Frontline nurse leaders' competences in evidence-based healthcare: A scoping review.

AIM: To identify evidence on frontline nurse leaders' competences in evidence-based healthcare (EBHC) and the instruments measuring these competences. DESIGN: A scoping review. DATA SOURCES: The search was conducted in June 2021 and complemented in June 2022. The CINAHL, ProQuest, Medline (Ovid), Scopus, Web of Science databases and MedNar along with the Finnish database Medic were searched. REVIEW METHOD: The scoping review was conducted in accordance with the Joanna Briggs institute methodology for scoping reviews. Titles, abstracts and full-text versions were screened independently by two reviewers according to the inclusion criteria. Deductive-inductive content analysis was used to synthesize data. RESULTS: A total of 3211 articles published between 1997 and 2022 were screened, which resulted in the inclusion of 16 articles. Although frontline nurse leaders had a positive attitude towards EBHC, they had a lack of implementing EBHC competence into practice. Part of the instruments were used in the studies, and only one focused especially on leaders. None of instruments systematically covered all segments of EBHC. CONCLUSION: There is a limited understanding of frontline nurse leaders' competence in EBHC. It is important to understand the importance of EBHC in healthcare and invest in the development of its competence at all levels of leaders. Frontline nurse leaders' support is essential for direct care nurses to use EBHC to ensure the quality of care and benefits to patients. Leaders must enhance their own EBHC competence to become role models for direct care nurses. It is also essential to develop valid and reliable instruments to measure leaders' competence covering all EBHC segments. The results can be utilized in the assessment and development of frontline nurse leaders' EBHC competence by planning and producing education and other competence development methods.

Advanced practice nurses' evidence-based healthcare competence and associated factors: A systematic review.

BACKGROUND: Evidence-based healthcare (EBHC) enables consistent and effective healthcare that prioritises patient safety. The competencies of advanced practice nurses (APNs) are essential for implementing EBHC because their professional duties include promoting EBHC. AIM: To identify, critically appraise, and synthesise the best available evidence concerning the EBHC competence of APNs and associated factors. DESIGN: A systematic review. DATA SOURCES: CINAHL, PubMed, Scopus, Medic, ProQuest, and MedNar. METHODS: Databases were searched for studies (until 19 September 2023) that examined the EBHC competence and associated factors of APNs were included. Quantitative studies published in English, Swedish and Finnish were included. We followed the JBI methodology for systematic review and performed a narrative synthesis. RESULTS: The review included 12 quantitative studies, using 15 different instruments, and involved 3163 participants. The quality of the studies was fair. The APNs' EBHC competence areas were categorised into five segments according to the JBI EBHC model. The strongest areas of competencies were in global health as a goal, transferring and implementing evidence, while the weakest were generating and synthesising evidence. Evidence on factors influencing APNs' EBHC competencies was contradictory, but higher levels of education and the presence of an organisational research council may be positively associated with APNs' EBHC competencies. CONCLUSION: The development of EBHC competencies for APNs should prioritise evidence generation and synthesis. Elevating the education level of APNs and establishing a Research Council within the organisation can potentially enhance the EBHC competence of APNs. IMPLICATIONS FOR THE PROFESSION: We should consider weaknesses in EBHC competence when developing education and practical exercises for APNs. This approach will promote the development of APNs' EBHC competence and EBHC implementation in nursing practice. REGISTRATION, AND REPORTING CHECKLIST: The review was registered in PROSPERO (CRD42021226578), and reporting followed the PRISMA checklist. PATIENT/PUBLIC CONTRIBUTION: None.

Nurses' experiences of competence in lifestyle counselling with adult patients in healthcare settings: A qualitative systematic literature review.

AIMS AND OBJECTIVES: To identify and synthesise nurses' experiences of competence in lifestyle counselling with adult patients in healthcare settings. BACKGROUND: Modifiable lifestyle risk behaviours contribute to an increased prevalence of chronic diseases worldwide. Lifestyle counselling is part of nurses' role which enables them to make a significant contribution to patients' long-term health in various healthcare contexts, but requires particular competence. DESIGN: Qualitative systematic literature review and meta-aggregation. METHOD: The review was guided by Joanna Briggs Institute's methodology for conducting synthesis of qualitative studies. PRISMA-checklist guided the review process. Relevant original studies were search from databases (CINAHL, PubMed, Scopus, Medic and Psych Articles, Ebscho Open Dissertations and Web of Science). After researcher consensus was reached and quality of the studies evaluated, 20 studies were subjected to meta-aggregation. RESULTS: From 20 studies meeting the inclusion criteria, 75 findings were extracted and categorised into 13 groups based on their meaning, resulting in the identification of 5 synthesised findings for competence description: Supporting healthy lifestyle adherence, creating interactive and patient-centred counselling situations, acquiring competence through clinical experience and continuous self-improvement, collaborating with other professionals and patients, planning lifestyle counselling and managing work across various stages of the patient's disease care path. CONCLUSION: The review provides an evidence base that can be used to support nurses' competence in lifestyle counselling when working with adult patients in healthcare settings. Lifestyle counselling competence is a complex and rather abstract phenomenon. The review identified, analysed and synthesised the evidence derived from nurses' experience which shows that lifestyle counselling competence is a multidimensional entity which relates to many other competencies within nurses' work. IMPLICATIONS FOR THE PROFESSION: Recognising the competencies of nurses in lifestyle counselling for adult patients can stimulate nurses' motivation. The acquisition of these competencies can have a positive impact on patients' lives and their health. PATIENT OR PUBLIC CONTRIBUTION: No Patient or Public Contribution. IMPACT: The research may enhance nurses' competence in lifestyle counselling, leading to improved health outcomes, better adherence to recommendations and overall well-being. It may also drive the development of interventions, improving healthcare delivery in lifestyle counselling. REPORTING METHOD: The review was undertaken and reported using the PRISMA guidelines. PROTOCOL REGISTRATION: Blinded for the review.

Implementation of oral hygiene practices in nursing homes - a qualitative approach among supervisor nurses.

OBJECTIVES: This study describes daily oral health care in private enhanced service housing units and nursing homes in Finland using a qualitative method. METHODS: Nineteen supervisor nurses were interviewed in the six largest cities in Finland. The interviews consisted of semi-structured questions. The interviews were then transcribed and analyzed using inductive content analysis. RESULTS: The qualitative content analysis revealed five main categories: diet, education in the oral health of older people, oral care equipment and taking care of them, caring for the mouths of residents, and professional oral health care. The results revealed that sugary snacks were given daily in the units and there was a need for oral health care education. The dental equipment of residents was taken care of well and the oral health of the residents was taken care of moderately well. Furthermore, there was a need for co-operation between dental professionals and only half of the residents had an individual oral care plan. CONCLUSIONS: It can be concluded that based on this qualitative study, the implementation of daily oral health care in most nursing homes and enhanced housing units seems to be at a sufficient level and more oral health-related practical and theoretical education is needed.

The antecedents of oral care in nursing facilities - a qualitative interview study among supervisor nurses.

OBJECTIVES: This qualitative study describes the views of supervisor nurses related to antecedents of oral care in Finnish nursing facilities. METHODS: In the six largest cities in Finland, 19 supervisor nurses were interviewed and asked five semi-structured questions related to the antecedents of oral care in the units. The interviews were analyzed using inductive content analysis. RESULTS: Qualitative content analysis revealed five main categories: awareness of nurses (3 categories, 9 subcategories), attitude and motivation (3 categories, 10 subcategories), supporting quality of life and health (4 categories, 11 subcategories), the meaning of oral health in the unit (3 categories, 10 subcategories), and the role of the supervisor nurse in oral health care (4 categories, 14 subcategories). The awareness of nurses regarding oral health was in most cases good. Nurses' attitudes towards oral health and their motivation to oral care vary but were mostly good. Nurses were aware that oral care enhances the quality of life. The role of the supervisor nurse in organizing oral care was crucial. CONCLUSIONS: The performed analysis identified five main categories to describe antecedents for oral care in Finnish nursing facilities. The categories that needed to be improved were knowledge and attitude, and motivation related to oral care.

Effects of a lifestyle counselling intervention on adherence to lifestyle changes 7 years after stroke - A quasi-experimental study.

BACKGROUND: Adherence to medication and healthy lifestyle is crucial for preventing secondary strokes and other vascular events. However, there is not enough evidence on the long-term effects of hospital-initiated lifestyle counselling. AIM: To determine the effects of The Risk Factor Targeted Lifestyle Counselling Intervention, which is implemented during acute hospitalisation, on adherence to lifestyle changes 7 years after stroke or TIA. METHODS: Quasi-experimental design with 7-year follow-up period. Baseline data (n = 150) were gathered from a neurology unit in Finland between 2010 and 2011. Patients received either the studied intervention (n = 75) or the prevailing form of counselling at the time (n = 75). Data concerning lifestyle and clinical values were measured at the baseline time point, while adherence to lifestyle changes was assessed 7 years later (2017-2018). Analysis of covariance and multivariate ordinal logistic regression were used to describe the mean differences between the intervention and control groups. RESULTS: Several between-group differences were detected, namely, members of the intervention group reported consuming less alcohol and having lost more weight during hospitalisation relative to the control group. No between-group differences in the prevalence of smokers were found, but the intervention group reported a greater number of daily cigarettes than the control group. Adherence to medication, importance of adherence to a healthy lifestyle, support from family and friends, and support from nurses were all significantly higher in the intervention group than in the control group. CONCLUSIONS: The results suggest that the lifestyle counselling intervention was effective in decreasing alcohol use and weight, as well as increasing factors that are known to support adherence to a healthy lifestyle. RELEVANCE TO CLINICAL PRACTICE: The results indicate that the adherence process already begins during acute phase counselling. To ensure long-lasting lifestyle changes, counselling should be started at the hospital, after which it can be provided by friends and family members.

Intensive care professionals' perceptions of the quality of counselling provided in the ICU: A cross-sectional study.

BACKGROUND: Intensive care professionals (ICPs) have a key role in counselling adult intensive care unit (ICU) patients and their family members. The counselling provided to ICU patients and their family members can be described based on the content, implementation, benefits, and resources. AIMS: The study had two specific aims: first, to assess ICPs' perceptions of the quality of counselling provided to ICU patients and their family members; and second, to explore which factors ICPs feel is associated with the quality of counselling. STUDY DESIGN: A cross-sectional survey of ICPs working in adult ICUs in Finnish university hospitals. Data were collected using the Counselling Quality Instrument. The data were analysed by descriptive statistics and chi-square and t-test statistical methods. RESULTS: A total of 182 ICPs returned the questionnaire, reflecting a response rate of 18.6%. Most of the respondents were nurses (97%) and the mean age was 42 years. The ICPs reported having adequate time for patient- (77%) and family-centered (73%) counselling, but only 47% felt that their units had the appropriate facilities. There were statistically significant differences between patient- and family-centered counselling and the ICP's self-assessed competence (p < .001), goal-oriented counselling (p < .001), and atmosphere during counselling (p < .001). ICPs' attitudes towards counselling impacted how these professionals assessed patients' and family members' confidence, along with patient recovery (p < .001). CONCLUSIONS: This study confirms that the provision of high-quality counselling has beneficial effects; however, it also indicates that there is a need for training that considers each ICP's professional experience and patient- and family-centered factors, which may differ from one another. RELEVANCE TO CLINICAL PRACTICE: According to ICPs, the quality of counselling can be enhanced by empowering ICPs to improve counselling and providing appropriate ICU facilities for counselling, such as a private room for family members.

Interprofessional Collaboration in the Context of Pain Management in Neonatal Intensive Care: A Cross-Sectional Survey.

PURPOSE: Describe interprofessional collaboration (IPC) in the context of pain management in neonatal intensive care based on healthcare team members' perceptions of partnership, cooperation and coordination. DESIGN: A descriptive cross-sectional study design was used. BACKGROUND: IPC improves the quality of pain management for neonates. IPC is teamwork involving both professionals and the neonates' parents. Parents play an important role in the holistic care of their infant, which includes pain management. METHODS: Data was collected with Assessment of Interprofessional Collaboration Scale (AITCS-II) from the healthcare teams featuring representatives (n = 132) of multiple professional groups who were working in neonatal intensive care units (n = 4) in Finland. Descriptive statistical methods and the Mann-Whitney or Kruskal-Wallis nonparametric tests were used to analyze the data. RESULTS: The results were examined in three subscales of IPC (partnership, cooperation and coordination) on three different levels: "need to focus on developing collaborative practice", "moving towards collaboration" and "good collaboration". Participants perceived all the subscales as well as the overall level of IPC for pain management in neonatal intensive care to be at level "moving towards collaboration". CONCLUSION: Participants appreciated each other as professionals and were willing to cooperate, but they had different perceptions of parental involvement in IPC. Attention should be paid to IPC in specific contexts such as pain management.

Job Satisfaction among Occupational Therapy Practitioners: A Systematic Review of Quantitative Studies.

A comprehensive description of the factors associated with job satisfaction among occupational therapy practitioners is needed to promote their work well-being. This systematic review aimed to describe occupational therapy practitioners' job satisfaction and the related intra-, inter-, and extra-personal factors. Original peer-reviewed studies published between 2010 and 2019 were retrieved from four databases with the review including fourteen studies. The review was conducted according to the Joanna Briggs Institute guideline. The data were analyzed by narrative synthesis. Occupational therapy practitioners experienced high job satisfaction. Job satisfaction was found to be associated with significantly lower rates of turnover intention and higher rates of rewards. The relationships between job satisfaction, professional identity, exhaustion, and social environment showed conflicting results.

Feasibility and Clinical Utility of the Finnish Version of the FLACC Pain Scale in PICU.

PURPOSE: To describe the feasibility and clinical utility of the Finnish FLACC scale when assessing children's pain in a Pediatric Intensive Care Unit (PICU). DESIGN AND METHODS: A non-experimental, descriptive cross-sectional study design was used to describe the feasibility and clinical utility in a Finnish PICU between May and August 2018. The nurses were asked to complete a data collection questionnaire about the feasibility and clinical utility of the Finnish FLACC every time they used the scale to assess pain in children. In total, the data consisted of 157 pain assessments cases. Quantitative data were analyzed statistically and responses to open-ended questions were analyzed using content analysis. RESULTS: In most cases, the nurses agreed that the Finnish FLACC scale was clearly structured (97%), easy to use (98%), helpful in assessing pain intensity (77%), and useful when reassessing pain after interventions (67%). Nurses found the scale more useable for children over one year old than for younger children. When assessing cry and consolability, pain was easier to score if the child was not intubated. CONCLUSIONS: The Finnish FLACC scale exhibits adequate feasibility and clinical utility when assessing pain in children in a PICU. However, more information is needed about its use during painful short-term procedures and with children under one year old. PRACTICE IMPLICATIONS: The Finnish FLACC scale is a helpful tool for nurses when assessing children's pain in a PICU. However, the Finnish version of the modified FLACC is needed for use with intubated children in the future.

Healthcare professionals' competence in digitalisation: A systematic review.

AIMS AND OBJECTIVES: To identify key areas of competence for digitalisation in healthcare settings, describe healthcare professionals' competencies in these areas and identify factors related to their competence. BACKGROUND: Digitalisation requires changes in healthcare practices, policies and actions to revise job expectations and workflows. The aspects of patient safety and integration of digitalisation into the professional context necessitate an assessment of healthcare professionals' competencies in digitalisation. DESIGN: Systematic review. METHODS: A systematic review was conducted following Center of Reviews and Dissemination guidelines, including application of a PRISMA statement. Four databases-CINAHL (EBSCO), MEDLINE (Ovid), Web of Science and Academic Search Premiere (EBSCO)-were searched for relevant original peer-reviewed studies published between 2012-2017. Twelve were chosen for final analysis: five quantitative studies and seven qualitative studies, which were, respectively, subjected to narrative and thematic synthesis. RESULTS: Key competence areas regarding digitalisation from a healthcare perspective identified encompass knowledge of digital technology and the digital skills required to provide good patient care, including associated social and communication skills, and ethical considerations of digitalisation in patient care. Healthcare professionals need the motivation and willingness to acquire experience of digitalisation in their professional context. Collegial and organisational support appear to be essential factors for building positive experiences of digitalisation for healthcare professionals. CONCLUSION: Healthcare organisations should both pay attention to the social environment of a workplace and create a positive atmosphere if they want to improve the response to digitalisation. The successful implementation of new technology requires organisational and collegial support. RELEVANCE TO CLINICAL PRACTICE: Recommendations for clinical practice include the following: development of competence in digitalisation by healthcare professionals when using technological equipment to minimise errors; provision of sufficient resources, equipment and room for technology usage; and provision of regular education that considers the participants' competencies.

The Quality of Patient Education in Day Surgery by Adult Patients.

PURPOSE: The purpose of the study was to describe the quality of patient education in day surgery as evaluated by adult patients. DESIGN: Descriptive design using survey methodology. METHODS: The data were collected by questionnaire and measured the quality and implementation of education resources for day surgery patients (n = 600) in a university hospital. The data were analyzed statistically using basic and multivariate methods. FINDINGS: The implementation of patient education has been done in a patient-centered and goal-oriented way by half of respondents. Most respondents (81%) were satisfied with the interaction in patient education. The education resources were reported as good by 77% of respondents. CONCLUSIONS: Health care staff should assess for the presence of anxiety as a barrier to the comprehension of information. In developing patient education, the professional expertise and skills of health care staff in educating patients should be used.

A systematic review: non-pharmacological interventions in treating pain in patients with advanced cancer.

AIMS: To assess and synthesize the evidence of the effects and safety of non-pharmacological interventions in treating pain in patients with advanced cancer. BACKGROUND: Pain is a common symptom experienced by patients with advanced cancer; the treatment of such pain is often suboptimal. To manage it, non-pharmacological interventions are recommended after pharmacological treatments have been re-evaluated and modified. However, there remains a lack of knowledge about the effects and safety of such interventions. DESIGN: A systematic review was conducted based on the procedure of the Centre of Reviews and Dissemination. DATA SOURCES: Research papers published between 2000-2013 were identified from the following databases: CINAHL, MEDIC, MEDLINE (Ovid) and PsycINFO. The references in the selected studies were searched manually. REVIEW METHODS: The studies selected were reviewed for quality, using Cochrane Effective Practice and Organisation of Care Review Group risk of bias assessment criteria. RESULTS: There was limited evidence that some of the non-pharmacological interventions were promising with respect to reducing cancer pain. Relatively, few adverse events were reported as a result of using such interventions. CONCLUSION: It was not possible to draw conclusions about the effects and safety of the non-pharmacological interventions in reducing cancer pain. Some interventions showed promising short-term effects, but there is a need for more rigorous trials. Qualitative studies are required to collect information about patients' perceptions. There are several research gaps: we found no studies about music, spiritual care, hypnosis, active coping training, cold or ultrasonic stimulation.

Predictors of good-quality counselling from the perspective of hospitalised chronically ill adults.

AIMS AND OBJECTIVES: To determine the factors that predict the quality of patient counselling from the perspective of hospitalised chronically ill adults. BACKGROUND: In view of the growing number of adults with chronic diseases and a lack of resources in health care, it would be valuable for healthcare professionals to know which factors result in good-quality counselling for such individuals. DESIGN: The study used a cross-sectional, descriptive design. METHODS: Data were collected from chronically ill adults (n = 106) in northern Finland and were analysed using logistic regression. RESULTS: Counselling implementation was perceived to be of good quality if it was preplanned (odds ratio = 24·07) and patient-centred (odds ratio = 16·03) and if interaction during counselling (odds ratio = 13·27) was good. Counselling about social support (odds ratio = 14·78), preplanned counselling (odds ratio = 9·69), counselling about the results of investigations (odds ratio = 7·84) and counselling about disease progression (odds ratio = 7·66) were statistically significant predictors of the content being considered good quality. The effects of counselling on disease treatment (odds ratio = 11·33), patient-centred counselling (odds ratio = 9·75) and counselling about the effects of attitudes (odds ratio = 9·52) were statistically significant predictors of highly beneficial counselling. Counselling about the effects of disease treatment (odds ratio = 9·71) and interaction during counselling (odds ratio = 4·91) predicted the quality of counselling materials and methods. CONCLUSION: The results could be used to help healthcare professionals to ensure good-quality counselling by highlighting the areas that are most important to meet the expectations of chronically ill adults. RELEVANCE TO CLINICAL PRACTICE: The results can be used to develop the quality of chronically ill adults' counselling as well as to educate staff to focus better on chronically ill patients' counselling because it is necessary to develop new ways to offer more patient-centred counselling in order to address patients' needs and fit care to patients' lifestyles.

Counselling offered to and needed by Finnish adult intensive care unit patients based on patients' records and memories.

OBJECTIVES: Objectives of this study were to characterize the counselling (broadly defined) that Finnish adult intensive care unit patients received and needed during intensive care according to patients' records and memories. DESIGN SETTING: The study was based on retrospective analysis of patient records and documented follow-up clinics, using a descriptive, qualitative approach and deductive-inductive content analysis. FINDINGS: According to both the records and documented memories of 162 patients (56 women and 106 men aged 18-75 years; mean 50.8, median 53.5 years) patients' confidence in their own recovery, including feelings of safety and ability to participate, is enhanced by counselling during intensive care. They had strong memories of counselling that gave them knowledge about their medical conditions and procedures, symptoms, care, and psychological support. At follow-up, patients did not have such strong memories of lifestyle counselling that they received during intensive care. CONCLUSION: Patients need counselling during an intensive care unit stay to improve their confidence in their recovery. The counselling strategy for intensive care should be documented, and patient memories collected during follow-up clinics, to help assessment of the quality of counselling provided in intensive care. IMPLICATIONS FOR CLINICAL PRACTICE: Counselling during intensive care enhances patients' confidence in their own recovery. To assess the quality of counselling it is essential to recognize the types provided and needed. Appropriate documentation is crucial for evaluating intensive care unit patient counselling, and planning its continuity.

The quality of long-term counselling for percutaneous coronary intervention patients: A cross-sectional study.

AIM: To compare the long-term counselling quality among the patients visited and not visited at cardiac nurse after percutaneous coronary intervention (PCI) and related factors one to two years after PCI. DESIGN: An explorative, register-based cross-sectional study. METHODOLOGY METHODS: A sample was drawn from the one university hospital's procedure register consisted of the patients undergone a PCI (n = 977). The data was collected by Counselling Quality Instrument (CQI) questionnaire by mail, and analysed by basic and multivariate methods. FINDINGS RESULTS: Of the respondents (n = 459), less than half the patients (48.4%) visited at cardiac nurse one to two years after PCI as instructed in the national current care guidelines. Patients, who visited the nurse (n = 194) had higher satisfaction for counselling than the ones not visited (n = 70). Nevertheless, patients, especially those who had no dyslipidemia, had Unstable Angina Pectoris or Non-ST-elevated myocardial infarction or were out of the workforce, were unsatisfied with counselling, and needed more social support, patient-centred counselling and goal orientating implementation from the cardiac nurse. A half of the PCI patients (51.6%) did not visit the cardiac nurse at the primary health care. PATIENT OR PUBLIC CONTRIBUTION: Cardiac nurses assisted the members of research group by assessing the questionnaire prior sending it to the patients and patients contributed by completing the questionnaires. We thank both parties for their contribution. IMPLICATION FOR PROFESSION AND PATIENT CARE: This study demonstrated, that patients out of the workforce and having emergency PCI are in need for better quality counselling, concentrating on social support, patient-centred counselling and goal orientating implementation from the cardiac nurse. Those patients, who did not visit the cardiac nurse, should be offered easier access to cardiac nurse for example, by novel digital solutions.

A quasi-experimental study of group counselling effectiveness for patient functional ability and quality of counselling among patients with hip arthroplasty.

AIM: The aim of this study was to investigate effectiveness of group counselling for the patients with hip arthroplasty, self-assessed functional ability, and quality of counselling. DESIGN: A quasi-experimental study. METHOD: The questionnaire included the Counselling Quality Instrument (CQI), Harris hip score and Oldwellactive self-rated wellness profile. A Mann-Whitney U- and chi-squared and t-tests were used. A Wilcoxon singed rank test were used to evaluate changes in functional ability. NO PATIENT OR PUBLIC CONTRIBUTION: Patients and the public were not involved in the design, recruitment and implementation of this study. RESULTS: Fifty patients participated. Patients reported better results for limping (p = 0.000), walking distance (p = 0.000) and use of a walking aid (p = 0.001) in the follow-up time point and they pain decreased. Patients were satisfied with interactions during counselling; gender (p = 0.000) and use of a walking aid (p = 0.044) were found to significantly affect. A lack of goal-oriented counselling was in depressive symptoms (p = 0.016), worries (p = 0.010) and loneliness (p = 0.026).

Health care Professionals' experiences of counselling competence in digital care pathways - A descriptive qualitative study.

AIM: Health care professionals are tasked with the role of supporting patients in using eHealth services in their personal care and counselling competence in digital environments to ensure appropriate patient care. Our aim was to describe health care professionals' experiences of counselling competence in Digital Care Pathways. DESIGN: A descriptive qualitative study. METHODS: Interviews with semi-structured questions were conducted. Twelve healthcare professionals were interviewed. The data were analysed using inductive content analysis. The results were reported according to the Consolidated Criteria for Reporting Qualitative Research. RESULTS: The analysis revealed eight distinct areas of competence related to counselling in Digital Care Pathways, namely, counselling competences related to the use of Digital Care Pathways, supporting patients' self-care, information technology competence, competence in creating an interactive counselling relationship on the Digital Care Pathway, information management, ethical competence related to counselling in Digital Care Pathways, competence to developing Digital Care Pathways services, and change competence. NO PUBLIC OR PATIENT CONTRIBUTION: Due to the complex and unpredictable circumstances of COVID, people's strict confinement in the hospital prohibited free access to them and the study environment. Therefore, the professionals involved in the study were interviewed through online systems.

Family members' perceptions of counselling during visits to loved ones in an adult ICU.

AIMS: The study's aims were to (1) assess family members' perceptions of the quality of the counselling they received while visiting a loved one in an adult ICU and (2) identify factors that influence family members' perceptions of counselling quality. DESIGN: A cross-sectional survey of visiting family members of adult ICU patients. METHODS: Family members (n = 55) at eight ICUs across five Finnish university hospitals completed a cross-sectional survey. RESULTS: Family members assessed the quality of counselling in adult ICUs to be good. Factors associated with the quality of counselling were knowledge, family-centred counselling, and interaction. Family members' ability to live normally was associated with understanding of the loved one's situation (ρ = 0.715, p < 0.001). Interaction was associated with understanding (ρ = 0.715, p < 0.001). Family members felt that intensive care professionals did not adequately ensure that they understood counselling-related issues and that they lacked opportunities to give feedback, in 29% of cases, staff asked the family members whether they understood the counselling and 43% of family members had opportunities to offer feedback. However, the family members felt that the counselling they received during ICU visits was beneficial.

Effectiveness of Digital Counseling Before Pediatric Diagnostic Imaging.

PURPOSE: To review and synthesize the available evidence on the effectiveness of preparatory digital counseling for children undergoing diagnostic imaging and their parents in terms of patient-related and imaging outcomes. METHODS: Relevant studies were identified by searching databases and gray literature resources. References from full-text articles identified in the initial search were searched manually to identify additional relevant studies. The reviewed literature included studies on children and adolescents aged 3 to 21 years, their parents, or both, who participated in digital counseling interventions before medical imaging examinations. Literature selection and quality appraisal were conducted by 2 independent reviewers. Data were extracted using standardized tools and synthesized using the narrative synthesis approach. This review was reported according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. RESULTS: Five randomized controlled trials and quasi-experimental studies were included in this review. Digital counseling was provided via multiple approaches with interactive elements. Digital counseling was reported to be effective at reducing anxiety and increasing knowledge and satisfaction among children and their parents. It also appeared to reduce the need for general anesthesia and to improve the success of imaging procedures based on image quality and number of repeated images required. Digital counseling also appeared to increase children's confidence and help them remain still during the imaging process. DISCUSSION: The increased knowledge from digital counseling can strengthen senses of security and self-efficacy, which are important for successful medical imaging examinations, especially in children. The digital counseling applications used in the included studies are location-independent, and children and their parents can use them as often as they want, which might help ensure the provision of sufficient counseling before procedures. CONCLUSIONS: Digital counseling seems to be an effective method for preparing children for diagnostic imaging and a useful tool for facilitating successful medical imaging examinations of children. Because of the small number of original studies in this area, further research is needed to confirm the effectiveness of digital counseling in children's diagnostic imaging.