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  • Matilainen, A.; Pohja-Mykrä, M.; Lähdesmäki, M.; Kurki, S. (2017)
    The use of natural resources often generates conflict among stakeholders. Conflict analysis and management in this sector has traditionally been based on compliance enforcement and/or education. Recently, however, the need for alternative approaches has been increasingly highlighted. In this study, we address the need for in-depth analysis, and introduce the theoretical concept of psychological ownership to improve the understanding and potential management of conflict situations. We suggest that ownership feelings may play a significant role both in successful co-operation, and in conflicts related to the use of natural resources. The study is qualitative in nature. The data consisted of two interview datasets related to nature tourism: nature tourism in private forests and bear watching safaris. We show that the ways the psychological ownership of stakeholder groups is constructed and taken into account in co-operative relationships are of the utmost importance for the sustainability and success of the interplay among stakeholders. (C) 2017 Elsevier Ltd. All rights reserved.
  • Kuitunen, Sini Karoliina; Kärkkäinen, Krista; Linden-Lahti, Carita; Schepel, Lotta; Holmström, Anna-Riia (2022)
    Background Smart infusion pumps with dose error reduction software can be used to prevent harmful medication errors. The aim of this study was to develop a method for defining and assessing optimal dosing limits in a neonatal intensive care unit's smart infusion pump drug library by using simulation-type test cases developed based on medication error reports. Methods This mixed-methods study applied both qualitative and quantitative methods. First, wrong infusion rate-related medication errors reported in the neonatal intensive care unit during 2018-2019 were explored by quantitative descriptive analysis and qualitative content analysis to identify the error mechanisms. The researchers developed simulation-type test cases with potential errors, and a literature-based calculation formula was used to set upper soft limits to the drug library. The limits were evaluated by conducting programming of pumps without errors and with potential errors for two imaginary test patients (1 kg and 3.5 kg). Results Of all medication errors reported in the neonatal intensive care unit, 3.5% (n = 21/601) involved an error or near-miss related to wrong infusion rate. Based on the identified error mechanisms, 2-, 5-, and 10-fold infusion rates, as well as mix-ups between infusion rates of different drugs, were established as test cases. When conducting the pump programming for the test cases (n = 226), no alerts were triggered with infusion rates responding to the usual dosages (n = 32). 73% (n = 70/96) of the erroneous 2-, 5-, and 10-fold infusion rates caused an alert. Mix-ups between infusion rates triggered an alert only in 24% (n = 24/98) of the test cases. Conclusions Simulation-type test cases can be applied to assess the appropriateness of dosing limits within the neonatal intensive care unit's drug library. In developing the test cases, combining hospital's medication error data to other prospective data collection methods is recommended to gain a comprehensive understanding on mechanisms of wrong infusion rate errors. After drug library implementation, the alert log data and drug library compliance should be studied to verify suitability of dosing limits.
  • Tuominen, Leena; Leino-Kilpi, Helena; Meretoja, Riitta (2020)
    Purpose: The purpose of this study was to explore comprehensively expectations of patients with colorectal cancer towards nursing care in the chemotherapy context. Methods: A purposive sample of patients with colorectal cancer (n = 15) was interviewed individually at the outpatient clinic in one university hospital chemotherapy unit. The data were analysed with thematic analysis. Results: Three main themes were identified in the data. Firstly, patients expected to be empowered with knowledge of disease process, side effects and their self-management and peer support. Secondly, patients expected to be humanely encountered, which included being encountered with support, compassion and hope. Thirdly, patients expected to be skillfully cared for with systematic assessment, expertise, continuity and advocacy. Conclusions: Besides reliable knowledge of cancer treatment and care, patients expected the sympathetic presence of a nurse whose professional skills they can trust. The results may be utilised in intervention development by focusing on themes significant to these patients. The results may help nurses to enhance person-centred care as well as to encounter patients according to their expectations.
  • Pyörälä, Eeva; Korsberg, Hanna; Peltonen, Liisa M (2021)
    Universities invest in teaching academies to reward outstanding teachers. Few studies have been published about the impact of teaching academies on teaching communities. The aim of this study was to see who excellent academic teachers spoke to when they discussed teaching and learning, and what kind of community a Teachers' Academy established in 2013 offered to its Fellows. We analysed the answers to two open-ended questions from two surveys. The first survey (2013) was addressed to first-round applicants to the Academy in 2013 (N = 46, 32%) and the second (2018) to its Fellows (N = 56, 65%). In both surveys, most teachers had meaningful discussions with their close colleagues. In the second survey, the conversations with pedagogical experts merged with the discussions at the Academy. The 2018 survey also examined how well the Academy's key objectives of providing teachers with an interdisciplinary community and peer support had been achieved in five years. The Academy had become an important community for teachers, in which teachers shared mutual appreciation for teaching and collaborated across disciplinary boundaries and campuses. A challenge for a teaching academy is to support its fellows in implementing the principles of scholarship of teaching and learning, that is, carrying out scholarly educational projects and sharing the results locally, nationally and internationally.
  • Jakonen, Antti; Mänty, Minna; Nordquist, Hilla (2022)
    Background: Emergency response driving (ERD) is a major occupational risk factor in emergency medical services (EMS). Inadequate communication has been acknowledged as a significant contributing cause for major incidents during ERD. Previous evidence shows that structured communication can promote safety in high-risk procedures, but knowledge in ERD context is lacking. The aim of this study was to examine what are the safety-critical points in ERD that should be secured using structured communication. Method: The nominal group technique (NGT) was used for gathering interview material from ERD experts’ (n = 11) workshop. In addition, semi-structured thematic interviews were conducted with other ERD experts (n = 15) from five different EMS areas in Finland. The interview material was analyzed using inductive content analysis. Results: Using NGT, 13 safety-critical points in ERD requiring the use of structured communication were identified. As a result of the interviews, two main categories were found: 1) Factors affecting the adaptation of the appropriate speed for the current situation and 2) Factors affecting orientation in a driving event. Conclusion: ERD comprises multiple safety-critical points that should be secured using structured communication between ambulance crew members. Pilot and implementation studies exploring the use of structured communication in ERD are needed in the future.
  • Perander, Katarina; Londen, Monica; Holm, Gunilla (2021)
    Purpose - The purpose of this study was to investigate how a workshop can enhance first-year university students' understanding of their study strategies and self-regulated learning. Design/methodology/approach - Aqualitative content analysis was done of 190 reflective journals written by first-year university students. Findings - The main findings confirmed that starting studies in higher education is challenging for many students. New insights were provided on how these challenges can be addressed, especially regarding selfregulated learning. Students perceived that they gained several insights from the workshop that they believed could benefit their studying and thereby enhance motivation. Practical implications - This study showed that even small measures promote both good study habits and specifically self-regulated learning skills. Interventions like the workshop described in this study ease first-year students' transition to the university and foster successful studies for all students. Originality/value - This study contributes to research on supporting students' transition to higher education by investigating how students perceive early study skill interventions. It adds to a holistic perspective of students' challenges and coping strategies during their first semester in higher education.
  • Rantapää, Minna; Virtanen, Ira A.; Pekkala, Seija (2021)
    This qualitative study explores the supportive strategies used by formal caregivers when interacting with Deaf people with dementia. The data consist of video-recorded interactions between dyads of nine caregivers and five Deaf participants in a nursing home for the Deaf in Finland. We analyzed 21 interactions (5 hours and 25 minutes in total), using two methods: inductive content analysis and the Interactive Coping Behavior Coding System. The study found that the formal caregivers used a wide range of supportive strategies. We identified five strategies: (1) interaction maintenance, (2) emotional support, (3) instrumental support, (4) informational support, and (5) memory support. The formal caregivers also used dismiss and avoidance behaviors when the interaction became challenging. Non-proficiency in sign language hindered support. In the future, attention should be paid to teaching formal caregivers national sign language and supportive communication competence for working with Deaf people with dementia.
  • Sandholm, Ditte; Simonsen, Julia; Ström, Kristina; Fagerlund, Åse (2023)
    Positive education is the teaching of both traditional school skills and skills for enhancingwell-being. This study examines teachers' (N = 72) experiences with training in positive education.Qualitative content analysis was used to provide an in-depth understanding of theexperiences, and quantitative measures investigated teachers' well-being. Results show thatteachers experienced both personal and professional growth. They also saw positive changesin their students. Teachers used methods of positive education e.g. when communicating withstudents and co-workers, and when supporting the students' socioemotional development.Challenges with implementing positive education practices mostly consisted of lack of timeor support from colleagues. The authors argue that positive education is an effective tool forenhanced well-being both for participating teachers and their students and could therefore be utilised on alarger scale. Future studies could focus on whether teachers continue systematicimplementing of positive education methods long-term, and the reasons behind continued ordiscontinued.
  • Postareff, Liisa; Mattsson, Markus; Lindblom-Ylanne, Sari; Hailikari, Telle (2017)
    The demands and pressures during the first study year at university are likely to arouse a variety of emotions among students. Nevertheless, there are very few studies on the role of emotions in successful studying during the transition phase. The present study adopts a person-oriented and mixed-method approach to explore, first, the emotions individual students experience during the first year at university. Hierarchical cluster analysis was used to group students (n = 43) on the basis of the emotions they described in an interview. Second, the study investigates how the students in the different clusters scored on approaches to learning (as measured on the Learn questionnaire) and how they succeeded (GPA) and progressed (earned credits per year) in their studies. Three emotion clusters were identified, which differed in terms of the deep and surface approaches to learning, study success and study progress: (1) quickly progressing successful students experiencing positive emotions, (2) quickly progressing successful students experiencing negative emotions and (3) slowly progressing students experiencing negative emotions. The results indicate that it is not enough to focus on supporting successful learning, but that attention should also be paid to promoting students' positive emotions and well-being at this time.
  • Lantta, Tella; Kontio, Raija; Daffern, Michael; Adams, Clive E.; Valimaki, Maritta (2016)
    Purpose: This paper aims to explore the acceptability of Dynamic Appraisal of Situational Aggression (DASA) from the perspective of patients, its actual use by mental health nurses, and the predictive validity of the DASA instrument. Methods: A feasibility study design incorporating quantitative and qualitative components was used. The study was conducted in three mental health inpatient units at three hospitals in southern Finland. Quantitative data were used to explore demand (nurses' actual use of the DASA), limited efficacy (predictive validity), and acceptability (measured through patients' participation in the project). Qualitative data were collected to enhance the understanding of acceptability by describing patients' perceptions of the strengths and weaknesses of the DASA. Results: Nurses used the DASA for most patient assessments. The predictive validity of the DASA was outstanding or excellent, depending on the type of aggression predicted, although the patient recruitment ratio was low. Patients reported both strengths and weaknesses of the DASA, providing complementary information regarding the instrument's acceptability and clinical application. Conclusion: The DASA accurately predicts inpatient aggression. The patients' preferences and concerns regarding risk assessment have been noted. More patient involvement in risk assessment research and violence prevention efforts is required.
  • Ameel, Maria; Leino, Hanna; Kontio, Raija; van Achterberg, Theo; Junttila, Kristiina (2020)
    Aims and objectives To identify and describe nursing interventions in patient documentation in adult psychiatric outpatient setting and to explore the potential for using the Nursing Interventions Classification in documentation in this setting. Background Documentation is an important part of nurses' work, and in the psychiatric outpatient care setting, it can be time-consuming. Only very few research reports are available on nursing documentation in this care setting. Methods A qualitative analysis of secondary data consisting of nursing documentation for 79 patients in four outpatient units (years 2016-2017). The data consisted of 1,150 free-text entries describing a contact or an attempted contact with 79 patients, their family members or supporting networks and 17 nursing care summaries. Deductive and inductive content analysis was used. SRQR guideline was used for reporting. Results We identified 71 different nursing interventions, 64 of which are described in the Nursing Interventions Classification. Surveillance and Care Coordination were the most common interventions. The analysis revealed two perspectives which challenge the use of the classification: the problem of overlapping interventions and the difficulty of naming group-based interventions. Conclusion There is an urgent need to improve patient documentation in the adult psychiatric outpatient care setting, and standardised nursing terminologies such as the Nursing Interventions Classification could be a solution to this. However, the problems of overlapping interventions and naming group-based interventions suggest that the classification needs to be further developed before it can fully support the systematic documentation of nursing interventions in the psychiatric outpatient care setting. Relevance to clinical practice This study describes possibilities of using a systematic nursing language to describe the interventions nurses use in the adult psychiatric outpatient setting. It also describes problems in the current free text-based documentation.
  • Lantta, Tella; Anttila, Minna; Kontio, Raija; Adams, Clive E.; Valimaki, Maritta (2016)
    Background: Patient violence against nurses in their work environments is a widespread global concern, particularly in the field of mental health care. A high prevalence of violent events impacts the well-being of nurses and may also impair overall ward climate. However, it has been proposed that nurses' use limited techniques to prevent patient violence, and, therefore, more comprehensive methods for dealing with patient violence are needed. There is still restricted understanding of the ward climate during the occurrence of a violent event as well as how these incidents could be more effectively prevented. This study aimed to explore nurses' experiences of violent events in psychiatric wards, give insight into ward climates and examine suggestions for violence prevention. Methods: This study employed a descriptive, exploratory design including focus groups (n = 5) and open-ended questions. The participants were registered and enrolled nurses (n = 22) working on three closed psychiatric inpatient wards in one Finnish hospital district. Focus groups were tape-recorded, transcribed and analyzed with inductive content analysis. Results: Nurses' experiences of violent events included a variety of warning signs and high-risk situations which helped them to predict forthcoming violence. Patient-instigated violent events were described as complicated situations involving both nurses and patients. When the wards were overloaded with work or emotions, or if nurses had become cynical from dealing with such events, well-being of nurses was impaired and nursing care was complicated. Suggestions for violence prevention were identified, and included, for example, more skilled interaction between nurses and patients and an increase in contact between nurses and patients on the ward. Conclusions: This study revealed the complexity of violent events on psychiatric wards as well as the implications of these events on clinical practice development and training, administration and policy. A routine process is needed through which nurses' experiences and ideas concerning prevention of violent events are acknowledged.
  • Vänskä, Nea; Sipari, Salla; Haataja, Leena (2020)
    Aims: The purpose of this study was to describe meaningful participation in everyday life from the perspectives of children with disabilities. Methods: Nine children (5-10 years, mean age 7.2 years, 5 boys, 4 girls) with disabilities participated in individual photo-elicitation interviews. The interview data was transcribed verbatim and analyzed with inductive content analysis. Results: The children's meaningful participation mainly comprised free leisure activities that fostered enjoyment, capability, autonomy and social involvement with family and friends. The children's emotions and physical sensations, opportunities to influence, knowledge about the activity and the participation context, presumptions and previous experiences of the activity and the environment played a vital role in their decisions to participate. Conclusion: The meaningful participation facilitated enjoyment and self-determination for the children. Identifying personal and environmental factors supporting or restricting participation from the child's perspective emerges as important in order to provide opportunities for the child's meaningful participation in everyday life. The photo-elicitation interviews demonstrated the potential to act as a tool to identify and explore the children's views about participation in a real-life context.