. Increases or reductions in service use were calculated and compared using percentages. Of the 2,676 papers retrieved, 18 were eligible for the review and they provided data from 19 countries and regions. Most studies assessed changes during the early phase of the COVID-19 pandemic, from March to July 2020, and three assessed the changes until October 2020. Fifteen studies reported a total of 21 service use outcomes that were quantitively examined. More than three-quarters of the 21 outcomes (81%) fell by 5-80% (mean reduction = 27.9%, SD = 35%). Ten of the 20 outcomes for psychiatric emergency department (ED) services reduced by 5% to 80% (mean = 40.1%, SD = 34.9%) during the pandemic. Reductions in service use were also recorded for ED visits due to suicide ideation and self-harm, referrals to secondary mental health services, psychiatric inpatient unit admissions and patients receiving treatment for eating disorders. However, there were also some increases. Suicide rate and the number of ED visits due to suicide attempts have increased, and there was an increase in the number of treatment sessions in a service that provided telemedicine. CONCLUSION Most of the studies showed reductions in the use of psychiatric services by children and young people during the early phase of the pandemic and this highlighted potential delays or unmet needs. Suicide rate has increased during the second wave of the pandemic. Further studies are needed to assess the pattern of service use in the later phases of the COVID-19 pandemic.
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Affiliation(s)
- Wan Mohd Azam Wan Mohd Yunus
- grid.1374.10000 0001 2097 1371Research Centre for Child Psychiatry, Department of Child Psychiatry, University of Turku, Lemminkäinenkatu 3, 3rd. floor, 20014 Turku, Finland ,grid.1374.10000 0001 2097 1371INVEST Research Flagship, University of Turku, Turku, Finland ,grid.410877.d0000 0001 2296 1505Department of Psychology, Faculty of Social Sciences and Humanities, Universiti Teknologi Malaysia, Johor Bahru, Johor Malaysia
| | - Laura Kauhanen
- grid.1374.10000 0001 2097 1371Research Centre for Child Psychiatry, Department of Child Psychiatry, University of Turku, Lemminkäinenkatu 3, 3rd. floor, 20014 Turku, Finland
| | - Andre Sourander
- grid.1374.10000 0001 2097 1371Research Centre for Child Psychiatry, Department of Child Psychiatry, University of Turku, Lemminkäinenkatu 3, 3rd. floor, 20014 Turku, Finland ,grid.1374.10000 0001 2097 1371INVEST Research Flagship, University of Turku, Turku, Finland ,grid.410552.70000 0004 0628 215XDepartment of Child Psychiatry, Turku University Hospital, Turku, Finland
| | - June S. L. Brown
- grid.13097.3c0000 0001 2322 6764Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King’s College London, London, England, UK
| | - Kirsi Peltonen
- grid.1374.10000 0001 2097 1371Research Centre for Child Psychiatry, Department of Child Psychiatry, University of Turku, Lemminkäinenkatu 3, 3rd. floor, 20014 Turku, Finland ,grid.1374.10000 0001 2097 1371INVEST Research Flagship, University of Turku, Turku, Finland
| | - Kaisa Mishina
- grid.1374.10000 0001 2097 1371Research Centre for Child Psychiatry, Department of Child Psychiatry, University of Turku, Lemminkäinenkatu 3, 3rd. floor, 20014 Turku, Finland ,grid.1374.10000 0001 2097 1371INVEST Research Flagship, University of Turku, Turku, Finland
| | - Lotta Lempinen
- grid.1374.10000 0001 2097 1371Research Centre for Child Psychiatry, Department of Child Psychiatry, University of Turku, Lemminkäinenkatu 3, 3rd. floor, 20014 Turku, Finland ,grid.1374.10000 0001 2097 1371INVEST Research Flagship, University of Turku, Turku, Finland
| | - Kalpana Bastola
- grid.1374.10000 0001 2097 1371Research Centre for Child Psychiatry, Department of Child Psychiatry, University of Turku, Lemminkäinenkatu 3, 3rd. floor, 20014 Turku, Finland ,grid.502801.e0000 0001 2314 6254Unit of Health Sciences, Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Sonja Gilbert
- grid.1374.10000 0001 2097 1371Research Centre for Child Psychiatry, Department of Child Psychiatry, University of Turku, Lemminkäinenkatu 3, 3rd. floor, 20014 Turku, Finland ,grid.1374.10000 0001 2097 1371INVEST Research Flagship, University of Turku, Turku, Finland
| | - David Gyllenberg
- Research Centre for Child Psychiatry, Department of Child Psychiatry, University of Turku, Lemminkäinenkatu 3, 3rd. floor, 20014, Turku, Finland. .,INVEST Research Flagship, University of Turku, Turku, Finland. .,National Institute for Health and Welfare, Helsinki, Finland. .,Department of Adolescent Psychiatry, Helsinki University Central Hospital, Helsinki, Finland.
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10
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Kurki M, Gilbert S, Mishina K, Lempinen L, Luntamo T, Hinkka-Yli-Salomäki S, Sinokki A, Upadhyaya S, Wei Y, Sourander A. Correction to: Digital mental health literacy -program for the first-year medical students' wellbeing: a one group quasi-experimental study. BMC Med Educ 2021; 21:602. [PMID: 34872544 PMCID: PMC8650248 DOI: 10.1186/s12909-021-03031-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Affiliation(s)
- Marjo Kurki
- Department of Child Psychiatry, University of Turku, Lemminkaisenkatu 3, FI-20014, Turku, Finland.
- Finland INVEST Research Flagship, University of Turku, FI-20014, Turku, Finland.
- ITLA Children's Foundation, Porkkalankatu 24, 00180, Helsinki, Finland.
| | - Sonja Gilbert
- Department of Child Psychiatry, University of Turku, Lemminkaisenkatu 3, FI-20014, Turku, Finland
- Finland INVEST Research Flagship, University of Turku, FI-20014, Turku, Finland
| | - Kaisa Mishina
- Department of Child Psychiatry, University of Turku, Lemminkaisenkatu 3, FI-20014, Turku, Finland
- Finland INVEST Research Flagship, University of Turku, FI-20014, Turku, Finland
- Department of Nursing Science, University of Turku, Joukahaisenkatu 3-5, FI-20014, Turku, Finland
| | - Lotta Lempinen
- Department of Child Psychiatry, University of Turku, Lemminkaisenkatu 3, FI-20014, Turku, Finland
- Finland INVEST Research Flagship, University of Turku, FI-20014, Turku, Finland
| | - Terhi Luntamo
- Department of Child Psychiatry, University of Turku, Lemminkaisenkatu 3, FI-20014, Turku, Finland
- Finland INVEST Research Flagship, University of Turku, FI-20014, Turku, Finland
- Turku University Hospital, PO Box 52, 20521, Turku, Finland
| | - Susanna Hinkka-Yli-Salomäki
- Department of Child Psychiatry, University of Turku, Lemminkaisenkatu 3, FI-20014, Turku, Finland
- Finland INVEST Research Flagship, University of Turku, FI-20014, Turku, Finland
| | - Atte Sinokki
- Department of Child Psychiatry, University of Turku, Lemminkaisenkatu 3, FI-20014, Turku, Finland
- Finland INVEST Research Flagship, University of Turku, FI-20014, Turku, Finland
| | - Subina Upadhyaya
- Department of Child Psychiatry, University of Turku, Lemminkaisenkatu 3, FI-20014, Turku, Finland
- Finland INVEST Research Flagship, University of Turku, FI-20014, Turku, Finland
| | - Yifeng Wei
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, 1E1 Walter Mackenzie Health Sciences Centre (WMC), 8440 112 St NW, Edmonton, AB, T6G 2B7, Canada
| | - Andre Sourander
- Department of Child Psychiatry, University of Turku, Lemminkaisenkatu 3, FI-20014, Turku, Finland
- Finland INVEST Research Flagship, University of Turku, FI-20014, Turku, Finland
- Turku University Hospital, PO Box 52, 20521, Turku, Finland
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Kurki M, Gilbert S, Mishina K, Lempinen L, Luntamo T, Hinkka-Yli-Salomäki S, Sinokki A, Upadhyaya S, Wei Y, Sourander A. Digital mental health literacy -program for the first-year medical students' wellbeing: a one group quasi-experimental study. BMC Med Educ 2021; 21:563. [PMID: 34742258 PMCID: PMC8571980 DOI: 10.1186/s12909-021-02990-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 10/20/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Medical students are prone to mental disorders, such as depression and anxiety, and their psychological burden is mainly related to their highly demanding studies. Interventions are needed to improve medical students' mental health literacy (MHL) and wellbeing. This study assessed the digital Transitions, a MHL program for medical students that covered blended life skills and mindfulness activities. METHODOLOGY This was a one group, quasi-experimental pretest-posttest study. The study population was 374 first-year students who started attending the medical faculty at the University of Turku, Finland, in 2018-2019. Transitions was provided as an elective course and 220 students chose to attend and 182 agreed to participate in our research. Transitions included two 60-minute lectures, four weeks apart, with online self-learning material in between. The content focused on life and academic skills, stress management, positive mental health, mental health problems and disorders. It included mindfulness audiotapes. Mental health knowledge, stigma and help-seeking questionnaires were used to measure MHL. The Perceived Stress Scale and General Health Questionnaire measured the students' stress and health, respectively. A single group design, with repeated measurements of analysis of variance, was used to analyze the differences in the mean outcome scores for the 158 students who completed all three stages: the pre-test (before the first lecture), the post-test (after the second lecture) and the two-month follow-up evaluation. RESULTS The students' mean scores for mental health knowledge improved (-1.6, 95% Cl -1.9 to -1.3, P<.001) and their emotional symptoms were alleviated immediately after the program (0.5, 95% Cl 0.0 to 1.1, P=.040). The changes were maintained at the two-month follow up (-1.7, 95% Cl -2.0 to -1.4, P<.001 and 1.0, 95% Cl 0.2 to 1.8, P=.019, respectively). The students' stress levels reduced (P=.022) and their attitudes towards help-seeking improved after the program (P<.001), but these changes were not maintained at the two-month follow up. The stigma of mental illness did not change during the study (P=.13). CONCLUSIONS The digital Transitions program was easily integrated into the university curriculum and it improved the students' mental health literacy and wellbeing. The program may respond to the increasing global need for universal digital services, especially during the lockdowns due to the COVID-19 pandemic. TRIAL REGISTRATION The trial was registered at the ISRCTN registry (26 May 2021), registration number 10.1186/ ISRCTN10565335 ).
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Affiliation(s)
- Marjo Kurki
- Department of Child Psychiatry, University of Turku, Lemminkäisenkatu 3, FI-20014, Turku, Finland.
- Finland INVEST Research Flagship, University of Turku, FI-20014, Turku, Finland.
- ITLA Children's Foundation, Porkkalankatu 24, 00180, Helsinki, Finland.
| | - Sonja Gilbert
- Department of Child Psychiatry, University of Turku, Lemminkäisenkatu 3, FI-20014, Turku, Finland
- Finland INVEST Research Flagship, University of Turku, FI-20014, Turku, Finland
| | - Kaisa Mishina
- Department of Child Psychiatry, University of Turku, Lemminkäisenkatu 3, FI-20014, Turku, Finland
- Finland INVEST Research Flagship, University of Turku, FI-20014, Turku, Finland
- Department of Nursing Science, University of Turku, Joukahaisenkatu 3-5, FI-20014, Turku, Finland
| | - Lotta Lempinen
- Department of Child Psychiatry, University of Turku, Lemminkäisenkatu 3, FI-20014, Turku, Finland
- Finland INVEST Research Flagship, University of Turku, FI-20014, Turku, Finland
| | - Terhi Luntamo
- Department of Child Psychiatry, University of Turku, Lemminkäisenkatu 3, FI-20014, Turku, Finland
- Finland INVEST Research Flagship, University of Turku, FI-20014, Turku, Finland
- Turku University Hospital, PO Box 52, 20521, Turku, Finland
| | - Susanna Hinkka-Yli-Salomäki
- Department of Child Psychiatry, University of Turku, Lemminkäisenkatu 3, FI-20014, Turku, Finland
- Finland INVEST Research Flagship, University of Turku, FI-20014, Turku, Finland
| | - Atte Sinokki
- Department of Child Psychiatry, University of Turku, Lemminkäisenkatu 3, FI-20014, Turku, Finland
- Finland INVEST Research Flagship, University of Turku, FI-20014, Turku, Finland
| | - Subina Upadhyaya
- Department of Child Psychiatry, University of Turku, Lemminkäisenkatu 3, FI-20014, Turku, Finland
- Finland INVEST Research Flagship, University of Turku, FI-20014, Turku, Finland
| | - Yifeng Wei
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, 1E1 Walter Mackenzie Health Sciences Centre (WMC), 8440 112 St NW, Edmonton, AB, T6G 2B7, Canada
| | - Andre Sourander
- Department of Child Psychiatry, University of Turku, Lemminkäisenkatu 3, FI-20014, Turku, Finland
- Finland INVEST Research Flagship, University of Turku, FI-20014, Turku, Finland
- Turku University Hospital, PO Box 52, 20521, Turku, Finland
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Mori Y, Tiiri E, Khanal P, Khakurel J, Mishina K, Sourander A. Feeling Unsafe at School and Associated Mental Health Difficulties among Children and Adolescents: A Systematic Review. Children (Basel) 2021; 8:children8030232. [PMID: 33802967 PMCID: PMC8002666 DOI: 10.3390/children8030232] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 03/09/2021] [Accepted: 03/11/2021] [Indexed: 11/16/2022]
Abstract
This study systematically reviewed the literature on perceived school safety. We investigated the prevalence, factors and associated mental health difficulties, as well as cross-cultural findings. Five databases were searched up to 9 February 2021 for peer-reviewed papers published in English. We included quantitative studies that explored the perception of school safety among children and adolescents. The reference lists of the selected papers were also searched. We conducted a narrative synthesis of the included studies. The review included 43 papers. The mean prevalence of the students who felt unsafe at school was 19.4% and ranged from 6.1% to 69.1%. Their perceived safety was associated with a wide range of personal, school, and social factors. Not feeling safe at school was related to being victimized and mental health difficulties, including depressive symptoms and suicidal behavior. Higher perceived school safety was associated with measures such as the presence of a security officer and fair school rule enforcement. The results showed the lack of cross-cultural studies on perceived school safety. Empirical studies are needed that examine the mechanisms of school safety, using valid measures. A clear definition of school safety should be considered a key aspect of future studies.
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Affiliation(s)
- Yuko Mori
- Department of Child Psychiatry, University of Turku, 20014 Turun Yliopisto, Finland; (P.K.); (J.K.); (K.M.)
- INVEST Research Flagship Center, University of Turku, 20014 Turun Yliopisto, Finland; (E.T.); (A.S.)
- Correspondence:
| | - Elina Tiiri
- INVEST Research Flagship Center, University of Turku, 20014 Turun Yliopisto, Finland; (E.T.); (A.S.)
- Department of Child Psychiatry, University of Turku and Turku University Hospital, 20521 Turku, Finland
| | - Prakash Khanal
- Department of Child Psychiatry, University of Turku, 20014 Turun Yliopisto, Finland; (P.K.); (J.K.); (K.M.)
- INVEST Research Flagship Center, University of Turku, 20014 Turun Yliopisto, Finland; (E.T.); (A.S.)
| | - Jayden Khakurel
- Department of Child Psychiatry, University of Turku, 20014 Turun Yliopisto, Finland; (P.K.); (J.K.); (K.M.)
- INVEST Research Flagship Center, University of Turku, 20014 Turun Yliopisto, Finland; (E.T.); (A.S.)
| | - Kaisa Mishina
- Department of Child Psychiatry, University of Turku, 20014 Turun Yliopisto, Finland; (P.K.); (J.K.); (K.M.)
- INVEST Research Flagship Center, University of Turku, 20014 Turun Yliopisto, Finland; (E.T.); (A.S.)
- Department of Nursing Science, University of Turku, 20014 Turun Yliopisto, Finland
| | - Andre Sourander
- INVEST Research Flagship Center, University of Turku, 20014 Turun Yliopisto, Finland; (E.T.); (A.S.)
- Department of Child Psychiatry, University of Turku and Turku University Hospital, 20521 Turku, Finland
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Soikkeli-Jalonen A, Mishina K, Virtanen H, Charalambous A, Haavisto E. Supportive interventions for family members of very seriously ill patients in inpatient care: A systematic review. J Clin Nurs 2021; 30:2179-2201. [PMID: 33616267 DOI: 10.1111/jocn.15725] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 07/27/2020] [Revised: 12/19/2020] [Accepted: 02/18/2021] [Indexed: 01/10/2023]
Abstract
AIMS AND OBJECTIVES To systematically review existing literature exploring supportive interventions for family members of very seriously ill patients in inpatient care. BACKGROUND Being around a patient with a very serious illness in inpatient care setting is stressful and burdensome for family members. There is little information available on interventions that support family members of very seriously ill patients in inpatient care. DESIGN A systematic review. METHODS The literature review was conducted in May 2020 using four databases: PubMed (Medline), CINAHL, PsycINFO and Cochrane. A quality assessment was performed using the Quality Assessment Tool for Before-After (Pre-Post) Studies With No Control Group by the National Heart, Lung, and Blood Institute. The PRISMA checklist was used to support specific reporting and the TIDieR checklist to form detailed descriptions of the interventions. RESULTS Of the 7165 identified studies, 11 studies were included in the review based on predetermined criteria. Interventions were based on meetings with family members, education or therapy. Mindfulness- and therapy-based interventions and multiple-session tailored interventions showed beneficial outcomes for psychological symptoms and educational interventions on preparedness and self-efficacy. Several different measuring instruments to evaluate similar outcomes, such as psychological symptoms and coping, were used. CONCLUSIONS Only a few supportive interventions for family members of very seriously ill patients in inpatient care were found, which made comparing the differences in the varying study methods and outcomes difficult. More studies on supportive interventions and their feasibility and effectiveness are essential. Further evaluation of instruments is necessary to identify the most valid and reliable ways of measuring symptoms and coping. RELEVANCE TO CLINICAL PRACTICE The results of this study can be used in clinical practice when selecting effective interventions or assessing family members' need for support. Additionally, the results can be used for guidance when developing new, effective interventions.
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Affiliation(s)
| | - Kaisa Mishina
- Department of Nursing Science, University of Turku, Turku, Finland.,Department of Child Psychiatry, University of Turku, Turku, Finland
| | - Heli Virtanen
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Andreas Charalambous
- Cyprus University of Technology, Limassol, Cyprus.,Department of Nursing Science, University of Turku, Turku, Finland
| | - Elina Haavisto
- Department of Nursing Science, University of Turku, Turku, Finland.,Satakunta Central Hospital, Pori, Finland
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Tiiri E, Luntamo T, Mishina K, Sillanmäki L, Brunstein Klomek A, Sourander A. Did Bullying Victimization Decrease After Nationwide School-Based Antibullying Program? A Time-Trend Study. J Am Acad Child Adolesc Psychiatry 2020; 59:531-540. [PMID: 30951802 DOI: 10.1016/j.jaac.2019.03.023] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 03/11/2019] [Accepted: 03/27/2019] [Indexed: 10/27/2022]
Abstract
OBJECTIVE We assessed changes in traditional and cyberbullying victimization, and their associations with mental health, before and after the introduction of a nationwide antibullying program in Finnish schools in 2009. METHOD This time-trend assessment comprised two methodologically identical cross-sectional survey studies, with 2,061 adolescents in 2008 (response rate 90.2%) and 1,936 in 2014 (91.8%). Their mean age was 14.4 years. They completed questionnaires about traditional and cyberbullying, mental health, and perceptions of school safety. Odds ratios (OR) and 95% CIs are presented with 2008 as the reference year. RESULTS From 2008 to 2014, traditional victimization decreased from 28.9% to 19.1% (odds ratio [OR] = 0.5, 95% CI = 0.4-0.7) among boys and from 23.2% to 17.4% (OR = 0.7, 95% CI = 0.6-0.9) among girls. Cyberbullying victimization remained fairly stable at 3.3% and 3.0% (OR = 0.7, 95% CI = 0.4-1.2) for boys and at 2.7% and 4.1% (OR = 1.4, 95% CI = 0.9-2.4) for girls. Combined traditional and cyberbullying victimization decreased from 6.1% to 3.9% (OR = 0.5, 95% CI = 0.4-0.8) among boys and from 7.5% to 6.7% (OR = 0.8, 95% CI = 0.6-1.2) among girls. Those experiencing both traditional and cyberbullying reported the highest mental health problems. Perceived school safety improved among boys, but not among girls. Both boys and girls reported greater efforts by teachers and fellow students to stop bullying. CONCLUSION Combined traditional and cyberbullying victimization was an indicator of comorbid mental health problems. Interventions that target both types of bullying, and that are integrated with mental health promotion, are needed.
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Affiliation(s)
- Elina Tiiri
- Faculty of Medicine, University of Turku, Finland; Turku University Hospital, Turku, Finland.
| | | | | | | | - Anat Brunstein Klomek
- Baruch Ivcher School of Psychology, Interdisciplinary Center (IDC), Herzlyia, Israel
| | - Andre Sourander
- Faculty of Medicine, University of Turku, Finland; Turku University Hospital, Turku, Finland; INVEST Research Flagship, University of Turku, Finland
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Ristkari T, Mishina K, Lehtola MM, Sourander A, Kurki M. Public health nurses' experiences of assessing disruptive behaviour in children and supporting the use of an Internet-based parent training programme. Scand J Caring Sci 2019; 34:420-427. [PMID: 31487074 PMCID: PMC7328683 DOI: 10.1111/scs.12744] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Accepted: 07/23/2019] [Indexed: 01/12/2023]
Abstract
BACKGROUND In Finland, although families generally receive support from child health clinics, some need more help in dealing with their child's emotions, behaviour and psychosocial development. Public health nurses play a central role in providing vital psychosocial support for families, but they often lack the confidence and competence to tackle mental health problems. AIM To describe how public health nurses used and experienced a working model that combined a psychosocial tool (Strengths and Difficulties Questionnaire, SDQ) to identify disruptive behaviour in four-year-old children and an Internet-based parent training programme with telephone coaching. METHODS This is a descriptive, cross-sectional survey study. The sample consists of public health nurses (n = 138) who were working in child health clinics in Finland that had used the working model. Statistical data were analysed using SPSS Statistics for Windows. The responses to an open-ended question were analysed using inductive content analysis. RESULTS The experiences about the working model were mainly positive. The public health nurses felt that the psychosocial tool, the SDQ, was easy and suitable to use in child health clinics. The availability of an Internet-based parent training programme provided greater support for parents by overcoming practical barriers. Overall, the working model helped nurses to develop their mental health competencies. CONCLUSION Within primary care, the need to tackle psychosocial problems is increasing, and for this, public health nurses need extra support and tools. It seems that the working model, including the SDQ and the online and telephone coaching programme, worked well in child health clinics. This working model can be used to provide parental support and improve nurses' mental health competencies.
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Affiliation(s)
- Terja Ristkari
- Department of Child Psychiatry, University of Turku, Turku, Finland.,Turku University Hospital, Turku, Finland
| | - Kaisa Mishina
- Department of Child Psychiatry, University of Turku, Turku, Finland.,Department of Nursing Science, University of Turku, Turku, Finland
| | | | - Andre Sourander
- Department of Child Psychiatry, University of Turku, Turku, Finland.,Turku University Hospital, Turku, Finland.,INVEST Research Flagship, University of Turku, Turku, Finland
| | - Marjo Kurki
- Department of Child Psychiatry, University of Turku, Turku, Finland
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16
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Mishina K, Tiiri E, Lempinen L, Sillanmäki L, Kronström K, Sourander A. Time trends of Finnish adolescents' mental health and use of alcohol and cigarettes from 1998 to 2014. Eur Child Adolesc Psychiatry 2018; 27:1633-1643. [PMID: 29704065 DOI: 10.1007/s00787-018-1158-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Accepted: 04/18/2018] [Indexed: 11/26/2022]
Abstract
This study reports time-trend changes in self-reported mental health problems, smoking, and alcohol habits among Finnish adolescents over a 16-year period using three cross-sectional studies with similar designs, methodologies, and geographical recruitment areas. There were 4508 participants with a mean age of 14.4 years (range 13-18) in 1998 (n = 1449), 2008 (n = 1560), and 2014 (n = 1499). The information they provided on their mental health was measured with the Strengths and Difficulties Questionnaire and they were also asked questions about their alcohol and smoking habits. The findings showed that from 1998 to 2014 females reported less hyperactivity and conduct problems and males reported fewer peer problems and better prosocial skills. The only mental health problem that showed a significant increase was emotional symptoms among females. Smoking and alcohol use consistently decreased in males and females during the 16-year period. Our findings suggest that overall adolescent's self-reported mental health problems were either stable or falling, indicating increased well-being. The decreased smoking indicates that anti-smoking campaigns have been successfully changing teenagers' attitudes towards smoking. The important finding is that self-reported emotional symptoms had increased in females. This may indicate an increase or earlier onset of affective disorders.
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Affiliation(s)
- Kaisa Mishina
- Department of Child Psychiatry, University of Turku, Lemminkäisenkatu 3/Teutori, 20014, Turku, Finland
| | - Elina Tiiri
- Department of Child Psychiatry, University of Turku, Lemminkäisenkatu 3/Teutori, 20014, Turku, Finland
- Turku University Hospital, Kiinamyllynkatu 4-8, 20521, Turku, Finland
| | - Lotta Lempinen
- Department of Child Psychiatry, University of Turku, Lemminkäisenkatu 3/Teutori, 20014, Turku, Finland
| | - Lauri Sillanmäki
- Department of Child Psychiatry, University of Turku, Lemminkäisenkatu 3/Teutori, 20014, Turku, Finland
| | - Kim Kronström
- Turku University Hospital, Kiinamyllynkatu 4-8, 20521, Turku, Finland
| | - Andre Sourander
- Department of Child Psychiatry, University of Turku, Lemminkäisenkatu 3/Teutori, 20014, Turku, Finland.
- Turku University Hospital, Kiinamyllynkatu 4-8, 20521, Turku, Finland.
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17
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Välimäki M, Mishina K, Kaakinen JK, Holm SK, Vahlo J, Kirjonen M, Pekurinen V, Tenovuo O, Korkeila J, Hämäläinen H, Sarajuuri J, Rantanen P, Orenius T, Koponen A. Digital Gaming for Improving the Functioning of People With Traumatic Brain Injury: Randomized Clinical Feasibility Study. J Med Internet Res 2018; 20:e77. [PMID: 29555622 PMCID: PMC5881042 DOI: 10.2196/jmir.7618] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Revised: 11/15/2017] [Accepted: 01/02/2018] [Indexed: 11/13/2022] Open
Abstract
Background Traumatic brain injury (TBI) is a major health problem that often requires intensive and long-term rehabilitation. Objective The aim of this study was to determine whether rehabilitative digital gaming facilitates cognitive functioning and general well-being in people with TBI. Methods A total of 90 Finnish-speaking adults with TBI (18-65 years) were recruited from an outpatient neuroscience clinic. The participants were randomly allocated to one of the three groups: a rehabilitation gaming group (n=29, intervention), an entertainment gaming group (n=29, active control), or a passive control group (n=32). The gaming groups were instructed to engage in gaming for a minimum of 30 min per day for 8 weeks. Primary and secondary outcomes were measured at three time points: before the intervention, after the intervention, and 3 months following the intervention. The primary outcome was cognitive status measured by processing speed and visuomotor tasks (The Trail Making Test; Wechsler Adult Intelligence Scale-Fourth Edition, WAIS-IV, symbol search, coding, and cancellation tasks). Secondary outcomes were attention and executive functions (Simon task), working memory (WAIS-IV digit span and Paced Auditory Serial Addition Test, PASAT), depression (Patient Health Questionnaire-9), self-efficacy (General Self-efficacy Scale), and executive functions (Behavior Rating Inventory of Executive Function-Adult Version). Feasibility information was assessed (acceptability, measurement instruments filled, dropouts, adherence, usability, satisfaction, and possible future use). Cognitive measurements were conducted in face-to-face interviews by trained psychologists, and questionnaires were self-administered. Results The effects of rehabilitation gaming did not significantly differ from the effects of entertainment gaming or being in a passive control group. For primary outcomes and PASAT tests, the participants in all three groups showed overall improvement in test scores across the three measurement points. However, depression scores increased significantly between baseline and after 8 weeks and between baseline and after 3 months in the rehabilitative gaming group. No differences were found in patients’ self-efficacy between the three measuring points in any of the groups. Participants did use the games (rehabilitation group: 93%, 27/29; entertainment group 100%, 29/29). Games were seen as a usable intervention (rehabilitation group: 70%, 14/29; entertainment group: 83%, 20/29). The rehabilitation group was less satisfied with the gaming intervention (68%, 13/29 vs 83%, 20/29), but they were more willing to use the game after the intervention period (76%, 16/29 vs 63%, 15/29). Total time spent on gaming during the intervention period was low (15.22 hour rehabilitation gaming group, 19.22 hour entertainment gaming group). Conclusions We did not find differences between the groups in improvement in the outcome measures. The improvements in test performance by all three groups may reflect rehearsal effects. Entertainment gaming had elements that could be considered when rehabilitative games are designed for, implemented in, and assessed in larger clinical trials for persons with TBI. Trial Registration ClinicalTrials.gov NCT02425527; https://clinicaltrials.gov/ct2/show/NCT02425527 (Archived by WebCite at http://www.webcitation.org/6esKI1uDH)
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Affiliation(s)
- Maritta Välimäki
- Department of Nursing Science, Faculty of Medicine, University of Turku, Turku, Finland.,Turku University Hospital, Turku, Finland.,School of Nursing, Hong Kong Polytechnic University, Hong Kong, China (Hong Kong)
| | - Kaisa Mishina
- Department of Nursing Science, Faculty of Medicine, University of Turku, Turku, Finland
| | - Johanna K Kaakinen
- Department of Psychology, Faculty of Social Sciences, University of Turku, Turku, Finland
| | - Suvi K Holm
- Department of Psychology, Faculty of Social Sciences, University of Turku, Turku, Finland
| | - Jukka Vahlo
- Turku School of Economics, Centre for Collaborative Research, University of Turku, Turku, Finland
| | - Markus Kirjonen
- Department of Psychology, Faculty of Social Sciences, University of Turku, Turku, Finland
| | - Virve Pekurinen
- Department of Nursing Science, Faculty of Medicine, University of Turku, Turku, Finland
| | - Olli Tenovuo
- Division of Clinical Neurosciences, Turku University Hospital, Turku, Finland.,Faculty of Medicine, University of Turku, Turku, Finland
| | - Jyrki Korkeila
- Faculty of Medicine, University of Turku, Turku, Finland.,Psychiatric Care Division, Satakunta Hospital District, Harjavalta, Finland
| | - Heikki Hämäläinen
- Department of Psychology, Faculty of Social Sciences, University of Turku, Turku, Finland
| | | | | | - Tage Orenius
- Orton Orthopaedic Hospital, Orton, Helsinki, Finland
| | - Aki Koponen
- Turku School of Economics, Centre for Collaborative Research, University of Turku, Turku, Finland
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Murakawa K, Mishina K, Yamamoto M, Nemoto F, Ashida M. [Reevaluation of ambulatory nursing--a support of continuity of nursing. Communication among the self-care ward, general ward, ambulatory section, and the local area outside the hospital: a communication system using patient transfer cards]. Kangogaku Zasshi 1988; 52:870-6. [PMID: 3204788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Farrell DL, Worth RM, Mishina K. Utilization and cost effectiveness of a family practice center. J Fam Pract 1982; 15:957-962. [PMID: 6813421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
In a prepaid group practice setting, a group of 45 Family Practice Center patients, carefully matched by age, sex, and employment, were compared with a group of 63 patients attending medical and pediatric clinics. Utilization rates for physician and nonphysician visits and costs of laboratory and x-ray services during a period of 33 months were examined. Despite a 25 percent greater prevalence of significant chronic medical problems, the family practice group used specialist care less than one half as much as did the matching group and made one extra physician visit per patient per year. Costs for laboratory and x-ray procedures did not differ significantly. Satisfaction expressed in responses to telephone interviews of both groups was found to be somewhat greater among the family practice patients. The findings of this study provide some support for greater cost effectiveness and patient satisfaction of family practice compared with alternative modes of primary care.
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Mishina K, Hariu T, Shiojima S. [Limitation of intravenous cholangiography]. Rinsho Hoshasen 1974; 19:859-65. [PMID: 4475199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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