Transition readiness and anxiety among adolescents with a chronic condition and their parents: A cross-sectional international study.

AIMS: To evaluate associations of age, transition readiness and anxiety in adolescents with chronic conditions and to compare perceptions of adolescents and their parents regarding health self-management and transition readiness. DESIGN: Cross-sectional international study, reported following STROBE guidelines. METHODS: Adolescents and young adults (N = 512, mean age 17.7) with a chronic medical condition and their parents (N = 322) from Finland and Australia. Data were collected through surveys (between September 2017 and December 2020). Adolescents reported the duration of their condition. Age at survey was defined by the response date of the questionnaires. Validated questionnaires were used to measure transition readiness (Am I ON TRAC? for Adult Care) and anxiety related to transition of care (State-Trait Anxiety Inventory short form). Perceptions of health self-management and transition readiness were compared in adolescent/parent dyads. Associations were explored using Spearman's correlation. RESULTS: Duration of condition and age at survey correlated weakly with transition readiness knowledge and behaviour. Higher transition readiness knowledge scores correlated with higher behaviour scores. Higher transition readiness behaviour scores were associated with lower levels of anxiety. Adolescents were less anxious than their parents and adolescents and parents mostly agreed about health self-management and transition readiness. CONCLUSION: Transition readiness should be determined by an assessment of knowledge, self-management and psychosocial skills instead of age alone. Further research should address how well transition readiness predicts positive health outcomes after the transfer of care. IMPLICATIONS FOR PATIENT CARE: Transition readiness and self-management skills should be formally assessed because positive feedback may decrease the anxiety of both adolescents and their parents regarding the transfer of care. REPORTING METHOD: We have adhered to the STROBE statement, using STROBE checklist for cross-sectional studies. PATIENT OR PUBLIC INVOLVEMENT STATEMENT: No patient or public involvement. TRIAL AND PROTOCOL REGISTRATION: ClinicalTrials.org NCT04631965.

Development and psychometric testing of the actualisation of evidence-based nursing instrument.

AIM: To describe the development of the Actualisation of Evidence-Based Nursing instrument targeted at nurses working in clinical practice (ActEBN-nurses), meant for evaluating the actualisation of individual and organisational-level support structures for evidence-based nursing within social and healthcare organisations, and to test its validity and reliability. DESIGN: Cross-sectional survey. METHODS: The FinYHKÄ model was used as the theoretical background of the instrument development and supplemented with the JBI Model of Evidence-Based Healthcare, previous literature and items from a previous instrument, the Evidence-Based Practice Process Assessment Scale, with permission of the copyright holders. After two rounds of expert panel and piloting, a national survey was conducted with the instrument in 2021. The target group consisted of nurses working in clinical practice. Psychometric testing included internal consistency (Omega, item analysis) confirmatory factor analysis and t-test for comparison of two groups' differences (sensitivity). RESULTS: A new instrument, ActEBN-nurses was developed, comprising two parts: Individual-level (32 items, 5-point Likert-scale) and Organisational-level support structures for evidence-based nursing (37 items, 5-point Likert-scale). In total, 1289 nurses participated in the survey. The ActEBN-nurses proved to have good internal consistency in both parts (Omega ω .931 and .966), structural validity and sensitivity based on the two educational levels within the sample. The structure of both parts was slightly modified, based on the CFA modification indices, considering the impact of the reverse worded items in part Individual and redundant items within both parts. CONCLUSION: The ActEBN-nurses has promising psychometrics, and it can be used for evaluating individual and organisational-level support structures for evidence-based nursing within social and healthcare organisations. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Evaluation of the support structures within social and healthcare organisations is needed to recognise shortcomings in current structures and advance evidence-based nursing across different contexts. REPORTING METHOD: The authors state that they have adhered to relevant EQUATOR guidelines: STROBE statement for cross-sectional studies. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Recognising older people's individual resources and home-care-specific tasks in home care in Finland: A document analysis of care and service plans.

BACKGROUND AND RATIONALE: Comprehensive care and service planning in home care is tailored to older people's individual needs and resources in order to support them living at home. However, little is known about how these individual resources and home-care-specific tasks are recognised in older people's care and service plans. AIMS: To describe the content of care and service plans in older people's home care with special attention to their individual resources and home-care-specific tasks. DESIGN: This was a document-based cross-sectional study with mixed-methods analysis, carried out in Eastern Finland during Spring 2018. METHODS: A document analysis using the deductive Finnish Care Classification (FinCC), and an inductively developed framework of older people's care and service plans (n = 71). The data were analysed with descriptive statistical methods. RESULTS: Altogether, 1718 notes were relevant to the FinCC main categories: 707 (41%) focused on older people's needs and 1011 (59%) on nursing interventions. We identified 1104 notes based on the 26 inductively developed main categories: the majority (n = 628, 57%) focused on individual resources and the remainder (n = 476, 43%) on home-care-specific tasks. Increasing age resulted in fewer notes on safety and sensory functions. There were fewer notes on resources related to sleeping and wakefulness after longer care and service periods. An increased number of home visits resulted in more documentation on tasks related to pharmaceutical issues, including repeat prescriptions. DISCUSSION: Individual resources for older people were documented, to some extent, in their care and service plans. It is necessary to review these alongside home-care-specific tasks that support older people's independence and safety at home. CONCLUSION: Individual resources need to be recognised in order to enable home-care professionals to provide tailored, high-quality home care services. Home-care-specific tasks should be supported by documentation with updated, sensitive home care classifications.

Effectiveness of an educational intervention to increase professional nurses' person-centred care competence in long-term care of older people-Quasi-experimental study.

BACKGROUND: Based on previous evidence person-centred care (PCC) as a quality indicator is important in long-term care (LTC) settings for older people. Effective ways to increase nurses' person-centred care competence are missing. AIM: To evaluate the effectiveness of a continuing education (CE) intervention named 'Person First-Please' (PFP) for improving nurses' PPC competence and its connection to PPC climate. METHODS: Quasi-experimental cluster design with intervention and control groups was carried out in LTC settings for older people. The intervention group (n = 77) received a 10-week CE intervention, with control group (n = 123) working as usual. The primary outcome was professional nurses' PCC competence. Secondary outcome was the PCC climate as perceived by nurses and, residents with their next of kin. Measurements were conducted pre-/post-intervention and after 6 weeks using the validated, Person-centred Care Competence scale and the Person-centred Care Climate questionnaire, staff and patient versions. Data was analysed with descriptive and inferential statistics. RESULTS: PCC competence was significantly increased in the intervention group and remained after 6 weeks of follow-up. PCC climate increased in the intervention group in total score and also in all sub-scales, across residents with their next of kin. The control group did not show any significant change. Comparisons of PCC competence and PCC climate in time between intervention and control groups confirmed that changes seen between groups were statistically significant in intervention group. LIMITATIONS: Measurements were self-assessments, which may have been affected by bias, especially in context of competence assessment. CONCLUSION: The intervention was effective in increasing professional nurses' PCC competence and on person-centred care climate in long-term care settings for older people.

Health and social care workers' professional values: A cross-sectional study.

BACKGROUND: Professional values create a basis for successful collaboration and person-centred care in integrated care and services. Little is known about how different health and social care workers assess their professional values. RESEARCH AIM: To describe and compare professional value orientation among different health and social care workers in Finland. RESEARCH DESIGN: A quantitative cross-sectional study. PARTICIPANTS AND RESEARCH CONTEXT: We carried out an online survey of health and social care workers from 8 March to 31 May 2022, using the Finnish version of the Nurses' Professional Values Scale-3. The data were analysed using descriptive and advanced statistics. ETHICAL CONSIDERATIONS: Permission was received from all participating organizations and those who completed the survey provided informed consent. RESULTS: A total of 1823 health and social care workers, representing seven professional groups and students, took part. The overall level of professional values among the participants was relatively high. Commitment to providing patients and clients with equal care was more important than engaging with society and professional responsibilities in the work environment. Professional values were strongest among professionals with higher educational degrees and training in professional ethics. The same was true for workers who received organizational support for ethical practice, were satisfied with their work and had shorter work experience. DISCUSSION: Our results showed shared professional values among different health and social care workers and students. These results are meaningful for integrated care and services. At the same time, a clear need for strengthening engagement with society and professional responsibilities for developing work environments were identified. CONCLUSIONS: Health and social care workers and students need training in professional ethics and organizational support for ethical practice and work satisfaction to maintain their professional values at different stages of their career.

Identification of research priorities of radiography science: A modified Delphi study in Europe.

Radiography science is a new discipline among health sciences. It is a discipline that investigates phenomena in medical imaging, radiation therapy, and nuclear medicine. It has merged from the need to provide research evidence to support these services. The domain of the discipline needs clarification and more research should be focused on its paradigmatic issues. Radiography research priorities have been previously charted on a national level in different countries but the viewpoint has been that of the needs of the profession, not of the discipline. This study aimed to identify the priorities of the discipline. The method chosen was a modified version of the Delphi technique with two rounds. The expert panel consisted of 24 European radiography researchers with long professional experience. This study shows that the research priorities in radiography science are related to the phenomena of radiographers' profession, clinical practices, and the safe and high-quality use of radiation and technology for medical imaging, radiotherapy, and nuclear medicine. Identifying these priorities can help focus research onto most important topics and clarify disciplinary perspective.

Disciplinary processes for nurses, from organizational supervision to outcomes: A document analysis of a regulatory authority's decisions.

AIM: This study aims to explore the disciplinary processes for nurses, from organizational supervision to final decisions by the Finnish regulatory authority. BACKGROUND: Regulatory authorities are responsible for protecting the public, by ensuring that they receive safe, competent and ethical nursing care, but little is known about the disciplinary processes for nurses. METHODS: This is a retrospective document analysis of 296 disciplinary decisions by the Finnish regulatory authority from 2007 to 2016. The data were analysed using a quantitative design with descriptive statistics. RESULTS: We studied 204 disciplined nurses (81.4% female) with a mean age of 43.5 years. The disciplinary process comprised organizational supervision, complaints, investigations and decisions. Nurses with substance abuse issues were more likely to face criminal investigations and receive temporary decisions. The process lasted from under 1 month to years and could have profound effects on nurses, colleagues and nurse managers and compromise patient safety. CONCLUSION: This study identified key factors that could inform the disciplinary processes for nurses. More knowledge is needed about how organisations ensure patient safety when unprofessional conduct is suspected. IMPLICATIONS FOR NURSING MANAGEMENT: Retaining nursing professionals is vital due to global shortages, and more attention should be paid to organizational supervision and support for nurses during disciplinary processes.

Effectiveness of a Digital Health Game Intervention on Early Adolescent Smoking Refusal Self-Efficacy.

Smoking poses a significant threat to adolescent health because of its immediate and long-term detrimental health effects. Smoking refusal self-efficacy predicts smoking behavior in adolescence. In adolescents' health education, digital interventions are potential tools to support smoking refusal self-efficacy. The aim of this two-arm cluster randomized controlled trial was to evaluate the effectiveness of a digital health game intervention compared with a no-intervention control group on smoking refusal self-efficacy in 10- to 13-year-old Finnish early adolescents. The early adolescents (n = 781) were randomized to the control group (n = 394) and the health game intervention group (n = 387). Smoking refusal self-efficacy, sources of smoking and snus refusal self-efficacy, and motivation to decline smoking and snus use in the future were measured at baseline, 2-week postintervention, and 3-month follow-up. Data were analyzed using linear mixed model and Wilcoxon rank-based test for clustered data. According to the results, the intervention group made improvements in sources of smoking and snus refusal self-efficacy between baseline and postintervention, and in sources of snus refusal self-efficacy between baseline and follow-up, compared with the control group. The intervention group showed improvements in smoking refusal self-efficacy among 12-year-olds between baseline and follow-up, and postintervention and follow-up compared with the control group. Similar improvements were also found among those with a smoking friend or a smoking parent between postintervention and follow-up. The results were promising for the use of digital health game interventions to promote early adolescent smoking refusal self-efficacy and preventing smoking experimentation. Further research can evaluate the long-term effects for adolescents.

Occupational well-being among health and social care educators: Structural equation modelling.

This study tested whether empirical data about health and social care educators' occupational well-being would fit the proposed Content Model for the Promotion of the School Community Staff's Occupational Well-being. Descriptive, cross-sectional survey was conducted with 552 health and social care educators in 2020. Results confirmed that the four-aspect Content Model for the Promotion of School Community Staff's Occupational Well-being is suitable for promoting health and social care educators' occupational well-being, with some modifications. The results strengthen the view of occupational well-being as a wide-ranging phenomenon, the development of which should take into account four aspects of promoting occupational well-being.

Patient- and proxy-perceptions on functioning after stroke rehabilitation using the 12-item WHODAS 2.0: a longitudinal cohort study.

PURPOSE: To analyse longitudinally patient- and proxy-perceptions on stroke survivors'(SSs') functioning using the 12-item WHO Disability Assessment Schedule 2.0 (WHODAS) after subacute inpatient stroke rehabilitation. METHODS: Sixty-five SSs and their significant others(proxies) responded to WHODAS questionnaire at discharge and 9 to 50 months later. Self-WHODAS ratings were compared with corresponding proxy-perceptions and informal ratings on self-reported functional recovery. RESULTS: On average, SSs' functioning improved after discharge, except according to self-WHODAS ratings of those with severe stroke. Individual changes were, however, notable. Association between time and change was statistically insignificant. SSs perceived greatest improvements in walking, household tasks, community life and working ability. The only items showing slight deterioration were emotions and relationships. In parallel, proxies rated all items except emotions and relationships improved. At discharge, proxies rated SSs' functioning more impaired than SSs themselves, mostly regarding those with severe stroke. Still, inter-rater reliability was very strong and increased significantly with time (ICC 0.799 vs. 0.979 at follow-up). Ninety percent of SSs with improved functioning according to self-WHODAS reported better functioning also in the informal questionnaire. CONCLUSION: WHODAS showed improvements in SSs' functioning 9-50 months after discharge from subacute stroke rehabilitation. Improvements were in line with proxy-perception and self-reported functional recovery.IMPLICATIONS FOR REHABILITATIONStroke survivors' functioning improved significantly during the 9-50 months follow-up after subacute inpatient stroke rehabilitation.Stroke survivors perceived slightly less difficulties in their functioning compared to evaluations by proxies.Strong correlation between patient- and proxy-perceptions on stroke survivors' functioning strengthened from subacute to chronic phase of stroke recovery.The 12-item WHODAS 2.0 seems to be a valuable patient- and proxy-reported outcome measure to assess longitudinal changes in stroke survivors' functioning after stroke.

An Instrument to Assess the Digital Competence of Nurse Educators.

BACKGROUND: The Educators and Educator Candidates' Competence in Digital Pedagogy instrument needed to be tested before using it in nursing education. PURPOSE: This study describes the further testing of this instrument to measure nurse educators' digital competence. METHODS: The study is reported according to the 7 steps of the MEASURE Approach. Psychometric testing was conducted with a sample of 111 Finnish nurse educators from 9 universities of applied sciences. The study was conducted during the years 2020 and 2023. RESULTS: The exploratory factor analysis results explained 56% of the variance with 3 factors, including 20 items. The factors were labeled to describe the nurse educators' digital competence: implementing appropriate independent and community learning, acting safely and responsibly, and guiding learning based on the evidence. Cronbach α and McDonald ω coefficients showed good reliability. CONCLUSIONS: The instrument can be used to assess digital competence and identify the development needs to facilitate educators' continuous professional development.

Nursing applicants' desire to work in nursing and related factors: a cross-sectional study.

BACKGROUND: The desire to work in the nursing profession has recently been identified as an important aspect to consider in the selection process of nursing students but very little is known about nursing applicants' or students' desire to work in nursing. AIMS: The study aimed to describe and explain the desire of undergraduate nursing applicants to work in nursing. DESIGN: A cross-sectional study design. METHODS: The Desire to Work in Nursing Instrument was used to collect the data. All nursing applicants (N = 974) who took part in an entrance examination organised in six Universities in October 2018 were eligible to participate. Eight Hundred and Forty-one applicants (response rate 86%, 102 males) participated in the study. Statistical analysis included the use of descriptive statistics and linear regression was used to assess if dependent variables explained the observed outcomes. RESULTS: A strong desire to work in nursing was demonstrated in all the four areas. The most common reason to desire this work was suitability to nursing and the nature of work, and the least common was the career opportunities. Gender, previous education, and a realistic image best explain the desire. CONCLUSIONS: The assessment of desire to work in nursing may assist career choice of nursing applicants, and may enhance recruitment and retention in nursing education. Applicants need to be more aware of the career development possibilities. Further studies are needed to investigate if the desire to work in nursing is different to men than to women to inform recruitment strategies.

An intervention to address nurse educators' occupational well-being: A process evaluation.

BACKGROUND: There is a global need for more support for the occupational well-being of educators working in nurse education, where nurse educators experience challenges when managing their own occupational well-being. However, there is a lack of research studies into occupational well-being interventions. Aim To evaluate the usability and utility of the Self-Help INtervention for Educators in nurse education. DESIGN: A process evaluation was conducted after the intervention in Spring 2022. SETTINGS: Educational organisations providing national regulated practical nurse education in Finland. PARTICIPANTS: Nurse educators (n = 37), completing the 8-workweek intervention. METHODS: Data were collected with the self-reported electronic feedback questionnaire consisting of three sections: 1) 10-item System Usability Scale, 2) 7-item Utility scale developed for this study and 3) 4 open ended questions. The data were analysed statistically and with content analysis. RESULTS: The intervention was found to be usable; especially the easy learnability and usage of the digital Smart Break-SHINE program and the applicable exercises. It was estimated to be moderately useful as a well-being and break promoter at work. The utility of the intervention to promote physical activity and recovery during working hours was statistically more positive for educators with <5 years of work experience than those with over 15 years. Usability and utility barriers were found especially regarding workload issues. CONCLUSIONS: The Self-Help INtervention for Educators supports the occupational well-being of nurse educators and includes well-being actions suitable for different work surroundings (e.g., remote working) without the need for constant facilitating. The intervention was found to be most beneficial for early career nurse educators. The Self-Help INtervention for Educators needs more development to overcome the usability and utility barriers related to workload issues.

Effectiveness of an Occupational Well-being Intervention Among Nurse Educators: A Quasi-Experimental Study.

BACKGROUND: Occupational well-being supports the retention of the nurse educator workforce and their ability to manage workload. There is a research gap regarding interventions promoting occupational well-being. PURPOSE: To evaluate the effectiveness of an 8-workweek digital occupational well-being intervention using self-conducted exercises among nurse educators in secondary vocational nursing schools in Finland. METHODS: A quasi-experimental study design was applied using an intervention group (n = 37) and a control group (n = 40). Data were collected at baseline, post, and 1-month follow-up using a questionnaire and a heart rate sensor to assess the resource-workload-balance and its associating and promoting factors. RESULTS: This study found no statistical effects on the resource-workload-balance. Positive effects were found on associating factors (general well-being) and promoting factors (recovery experiences and self-regulation). CONCLUSIONS: Self-Help INtervention for Educators (SHINE) has the potential to promote recovery experiences during working hours; however, the intervention needs more investigation.

Professional competence, personal occupational well-being, and mental workload of nurse educators - A cross-sectional study in four European countries.

BACKGROUND: Nurse educators need a high level of professional competence to educate future health care professionals. Professional competence supports occupational well-being whilst high mental workload can undermine it. There is little existing research into nurse educators' professional competence, occupational well-being, mental workload, and the relationships between them, particularly in the European context. OBJECTIVES: To describe the professional competence, personal occupational well-being, and mental workload of nurse educators in four European countries, and to explore how the professional competence and mental workload of nurse educators relate to their personal occupational well-being. DESIGN: Cross-sectional study design with quantitative survey data. SETTING: Nurse educators from Finland, Spain, Slovakia, and Malta. METHODS: The data were collected from 302 nurse educators through an online questionnaire which used the Health and Social Care Educator's Competence (HeSoEduCo) instrument. This contains 43 items which measure areas of professional competence. Statistical analysis involved descriptive and multivariate analysis. RESULTS: Nurse educators self-assessed their overall professional competence as high. Competence in evidence-based practice was assessed as the highest whilst cultural competence was perceived to be the lowest of the six competence areas. Nurse educators perceived their levels of personal occupational well-being and the balance of mental workload as moderate. However, these levels varied between the four countries. Professional competence, more specifically administrative and curriculum competence, and a balanced mental workload were positively related to personal occupational well-being. CONCLUSIONS: The educators who perceive themselves to have very good professional competence and a balanced mental workload are more likely to report high occupational well-being. The findings suggest that nurse educators' cultural competence needs to be strengthened and intervention research is needed to determine ways of reducing mental workload and increasing the occupational well-being of nurse educators.

Psychological capital, grit and organizational justice as positive strengths and resources among registered nurses: A path analysis.

AIM: To examine registered nurses' individual strengths (psychological capital and grit) and an organizational resource (organizational justice) as well as associated work-related outcomes. In a time of a global nursing shortage, there is an urgent need to identify strengths and resources that can have a positive impact on the health, well-being and retention of registered nurses. DESIGN: A cross-sectional survey. METHODS: A nationwide convenience sample of 514 registered nurses responded to a survey. Data were collected using a self-reported questionnaire between March and May 2018. Data were analysed using descriptive statistics and multivariate path analysis. RESULTS: Participants rated their psychological capital and grit moderately high. Grit and organizational justice were found to have significant direct effects on psychological capital. Furthermore, psychological capital had positive direct effects on engagement and the perception of well-conducted everyday nursing as well as negative direct effects on burnout, the stress of conscience and the intent to leave the profession. CONCLUSION: The results suggest that nurse leaders and managers could consider improving registered nurses' well-being with two complementary approaches. It might be useful to reinforce positive, individual strengths, such as psychological capital, and at the same time create more favourable nursing work environments, for example by strengthening organizational justice. IMPLICATIONS FOR THE PROFESSION: Psychological capital and grit are emerging concepts in nursing workforce research. Identifying registered nurses' positive strengths and resources is important for inventing interventions that enhance nurses' engagement and well-being as well as reduce turnover intentions. IMPACT: Nurse leaders and managers play crucial roles in managing and developing registered nurses' individual strengths and organizational resources. This has gained even more importance now as the COVID-19 pandemic could have a long-term negative impact on nurses' well-being. REPORTING METHOD: The study is reported following STROBE guidelines. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Person-centred care competence and person-centred care climate described by nurses in older people's long-term care-A cross-sectional survey.

BACKGROUND: Person-centred care requires that nurses are competent in this approach to care. There may be an association between person-centred care competence and person-centred care climate, but it has not been demonstrated in the literature. This is the justification for the survey study to gain staff's perceptions of such a relationship. OBJECTIVES: The aim of this study was to analyse the levels and associations between person-centred care competence and the person-centred care climate as assessed by professional nurses in long-term care settings for older people. METHODS: A descriptive cross-sectional survey design with cluster sampling was used to recruit professional nurses of different levels from six long-term care institutions for older people. Data were collected using the Patient-centred Care Competency scale (PCC) and the Person-centred Climate Questionnaire staff version (PCQ-S) in September 2021 and analysed with descriptive and inferential statistics. RESULTS: The mean score on the PCC was rated at a good level of 3.80 (SD 0.45), and the PCQ-S was rated at a good level of 3.87 (SD 0.53). The correlation between PCC and PCQ-S total scores (r = .37, p < .001) indicated that person-centred care competence and person-centred care climate were associated. No associations were detected between nurses' educational levels and PCC (p = .19) or PCQ-S (p = .13) or in terms of age or work experience. CONCLUSIONS: The results provide insights into competence and climate levels of person-centred care and preliminary evidence of an association between nurses' assessed competence in person-centred care and the perceived person-centred care climate in long-term care. Nurses' individual characteristics did not appear to affect the level of person-centred care competence or climate. In the future professional nurses of different levels could benefit from effective continuing education in person-centred care. This study design serving for the future intervention study registered to the ClinicalTrials.goc NCT04833153.

Supporting lifestyle change in obese pregnant mothers through the wearable internet-of-things (SLIM) -intervention for overweight pregnant women: Study protocol for a quasi-experimental trial.

OBJECTIVES: To assess, in terms of self-efficacy in weight management, the effectiveness of the SLIM lifestyle intervention among overweight or obese women during pregnancy and after delivery, and further to exploit machine learning and event mining approaches to build personalized models. Additionally, the aim is to evaluate the implementation of the SLIM intervention. METHODS: This prospective trial, which is a non-randomized, quasi-experimental, pre-post intervention, includes an embedded mixed-method process evaluation. The SLIM Intervention is delivered by public health nurses (n = 9) working in maternity clinics. The public health nurses recruited overweight women (n = 54) at their first antenatal visit using convenience sampling. The core components of the intervention i.e. health technology, motivational interviewing, feedback, and goal setting, are utilized in antenatal visits in maternity clinics starting from gestational week 15 or less and continuing to 12 weeks after delivery. Mixed effect models are used to evaluate change over time in self-efficacy, weight management and weight change. Simple mediation models are used to assess calories consumed and moderate to vigorous physical activity (MVPA) as mediators between self-efficacy and weight change. Signal processing and machine learning techniques are exploited to extract events from the data collected via the Oura ring and smartphone-based questionnaires. DISCUSSION: The SLIM intervention was developed in collaboration with overweight women and public health nurses working in maternity clinics. This study evaluates the effectiveness of the intervention among overweight women in increasing self-efficacy and achieving a healthy weight; thus, impacting the healthy lifestyle and long-term health of the whole family. The long-term objective is to contribute to women's health by supporting weight-management through behavior change via interventions conducted in maternity clinics. TRIAL REGISTRATION: The trial was registered at the Clinicaltrials.gov register platform (ID NCT04826861) on 17 March 2021.

Nurse educator competence in four European countries-A comparative cross-sectional study.

AIM: The aim of this article is to describe and compare the nurse educator competences in four European countries using three different evaluators: nurse educators (n = 329), heads of a nursing subject (n = 60) and student nurses (n = 1058). DESIGN: The study was conducted as a comparative cross-sectional survey in Finland, Malta, Slovakia and Spain between May 2021 and February 2022. METHODS: The data were collected with an online survey. The instrument used was a 20-item Tool for Evaluation of Requirements of Nurse Teachers, utilizing a 5-point Likert-type scale. The data were analysed statistically and reported according to STROBE guidelines. RESULTS: Nurse educators' competence evaluated positively in all the groups of evaluators, with a mean of >3.5. The self-evaluation of nurse educators' competence was higher than the other evaluators' evaluations. Having a degree in nursing, having completed some pedagogical studies and longer work experience as a nurse educator had a positive association with higher self-evaluated competence among nurse educators. CONCLUSIONS: Nurse educator competence is at a good level in the selected European countries, but further studies are required to find the reasons behind the differences in evaluations. PUBLIC CONTRIBUTION: Each participating educational institution named a contact person who distributed the surveys to the participants and returned the study's metadata to the researchers.

Comparing prenatal and postpartum stress among women with previous adverse pregnancy outcomes and normal obstetric histories: A longitudinal cohort study.

OBJECTIVE: The aim of this study was to compare subjectively and objectively measured stress during pregnancy and the three months postpartum in women with previous adverse pregnancy outcomes and women with normal obstetric histories. METHODS: We recruited two cohorts in southwestern Finland for this longitudinal study: (1) pregnant women (n = 32) with histories of preterm births or late miscarriages January-December 2019 and (2) pregnant women (n = 30) with histories of full-term births October 2019-March 2020. We continuously measured heart rate variability (HRV) using a smartwatch from 12 to 15 weeks of pregnancy until three months postpartum, and subjective stress was assessed with a smartphone application. RESULTS: We recruited the women in both cohorts at a median of 14.2 weeks of pregnancy. The women with previous adverse pregnancy outcomes delivered earlier and more often through Caesarean section compared with the women with normal obstetric histories. We found differences in subjective stress between the cohorts in pregnancy weeks 29 and 34. The cohort of women with previous adverse pregnancy outcomes had a higher root mean square of successive differences between normal heartbeats (RMSSD), a well-known HRV parameter, compared with the other cohort in pregnancy weeks 26 (64.9 vs 55.0, p = 0.04) and 32 (63.0 vs 52.3, p = 0.04). Subjective stress did not correlate with HRV parameters. CONCLUSIONS: Women with previous adverse pregnancy outcomes do not suffer from stress in subsequent pregnancies more than women with normal obstetric histories. Healthcare professionals need to be aware that interindividual variation in stress during pregnancy is considerable.