Biomedical subjects

Sanna Salanterä

Publications and source records attributed to Sanna Salanterä.

18 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

'Facilitated tucking by parents' in pain management of preterm infants-a randomized crossover trial.

BACKGROUND: There is a need for a safe and effective non-pharmacological pain management method for preterm infants. The parents could be given an active role in the pain management which may help the parents to cope with the stress related to painful situations of the infant. AIMS: To examine the effectiveness of a method called 'facilitated tucking by parents' (a parent holds the infant in a flexed position) in pain management during endotracheal/pharyngeal suctioning of preterm infants. In addition, the parental perception of the method was studied. STUDY DESIGN: A randomized crossover trial. SUBJECTS: Twenty preterm infants with one of their parents participated in the study. Infants' gestational age ranged from 24 to 33 (median 28) weeks and postnatal age from 6 to 37 days (median 15 days). OUTCOME MEASURES: The primary outcome was the Neonatal Infant Pain Scale (NIPS) score. Heart rate and oxygen saturation were recorded. Parents completed a questionnaire about their perception of the procedure. RESULTS: The highest NIPS score was median 3 (range from 2 to 6) using 'facilitated tucking by parents' and median 5 (range from 2 to 7) without tucking during suctioning (p < 0.001). The infants calmed down more quickly after 'facilitated tucking by parents' (5 s vs. 17 s, p = 0.024). Nineteen out of twenty parents preferred facilitated tucking during suctioning compared to control care. CONCLUSIONS: Facilitated tucking by parents is an effective and safe pain management method during suctioning of preterm infants. This study shows that parents can be given an active role in the pain care of their preterm infants.

Adolescent↗

PubMed2006

Children with a long-term illness: parents' experiences of care.

A diagnosis of a long-term illness in a child will bring on a major upheaval in the lives of the whole family involved and leads to a long-standing relationship with health care personnel. The purpose of this study was to describe parents' experiences with their child's illness and treatment and with their relationships with health professionals during the process of learning to care for their child. Data were collected by conducting open-ended interviews with parents (N = 11) whose child had been diagnosed with a physical long-term illness at least 1 year previously and were analyzed using qualitative content analysis. Parents' needs for information and support varied and consisted of different components in different phases of the process. During the diagnostic phase, parents were recipients of information; it was important for them to receive consistent empathetically provided information. In the next phase, parents, having gained experience of day-to-day home care, engaged in a change toward a two-way flow of information with the professionals; mutual trust was essential for the exchange of information needed for a child's proper care. Without a permanent relationship with health professionals, parents showed lack of trust in professionals' knowledge of their child's condition and care. Professionals' lack of trust in parents' expertise in their child's care was also problematic. Health professionals should lay the groundwork for a partnership in which both parties acknowledge each other's competencies; parents' needs ought to be continuously reassessed. A permanent relationship between families and health care personnel is required to achieve this.

Adaptation, Psychological↗

PubMed2006

Ketoprofen and tramadol for analgesia during early recovery after tonsillectomy in children.

BACKGROUND: Pain following tonsillectomy is often intense. Nonsteroidal anti-inflammatory drugs and opioids are effective, but both can cause adverse effects. Tramadol may be a viable alternative for post-tonsillectomy pain. This study was designed to compare the analgesic effects of ketoprofen and tramadol during the early recovery period after tonsillectomy. METHODS: Forty-five ASA class I children (9-15 years) were randomized to receive either saline, ketoprofen (2 mg.kg(-1)) or tramadol (1 mg.kg(-1)) after induction of anesthesia. Upon completion of surgery, the study treatment was continued as a 6 h intravenous (i.v.) infusion of another dose of saline, ketoprofen (2 mg.kg(-1)) or tramadol (1 mg.kg(-1)). Postoperatively, each patient received rescue analgesia with patient-controlled analgesia (PCA) device programmed to deliver 0.5 microg.kg(-1) bolus doses of fentanyl. Postoperative pain was assessed using Visual Analog Scale (VAS) during swallowing. Intraoperative blood loss was measured. RESULTS: The total number of requests of PCA-fentanyl was significantly less in ketoprofen group compared with tramadol and placebo groups (P = 0.035 and P = 0.049, respectively, in pairwise comparisons) and the VAS scores for pain were significantly lower in ketoprofen group compared with tramadol (P = 0.044) or placebo groups (P = 0.018) during the first six postoperative hours. Measured intraoperative blood loss was greater in ketoprofen-treated patients than in those receiving placebo (P = 0.029). CONCLUSION: A dose of 4 mg.kg(-1) of i.v. ketoprofen provided good pain relief with moderate supplemental PCA-fentanyl requirements during the first six postoperative hours after tonsillectomy in children whereas the effects of 2 mg.kg(-1) of i.v. tramadol did not differ from those of placebo.

Adolescent↗

PubMed2006

Nursing advocacy: how is it defined by patients and nurses, what does it involve and how is it experienced?

UNLABELLED: THE STUDY'S RATIONALE: Advocacy is an integral part of nursing. However, there is a scarcity of empirical evidence on nursing advocacy process and most of that evidence concerns nurses' views on the care of certain vulnerable patient groups in acute care settings. Before nursing practice can truly adopt advocacy as an inherent and natural part of nursing, a clearer understanding is needed of how it is defined and what activities are needed to accomplish advocacy. AIMS AND OBJECTIVES: The aim was to describe the way that nursing advocacy is defined, the activities through which nursing advocacy is accomplished and the way that nursing advocacy is experienced by patients and nurses. METHODOLOGICAL DESIGN AND JUSTIFICATION: Based on a qualitative approach, the study was limited to adult patients experiencing procedural pain in somatic care. Interviews were conducted in a convenience sample of patients (n = 22) and nurses (n = 21) from four medical and four surgical wards in Finland. A qualitative content analysis of the tape-recorded data was then carried out. ETHICAL ISSUES AND APPROVAL: The appropriate ethical principles were followed. All the participants gave their informed consent and formal approval for conducting the research was obtained according to national and local directives. RESULTS: Nursing advocacy seems to integrate aspects of individuality, professionalism and experiences of empowering, exceptional care. It is not a single event, but a process of analysing, counselling, responding, shielding and whistleblowing activities in clinical nursing practice. CONCLUSIONS: In nursing practice the abstract concept of nursing advocacy finds expression in voicing responsiveness, which integrates an acknowledged professional responsibility for and active involvement in supporting patients' needs and wishes.

Adult↗

PubMed2006

Theoretical considerations of ethics in text mining of nursing documents.

This paper discusses theoretical considerations of ethics in building and using a text mining application in nursing documentation. Nursing documentation is based on the process of gathering information from the patient, setting goals for care, documenting nursing interventions and evaluating delivered nursing care. Privacy-sensitive health care documentation brings specific ethical concerns and difficulties that one needs to be aware of and conform to when developing and using text mining tools in electronic patient records. We discuss how patient confidentiality can be ensured in this domain and how text mining might support nurses to give better and more efficient care for their patients. Our conclusion is that text mining of nursing documents holds the promise of great benefits when the potential risks are taken into consideration.

Confidentiality↗

PubMed2006

How to structure an empowering patient education program for internet.

There is a lot of health related information in the Internet. However a little is known about the quality of that. The purpose of this study is to analyze the structure and the applicability of the empowering internet based ambulatory surgery patients' education program. The education material was created and tested for this study. The structure is evaluated with structure analysis and applicability with AWStats-counter program and a survey. The evaluation of the program's structure and applicability, gives feedback about the usability of the program and helps to create criteria for a useable structure of the patients' education program.

Finland↗

PubMed2006

Towards automated classification of intensive care nursing narratives.

Nursing narratives are an important part of patient documentation, but the possibilities to utilize them in the direct care process are limited due to the lack of proper tools. One solution to facilitate the utilization of narrative data could be to classify them according to their content. In this paper, we addressed two issues related to designing an automated classifier: domain experts' agreement on the content of the classes into which the data are to be classified, and the ability of the machine-learning algorithm to perform the classification on an acceptable level. The data we used were a set of Finnish intensive care nursing narratives. By using Cohen's kappa, we assessed the agreement of three nurses on the content of the classes Breathing, Blood Circulation and Pain, and by using the area under ROC curve (AUC), we measured the ability of the Least Squares Support Vector Machine (LS-SVM) algorithm to learn the classification patterns of the nurses. On average, the values of kappa were around 0.8. The agreement was highest in the class Blood Circulation, and lowest in the class Breathing. The LS-SVM algorithm was able to learn the classification patterns of the three nurses on an acceptable level; the values of AUC were generally around 0.85. Our results indicate that one way to develop electronic patient records could be tools that handle the free text in nursing documentation.

Algorithms↗

PubMed2005

Developing terminology for documenting perioperative nursing interventions.

OBJECTIVE: To develop terminology for documenting perioperative nursing interventions. METHOD: Nursing documentation of 250 patients was explored by content analysis. The study was conducted to validate further the Perioperative Nursing Data Set (PNDS) in Finland. The data included 3442 terms that were clustered into 104 nursing interventions. A Delphi-panel (N=5) evaluated the relevance of each term on a scale from 1 to 4. The structure of each nursing intervention was checked to meet the minimum requirements of the ISO reference terminology model for nursing action concepts. Finally, the nursing interventions were compared with the original PNDS-interventions. RESULTS: The Delphi-panel accepted 98 nursing interventions with Content Validity Index from 0.88 to 1.0. Of the 133 nursing interventions in the PNDS, 60% (n=80) were covered by nursing interventions identified in this study. A notable portion of the nursing interventions related to preventive aspects of perioperative care and the patients' coping with perioperative experience. CONCLUSION: The findings supported the need for cross-cultural validation of a nursing language prior to clinical implementation. The ISO reference terminology model is recommended as framework in constructing concepts for nursing interventions in a regular form.

Delphi Technique↗

PubMed2005

Sense of coherence among Finnish young men--a cross-sectional study at military call-up.

The aim of this study was to study associations between sense of coherence (based on Antonovsky's theory), and mental health problems, the use of mental health services, substance use, predisposition to suicide and possible psychiatric diagnosis among Finnish young men. The study included 2314 18-year-old young men who attended military call-up in autumn 1999 and completed the 13-item Orientation to Life Questionnaire (SOC-13) questionnaire (89.1% of the study sample attending military call-up). Furthermore, all young men had a medical examination at military call-up, including evaluation of possible psychiatric disorder. Suicidality, perceived mental health problems, psychiatric diagnosis at military call-up medical examination, use of mental health services, excessive alcohol consumption and use of illicit drugs were identified as independent factors associated with sense of coherence. Sense of coherence is a valuable construction in psychiatric evaluation of adolescents. SOC-13 can be used both in clinical practice and in epidemiological research to evaluate the adolescent's health resources. Future research on its applications in clinical practice is warranted.

Adaptation, Psychological↗

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↗

PubMed2005

Perioperative nurses' attitudes toward the use of nursing diagnoses in documentation.

AIM: This paper reports a study of nurses' attitudes towards the use of nursing diagnoses in perioperative documentation and the factors affecting these attitudes. BACKGROUND: There are both international and national requests for nurses to move from natural language-based narrative documentation to electronic documentation and clinical use of nursing classifications. However, nurses' attitudes toward nursing classifications have not been widely studied. METHODS: A questionnaire was distributed to a purposive sample of perioperative nurses (n = 146) who had participated in clinical testing of nursing diagnoses. The response rate was 60% (n = 87). The data were collected in 2003. RESULTS: In general, nurses' attitudes toward nursing diagnoses were positive. Those over 40 years of age who had clinical experience from 10 to 19 years, postbasic nursing education and previous knowledge of nursing diagnoses were most positive in their attitudes. However, the use of nursing diagnoses in perioperative practice was not seen as either necessary or accurate in describing patients' problems. Furthermore, the documentation of perioperative routines was seen as time-consuming and frustrating. CONCLUSIONS: Nursing classifications should be included in both preregistration nursing curricula and in-service educational programmes to ensure theoretical knowledge of and practical skills in standardized clinical languages. The perioperative nursing diagnoses should be reviewed to fit better with clinical practice. In addition, current perioperative documentation practices should be reconsidered and updated as appropriate to address clinical requirements better.

Adult↗

PubMed2005

Prostatectomy patients' postoperative pain assessment in the recovery room.

AIM: This paper reports a study to assess the usability and use of different pain assessment tools and to compare patients' and nurses' pain assessments in the recovery room after prostatectomy. BACKGROUND: Pain assessment is the first step towards providing adequate pain relief but poses problems because of the subjective nature of the pain experience and the lack of quantifiable measurements. Pain tools have been tested in several clinical settings, but not in the recovery room. METHODS: Data were collected in the recovery room from 45 consecutive patients who had undergone prostatectomy by asking them to evaluate their pain intensity using visual analogue scale, numeric rating scale and verbal expressions. One of two research nurses measured patients' pain at regular intervals and at the same time as the patients. Physiological parameters were also evaluated. Data were analysed as frequencies and percentages. Sum variables were formed and results were analysed using Spearman's rank correlation, Pearson's correlation and with multiple regression analysis. RESULTS: Patients varied in their ability to assess the intensity of their pain using different tools, but assessments were correlated with each other and with nurses' estimations. Nurses and patients obtained similar assessments, but nurses both underestimated and overestimated patients' pain. Patients' verbal assessments varied widely. Patients' and nurses' pain assessments showed no association with patients' pulse or mean arterial blood pressure. CONCLUSIONS: According to our results, it is not totally clear whether pain tools are usable in the recovery room. This issue calls for further research.

Aged↗

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↗

PubMed2003

Need for change in patient education: a Finnish survey from the patient's perspective.

This study aims to find out how hospital patients in Finland perceive and evaluate the education they receive. It represents the first part of a patient education project at one university hospital in which the ultimate goal is to support patients' decision-making and self-care and in this way to facilitate the independent empowerment with health problems. The survey comprised of 754 patients from 63 of the hospital's 100 wards during a randomly selected week in spring 2001. The results show that most patients described the patient education they had received as sufficient, although some did indicate they had not learned enough about the possible side effects of care, problems of care and future care. Patients were not content with the education they received in support of social, experiential, ethical and financial aspects. The methods used in patient education should also be more diversified and patient-centred.

Adult↗

PubMed2002

Nurses' decision-making in collecting information for the assessment of patients' nursing problems.

1. The paper addresses two questions: Firstly, what kind of information do nurses acquire from cancer patients for purposes of judging their patients' problems and preparing a care plan? Secondly, how systematically do nurses proceed in the decision-making process from the formulation of initial assumptions about the patient's situation to the final definition of problems? 2. The instrument used for data collection was a computer-simulated case description compiled by a team of four nursing researchers and one medical researcher. The case description was based on a real patient history. 3. The sample consisted of 107 Registered Nurses on four oncology, two internal medicine and five surgical wards of two central university hospitals in Finland. Data were collected in autumn 1998 and spring 1999 using a laptop computer and a tape recorder. 4. The four most important problems identified by nurses at baseline were pain (85%), pain medication (59%), family situation (66%) and spread of cancer (49%). Presented with a list of 23 options, they obtained additional information on average on 13 areas. Almost one-third collected information from 16 to 22 areas. On average nurses identified 12 of the 28 nursing problems specified. A statistically significant association was observed between information acquisition and problem definition in seven different variables. These had to do with pain, general condition and prognosis. 5. Nurses adequately prioritized their patients' problems and systematically collected data on those problems. On the other hand they also identified a number of problems that were not relevant to the situation.

Clinical Competence↗

PubMedDate not supplied

Developing an instrument to measure and describe clinical decision making in different nursing fields.

The purpose of this study was to develop and test a decision-making instrument for nursing, to consider the nursing decision-making models in different nursing fields, and to create a scoring system for the instrument. A 56-item instrument was developed on the basis of different decision-making theories and earlier studies about nursing decision making. The instrument was evaluated by using several different convenience samples of nurses from seven different countries (N = 1,460). Statistical analysis used were correlation coefficients, factor analysis, factor scores, and factor reliability coefficients. The results indicated that nurses from different countries and working in different fields of nursing respond similarly. The results of the studies using the 56-item instrument showed that nurses use four kinds of decision-making models (analytical, analytical-intuitive, intuitive-analytical, and intuitive). The factor reliability scores were high (alpha = 0.85-0.91). According to the results, 60 per cent of the nurses used the analytical-intuitive and intuitive-analytical decision-making models, 14 per cent used the analytical model, and 26 per cent used the intuitive model. However, these models vary both between and within different fields of nursing.

Decision Making↗

PubMedDate not supplied

Initial validation of the perioperative nursing data set in Finland.

PURPOSE: To explore the relevance of the Perioperative Nursing Data Set (PNDS) in Finland. METHODS: A three-round Delphi technique (10 participants) and content analysis of 134 articles from the Journal of the Finnish Operating Room Nurses Association. FINDINGS: All the PNDS outcomes, 86% of the diagnoses, and 87% of the interventions were found to be relevant. The Delphi panel suggested, and content analysis revealed, 6 new outcomes, 43 new diagnoses, and 11 new interventions. Consensus was achieved on 77%. The phrases used in perioperative articles corresponded with those of PNDS 56%-78% of the time. CONCLUSIONS: PNDS can be used to describe perioperative nursing in Finland. Further conceptualization and validation are needed before using the data set in perioperative practice. IMPLICATIONS FOR PRACTICE: Although PNDS cannot be implemented in Finland as is, it is a valid structure for further development of the terminology, contents, methods, and practice of Finnish perioperative documentation.

Documentation↗