Hoitotiede最新文献

The use and definition of the concept compliance has been variable. The concepts compliance, adherence and co-operation have been used in the English literature. The terminology in the Finnish literature is also variable such concepts as hoitomyöntyvyys, hoitomyötäys, hoitokuuliaisuus and hoitoon sitoutuminen have been used. The purpose of this study is to illustrate the empirical structure of the concept compliance. The baseline was the definition of compliance of young diabetics. According to this definition, compliance is an active, intentional and responsible process by which young diabetics work to maintain their health in collaboration with the health care staff. The data were collected (1994) by a questionnaire from young diabetics aged 13-17 years (N = 403). To test the structure of the concept compliance, LISREL-analysis was used. The results of the study support the baseline definition of compliance.

The aim of the paper is to describe the development of nursing theory. As an example, a theoretical model of the compliance of young diabetics and related factors is built. The content of the theoretical model is not described but the process of developing the model is presented. In the first phase, a hypothetical model of young diabetics' compliance was developed inductively. The data were collected by interviewing 51 young diabetics aged 13-17 years, by observing the behaviour of 18 of these young people during an adaptation course and by analysing their drawings (N = 17). The data were analysed by using continuous comparative analyses and content analyses. In the second phase, an instrument for testing the model was developed. For this purpose, data were collected with a questionnaire from young diabetics aged 12-17 years (N = 91). The content validity, construct validity and reliability of the instrument turned out to be quite good. In the third phase, the hypothetical model was tested and developed further by using LISREL (linear structural relations) analyses. The data were collected with a questionnaire from young diabetics aged 13-17 years (N = 346). In the fourth phase, the model was expanded using the qualitative data (N = 51). The categories which had been discovered by continuous comparative analyses were quantified. The data were analysed by cross-tabulation, the chi square test and discriminant analyses. A summary of the results has been presented by building a theoretical model of young diabetics' compliance and related factors.

The purpose of the study was to describe school-aged children's experiences of pain in hospital. The view of pain as a complex phenomenon and the child's experience of pain considered from the physiological, psychological and experiential perspectives of child development made up the theoretical basis of the work. Data were collected from 20 school-aged children between 7 and 11 years of age who were hospitalized in the pediatric wards of the University Hospital. Each of the children wrote an essay on their experiences of pain in hospital and they were then interviewed on the basis of their essays. The data were analysed inductively using content analysis. On the basis of the analysis, the situations that caused pain to all children in hospital were procedures connected with treatment, and the children described their experiences of pain such as physiological and psychological feelings of pain. The children described physiological pain in a versatile manner (for example as pinching, stinging, aching) and were able to describe mainly the quality of pain. According to the children's descriptions, the psychological feelings of pain were unpleasant feelings, horror, anxiety and fear. The results of this research indicate school-aged children's ability to describe their own experiences of pain. This means that to assess and treat school-aged children's pain, we should listen to the child. Furthermore, painful situations cannot be eliminated in hospital, but we could pay attention to the methods that relieve child's pain and reduce psychological pain in the nursing practice.

The purpose of this study was to assess patient satisfaction with care in HUCH, Surgical Hospital 1994 and to compare the results to the results of a-study done with the same questionnaire in 1990. The data were collected using SPRI:s (Sjukvårdens och socialvårdens planerings- och rationaliseringsinsitut) questionnaire from patients (N = 215) at seven wards. The response rate was 72. The structured questions were analysed by using the SOLO calculating program and the open-ended questions by using content analyses method. The results are presented in percentages and cross tabulations in the article. According to the results the patients were elder, suffered from more serious diseases and stayed for a longer time in the hospital than 1990. Patients' satisfaction was improved with information and nursing. However, even if the information was improved, most patients wanted more written information. On the whole, patients were satisfied with nursing care but some criticism was expressed concerning environment.

In Finland nursing education and research in universities was established in 1979. Research in nursing, however, was done in some amount even before in other disciplines and in the Institute of Nursing Research. In this article, nursing research during 1958-1995 is described, based on the articles in the Finnish Yearbook of Nursing (1958-1988), in the Journal of Nursing Science (Hoitotiede, 1989-1995) and academic licentiate and doctoral dissertations. The analysis indicates strong growth of nursing research in Finland since 1950s. The content of research is multidimensional. The nature of research is quantitative and descriptive; many of the doctoral dissertations in 1990s are qualitative. The research interest has been mainly the patient. Articles in research methods and concept analysis are rare.

Three dominant themes of transcultural nursing as a global humanizer, diversifier, and unifier are discussed in relation to their meaning and uses in education, practice, research and consultation. The presenter takes the position that these three dominant themes are essential and imperative to promote, transform, and maintain desired care outcomes which are beneficial, satisfying, and healthy for people of diverse and similar cultures. The three themes are discussed within Leininger's theory of Culture Care Diversity and Universality with focus on the modes of action and decision-making. The author encourages transcultural nurses to take leadership to be an active global humanizer, diversifier, and unifier and transform nursing and health care into the 21st century.

The dynamics of hope--the dialectics between hope and hopelessness--is a central dimension in the essence of human being, in health and illness, as well as in nursing. In this paper nursing research on hope and hopelessness in elderly people is described. CINAHL- and MEDLINE EXPRESS-database were used as sources of research material. The purposes, the target populations, the methods of data collection and the central results from 10 research articles were analyzed using the method of content analysis. In addition qualitative content analysis was used to illustrate the dynamics of hope. The research on the dynamics of hope in nursing science has mostly focused on young adults, and less on elderly people. Most of the studies on hope and hopelessness in elderly people were descriptive, cross-sectional research based on quantitative assumptions. The dynamics of hope was described as the dynamics of life and death in which elderly people's significant relationships, feelings and the ability to act were central elements. Qualitative, longitudinal designs are needed in nursing science in order to capture the essence of the dynamics of hope in elderly human beings.

The purpose of this study was to describe the nature, manifestation, and amount of envy among the staff of a nursing community. The definition of envy is commonly based on views of essence of envy and organisational culture. The population study consisted of random sample of 120 subjects drawn from among the employees in the Kainuu Central Hospital. Frequency and percentage distributions were used to present the data. The correlations between the variables were examined using cross-tabulation. Summarized variables were formed for nature of envy, and the Cronbach alpha coefficient was used to test the internal consistency of those. Factor analysis and cross-tabulation were also used. Open-ended questions were analysed by qualitative contact analysis. These results were used to complement quantitative data. The results of this study indicated that the employee's view of his/her official position in the nursing society, his/her relations with his/her fellow workers and the management as well as the relations to other nursing societies are all related to enviousness. The employees's view of his/her official position intensified his/her feelings of envy, if he/she had other negative feelings (anxiety, dissatisfaction with him/herself, and feeling if looks could kill). If the employee was ambitious and hard-working, his/her envy manifested in a comparison of his/her own work and the work of other employees. The major object of envy was fellow workers' salary. Envy was also caused by new, proficient, and senior co-workers and possible favourites or proteges of management. Envy towards other nursing community was generated by alleged differences in the amount of labour, or by the charge nurse's greater interest in other section. Employees coped with envy by hiding these feelings and being modest. Women coped with envy by being silent.

This article focuses on factors which are relevant while using a diary in qualitative health related research. Diary is a data collection method which has several advantages: it approximates the real activities of research persons, it diminishes memory errors which may occur in retrospective interviews, and it helps to better understand the lifeworld of the research persons. Diaries can be used as an independent data collection method or combined with other methods, such as semi-structured or deep-interviews or observations. Using a qualitative diary needs a careful consideration of the design and aims of the research in question. For these reasons water-proof instructions of using diaries are not eligible. Rather, the method should be applied each time it is used. In the area of nursing science there are several possibilities for applications. For example, the view-points of a hospital patient or a client of health care services can be reached and understood better.