Hoitotiede最新文献

The purpose of the study was to describe the childbirth experience of fathers and nursing interventions used during labour and delivery. The data were collected by questionnaires from fathers attending delivery room during one month (n = 137). Five fathers refused to participate. The return rate was 81% out of 132 fathers. Data analysis included cross tabulations, factor analysis as well as content analysis for open ended questions. Nursing interventions which fathers found supportive were infant care, getting information and attention from the staff. Most of the respondents felt they got encouragement to take care of the infant. They also got information of the delivery and newborn's welfare. However, about half felt they got little encouragement to show their own feelings. Fathers found that being present at the delivery was an important part of their fatherhood. The best moments were attached to enjoyment of taking care of the newborn. Fathers felt themselves unable to help their partner enough. They felt very difficult to see their partner in pain. Most of the father were quite satisfied with nursing interventions used during labour. They wanted more attention to be paid to pain management. Fathers would like to get more advice during labour.

Humane Caring Scale has been developed at the Kuopio University Hospital. The purpose of this study was to investigate which items of Humane Caring Scale were important and relevant to the patients at the hospital and which issues were missing. The data (n = 501) were collected in April 1996 by a questionnaire. The response rate was 77%. The data were analysed using statistical methods and content analysis. Majority of the items were important to the patients. Professional care and understandable communication were the most important issues. Aspects such as professional working, holistic care, physical environment, enough staff and patient-doctor relationship were also important. Women considered more aspects more important than men. Missing parts of the scale were no question for preparing patients to home care, supporting of rehabilitation and outcomes of the patients. Humane Caring Scale should be tightened up and the concepts used in the instrument clarified. The caring at the Kuopio University Hospital was estimated as good on the average by the patients. Young patients were more critical than elderly ones.

In this qualitative study the attitudes of the different groups of people to active euthanasia are described. 32 persons having incurable cancer, 13 relatives, 13 nurses and 13 doctors participated in the study. The study was carried out in two central hospitals and in four local hospitals. The data was collected by theme-interviews. The interviews were taped and transcribed. The interview-texts were analysed by content analysis. More than half of the participants in the study approved of active euthanasia. Among the relatives and the nurses the approval was most common. Also the attitudes of the doctors were more positive that it has been reported in the earlier studies. In the decision making concerning active euthanasia the persons with positive attitude emphasized the meaning of terminal illness, the existence of suffering and pain and the self-determination of the person. The persons with negative attitude said that a human being has no right to decide on the death of an other human being. The misuses, the uncertainty of the finality of the situation and the effective possibilities to the symptom control came out too. The doctors mentioned also the arguments concerning their own profession.

Participant observation as data collection method in nursing research is explored in this article. The scientific basis of observation method comes from symbolic interactionism. Nature and epistemological starting points of the knowledge produced by observational method can vary depending on the purpose of the study. Participant observation is a process, which aims at scientific research through observer's presence in social situations. Fieldwork should be carefully prepared because the main problem in participant observation is observer's influence on phenomenon which is being studied. In the beginning of the field-work researcher tries to get a general view what happens in the situation. After the analysis the researcher can focus his observations according to his research problems and finally observe selectively. The data consists of record-keeping, descriptions and field-work note book. Participant observation is the most subjective observation method of data collection. By using triangulation a researcher can avoid his personal influence on results and make the validity of his study better. The researcher must take ethical issues into consideration when collecting data by participant observation.

The purpose of the study is to generate, in the context of a health centre hospital, knowledge about the expectations that nursing leaders have of their nursing staff in a situation involving change. The goal is to change the model of care delivery to primary nursing and to use research-based knowledge as the point of departure for the development work. The study is based on the theory of primary nursing and it tries to answer questions like "What do nursing leaders expect of their nursing staff" and "How do these expectations manifest themselves in practice?" A total of 26 nursing leaders who were involved in the development work wrote free-form essays to answer the research questions. These data were then categorized by using component analysis. According to the results, what is expected of nurses is, most importantly, patient-centred practice involving commitment to primary nursing, an ability and the will to cooperate, and flexibility and preparedness for changes. The content of the components was described in a form in which it is expected to appear in practice. The research results show that nurse education and nursing leadership need to be developed in a direction which will ensure that nurses are able to practise in accordance with what is expected of them.

The aim of this research was to eludicate functioning of a nursing college according to perspective of teachers. The teachers were asked to evaluate the procedures of the institute and personnel and goals of functioning. The aim was to eludicate the existing basic principles and the bodies of knowledge among the teachers. The research was made as a case study in a average-sized nursing college during autumn 1992. A questions blank was sent to all the teachers (N = 68) and the questions were non-structured. The blank was returned by 39 teachers. Their answers were analyzed by using qualitative methods. The results of this research refer that a nursing college resembles Mintzberg's (1979) description of professional bureaucracy. The teachers way of thinking is typical among well-educated experts, who work quite independently (and alone) in relation to their colleagues. Despite of this they work very closely with their clients, who are students. The teachers thought that they are experts in pedagogics, but not in the knowledge of science of nursing. Their opinions about the position of students and the function of the institute were controversial. The students were seen either as self-directing gatherers or passive receivers of information. Most of the teachers were dissatisfied with leadership and cooperation of the organization.

The purpose of this study was to describe the views of clients and public health nurses of home visits in maternal and child health care and their advantages. In addition, a description of freedom to choose between home visits or child health care clinics visits is given. The data were gathered using semi-structured questionnaires from 263 public health nurses and 323 clients during October-November 1992 from 203 Finnish health centers. Methods of statistical description included frequencies, percentage distributions and cross-tabulation. Clients regarded the home visits to be important for them in public health nursing. Clients described that the most important function of home visits was the information they got of child's growth and care. As for the public health nurses, support given to the clients and continuity of the care were considered to be the most important issues. Both clients and public health nurses regarded it to be important that the family and the child can stay at home and the mother does not need to go to the clinic. In addition, public health nurses described that the advantages of home visits were the possibilities to get a picture of family's situation and circumstances. The disadvantages were connected with the time-consuming nature of the home visits. Clients and public health nurses had different opinions of the clients' possibilities to choose either home visit or regular visit to the health center. About half of the clients described that they could make a choice. On the other hand, the majority (90%) of public health nurses felt that clients had opportunities to choose what they want.

The article analyses the concept of family nursing, which is defined and described by reference to its key characteristics (e.g. Rodgers 1989, Meleis 1991). Other, closely related and to some extent even substitutable concepts identified in the article are family systems nursing and family-centered nursing. The broad area of family therapy is excluded from the discussion since the purpose is to concentrate on the nursing of healthy families. Family nursing is defined in three different ways depending on the place and the role of the family on practical nursing: family as a context, as a sum of its parts and as a client. Concept of family-centered nursing is included in these three levels, but also levels minimal emphasis on family and family therapy, which are not included in the concept of family nursing. However, it is concluded that the two concepts can be regarded as closely related. Family systems nursing can be regarded either as one sub-concept to family nursing and family-centered nursing or as a kindred concept. It is suggested that a serious debate should be started in Finland on these concepts and that research should be undertaken in different nursing situations to find out how these concepts occur in reality.

Phenomenological approach in nursing research is described in this paper. Examples used are based on PhD. dissertation in nursing science, where experiences of health, well-being and nursing are studied from the point of view of clients and nurses. Both epistemological questions and research practice are examined and differences between phenomenological and empiristic research are reported in this article. These are eg. use of previous research results and data-collection and analysis in a study. Also questions of reliability and validity of the phenomenological research are different from those of empiristic research. Especially a phenomenological researcher is supposed to report his qualitative study in details.

The aim of this article is to describe Colaizzi's (1978) phenomenological method using as an example a study of good care. The purpose of phenomenological method is to uncover the genuine experience of the phenomenon under investigation; Colaizzi's method consists of seven steps. First informants' descriptions of the experiences are read in order to acquire a sense of the whole. After that significant statements are extracted. Meanings are formulated from the significant statements. Formulated meanings are organised into themes. Themes are integrated into an exhaustive description. The essential structure of the phenomenon is formulated. And finally for validation the informants will evaluate the result of the analysis, if it means the same as their original experiences were. The modification of Colaizzi's method was used in order to conceptualize good care based on the experiences of a population of ex-patients.