Jouko Katajisto

Work ability risk management and analysis (WARMA) requires professional competence to ensure effective, consistent, and high-quality occupational health nu

Aims and Objectives: Register data and tracking evaluations by patients and their significant others through feedback can assist in the quality assurance of patient education. This study uses an observational, feedback‐registry study to analyse systematic, register‐based evaluative feedback from patients and their significant others on received knowledge of their care in one university hospital district and the factors connected to the feedback. Design: An observational, feedback‐register study. Methods: The data consisted of evaluative feedback on received knowledge ( n = 83,388) in 2019 at a Hospital District in Finland. The data was extracted from a feedback register. Initially, the patients and their significant others gave feedback with structured feedback surveys and/or feedback text messages. Data were analysed with descriptive and inferential statistics. Results: Evaluative feedback from patients and their significant others on the quality, understandability, sufficiency and clarity of received knowledge of their care was rather positive. Feedback from patients was more positive than that from their significant others and, correspondingly, from elective patients compared to emergency patients. Positive feedback on received knowledge correlated with a positive perception of the general quality of care. Conclusions: The results indicate mainly positive evaluations of received knowledge. These findings are relevant for several stakeholders: in the quality assurance of patient education, for example, nurses, healthcare managers and researchers can act in key positions.

AimThe aim of the study was to test the psychometric properties of the Facilitative Student-Patient Relationship (FSPR) Scale in clinical practicum in hospital settings within six European countries. DesignA multi-country, cross-sectional survey design was applied. MethodsA convenience sample of graduating nursing students (N = 1,796) completed the FSPR Scale. Psychometric testing was carried out through explorative factor analysis and confirmatory factor analysis. Internal consistency was assessed using Cronbach's alpha. ResultsBoth validity and reliability of the scale were confirmed. The explorative factor analysis yielded a two-factor construct explaining 47.7% of the total variance, identifying two sub-scales: caring relationship and learning relationship. Confirmatory factor analysis confirmed the two-factor structure. The Cronbach alpha coefficients (0.8-0.9) indicated acceptable reliability of the scale.

This study aimed to determine the prevalence of foot health problems in people living with any rheumatic condition and explore potential associations with exposure variables. A cross-sectional observational epidemiological design was applied. The participants were recruited from one regional patient association in southwest Finland. The data were collected in January–February 2019 and included the Self-reported Foot Health Assessment Instrument (S-FHAI) and demographic questions. In total, 495 responses were obtained. Overall, participants had many foot problems. The point prevalence of self-reported foot problems was 99 per 100 people living with a rheumatic condition. The most prevalent problems were foot pain (73%), dry soles (68%), thickened toenails (58%) and cold feet (57%). Lower educational attainment, increased amount of daily standing and accessing medical or nursing care for foot problems were associated with poorer foot health. The results reveal a high frequency of foot pain among people with rheumatic conditions. The study highlighted the importance of person-centred care and the biological focus that underpins and impacts foot health (what we understand, what we do, and our health-seeking behaviour). Interventions to promote biopsychosocial approaches to personalised foot care could advance people’s readiness, knowledge and skill to care for their own feet.

Aims and objectives: The aim of this study was to discover the nature of the adverse events in Finnish long‐term professional homecare reported by professionals, and to identify the circumstances in which adverse events occur and their consequences.Background: Adverse events are incidents causing unintended and unnecessary harm to older people at home. Safety is a basic human right and a fundamental prerequisite for independent living among older people at home. Few studies have focused on both long‐term professional homecare environment and the safety of older people.Design: The research was a descriptive registry‐based study.Methods: This study consisted of adverse events (N = 61248) in Finnish public long‐term professional homecare (2009–2019). Data were described using frequencies and percentages. STROBE statement checklist was chosen for reporting the study process.Results: By profession, practical nurses and registered nurses reported the most of adverse events (89.8%). These were either critical incidents (78.3%) or near misses (20.0%) and concerned medicine, injuries and accidents, information flow or management. Consequences for older people were usually rated from no‐harm to moderate harm. For long‐term professional homecare, image harm, extra financial costs, no‐harm and prolonged care for older people were among the consequences. Personnel frequently observed the older people afterwards and informed older people of adverse events, yet some of actions were unknown.Conclusions: Many harmful adverse events are considered harmless for older people. Sometimes this can lead to unmet care needs or missed care. The degree of harm needs to be assessed in terms of physical, mental and social health with the HaiPro reporting system for homecare.Relevance to clinical practice: An understanding and a comprehensive view of the situation and holistic assessment of care needs includes safety and safety risks to increase safety and feeling of safety for older people at home.

Background: Relationships with patients are seen as the core component of establishing the quality of patient-centred care and promoting patients’ autonomy and relevant use of services. A clinical learning environment that emphasizes relationship-based healthcare is essential for encouraging future healthcare professionals to work in partnership with patients. There is also broad agreement that the insight of patients should be used actively in healthcare students’ clinical learning. The aim of this study was to describe healthcare students’ perceptions of their relationship with patients and the quality of the clinical learning environment and to identify factors associated with both of these. Methods: A cross-sectional survey using an electronic questionnaire was applied to collect data from 1644 Finnish healthcare students, mostly nursing students, between January 2018 and May 2018. The data were analysed statistically using descriptive statistics, Spearman’s correlation coefficients, and multifactor analysis of variance. Results: Students perceived the level of the student-patient relationship and the role of the teacher as good while pedagogical atmosphere, premises of care, premises of learning, and supervisory relationship were perceived to be at very good level. The correlations between the student-patient relationship and all clinical learning environment dimensions were perceived as moderate. Furthermore, a number of student-related factors associated with the student-patient relationship and the quality of the clinical learning environment were detected. Conclusions: In this study, the rarely explored perspective of the student-patient relationship within the context of the clinical learning environment was included. The student-patient relationship and the quality of the clinical learning environment were perceived as good by the students, with a number of determining factors affecting these perceptions. Giving the student-patient relationship a role in clinical education may be conducive to students’ learning with the patient in focus, and may thus promote the competence needed in the rapidly evolving healthcare environment and the changing scope of clinical practice.

Purpose: In patient education, there is a need for valid and reliable instruments to assess and tailor empowering educational activities. In this study, we summarize the process of producing two parallel instruments for analyzing hospital patients’ expectations (Expected Knowledge of Hospital Patients, EKhp) and received knowledge (Received Knowledge of Hospital Patients, RKhp) and evaluate the psychometrics of the instruments based on international data. In the instruments, six elements of empowering knowledge are included (bio-physiological, functional, experiential, ethical, social, and financial). Patients and Methods: The original Finnish versions of EKhp and RKhp were tested for the first time in 2003, after which they have been used in several national studies. For international purposes, the instruments were first translated into English, then to languages of the seven participating European countries, using double-checking procedure in each one, and subsequently evaluated and confirmed by local researchers and language experts. International data collection was performed in 2009– 2012 with a total sample of 1,595 orthopedic patients. Orthopedic patients were selected due to the increase in their numbers, and need for educational activities. Here we report the psychometrics of the instruments for potential international use and future development. Results: Content validities were confirmed by each participating country. Confirmatory factor analyses supported the original theoretical, six-dimensional structure of the instruments. For some subscales, however, there is a need for further clarification. The summative factors, based on the dimensions, have a satisfactory internal consistency. The results support the use of the instruments in patient education in orthopedic nursing, and preferably also in other fields of surgical nursing care. Conclusion: EKhp and RKhp have potential for international use in the evaluation of empowering patient education. In the future, testing of the structure is needed, and validation in other fields of clinical care besides surgical nursing is especially warranted.

Aims and objectives: To describe the nursing student–patient relationship in terms of three types of relationships—mechanistic, authoritative and facilitative—and analyse the factors related to the type of relationship.Background: As future professionals, nursing students have a central role in facilitating patient autonomy while working in partnership with patients. Supporting student–patient relationship throughout the nursing education may result in positive outcomes for both students and patients.Design: A cross‐sectional study.Methods: The data were collected from a convenience sample of Finnish nursing students using a structured web survey. Statistical data analysis was performed using chi‐square test, two‐sample t test, one‐way analysis of variance and multinomial logistic regression. The STROBE Statement — Checklist for cross‐sectional studies was used (Appendix S1).Results: Students most often assessed their relationship with the patients as facilitative, followed by authoritative and mechanistic relationships. The results revealed three predictors for facilitative relationship: students’ older age, long enough contact time with the patient and higher competence in ensuring quality. In authoritative and facilitative relationships, students had significantly more positive perceptions of the contextual factors and consequences of the relationship and higher ratings of self‐assessed competence levels than students in a mechanistic relationship.Conclusions: It seems that the facilitative student–patient relationship is connected to the professional competence of nursing students, especially in the area of ensuring the quality of patient care. Therefore, sustaining clinical learning environments and pedagogical approaches that value and support facilitative relationships in students’ clinical learning should be enhanced.Relevance to clinical practice: Efforts aimed at contributing to facilitative student–patient relationships have a crucial role in shaping students’ competency and in promoting high‐quality patient care. Thus, supervision of students organised around establishing mutual student–patient relationships with the preceptors acting as facilitators will benefit both students and patients.

Objective: This study aimed to describe and compare the group-level findings from 2005–2006 and 2015–2016 regarding students’ and patients’ views of the nursing student-patient relationship and associated factors. Methods: The data were in both cases collected using Student-Patient Relationship Scales. The data were analysed statistically. Results: In both student cohorts, authoritative and facilitative student-patient relationships were reported by the students more frequently than mechanistic relationships. Authoritative relationships were most common in both patient cohorts, whereas facilitative relationships had become more frequent than mechanistic relationships. A positive change of views in the student and patient cohorts was found in factors associated with the relationship. Conclusion: In order to strengthen a clinical learning culture that reflects a facilitative student-patient relationship, further research is needed on the processes and outcomes of that relationship.

During nursing education, nursing students are required to develop their competence to be able to fulfill their duties safely as Registered Nurses. The aims of this study were to explore 1) nursing students’ self-assessed competence levels during education 2) the relationship with competence and frequency at which competencies are utilized in clinical practice, and 3) factors related to competence levels. 841 (response rate 67.6 %) nursing students responded to the Nurse Competence Scale in a cross-sectional study. The self-assessed overall competence levels were improving during the education continuum (VAS-means 1st 56.6; 2nd 58.3; 3rd 59.8 and 3.5th -year students 68.4). Every group revealed a significant positive correlation with competence and frequency at which competencies are utilized in clinical practice in clinical placement. Risk factors for low competence were also identified. Systematic multimethod competence evaluations with longitudinal designs are needed to monitor outcomes of nursing education.