What Counteracts Problematic Social Media Use in Adolescence? A Cross-National Observational Study.

PURPOSE: Social media use has increased rapidly during the past decade, raising concerns about adolescents who display problematic social media use (PSMU), as indicated by addiction-like symptoms (e.g., preoccupation, tolerance). We aimed to assess the extent to which an individual resource (health literacy), and social resources (friend support and family support), moderated the association between a range of individual characteristics (gender, age, family affluence, and depressive feelings) and PSMU; also the association between PSMU and health outcomes (self-rated health, life satisfaction, and sleep difficulties), both cross-nationally and nationally. METHODS: Our sample included 22,226 adolescents from six European countries. We used data from the Health Behaviour in School-aged Children cross-sectional survey (2017/2018). Random-effects models and moderator analyses were applied. RESULTS: Six moderations were found, with the resources moderating the association between individual characteristics and PSMU. One moderation emerged cross-nationally, namely that a higher level of family support was associated with a lower likelihood of PSMU, especially among adolescents who did not have frequent depressive feelings. In addition, five national moderations were identified. For example, a higher level of health literacy was associated with a lower likelihood of PSMU among Finnish girls. The resources were also found to moderate the association between PSMU and health outcomes, with two moderations emerging cross-nationally. For instance, a higher level of family support was related to higher self-rated health, especially among problematic users. In addition, nine national moderations were identified; these included a higher level of health literacy being associated with having less sleep difficulties, especially among problematic users in Germany. DISCUSSION: In adolescence, health literacy, family support, and friend support have the potential to moderate the association between individual characteristics and PSMU, and between PSMU and health outcomes, cross-nationally and nationally. We recommend the use of universal and targeted interventions to promote individual and social resources to counteract PSMU.

The development and cross-national validation of the short health literacy for school-aged children (HLSAC-5) instrument.

Health literacy is an asset for and indicator of adolescents' health and wellbeing, and should therefore be monitored and addressed across countries. This study aimed to develop and validate a shorter version of the original 10-item health literacy for school-aged children instrument in a cross-national context, using data from the health behaviour in school-aged children 2017/18 survey. The data were obtained from 25 425 adolescents (aged 13 and 15 years) from seven European countries. Determination was made of the best item combination to form a shorter version of the health literacy instrument. Thereafter, the structural validity, reliability, measurement invariance, and criterion validity of the new 5-item instrument were examined. Confirmatory factor analysis showed a good model fit to the data across countries and in the total sample, confirming the structural validity (CFI = 0.995, TLI = 0.989, SRMR = 0.011, RMSEA = 0.031). The internal consistency of the instrument was at a good level across countries (α = 0.87-0.98), indicating that the instrument provided reliable scores. Configural and metric invariance was established across genders, ages, and countries. Scalar invariance was achieved for age and gender groups, but not between countries. This indicated that the factor structure of the scale was similar, but that there were differences between the countries in health literacy levels. Regarding criterion validity, structural equation modelling showed a positive association between health literacy and self-rated health in all the participating countries. The new instrument was found to be valid and reliable for the purposes of measuring health literacy among adolescents in a cross-national context.

Online health information-seeking behaviour and mental well-being among Finnish higher education students during COVID-19.

Online health information-seeking behaviour has increased since the World Health Organization declared COVID-19 a global pandemic in March 2020. This study examined whether health-related information on COVID-19 searched on the internet was associated with mental well-being among higher education students. A cross-sectional internet survey was conducted among 18- to 34-year-old students in Finland (N = 2976; mean age 24.61 years and median 24) in the spring of 2020. The data were analysed using descriptive statistics, Pearson's chi-square tests, Kruskal-Wallis nonparametric H tests, and a two-way ANOVA. The results indicated that most students (86% of females, 82% of males) used the internet to search for information on COVID-19. Students' self-perceived abilities to determine the relevance of online information on COVID-19 were associated with mental well-being.

Patient satisfaction - results of cluster analysis of finnish patients.

BACKGROUND: Healthcare providers must understand patients' expectations and perceptions of the care they receive to provide high-quality care. The purpose of this study is to identify and analyse different clusters of patient satisfaction with the quality of care at Finnish acute care hospitals. METHODS: A cross-sectional design was applied. The data were collected in 2017 from three Finnish acute care hospitals with the Revised Humane Caring Scale (RHCS) as a paper questionnaire, including six background questions and six subscales. The k-means clustering method was used to define and analyse clusters in the data. The unit of analysis was a health system encompassing inpatients and outpatients. Clusters revealed the common characteristics shared by the different groups of patients. RESULTS: A total of 1810 patients participated in the study. Patient satisfaction was categorised into four groups: dissatisfied (n = 58), moderately dissatisfied (n = 249), moderately satisfied (n = 608), and satisfied (n = 895). The scores for each subscale were significantly above average in the satisfied patient group. The dissatisfied and moderately dissatisfied patient groups reported scores for all six subscales that were clearly below the average value. The groups significantly differed in terms of hospital admission (p = .013) and living situation (p = .009). Patients representing the dissatisfied and moderately dissatisfied groups were acutely admitted more frequently than patients in other groups and were more likely to live alone than satisfied and moderately satisfied patients. CONCLUSION: The results mostly demonstrated high levels of patient satisfaction; however, the perceptions of minority populations of dissatisfied patients should be assessed to identify shortcomings in the care provided. More attention should be paid to acutely admitted patients who are living alone and the pain and apprehension management of all patients.

Mental health profiles of Finnish adolescents before and after the peak of the COVID-19 pandemic.

BACKGROUND: The COVID-19 pandemic has had implications for adolescents' interpersonal relationships, communication patterns, education, recreational activities and well-being. An understanding of the impact of the pandemic on their mental health is crucial in measures to promote the post-pandemic recovery. Using a person-centered approach, the current study aimed to identify mental health profiles in two cross-sectional samples of Finnish adolescents before and after the peak of the pandemic, and to examine how socio-demographic and psychosocial factors, academic expectations, health literacy, and self-rated health are associated with the emerging profiles. METHODS AND FINDINGS: Survey data from the Health Behaviour in School-aged Children (HBSC) study conducted in Finland in 2018 (N = 3498, age M = 13.44) and 2022 (N = 3838, age M = 13.21) were analyzed. A four-profile model using cluster analysis was selected for both samples. In Sample 1, the identified profiles were (1) "Good mental health", (2) "Mixed psychosocial health", (3) "Somatically challenged", and (4) "Poor mental health". In Sample 2, the identified profiles were (1) "Good mental health", (2) "Mixed psychosomatic health", (3) "Poor mental health and low loneliness", and (4) "Poor mental health and high loneliness". The results of the mixed effect multinomial logistic regression analysis showed that in both samples, being a girl and reporting lower maternal monitoring; lower family, peer, and teacher support; higher intensity of online communication; a less positive home atmosphere and school climate; and poor self-rated health were most strongly linked to belonging to a poorer mental health profile. In addition, in Sample 2, low subjective health literacy was a key factor associated with poorer mental health profiles, and teacher support was more important than before COVID. CONCLUSIONS: The current study stresses the importance of identifying those vulnerable to developing poor mental health. To maximize post-pandemic recovery, the role of schools, especially teacher support and health literacy, along with the factors that remained important over time should be taken into account in public health and health promotion interventions.

Systematic education has a positive impact on nurses' evidence-based practice: Intervention study results.

AIMS: To evaluate how an education program on evidence-based practice (EBP) affected nurses´ knowledge, practices, and attitudes related to EBPs in patient care. METHODS: Nurses of one Finnish university hospital participated in two separate EBP education programs in 2016-2017 and 2018-2019. Data was collected by a questionnaire given before and after each program. Reliable instruments for measuring EBP were used: The Evidence-Based Practice Questionnaire (24 items) and the Attitudes to Evidence-Based Practice Questionnaire (17 items). Means and frequencies were evaluated with the Mann-Whitney U test and linear regression. RESULTS: Nurses reported that their EBP practice, skills and the Work based on EBPs improved substantially after the education program. We found that scores on the Work based on EBPs and the attitudes towards EBP could predict the nurses' overall self-evaluations of practices, attitudes, and skills. DISCUSSION: EBP education affects positively on implementation of nurses' practices and skills. There is still a need to change attitudes towards evidence based practice. IMPLICATIONS FOR PRACTICE, RESEARCH, POLICY, MANAGEMENT, AND EDUCATION: Organizations need to maintain and develop efficient, attractive EBP educational programs to promote lifelong learning. CONCLUSIONS: When designing EBP educational content, it is crucial to teach participants to develop evidence-based methods and consider how to implement them in practice.

The role of health literacy in the association between academic performance and substance use.

BACKGROUND: To address social inequalities in adolescent substance use and consequent disparities in health, it is important to identify the mechanisms of the association between substance use and academic performance. We study the role of health literacy (HL) in the association between academic performance and weekly smoking, monthly alcohol use and cannabis ever-use among adolescents in Europe. METHODS: SILNE-R school survey data, which was collected in 2016-17 with paper-and-pencil-method from Hanover (GE), Amersfoort (NL) and Tampere (FI), were used (N = 5088, age 13-19). Health Literacy for School-aged Children instrument was used to assess students' HL. Logistic regression analyzed the association of substance use with academic performance and HL, separately and in the same model. Linear and multinomial logistic regression analyzed the association between academic performance and HL. RESULTS: Poor academic performance compared with high was associated with smoking [odds ratio (OR) 3.94, 95% confidence interval (CI) 2.83-5.49], alcohol use (OR: 2.94, 95% CI: 2.34-3.68) and cannabis use (OR: 2.56, 95% CI: 1.89-3.48). Poor HL was also associated with each substance use (with ORs of 2.32, 1.85 and 1.29). HL was positively associated with academic performance (ß = 1.04, 95% CI: 0.89-1.20). The associations between academic performance and substance use were only slightly attenuated after controlling for HL. CONCLUSIONS: Academic performance and HL were both determinants of substance use, confirming their role in tackling the disparities in substance use. However, HL did not demonstrably mediate the association between academic performance and substance use. A wider set of factors needs to be tackled to address emerging social inequalities in adolescent substance use.