Validation of the Nurses' Skills to Care for Alcohol-Intoxicated Patients in Emergency Department (NSCAIP-ED) instrument.

Aim To report the development and validation of the Nurses' Skills to Care for Alcohol-Intoxicated Patients in Emergency Department instrument, shortened NSCAIP-ED. Methods: A mixed-methods design was used to develop the instrument. It was used to conduct a survey where ED nurses self-evaluated their skills to care for acutely ill alcohol-intoxicated patients (N = 1220, n = 252). The data were utilised to perform instrument validation using confirmatory factor analysis (CFA) and Cronbach's alpha. Results: The construct validity was tested statistically. The CFA model fit indicators showed mostly acceptable fit (chi-square test p < 0.001; RMSEA 0.079; CFI 0.923; TLI 0.918; SRMR 0.084) and instruments' scales had well acceptable Cronbach's alpha values (all alphas were in the range of 0.866-0.912). Conclusions: The NSCAIP-ED is a feasible and reliable instrument that can be used when measuring nurses' skills to care for alcohol-intoxicated patients in the ED. This instrument could be useful for nursing managers in EDs for evaluating their nursing staff's skills in the care area in question, but also for designing continuing education based on the results.

Contents, Methods, and Outcomes of Adolescent Sexual Health Promotion in School Environments: A Scoping Review.

BACKGROUND: Schools play a significant role in adolescent sexual health (SH) promotion. Although adolescents' SH has improved, growing challenges still exist in some areas. Previous studies have noted a lack of knowledge about SH promotion implementation in school environments. The purpose of this review is to describe the contents, methods, and outcomes of adolescent SH promotion in school environments. METHODS: Three databases (Cinahl, ERIC, Medline) were searched for peer-reviewed articles published in 2011 to 2022, to identify SH promotion in school environments for adolescents aged 12 to 19 years old. After critical appraisal, inductive content analysis was conducted. RESULTS: After screening, 25 studies from 8 countries were included. Sexually transmitted diseases and contraception were emphasized in the contents of the methods. Five SH promotion methods were identified: traditional, virtual, interactive, practical skills supporting, and creative. The outcomes were advancement in SH abilities, changes in sexual behavior, and the strengthening of sexual identity. CONCLUSIONS: The contents mostly considered negative consequences of sexual behavior, whereas positive aspects were less discussed. Traditional methods were emphasized, yet positive outcomes were identified regardless of the method. SH promotion should aim to better support adolescents' sexual identity reinforcement.

First-Time Parents' Bonding with Their Baby: A Longitudinal Study on Finnish Parents during the First Eight Months of Parenthood.

Early positive bonding between parents and babies promotes the development of parenting skills and parents' sensitivity to their infant's needs. Positive bonding has been suggested to decrease the risk of maltreatment. There is less research into the differences between primiparae's and their spouses' bonding with their baby and changes in the parent-to-infant bonding during the first year of the baby's life. The aim of this study was to describe bonding with one's baby and related differences and changes within first-time parents. The data were collected from nine maternal health clinics in 2019-2021 in one city in Finland. The Mother-to-Infant Bonding Scale (MIBS) and the Edinburgh Postnatal Depression Scale (EPDS) were used. The data were collected during pregnancy (T1) and when the baby was aged 1-2 months (T2) and 6-8 months (T3). The questionnaire was completed separately by the primiparae (n = 81 at T1) and their spouses (n = 79 at T1). The findings demonstrated that both parents had positive feelings for their baby. The primiparae's and their spouses' MIBS scores were relatively low at T2 and T3. The change between time points or the difference in the parents' bonding was not statistically significant when examining MIBS total scores. The present study identified a positive weak-to-moderate correlation between the MIBS and EPDS. This association was highlighted in the group of primiparae. The results of this study can be used to develop maternity and child health clinic services, and to promote parents' equal growth in parenthood.

Experiences of Help from the Perspective of Parents Whose Adolescent Is Harming Themselves or Has Died by Suicide.

Adolescent self-harm or suicide are emotionally difficult for parents, thus also parents need help. This qualitative descriptive study aimed to produce knowledge on the experiences of help received by Finnish parents (n = 23) whose adolescent is harming themselves or has died by suicide. The parents received diverse help for themselves, and for their self-harming adolescent or the deceased adolescent's sibling. Parents described negative experiences, but also factors that promoted their experience of help. There are many barriers to help related to the parents themselves, the adolescent, or to the social support system. Professional help should be easier to obtain and be based on the parents' individual expectations.

Contemplating Help-Seeking in Perinatal Psychological Distress-A Meta-Ethnography.

Perinatal psychological distress (PPD) may cause delays in help-seeking in the perinatal period, which is crucial for families with small children. Help-seeking theories focus on rational processes of behavior wherein 'help-seeking' is viewed as a decision-making process, in which action is preceded by recognizing a problem. We identified the phase prior to actual help-seeking actions as a life situation and a phenomenon through which to gain a deeper understanding from women's own perspectives. The aim of this study was to integrate and synthesize knowledge of women's experiences of contemplating seeking help for PPD. We chose interpretative meta-ethnography by Noblit and Hare (1988) and implemented eMERGe guidelines in reporting. The search was performed systematically, and the 14 included studies were evaluated with Critical Appraisal Skills Programme checklist (CASP). We identified seven themes and a metaphor in a lines-of-argument synthesis, showing that contemplating help-seeking is a multidimensional phenomenon. We did not observe a straightforward and linear process (as previous research suggests) but instead a complex process of contemplating help-seeking. A clinical implication is that service providers should work with outreach and develop their tools to connect with mothers with PPD. Another suggestion is to improve training in mental health literacy prior to or during pregnancy.

Experiences of Help From the Perspective of Finnish People Who Self-Harmed During Adolescence.

Adolescent self-harm is a widespread phenomenon, and a significant problem worldwide. This study describes the experiences of help from the perspective of Finnish people who have suffered self-harm during adolescence. Data were collected from 27 participants as essays and interviews. Participants included both females and males with different backgrounds and treatment experiences. The data were analysed using inductive content analysis. Participants described having received help from other people in informal and formal ways, and they had both positive and negative experiences of help. The results show that several barriers exist for self-harming adolescents to access help, thus improvement in this area are necessary.

Caring for alcohol-intoxicated patients in an emergency department from the nurses' point of view - focus on attitudes and skills.

BACKGROUND: Healthcare professionals have a key role in detecting health risks from alcohol use. The earlier the alcohol misuse is identified and addressed, the lower the risk of harm and the need for actual drug treatment. Positive attitudes and high motivation on the part of nurses are needed for achieving success in the care of intoxicated patients. AIM: The aim of the study was to describe nurses' skills to care for and attitudes towards the care of patients with alcohol intoxication in emergency departments (EDs). METHOD: The data were collected from nursing staff who participated in online training related to the care of alcohol-intoxicated patients in the EDs (N = 20, n = 17). As part of the training, nurses wrote two essays. The essays made up the data of this study which were analysed using inductive content analysis. RESULTS: Three main categories emerged from the nurses' descriptions of their skills in caring for and attitudes towards the care of patients with alcohol intoxication: nurse's lack of commitment to intoxicated patient care; nurse's commitment to intoxicated patient care; and nurse's skills in intervention methods. CONCLUSION: Many different factors influence nurses' commitment or lack of commitment in the care of intoxicated patients. Nurses' attitudes and skills are linked to the success of care of intoxicated patients in ED. IMPLICATIONS FOR NURSING OF ALCOHOL-INTOXICATED PATIENTS: Increasing awareness of alcohol-related issues seems to help nurses to understand better the situation of a patient with alcohol intoxication, make their attitudes more positive and help them to use the intervention methods.

The Care of the Patients With Alcohol Intoxication in the Emergency Department of a Central Hospital: Nurses' Skills, Knowledge, and Attitudes.

AIM: The aim of the study was to describe nurses' skills, knowledge of care, and attitudes toward the care of patients with alcohol intoxication in the emergency department. METHOD: The data were collected using theme interviews in 2016. The study participants were nurses working in the emergency department (n = 6) that has a sobering unit. The data were analyzed using inductive content analysis. RESULTS: On the basis of the interviewees' descriptions, five main categories were formed: the skills to discuss the use of alcohol on arrival, safety skills, teamwork skills, the skills to organize follow-up care, and nurses' attitudes and ethics in patients' care. Asking about the use of alcohol as well as the use of a screening tool varied. The interviewees emphasized the skills to anticipate the risk of violence as well as ensuring the safety of the working environment. Nurses' attitudes were seen as the ability to regulate negative emotions raised by the patient. Factors related to nurses' attitudes emerged in patients' behavioral disorders and commitment to treatment. Despite some negative feelings toward patients, nurses thought that it is important to ensure ethicality in patients' care. CONCLUSIONS: The nurses' skills and knowledge of care and attitudes toward patients with alcohol intoxication varied. There is a need for additional training on issues relating to the treatment of patients with alcohol intoxication.

Attitudes, knowledge and sexual behavior among Finnish adolescents before and after an intervention.

Adolescents are an important target group for sexual health promotion, and there are numerous programs and interventions carried out in this field. The aim of this study is to describe adolescents' attitudes, knowledge and sexual behavior before and after a sexual health promotion intervention. The intervention was developed in the study and consisted of three elements: (i) class-room session, (ii) information materials and (iii) free condom distribution. The study was carried out in eight randomly selected vocational schools in Finland. The participants were first year students aged 15-19 years. The data were collected using an electronic questionnaire before intervention (intervention baseline n = 500, control baseline n = 183) and two times after the intervention (intervention first follow-up n = 173/second follow-up n = 202, control first follow-up n = 115/second follow-up n = 46). There were significant differences before and after the intervention concerning better knowledge and more frequent testing for sexually transmitted infections (STIs). Schools are an important environment to reach adolescents during the phase where their sexual health is developing and there is an increased risk of STI transmission. More school-based interventions are therefore needed, and the results of this study can be utilized when developing sexual health promotion interventions among adolescents.

Lesbian and bisexual women's experiences of health care: "Do not say, 'husband', say, 'spouse'".

AIMS AND OBJECTIVES: To describe the experiences and wishes of lesbian and bisexual women concerning health care in Finland. BACKGROUND: Sexual orientation is a personal aspect of identity and also an important aspect of holistic health care. Lesbian and bisexual women have unmet health needs. The way that healthcare personnel encounter lesbian and bisexual women affects whether they disclose their sexual orientation. DESIGN: Qualitative inductive survey. METHODS: The research data for this study were collected in spring 2018 using an electronic survey (n = 22). The data were analysed using inductive content analysis. The research report has been checked using COREQ checklist, see Appendix S1. RESULTS: The research data were divided into two main domains: experiences and wishes. Women described health care as being heteronormative. They had both good and bad experiences, and their own poor experiences and those of others had a negative impact on their utilisation of healthcare services. Women had apprehensions about encountering stereotyping in health care and did not always disclose their orientation, even though recognising it would be integral to the provision of holistic health care. Lesbian and bisexual women wished that health care would refrain from heteronormativity, acknowledge issues that were important to them and engage with them without any prejudgement. They also wished healthcare environments would be improved to reflect an open acceptance of sexual minorities and also co-operate with sexual minority organisations. CONCLUSIONS: Women had conflicting experiences. Heteronormativity was seen as an obstacle for holistic health care. Women hoped health care would collaborate with the third sector. RELEVANCE TO CLINICAL PRACTICE: Sexual diversity should be acknowledged and better communicated to patients. Women hoped personnel would have the understanding to treat them in the same professional way as any other patients, but with expertise specific to their needs, for example in sexual health guidance.

Using interventions to reduce seclusion and mechanical restraint use in adult psychiatric units: an integrative review.

The aim of this integrative review was to describe interventions aimed at reducing seclusion and mechanical restraint use in adult psychiatric inpatient units and their possible outcomes. CINAHL, MEDLINE, PsycINFO and Medic databases were searched for studies published between 2008 and 2017. Based on electronic and manual searches, 28 studies were included, and quality appraisal was carried out. Data were analysed using inductive content analysis. Interventions to proactively address seclusion were environmental interventions, staff training, treatment planning, use of information and risk assessment. Interventions to respond to seclusion risk were patient involvement, family involvement, meaningful activities, sensory modulation and interventions to manage patient agitation. Interventions to proactively address mechanical restraint were mechanical restraint regulations, a therapeutic atmosphere, staff training, treatment planning and review of mechanical restraint risks. Interventions to respond to mechanical restraint risks included patient involvement, therapeutic activities, sensory modulation and interventions to manage agitation. Outcomes related to both seclusion and mechanical restraint reduction interventions were varied, with several interventions resulting in both reduced and unchanged or increased use. Outcomes were also reported for combinations of several interventions in the form of reduction programmes for both seclusion and mechanical restraint. Much of the research focused on implementing several interventions simultaneously, making it difficult to distinguish outcomes. Further research is suggested on the effectiveness of interventions and the contexts they are implemented in.

Vocational school students' self-evaluations of a sexual health promotion intervention.

Sexually transmitted infections (STIs) continue to pose a health risk among adolescents. School is therefore a logical place for promoting sexual health through interventions, but previous research has not examined student's self-evaluations of these interventions. The purpose of this study was to examine students' self-evaluations of a sexual health promotion intervention carried out in four randomly selected vocational schools in Finland in the year 2011. The participants (n = 168) were first-year students aged 15-19 years. The intervention (11 weeks) consisted of three components: (i) a teacher-delivered classroom lesson about sexual health, (ii) information materials about sexual health and (iii) free condom distribution in the school corridors. An electronic questionnaire was developed and administered to the students after the intervention. The participants' evaluations of the intervention were fairly positive. Almost all of the participants were at least partly satisfied with the classroom lesson. They mostly reported learning new information about STIs and sexuality. Information material was also read and participants self-evaluated themselves as having learned from the materials. Free condoms were obtained and the students felt that the condom distribution was useful. Sexual health promotion interventions might in the future include the classroom lesson, information material and free condom distribution components used in this study.

Caring Interaction with stroke survivors' family members-Family members' and nurses' perspectives.

AIMS AND OBJECTIVES: To examine emotional support given by nurses to family members in the acute phase after a working-aged patient's stroke based on nurses' and family members' experiences. BACKGROUND: The number of patients with stroke is increasing globally. There is a lack of knowledge about the emotional support of family members during the acute phase of working-aged stroke victims. To be able to provide high-quality nursing care during this phase, we need information about emotional support from family members' and nurses' perspective. METHOD: Using a Glaserian grounded theory approach, the study was conducted using open interviews with family members and group interviews with nurses. Data were collected between 2012-2013. RESULTS: In this study, emotional support is identified as Caring Interaction. The changed life situation and diverse feelings aroused by the stroke are the starting point of providing emotional support to family members. It is important that the nurses notice family members' need for support at the right time, use their intuition and respond appropriately. CONCLUSIONS: The patient's family members are important when providing holistic nursing care for the whole family. As well as providing emotional support, high-quality nursing interventions enhance the care of family members. This study provides an explanation of the interaction process between family members and nurses. It helps family members and nurses to better understand each other. Although the data were collected 5 years ago, it is assumed that the interaction between family members and nurses has not changed during these years remarkably. RELEVANCE TO CLINICAL PRACTICE: According to the experiences of family members and nurses who participated in this research, emotional support manifests in Caring Interaction. Being aware of body language and behaviour of family members, nurses can better interact with them.

Experiences of living with a sexually transmitted disease: an integrative review.

PURPOSE: This integrative review describes experiences related to living with a sexually transmitted disease (STD). DESIGN: The data search was conducted using the CINAHL, MEDLINE (Ovid), PsycINFO and PubMed databases between the years 2000 and 2016. A manual search was also used. The retrieved data consisted of 33 original articles which were analysed using deductive and inductive content analysis. RESULTS: Based on the results, an infected person has a need for information about STDs and experiences emotions such as a loss of purity and control over his/her body. In addition, the ego of the infected person is wounded due to the infection. Concerns about the results of treatments, suffering side effects, and experiences of unprofessional behaviour by nursing staff are related to the treatment of an STD. Having an STD in everyday life means coping with a changing condition, but there are resources that can provide support. The quality of life can also be negatively affected by an STD, and a future with an STD can manifest different hopes and concerns. In relation to other people, an STD has a marked effect, especially concerning sexual relations. The person's sex life can fade away; however, it may remain as an enjoyable experience. The infected person may also adopt safer sexual behaviours or continue with a risk-taking behaviour. CONCLUSION: The results of this review can be used in the development of nursing practices, as well as be used in the prevention of STDs.

Knowledge of HIV infection and other sexually transmitted diseases among men who have sex with men in Finland.

BACKGROUND: The purpose of this study was to describe what is known about HIV infection and other sexually transmitted diseases, infection transmission routes, care, and sources of information, from the viewpoint of men having sex with men. METHODS: National data (n = 2,072) was collected from June to August 2010 in Finland as part of a joint internet-based survey conducted in 38 countries (EMIS, European MSM Internet Sex Survey). RESULTS: The respondents' age, place of residence, highest education and employment status were statistically significantly related to how often the respondent sought information on HIV, testing and treatments, and what they knew about infection transmission routes. The respondents' information seeking behavior was not seen as active regarding HIV infection and other sexually transmitted diseases. CONCLUSIONS: We should also consider the possibility of using internet-based interventions, especially in smaller and northern catchment areas, in order to improve the knowledge level of men having sex with men.

The Therapeutic Approach to a Patient's Criminal Offense in a Forensic Mental Health Nurse-Patient Relationship-The Nurses' Perspectives.

PURPOSE: The purpose of this study is to describe the therapeutic approach to a patient's criminal offense in a forensic mental health nurse-patient relationship from the nurse's perspective. DESIGN AND METHODS: Eight nurses in a Finnish forensic psychiatric hospital were interviewed, and the resultant research material was analyzed by inductive content analysis. FINDINGS: The results revealed the process of the therapeutic approach to a patient's offense, which comprises numerous steps and various phases. PRACTICE IMPLICATIONS: For the nurse, the process of working through the offense can be divided into stages in which an attempt is made to respond to the patient's behavior and interaction in a manner that leads to working through the criminal act.

Mental Health Service Users' Experiences of Training Focused on Empowerment: Training Environment and the Benefits of Training.

This qualitative study investigated the mental health service users' (MHSUs') experiences of empowerment training and it was based on individual interviews with 24 MHSUs. Findings showed that MHSUs described the training environment through three dimensions: social interaction, learners' internal resources and the pedagogical execution of training. The training reinforced their positive internal resources, stimulated their inner mind activity and gave meaning to their lives. The knowledge of the training environment helps to build environment, which will support MHSUs' training. Empowerment training could be used to strengthen MHSUs' positive internal resources giving them also a possibility to train their cognitive activities.

Psychiatric Nurses' Emotional and Ethical Experiences Regarding Seclusion and Restraint.

The purpose of this study was to describe psychiatric nurses' emotional and ethical experiences regarding seclusion and restraint, and factors associated with these experiences. The data (n = 165) was collected in southern Finland, using the electronic version of the Seclusion and Restraint Experience Questionnaire (SREQ) and analyzed with statistical methods. We found that the experiences of control and duty were strongly emphasized in responses, especially among nurses with short work experience or temporary employment. These results offer new information about psychiatric nurses' experiences regarding seclusion and restraint. These results can be utilized both in the teaching and in management of the nursing.

Social networks of older adults living with HIV in Finland.

The aim of this study was to explore the social networks of older adults living with HIV. Interviews were conducted with nine individuals aged 50 or older living with HIV in Helsinki, Finland. Analysis of transcripts was analysed by inductive qualitative content analysis. Results indicated that these participants' networks tended to be large, including those both aware and unaware of the participants' health status. Analysis identified three main themes: large multifaceted social networks, importance of a support group, and downsizing of social networks. Support received appeared to be of great importance in coping with their health condition, especially since the time of diagnosis. Friends and family were the primary source of informal support. The majority of participants relied mostly on friends, some of whom were HIV-positive. Formal support came primarily from the HIV organisation's support group. In this study group, non-disclosure did not impact participants' well-being. In years to come, social networks of older adults living with HIV may shrink due to personal reasons other than HIV-disclosure. What is of primary importance is that healthcare professionals become knowledgeable about psychosocial issues of older adults living with HIV, identifying latent problems and developing adequate interventions in the early stages of the disease; this would help prevent social isolation and foster successful ageing with HIV.

Russian nursing students' knowledge level and attitudes in the context of human immunodeficiency virus (HIV) - a descriptive study.

BACKGROUND: The purpose of this study was to describe the knowledge of Russian nursing students regarding HIV and Acquired Immuno-Deficiency Syndrome (AIDS), and their attitudes towards caring for people/patients living with HIV or AIDS (PLWHA - People Living With HIV/AIDS) and their possible homophobic attitudes. The HIV epidemic in Russia is substantial and increasing rapidly. Hence this study provides important new information regarding this phenomenon. METHODS: The data was collected by questionnaire from students in three nursing schools (n = 102, response rate 95.3%). The data was analyzed using PASW Statistics version 18. For computing the level of the students' AIDS knowledge, all correct answers were recorded as equal to (1), while all incorrect and "Don't know" answers were recorded as equal to (0). Each respondent's scores were totaled and individual scores were analyzed using regression analysis. The effect of demographic variables on the average scores of attitudes was also subjected to regression analysis. RESULTS: Overall, students' knowledge level regarding HIV and AIDS was moderate (range 5-26). Of a maximum score of 33, the mean of correct answers was 19.8 (SD = 3.70). Nursing students' attitudes were quite negative and they also demonstrated homophobic attitudes. The mean scale score for nursing students' general attitude was 2.75, and for homophobic attitudes it was 3.3 (min = 1, max = 5). Only the background factor of gender correlated with the homophobic level demonstrated (p = .05, ß = -.67). Nursing students' overall willingness to provide care for PLWHA was associated with their attitudes (p = .003, ß = -.534). CONCLUSIONS: Given that the HIV epidemic in Russia is both substantial and increasing, it is essential to improve HIV nursing education to provide sufficient and up-to-date information about HIV and also to prepare nursing students for caring for PLWHA. In doing so, this may help to address both the deficits in student knowledge, and also modify their attitude towards PLWHA.