Biomedical subjects

Jouko Katajisto

Publications and source records attributed to Jouko Katajisto.

11 recordsLinked to original sources

PubMed2006

Empowering orthopaedic patients through preadmission education: results from a clinical study.

OBJECTIVE: To determine whether it is possible to increase patients' knowledge and certainty about care-related issues, to reach a more empowering learning experience and to exercise a more positive impact on selected clinical outcomes by means of additional preadmission education (education using the concept map method added to standard preadmission education) than by means of standard preadmission education (written educational material with non-systematic oral education). METHODS: Elective hip arthroplasty patients were randomized into group A (n=62), who received preadmission education using the concept map method with written educational material; and group B (n=61), who received the written educational material and non-systematic oral education. Data were collected from both groups 4 weeks prior to hospital admission, at admission and at discharge using questionnaires. RESULTS: In the first post-test at admission, group A had significantly better knowledge and certainty of care-related issues than group B. Group A also reported a significantly more positive learning experience than patients in group B. In the second post-test at discharge, patients in group A still had better knowledge and certainty of care-related issues than patients in group B. CONCLUSION: Preadmission education using the concept map method and written educational material seems to yield better learning results than the use of written educational material with non-systematic oral education. PRACTICE IMPLICATIONS: Empowering preadmission education using the concept map method is beneficial for patients.

Adaptation, Psychological↗

PubMed2006

Provision of individualised care improves hospital patient outcomes: an explanatory model using LISREL.

BACKGROUND: Previous studies propose the efficacy of individualised care for hospital patients. Individualised care and proposed correlates have not been tested by means of a single multivariate analyses simultaneously. OBJECTIVES: The aim of this study is to examine predicted relationships between individualised care and patient satisfaction, patient autonomy and health-related quality of life. DESIGN: A cross-sectional correlational survey. SETTINGS: This study was carried out in six acute hospitals in Southern Finland. PARTICIPANTS: A sample of 861 (response rate 84%) pre-discharged hospitalised adult patients were recruited from surgical, gynaecological and internal medicine units. METHODS: A correlational survey design was used to investigate to complete a battery of instruments measuring individualised care (the ICS), patient satisfaction with nursing care (the PSS), patient autonomy and perceived health-related quality of life (the 15D). The data from these instruments were used to test the proposed model using LISREL implementing the Maximum Likelihood estimation procedure. RESULTS: The findings support the proposed model linking individualised nursing care directly to the positive patient outcomes defined. The initial model, permitting all possible covariances, showed a good fit between the variables. Independent variables, supported individuality through nursing interventions (ICS-A) and perception of individuality in their own care (ICS-B) accounted for 58% of the variance in the frequency of individualised care. Individualised care explained the variance on the dependent variables patient satisfaction and patient autonomy. A low but significant association was also found between individualised care and perceived health-related quality of life. CONCLUSIONS: The results of this study highlight the contribution of individualised nursing care to positive patient outcomes, such as patient satisfaction, patient autonomy and perceived health-related quality of life. Not only clinically important, this model also has implications for further research into individualised care and its relationship with positive patient outcomes.

Adult↗

PubMed2006

Patient satisfaction with psychiatric inpatient care.

AIM: This paper reports a study of psychiatric inpatient satisfaction with care in one Finnish psychiatric hospital, and explores the factors associated with satisfaction. BACKGROUND: Patient satisfaction is a central indicator for healthcare quality. Previous literature has shown that psychiatric inpatients are quite satisfied with their care in general, but have reported dissatisfaction in the areas of information access and compulsory care. Changes in the structure of Finnish mental health services due to dehospitalization have increased interest in exploring psychiatric patients' treatment experiences and general satisfaction. METHOD: Data were collected in inpatient settings using a self-rating patient satisfaction questionnaire. A total of 316 patients leaving the study units during a 1-year period (May 2000-April 2001) was recruited. The response rate was 61% (n = 313). FINDINGS: In general, patients were quite satisfied with their care. Of seven different satisfaction areas, they were most satisfied with staff-patient relationships, and reported most dissatisfaction in the areas of information, restrictions, compulsory care and ward atmosphere/physical milieu. Younger and female patients were less satisfied with staff-patient relationships than older patients and men. manova (five factors, main effects and two-way interactions in the model) showed that male patients with occasional symptoms or symptoms persisting for less than a month were more satisfied with staff than were women. Further, when symptoms persisted for a month or up to 1 year or more, women were more satisfied with staff than men. CONCLUSION: General patient satisfaction in psychiatric hospital care was good. However, more innovative methods for improvement in the areas of dissatisfaction need to be developed. Special attention should be paid to collaboration with young adults (18-24 years) and female patients with mental health problems of short duration.

Adolescent↗

PubMed2005

Preoperative education for orthopaedic patients: systematic review.

AIMS: This paper presents a systematic review whose aim was to describe the scope and methods of the current literature on preoperative patient education and to identify the effects of this education. BACKGROUND: Preoperative patient education is a common and important intervention in surgical nursing, yet there is very limited systematic evidence on its precise role. METHODS: The Medline, CINAHL, Eric, Psycinfo and Social Sciences Index databases and the Cochrane Library were searched, covering the period from the beginning of each database to April 2003. Studies were included if they concerned adult orthopaedic patients, preoperative nursing patient education and were based on randomized controlled or clinical trials. Meta-analysis was carried out where appropriate. RESULTS: We identified 11 articles involving 1044 participants. Most studies included one experimental and one control group; only two had more than one experimental and control group. The educational interventions varied widely, but the majority were based on written materials alone, or written materials in combination with other teaching methods. The most common outcome measures related to pain, knowledge, anxiety, exercises and length of stay, and the least common to self-efficacy and empowerment. The methodological quality of the studies varied. Almost all reported one or more statistically significant effects. Based on the findings of the meta-analysis, preoperative education appears to have some impacts on patients' anxiety and knowledge levels. CONCLUSIONS: The review clearly highlights the need for well-designed, methodologically sound research into the outcomes of patient education. It also points to the need to study patient education from the point of view of empowerment.

Anxiety↗

PubMed2004

Written orthopedic patient education materials from the point of view of empowerment by education.

Written patient education materials are one way of supporting patient empowerment. The aim of this study was to evaluate written orthopedic patient education materials (n = 25) drawn from a university hospital's electronic databank. In the absence of suitable tools for evaluation, an analytic framework was developed by a panel of nursing scientists and clinical experts. The materials were evaluated from the point of view of empowerment by their external appearance, content and instructiveness. In terms of their external appearance the materials were well prepared, but much was left to be desired with regard to contents and instructiveness. Development needs to focus on making better use of methods of visual representation, on increasing the coverage of content areas that so far have received less attention, like social, experiential, ethical and financial empowerment, and on providing a more focused perspective on the patient.

Attitude to Health↗

PubMed2004

Sense of coherence among unemployed nurses.

AIMS: This paper reports a study assessing Finnish unemployed nurses' sense of coherence and the factors relating to it. BACKGROUND: During the 1990s, due to the widespread economic downturn in Finland, the nursing profession suffered from a high level of unemployment. Previous research has clearly indicated that unemployment is detrimental to health. It creates stress by disturbing a person's sense of identity and self-esteem and by disrupting social networks. In Finland, many studies have been conducted on the impact of unemployment, but have not examined the sense of coherence of unemployed nurses. METHODS: Data were collected in one Employment and Economic Development Centre area in Finland in 1998. Structured questionnaires were used to collect data among Finnish unemployed nurses (n = 183), and included the General Health Questionnaire, measuring nurses' mental health; socio-demographic questions; and the 13-item version of the Sense of Coherence scale based on Antonovsky's salutogenic model to measure sense of coherence. RESULTS: Although the majority of unemployed nurses had a strong sense of coherence, many felt that during their period of unemployed they did not feel at ease, did not know what to do and had a sense of being unfairly treated. Daily household chores, on the whole, were perceived as meaningful. Income and the state of mental health were positively correlated with nurses' sense of coherence: the better the family income and state of mental health, the stronger was their sense of coherence. Because of the low response rate (less than 50%), the results might be skewed by those whose higher sense of coherence made them more motivated to complete the questionnaires. CONCLUSIONS: Many of the nurses reported low sense of coherence and poor general health. Special interventions should be designed to improve their sense of coherence and high motivation level, and to maintain their professional competence when they return to work. This kind of support may prevent further out-migration and nursing shortages from Finland and other industrialized countries.

Adaptation, Psychological↗

PubMed2004

Testing the individualized care model.

BACKGROUND: Although there has been some research to identify the dimensions on which individualized care should be measured, the indicators that constitute individualized care remain unclear. OBJECTIVES: To describe briefly the maintenance of individualized care and to test a hypothetical model of individualized care in a sample of surgical patients. DESIGN AND METHODS: A correlational survey design was used. Data were collected with questionnaires from adult patients (n = 454) discharged from surgical wards in one Finnish hospital district (response rate 91%). Structural equation modelling LISREL SIMPLIS using maximum likelihood estimation was used to estimate and test the parameters of the hypothesized model derived deductively from the previous literature. RESULTS: The goodness-of-fit statistics supported the basic solution of the Individualized Care Model, although two additional paths indicating error covariances between the sub-concepts were identified in the revised model. In this model individualized care is defined in terms of patients' views of nursing activities aimed at supporting individuality in care and in terms of perceptions of individuality in their own care. CONCLUSIONS: The model has been found to capture attributes that characterize individualized care. It can be used as a basis for evaluation in clinical nursing practice from patients' point of view. The study highlights the importance of patients' clinical situation, personal life situation and decisional control as predictors of individualized care. The results also confirm the construct validity of the previously developed Individualized Care Scale.

Analysis of Variance↗

PubMed2003

Promoting or impeding empowerment? Nurses' assessments of their work environment.

OBJECTIVE: This article reports the results of a quantitative study of individual nurses' views concerning factors promoting or impeding empowerment in healthcare organizations. BACKGROUND: Changes in healthcare have lead to the formation of ever larger units, reduced resources, and an increasing demand for efficiency. Besides having extensive professional knowledge, personnel are expected to be independent decision-makers engaged in continuous development of both themselves and their work. The leadership must be goal-directed, providing support and opportunities to the personnel. Concerns exist as to how to safeguard the attractiveness of the healthcare field in a possible future competition for potential workers and students. METHODS: The concept used as theoretical framework is empowerment, which has widely been found useful not only in developing patient care but also in education and personnel management. Data (n = 416) were collected by a questionnaire based on five categories obtained in an earlier qualitative study. RESULTS: Factors that prevented empowerment included authoritarian leadership, poor access to information, and short working periods. Factors found to increase empowerment were job satisfaction, career consciousness, further training, and commitment. Further research into the effects of personnel governance and organizational changes upon empowerment seems indicated.

Adult↗

PubMedDate not supplied

Patient characteristics in relation to perceptions of how individualized care is delivered--research into the sensitivity of the Individualized Care Scale.

The purposes of this study were to examine how hospital patients' backgrounds and clinical illness are related to their perceptions of the individualized care they receive and to test the sensitivity of the Individualized Care Scale (ICS). Cross-sectional explorative survey data were obtained using questionnaires completed by 861 (response rate = 88%) predischarge hospital patients from six hospitals in Southern Finland in 2004. Self-administered questionnaires included the ICS as well as the 15D, a measure of health-related quality of life, and gathered information about the patients' backgrounds. Based on association tests, younger age, poorer state of health, and higher level of education were associated with more critical perceptions of individualized care. Using simultaneous regression analysis and presenting the results from stronger to weaker, we found age to be the strongest predictor of patients' positive perceptions of the individualized care they received. This was followed by health-related quality of life (HRQoL) as measured by the 15D, vocational education, and type of admission. The ICS was found to be a valid tool for the measurement of individualized care in hospitals. The self-reported patient data from this survey suggest that some patient characteristics are associated with the patients' perceptions about the individualized care they receive. There is now a need to consider how these characteristics can be taken into account in nursing care delivery to increase individualized care for hospital patients. The results also support use of the ICS in the measurement of individualized care in hospitals.

Adolescent↗

PubMedDate not supplied

Do nurses feel empowered? Nurses' assessments of their own qualities and performance with regard to nurse empowerment.

Empowerment ideology has been adopted increasingly as one conceptual framework for the development of nursing care, training, and management. The present article examines a quantitative study (n = 416) on critical care, long-term care, and public health nurses' views over their personal qualities and performance in relation to an ideal model of nurse empowerment. The results obtained provide strong evidence that nurses do have a positive image of their own empowerment. There was only slight variation between different groups of nurses. Length of working history and employment status (permanent/temporary) correlated highly with empowerment. The ideal model seems to depict nurse empowerment relatively well. It might be feasible to develop these concepts further so as to obtain a tool for the enhancement of professional competence, nursing education, and personnel management.

Adult↗

PubMedDate not supplied

Nurse empowerment, job-related satisfaction, and organizational commitment.

Developing nursing care and the new technologies involved also require nurses to learn continuously and update their expertise. Attention has also been paid to the attractiveness of the profession-its ability to attract young people and retain nurses currently working in the profession. The concept of empowerment has been widely adopted in nursing research and in development of nursing care, education, and management. In the literature it has generally considered in the context of organizations' functioning and personnel management methods. In the psychological theory, used in this study, empowerment is seen as a process of personal growth and development. The qualities, values, and endeavours inherent in the individual as well as environmental factors are key factors here. The purpose of this article is to describe the results of a quantitative study (n = 416) dealing with nurse empowerment and to identify the background factors significant for its realization. Consistent with numerous previous studies, job satisfaction and organizational commitment were found to be crucial elements of nurse empowerment, too.

Adult↗