Browsing by Subject "qualitative research"

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  • Katainen, Anu; Lehto, Anna-Sofia; Maunu, Antti (2015)
    The article explores how young people understand the risks of alcohol use and how these understandings are associated with differing drinking situations and social settings. By taking account of situational factors, the aim is to demonstrate how young people have highly nuanced notions of drinking styles that suit different drinking situations and of associated risks. The data for the research were gathered in 18 group interviews with Finnish ninth graders aged 14-15 years. Short film clips portraying young people in different drinking situations were used as stimulus material for the interviews. Data analysis focussed on the risk factors related to the social situations illustrated in the film clips. The results show that young people's risk assessments are not based on alcohol itself, but the magnitude of risk is estimated in relation to the social setting of the drinking situation. What is relevant for young people is whether the social situation allows them to make choices with which they feel comfortable. At the opposite pole of problem drinking was social drinking for the purpose of having fun together with other people in such a way that one remains in control of the drinking situation. From a prevention point of view, a key implication is that awareness of the risks is closely associated with situational and social factors. However, the awareness of those risks does not necessarily prevent young people from drinking because they may be accepted as part of the drinking experience.
  • Lerkkanen, Tuulia; Egerer, Michael; Alanko, Anna; Järvinen-Tassopoulos, Johanna; Hellman, Matilda (2020)
    This study fills a gap in gambling research by inquiring into the ways in which people make sense of their country's gambling policy as a comprehensive logic with interrelated facets. Nineteen focus group interviews were conducted with 88 persons in Helsinki, Finland. The interview protocol involved discussion stimuli and tasks. The study participants expressed the view that the public image and function of gambling provision involves a great deal of contradictory elements. Even though the existing monopoly system was given approval in terms of yielding funding to good causes, the interviewees were still critical of how the monopoly system worked when it comes to advertising, availability, and customer loyalty programs. A core dilemma identified was whether the system aims to prevent gambling-related problems or whether it does, in fact, promote gambling consumption. If skilfully executed, the study method can be fruitful for discerning core logical inconsistencies in the gambling regulation systems of other countries as well.
  • Tiusanen, Roosa; Saltychev, Mikhail; Ervasti, Jenni; Kivimäki, Mika; Pentti, Jaana; Stenholm, Sari; Vahtera, Jussi (2022)
    Objectives To identify concurrent developmental trajectories of physical activity and body mass index (BMI) over time. Design Prospective cohort study, repeated survey. Setting Cohort study in Finland. Participants 66 852 public sector employees, who have been followed up for 16 years. Outcome measures Shapes of trajectories of changes in physical activity and BMI. Results At baseline, mean age was 44.7 (SD 9.4) years, BMI 25.1 (SD 4.1) kg/m(2) and physical activity 27.7 (SD 24.8) MET hours/week. Four clusters of concurrent BMI and physical activity trajectories were identified: (1) normal weight (BMI 35 kg/m(2)) and low level of physical activity (
  • Heikkilä, Riie; Katainen, Anu (2021)
    In qualitative interviews, challenges such as deviations from the topic, interruptions, silences or counter-questions are inevitable. It is debatable whether the researcher should try to alleviate them or consider them as important indicators of power relations. In this methodological article, we adopt the latter view and examine the episodes of counter-talk that emerge in qualitative interviews on cultural practices among underprivileged popular classes by drawing on 49 individual and focus group interviews conducted in the highly egalitarian context of Finland. Our main aim is to demonstrate how counter-talk emerging in interview situations could be fruitfully analysed as moral boundary drawing. We identify three types of counter-talk: resisting the situation, resisting the topic, and resisting the interviewer. While the first type unites many of the typical challenges inherent to qualitative interviewing in general (silences, deviations from the topic and so forth), the second one shows that explicit taste distinctions are an important feature of counter-talk, yet the interviewees mostly discuss them as something belonging to the personal sphere. Finally, the third type reveals how the strongest counter-talk and clearest moral boundary stemmed from the interviewees' attitudes towards the interviewer herself. We argue that counter-talk in general should be given more importance as a key element of the qualitative interview. We demonstrate that all three types of counter-talk are crucial to properly understanding the power relations and moral boundaries present in qualitative interviews and that cultural practices are a particularly good topic to tease them out.
  • Kvarnström, Kirsi; Westerholm, Aleksi; Airaksinen, Marja; Liira, Helena (2021)
    Introduction: Medication adherence continues to be a significant challenge in healthcare, and there is a shortage of effective interventions in this area. This scoping review studied the patient-related factors of medication adherence. Methods: We searched Medline Ovid, Scopus, and Cochrane Library from January 2009 to June 2021 to find the most recent original qualitative studies or systematic reviews that addressed the patient-related factors of medication adherence in treating chronic conditions. We used the PRISMA-ScR checklist to ensure the quality of the study. Results: The initial search revealed 4404 studies, of which we included 89 qualitative studies in the scoping review. We inductively organized the patient-related factors causing barriers, as well as the facilitators to medication adherence. The studies more often dealt with barriers than facilitators. We classified the factors as patient-specific, illness-specific, medication-related, healthcare and system-related, sociocultural, as well as logistical and financial factors. Information and knowledge of diseases and their treatment, communication, trust in patient-provider relationships, support, and adequate resources appeared to be the critical facilitators in medication adherence from the patient perspective. Discussion and conclusions: Patients are willing to discuss their concerns about medications. Better communication and better information on medicines appear to be among the critical factors for patients. The findings of this scoping review may help those who plan further interventions to improve medication adherence.
  • Mononen, Niina; Pohjanoksa-Mäntylä, Marika; Airaksinen, Marja S. A.; Hämeen-Anttila, Katri (2020)
    Objective Finland is one of the few countries that has established a national Medicines Information (MI) Strategy. The ultimate goal of the strategy is a well-implemented medication use process resulting in well-informed adherent patients. This study aimed at evaluating the implementation of the strategy 3years after its launch. Design The evaluation applied a pragmatic approach and was conducted by interviewing stakeholders involved in the National MI Network enhancing the MI Strategy's implementation. The network comprises national key stakeholders producing and using MI. Data were deductively analysed according to the medication use process of the MI Strategy using the framework method, complemented with inductively derived categories. Setting National implementation of the MI Strategy throughout the healthcare system after the first operational period (2012-2014) in 2015. Participants The members of the National MI Network (n=79/111, participation rate 71%, representing 42/53 stakeholder organisations). Outcome measures A new conceptual framework was developed based on stakeholders' views on well-implemented actions and actions needing development in the medication use process at (1) infrastructure (macro), (2) healthcare professionals (meso) and (3) patient (micro) levels. Results Medication counselling by community pharmacists was the primary implemented action, followed by physicians' actions while starting a new medication, and advice given by nurses. The major development needs concerned (1) poor access to patient information and its transfer in healthcare, particularly the lack of reconciled medication lists and electronic health records (macro); (2) poorly functioning medication use process in home care and social care units, such as nursing homes (meso); and (3) limited patient involvement in their care (micro). Conclusions Far more actions for development than well-established practices in the medication use process were identified. Major challenges found in this evaluation are considered in the ongoing Rational Pharmacotherapy Action Plan 2018-2022 by the Ministry of Social Affairs and Health.
  • Halinen, Taina (Helsingin yliopisto, 2017)
    The theoretical context of this qualitative study are the leadership in early childhood education and the organizational change. The leadership and the change of leadership are studied generally and then the distributed leadership and the distributed organization are studied specifically. This study examines how teachers and leaders view the distributed leadership and what kind of skills the leaders and the workers need in the organization of distributed leadership and how they view the organizational change. This is qualitative phenomenology research. The material of the study was collected at half structured interviews which were taken part in six teachers and two leaders from the city of Hamina during November and December 2017. The interviews were recorded and transcribed for analysis. The analysis was done with the methods of content analysis. This study shows that the leadership in early childhood education is in change and the leadership meets new challenges. Distributed leadership challenges both the leaders and the workers. The results of the study show that the interviewed teachers and leaders see distributed leadership as teamwork and interactional work custom. The distributed leadership was difficult to execute, because teachers worked as leaders without the status of the leader. The interviewed viewed that the difficulties of distributed organization are indefinite structures and work tasks of leadership and too large entireties of leadership. The interviewed viewed that the organizational change was unsuccessful. The interviewed teachers and the leader felt that they didn't have an opportunity to influence the change and the given reasons for doing the organizational change were incoherent and the results of the change were not estimated. They would like to increase the number of leaders and clear the determinations of work roles and responsibilities. This study suggests that the city of Hamina should increase the competence of the leaders and the personnel. In practice distributed leadership means investing the knowhow of leadership and working community skills. The human resource management and the motivating of the personnel are the main challenges in the future. Qualitative early childhood education is possible only with the motivated workers.
  • Laiti, Minna; Parisod, Heidi; Pakarinen, Anni; Sariola, Salla; Hayter, Mark; Salanterä, Sanna (2021)
    Previous research shows that lesbian, gay, bisexual, transgender, queer/questioning, and other (LGBTQ+) students can experience substantial emotional- and health-related issues at school, but research into LGBTQ+ students' experiences of school nursing is limited. This qualitative study describes the experiences of Finnish LGBTQ+ students engaging with junior high school nurses. Data were collected from 35 LGBTQ+ students using an online survey tool comprising of a set of open-ended questions. Two interconnecting themes were identified following thematic analysis: (1) junior high school nurse engagement: a mixed or unsatisfactory experience and (2) LGBTQ+ students' needs for diversity-affirming junior high school nursing. Findings show that LGBQT+ students felt junior high school nurse engagement was often unsupportive with issues around their sexuality and gender identity. LGBTQ+ students expressed the need for diversity-affirming information and support in school settings. Further research from school nurses' perspective is needed to increase understanding of this topic.
  • Palojärvi, Donna (Helsingin yliopisto, 2018)
    Objectives. The purpose of this study is to describe, analyze and interpret the way novice class teachers see school bullying. The secondary purpose is to describe how peer harassment affects the novice teachers’ job. In 2010-centery studies, school bullying has been seen as a form of negative social behavior between pupils (Repo, 2015; Herkama, 2012). Teachers have to focus more and more on teaching social skills to pupils rather than the actual teaching. This has been associated with younger teachers’ increased stress levels at work and even plans on switching ca-reers (Aho, 2011). This study examines the education side of teacher job at the context of school bullying. Methods. This study is a qualitative research from the point of view of phenomenography. The material has been produced in a group chat between three novice teachers and the interviewer. All teachers have graduated during the last year and worked their first year as teachers. Besides of novice teachers I will also call them young teachers at this study, since all of them were under thirty years old. Results and conclusion. The peer harassment has changed because of new technology and smart phones. The term ‘school bullying’ has become an inadequate way in describing the reality of the bullying experiences that pupils have to deal with. From novice teachers’ perspective, it seemed that low social skills of pupils were the main reason why there are so much conflicts be-tween pupils in everyday life. The actual school bullying was rare, but the preventative jobs, such as conflict solving, took lots of time from teaching and learning in the class. Decision mak-ing, insecurity regarding the effectivity of one’s own practices as well as co-operation with the parents were experienced as a burden with negative effects on teaching. In conclusion, bullying and the bullying-preventive work increases the overall workload of teachers and takes up time and resources from the actual teaching.
  • Karikoski, Essi; Junttila, Kristiina; Järvinen, Mirkka; Sarkola, Taisto; Blomqvist, My (2022)
    Purpose Congenital heart disease (CHD) is one of the most common congenital anomalies in children. Children with major CHD are at risk for developing endocarditis. Acute endocarditis may be life threatening and lead to heart failure. The purpose of this study was to explore parental perceptions and experiences of an early oral health promotion intervention (OHPI) targeting children with major CHD at risk for developing endocarditis later in life, and use this information to examine intervention feasibility. Methods Nine parents (three fathers and six mothers) participating in a one and a half year OHPI were purposefully selected for qualitative evaluation of intervention feasibility using semi-structured interviews. The interviews were analysed with an inductive content analysis method. Results The analysis resulted in four main categories and 14 subcategories that describe parental perceptions and experiences of the OHPI. The four main categories were timing of first intervention contact, effortlessness of intervention process, individuality of support, and relevancy of support. Conclusion Parents of children with CHD perceived the OHPI as important and feasible to be implemented in daily life in children with systemic diseases overall. Further studies on timing of first contact and use of additional Web-based support are needed.
  • Janssens, Rosanne; Lang, Tamika; Vallejo, Ana; Galinsky, Jayne; Plate, Ananda; Morgan, Kate; Cabezudo, Elena; Silvennoinen, Raija; Coriu, Daniel; Badelita, Sorina; Irimia, Ruxandra; Anttonen, Minna; Manninen, Riikka-Leena; Schoefs, Elise; Vandebroek, Martina; Vanhellemont, Anneleen; Delforge, Michel; Stevens, Hilde; Simoens, Steven; Huys, Isabelle (2021)
    Background: Investigational and marketed drugs for the treatment of multiple myeloma (MM) are associated with a range of characteristics and uncertainties regarding long term side-effects and efficacy. This raises questions about what matters most to patients living with this disease. This study aimed to understand which characteristics MM patients find most important, and hence should be included as attributes and levels in a subsequent quantitative preference survey among MM patients. Methods: This qualitative study involved: (i) a scoping literature review, (ii) discussions with MM patients (n = 24) in Belgium, Finland, Romania, and Spain using Nominal Group Technique, (iii) a qualitative thematic analysis including multi-stakeholder discussions. Results: MM patients voiced significant expectations and hopes that treatments would extend their lives and reduce their cancer signs and symptoms. Participants however raised concerns about life-threatening side-effects that could cause permanent organ damage. Bone fractures and debilitating neuropathic effects (such as chronic tingling sensations) were highlighted as major issues reducing patients' independence and mobility. Patients discussed the negative impact of the following symptoms and side-effects on their daily activities: thinking problems, increased susceptibility to infections, reduced energy, pain, emotional problems, and vision problems. MM patients were concerned with uncertainties regarding the durability of positive treatment outcomes, and the cause, severity, and duration of their symptoms and side-effects. Patients feared short-term positive treatment responses complicated by permanent, severe side-effects and symptoms. Conclusions: This study gained an in-depth understanding of the treatment and disease-related characteristics and types of attribute levels (severity, duration) that are most important to MM patients. Results from this study argue in favor of MM drug development and individual treatment decision-making that focuses not only on extending patients' lives but also on addressing those symptoms and side-effects that significantly impact MM patients' quality of life. This study underscores a need for transparent communication toward MM patients about MM treatment outcomes and uncertainties regarding their long-term efficacy and safety. Finally, this study may help drug developers and decision-makers understand which treatment outcomes and uncertainties are most important to MM patients and therefore should be incorporated in MM drug development, evaluation, and clinical practice.
  • Venesoja, Anu; Castrén, Maaret; Tella, Susanna; Lindström, Veronica (2020)
    Background Research on patient safety in emergency medical services (EMS) has mainly focused on the organisation's and/or the EMS personnel's perspective. Little is known about how patients perceive safety in EMS. This study aims to describe the patients' experiences of their sense of safety in EMS. Methods A qualitative design with individual interviews of EMS patients (n=21) and an inductive qualitative content analysis were used. Results Patients' experiences of EMS personnel's ability or inability to show or use their medical, technical and driving skills affected the patients' sense of safety. When they perceived a lack of professionalism and knowledge among EMS personnel, they felt unsafe. Patients highlighted equality in the encounter, the quality of the information given by EMS personnel and the opportunity to participate in their care as important factors creating a sense of safety during the EMS encounter. Altogether, patients' perceptions of safety in EMS were connected to their confidence in the EMS personnel. Conclusions Overall, patients felt safe during their EMS encounter, but the EMS personnel's professional competence alone is not enough for them to feel safe. Lack of communication or professionalism may compromise their sense of safety. Further work is needed to explore how patients' perceptions of safety can be used in improving safety in EMS.
  • Dsilva, Keshia (Helsingin yliopisto, 2018)
    There exists an extensive body of research on homosexuality, yet only a few studies address local meanings of homosexuality and still fewer attempt to understand the processes that construct these meanings and the values and beliefs of the people that share these meanings. Such studies would be particularly relevant in India as a developing and highly pluralistic country where the legal status of homosexuality has been in a state of flux. The unique history and religious diversity in India have shaped the way in which different communities come to understand homosexuality. Influences of both colonization and tradition are salient and constantly interacting, yet in many ways conflicting with each other. To explore these influences and intersections in relation to conceptions of homosexuality, the social representation theory was used as a methodological framework. Semi-structured interviews were conducted in Bangalore with six families from the urban middle class representing the major religions of Hinduism, Islam and Christianity. Out of these six families, two families from each of the three religions participated. For each family, one member belonged to the youngest generation (18+ years of age), one to the middle generation and one to the grandparents’ generation. As Bangalore is the second fastest growing metropolis in India, it provided a good background to explore potential influences of modernisation. The inter-generational and inter-religious approach helped to provide insights on how these categories, in addition to their national identity as Indians, entwine and frame these participants’ representations of homosexuality. Across religions and generations, three representations of homosexuality were identified: nature, nurture and culture. In the first, homosexuality was categorized in terms of what is ‘natural’ and ‘unnatural’, in the second in terms of ‘normal’ and ‘abnormal’ and in the third, in terms of ‘deviant’ and ‘non-deviant’. Despite these convergent primary categorizations, participants’ ages, religions and gendered perceptions of what constitutes homosexuality intersected in diverse yet specific and patterned ways. My analysis sheds light on the functions served by these representations, local practices and customs, as well as social change in India with respect to meanings, understandings and practices of homosexuality.
  • Linnanvirta, Suvi; Kroll, Christian; Blomberg, Helena (2019)
    Discussions on the pros and cons of a basic income (BI) have remained mainly at the 'systemic level'. Based on survey and interview data, this study provides a 'bottom-up' perspective on the legitimacy of the idea of a basic income among people queuing in breadlines in Helsinki in late 2016, who are assumed to be affected positively by this benefit. While general support for the idea is high, not everyone supports an unconditional BI. Despite the likely 'objective interest', a BI does not seem to be supported by food aid recipients any more than by the general population as measured by a previous study. Besides interests, normative beliefs and perceptions of deservingness seem of importance for legitimacy too, especially among those not supporting a BI. Doubts regarding a BI are to some extent connected to wishes to limit the social citizenship of some of the persons in the breadlines.
  • Niemistö, Charlotta; Hearn, Jeff; Tallberg, Teemu; Niemi, Hertta; Gripenberg, Pernilla; Jyrkinen, Marjut; McKie, Linda (Hanken School of Economics, 2012)
    This working paper reports the ongoing research conducted in the research project, The Quest for Well-being in Growth Industries: A Collaborative Study in Finland and Scotland, under the auspices of Academy of Finland research programme, The Future of Work and Well-being. The research project examines the contradictory pressures for policies and practices towards both the inhibition and the enhancement of work-related well-being that are likely in growth industries. The overall aim is to evaluate the development, implementation and use of work-related well-being policies and practices in four selected growth industries. These – electronics, care, finance and accounting, and tourism – have been selected on the basis of EU and national forecasts, and demographic and socio-economic trends in standard and non-standard employment. Following an earlier survey of 127 employing organisations on questions of growth and well-being, in this working paper we present the initial results of the qualitative phase of the project. This phase comprised ‘portraits of practice’ in nine case companies, selected on the basis of some of the quantitative analysis of the survey, with interviews, ‘mini-ethnographies’, and other data and documents received from the organisations. The working paper concludes with discussion of methodological issues across the quantitative and qualitative phases of the project.
  • Howard, Ian; Cameron, Peter; Wallis, Lee; Castrén, Maaret; Lindström, Veronica (2020)
    Introduction In South Africa (SA), prehospital emergency care is delivered by emergency medical services (EMS) across the country. Within these services, quality systems are in their infancy, and issues regarding transparency, reliability and contextual relevance have been cited as common concerns, exacerbated by poor communication, and ineffective leadership. As a result, we undertook a study to assess the current state of quality systems in EMS in SA, so as to determine priorities for initial focus regarding their development. Methods A multiple exploratory case study design was used that employed the Institute for Healthcare Improvement's 18-point Quality Program Assessment Tool as both a formative assessment and semistructured interview guide using four provincial government EMS and one national private service. Results Services generally scored higher for structure and planning. Measurement and improvement were found to be more dependent on utilisation and perceived mandate. There was a relatively strong focus on clinical quality assessment within the private service, whereas in the provincial systems, measures were exclusively restricted to call times with little focus on clinical care. Staff engagement and programme evaluation were generally among the lowest scores. A multitude of contextual factors were identified that affected the effectiveness of quality systems, centred around leadership, vision and mission, and quality system infrastructure and capacity, guided by the need for comprehensive yet pragmatic strategic policies and standards. Conclusion Understanding and accounting for these factors will be key to ensuring both successful implementation and ongoing utilisation of healthcare quality systems in emergency care. The result will not only provide a more efficient and effective service, but also positively impact patient safety and quality of care of the services delivered. © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
  • Krannila, Elina (Helsingfors universitet, 2012)
    In pharmaceutical industry GMP compliance and quality of operations can be ensured with quality management system (QMS). QMS is an operational system, which consist of multiple different elements depending on the size of the company and nature and complexity of its operations. For the QMS to be functional, documented and defined operations need to be managed and monitored systematically. Conducting internal audits has been considered necessary with regard to QMS, though it has not always been perceived as adding value or seen as an opportunity to utilise more fully. Internal audits are mainly utilized to control compliance to requirements. However, there are possibilities to utilise it more in improving and developing operations, preparation to external audits, quality risk assessment, finding out the best practices, basis for decision making, learning experience as well as the assessment of functionality and effectiveness of the QMS. The aim of this study was to examine the utilisation of internal audits in Orion (Espoo) and find solutions to improve the utilisation of internal audits with QMS. The focus was on how internal audits can monitor and guide QMS and what is required from internal audits for monitoring and guidance of QMS. These aims were approached qualitatively by conducting semi-standardized open-ended interviews. Interviewees (n=9) were selected from both auditor and auditee side and they had their background in quality assurance or production. Data compiled from these interviews was analysed mainly by qualitative methods, using also some quantitative analysis. Monitoring of the QMS can be looked at as the starting point to guide QMS. Valuable information can be gathered with internal audits with regard to QMS. By utilising this information, internal audit process and QMS can be improved and the quality of operations can be ensured. Based on this work internal audits can be utilised to monitor and have the potential to guide QMS under certain conditions. Internal audit topics need to be systematically selected, QMS needs to be monitored and guided based on the internal audit findings, flow and distribution of information needs to be efficient and flexible, and internal audits should be better utilised and managed. Further research is needed on the development and deployment of tools to aid better utilisation of internal audits in the control of QMS. Also ways to measure the effects of internal auditing should be further investigated.
  • Kumpulainen, Kristiina; Sairanen, Heidi; Nordström, Alexandra (2020)
    This socioculturally framed case study investigates the digital literacy practices of two young children in their homes in Finland. The aim is to generate new knowledge about children's digital literacy practices embedded in their family lives and to consider how these practices relate to their emergent literacy learning opportunities. The study asks two questions, 'How do digital technologies and media inform the daily lives of children in their homes? Moreover, how do the sociocultural contexts of homes mediate children's digital literacy practices across operational, cultural, critical and creative dimensions of literacy?' The empirical data collection drew on the 'day-in-the-life' methodology, using a combination of video recordings, photographs, observational field notes and parent interviews. The data were subjected to thematic analysis following an ethnographic logic of enquiry. The findings make visible how children's digital literacy practices are intertwined in families' everyday activities, guided by parental rules and values. The study demonstrates children's operational, cultural and creative digital literacy practices. The study also points out the need for more attention to children's critical engagement in their digital literacy practices.