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  • 51.
    Lindh, Inga-Britt
    et al.
    Kristianstad University, School of Health and Society.
    Severinsson, Elisabeth
    Faculty of Health Sciences, Vestfold University College, Tønsberg.
    Berg, Agneta
    Kristianstad University, School of Health and Society.
    Nurses' moral strength: a hermeneutic inquiry in nursing practice2009In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 65, no 9, p. 1882-1890Article in journal (Refereed)
    Abstract [en]

    Aim. This paper is a report of a study to interpret nurses' experiences of moral strength in practice. Background. Moral strength is said to be beneficial in providing nursing care for patients, thereby contributing to high qualitative care. However, few studies focus on the meaning of nurses' moral strength. Methods. This study included eight Registered Nurses working in different aspects of health care in southern Sweden. Individual interviews were conducted in 2006 and 2007. We recorded, transcribed verbatim, and interpreted the interviews by a method grounded in hermeneutics. Findings. Three themes were interpreted on three different levels: the action level as 'having courage to act on one's convictions', the relational level as 'being attentive and recognizing vulnerability', and the existential level as 'facing the unpredictable'. Overall, moral strength was understood as a driving force to be someone special in the care of patients, i.e. someone who makes a difference. Conclusion. The value of nurses' moral strength in patient care should be recognized. Attention must be given to aspects outside the individual, e.g. professional and institutional processes that influence the work environment. Clinical team supervision can help make such processes visible and supportive.

  • 52.
    Papastavrou, Evridiki
    et al.
    Cyprus University of Technology.
    Acaroglu, Rengin
    Istanbul University.
    Sendir, Merdiye
    Istanbul University.
    Berg, Agneta
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap II. Kristianstad University, Research Platform for Collaboration for Health.
    Efstathiou, Georgios
    Ministry of Health, Cyprus.
    Idvall, Ewa
    Malmö University.
    Kalafati, Maria
    National and Kapodistrian University of Athens.
    Katajisto, Jouko
    University of Turku.
    Leino-Kilpi, Helena
    University of Turku.
    Lemonidou, Chryssoula
    National and Kapodistrian University of Athens.
    da Luz, Maria Deolinda Antunes
    Unidade de Investigaca˜o e Desenvolvimento em Enfermagem (UI&DE), Escola Superior de Enfermagem de Lisboa.
    Suhonen, Riitta
    University of Turku.
    The relationship between individualized care and the practice environment: an international study2015In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 52, no 1, p. 121-133Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Previous research studies have found that the better the quality of practice environments in hospitals, the better the outcomes for nurses and patients. Practice environment may influence nurses' ability to individualize care but the detailed relationship between individualized care and the professional practice environment has not been investigated widely. Some evidence exists about the association of practice environments with the level of individualization of nursing care, but this evidence is based on single national studies.

    OBJECTIVES: The aim of this study was to determine whether nurses' views of their professional practice environment associate with their views of the level of care individualization in seven countries.

    DESIGN: This study had an international, multisite, prospective, cross-sectional, exploratory survey design.

    SETTINGS: The study involved acute orthopedic and trauma surgical inpatient wards (n=91) in acute care hospitals (n=34) in seven countries, Cyprus, Finland, Greece, the State of Kansas, USA, Portugal, Sweden, and Turkey.

    PARTICIPANTS: Nurses (n=1163), registered or licensed practical, working in direct patient care, in orthopedic and trauma inpatient units in acute care hospitals in seven countries participated in the study.

    METHODS: Self-administered questionnaires, including two instruments, the Revised Professional Practice Environment and the Individualized Care Scale-Nurse (Individualized Care Scale-Nurse A and B) were used for data collection. Data were analyzed statistically using descriptive statistics, simultaneous multiple regression analysis, and generalized linear model.

    RESULTS: Two regression models were applied to assess the predictive validity of the Revised Professional Practice Environment on the Individualized Care Scale-Nurse-A and B. The results showed that elements of the professional practice environment were associated with care individualization. Internal work motivation, cultural sensitivity, control over practice, teamwork, and staff relationship with physicians were predictors of support (Individualized Care Scale-A) for and the delivery (Individualized Care Scale-B) of individualized care.

    CONCLUSIONS: The results of this study provide evidence that environment aspect could explain variations in care individualization. These findings support the assertion that individualized care needs to be understood in a broader context than the immediate nurse-patient relationship and that careful development of the care environment may be an effective way to improve care quality and outcomes.

  • 53.
    Papastavrou, Evridiki
    et al.
    Lecturer, Department of Nursing, School of Health Studies, Cyprus University of Technology, Limassol.
    Efstathiou, Georgios
    Lecturer, Department of Nursing, School of Health Studies, Cyprus University of Technology, Limassol.
    Acaroglu, Rengin
    Florence Nightingale School of Nursing, Istanbul University.
    Antunes da Luz, Maria Deolinda
    Nursing research and development Unity ui&de), Lisbon.
    Berg, Agneta
    Kristianstad University, School of Health and Society. Kristianstad University, Forskningsplattformen Hälsa i samverkan.
    Idvall, Ewa
    Faculty of Health and Society, Malmö University.
    Kalafati, Maria
    Faculty of Nursing, National and Kapodistrian University of Athens.
    Kanan, Nevin
    Florence Nightingale School of Nursing, Istanbul University.
    Katajisto, Jouko
    Department of Statistics, University of Turku.
    Leino-Kilpi, Helena
    Department of Nursing Science/Hospital District of Southwest Finland, University of Turku.
    Lemonidou, Chryssoula
    Faculty of Nursing, National and Kapodistrian University of Athens.
    Sendir, Merdiye
    Florence Nightingale School of Nursing, Istanbul University.
    Sousa, Valmi D.
    School of Nursing, The University of Kansas, Kansas City.
    Suhonen, Riitta
    Department of Nursing Science, University of Turku.
    A seven country comparison of nurses’ perceptions of their professional practise environment2012In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 20, no 2, p. 236-248Article in journal (Refereed)
    Abstract [en]

    Aims  To describe and compare nurses’ perceptions of their professional practice environment in seven countries.

    Background  There is evidence of variation in the nursing professional practice environments internationally. These different work environments affect nurses’ ability to perform and are linked to differing nurse and patient outcomes.

    Methods  A descriptive, comparative survey was used to collect data from orthopaedic and trauma nurses (n = 1156) in Finland, Cyprus, Greece, Portugal, Sweden, Turkey and Kansas, USA using the 39-item Revised Professional Practice Environment instrument.

    Results  Differences were found between participants from the northern countries of Europe, Kansas, USA, and the Mediterranean countries regarding perceptions about control over practice. No between-country differences were reported in the internal work motivation among the nurses from any of the participating countries.

    Conclusions  Although between-country differences in nurses’ professional practice environment were found, difficulties related to demographic, cultural and health system differences and the way in which nursing is defined in each country need to be considered in the interpretation of the results.

    Implications for Nursing Management  The results support investment to improve nurse’s work environment, which is important for improving the quality of patient care, optimizing patient outcomes and developing the nursing workforce.

  • 54.
    Springett, Jane
    et al.
    Kristianstad University, Department of Health Sciences.
    Blomqvist, Kerstin
    Kristianstad University, Department of Health Sciences. Kristianstad University, Research Platform for Collaboration for Health.
    Höglund, Birgitta
    Kristianstad University, Department of Health Sciences.
    Säthersten Haraldsson, Sara
    Kristianstad University, Department of Health Sciences.
    Abrahamsson, Agneta
    Kristianstad University, Department of Health Sciences.
    Berg, Agneta
    Kristianstad University, Department of Health Sciences.
    Dychawy Rosner, Irena
    Kristianstad University, Department of Health Sciences.
    Hägglöf, Susanna
    Kristianstad University, Department of Health Sciences.
    Johansson, Yvonne
    Kristianstad University, Department of Health Sciences.
    Lindell, Lisbeth
    Kristianstad University, Department of Health Sciences.
    Lindskov, Cecilia
    Kristianstad University, Department of Health Sciences.
    Nilsson, Marie
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, School of Health and Society, Avdelningen för Oral hälsa och folkhälsovetenskap. Kristianstad University, Research Platform for Collaboration for Health. Kristianstad University, Forskningsmiljön Människa - Hälsa - Samhälle (MHS).
    Olsson, Ingela
    Kristianstad University, Department of Health Sciences.
    Olsson, Sven-Erik
    Kristianstad University, Department of Health Sciences.
    Petersson, Pia
    Kristianstad University, Department of Health Sciences.
    Närsjukvård: bakgrund, erfarenheter och pilotstudie2005Report (Other academic)
    Abstract [sv]

    Närsjukvård är ett centralt begrepp i ett förändringsarbete som för genomförs i nordöstra Skåne för att utveckla hälso- och sjukvårdsväsendet. Det ingår därmed som en av de centrala delarna av Region Skånes vision om hälso- och sjukvård: Skånsk livskraft – vård och hälsa. Syftet med denna rapport är att ge en bakgrund till begreppet (Del A) och att presentera en del preliminära rön beträffande hur olika aktörer i nordöstra Skåne uppfattar begreppet (Del B). Del A ger en översikt kring ursprunget till begreppet Närsjukvård inom ramen för de förändringar i hälso- och sjukvården som sker i Sverige i stort. Den beskriver sedan vilka slags förändringar som har planerats på politisk nivå och som nu håller på att genomföras under detta paraplybegrepp, nationellt, regionalt och lokalt. För detta syfte används statliga dokument och publicerade utvärderingsstudier i stor utsträckning som källmaterial. Denna del ska därför inte ses som en heltäckande översikt. Del B inriktas på att belysa hur långt förverkligandet av idén om Närsjukvård har kommit inom regionen. Avsnittet är en kartläggning av olika aktörers förståelse av Närsjukvård i den nordöstra delen av Region Skåne. Forskningsfrågorna inriktades på hur folk pratade om Närsjukvård, det vill säga på hur de förstod och använde begreppet.

  • 55.
    Suhonen, R.
    et al.
    Finland.
    Charalambous, A.
    Cypern.
    Berg, Agneta
    Kristianstad University, School of Health and Society, Avdelningen för Sjuksköterskeutbildningarna. Kristianstad University, Research Platform for Collaboration for Health.
    Katajisto, J.
    Finland.
    Lemonidou, C.
    Grekland.
    Patiraki, E.
    Grekland.
    Sjövall, K.
    Lund University.
    Stolt, M.
    Finland.
    Older cancer patients' perceptions of care guality - an international study2016In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 72, no S1, p. 29-29Article in journal (Refereed)
    Abstract [en]

    Background: Cancer is considered as chronic condition, especially in the older people. Prevalence of cancer is especially high in the Nordic countries and Mediterranean countries. People with cancer are a common patient group in the healthcare system.

    Introduction: User perspective, such as patient assessments of care and care quality are central in developing healthcare services. These assessments have a high value in time when there are reforms in social and healthcare services. One core principle in these reforms is patient-centeredness. Earlier studies have shown that older patients differ from other age-based patient groups in their assessments of care quality elements. They were reported to be more positive in their evaluations.

    Aim: The aim of this study was to analyse cancer patients’ perceptions of patient-centered quality and individuality in care and trust in nurses, and to compare these perceptions between patients in the working age and older people. The research questions were: To what extent cancer patients perceive their care is patient-centered quality care, individualised and do they trust in nurses? Are there differences between older cancer patients and those in working age in their perceptions of person-centered quality of care, individuality in care and trust in nurses?

    Materials and methods: The study employed a cross-sectional comparative survey design. Data were collected using questionnaires among hospitalised cancer patients (N = 876, n = 599, 68%) in four countries: Greece, Cyprus, Sweden and Finland. The following instruments were used: The Oncology Patients perceptions of the Quality of Nursing Care Scale (OPPQNCS), the Individualised care Scale (ICS-patient) and Trust in Nurses. The data were divided into two sub-samples based on age (cut point 65 years): Older patients (n = 209) and patients in the working age (n = 387). Data were analysed statistically using cross-tabulation and chi-square statistics, or paired samples t-test.

    Results: In this study cancer patients’ perceptions about individualization and coordination of care, support of individuality and perceived individuality in care were only moderate. Proficiency and responsiveness as part of care quality were reported well realised. Trust in nurses was strong. Older patients and those patients in the working age did not differ in their perceptions of either patient-centered quality of care, individualised care or trust in nurses.

    Conclusions: The results of this study point out topics that need development in order to provide individualised and patient-centered nursing care. Contradictory to many earlier study results, age was not associated with cancer patients’ assessment.

  • 56.
    Suhonen, R.
    et al.
    Finland.
    Charalambous, A.
    Cypern.
    Berg, Agneta
    Kristianstad University, School of Health and Society, Avdelningen för Sjuksköterskeutbildningarna. Kristianstad University, Research Platform for Collaboration for Health.
    Katajisto, J.
    Finland.
    Lemonidou, C.
    Grekland.
    Patiraki, E.
    Grekland.
    Sjövall, K.
    Lund University.
    Stolt, M.
    Finland.
    Radwin, L. E.
    USA.
    Hospitalised cancer patients' perceptions of individualised nursing care in four European countries2018In: European Journal of Cancer Care, ISSN 0961-5423, E-ISSN 1365-2354, Vol. 27, no 1Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to describe hospitalised cancer patients' perceptions of individualised care in four European countries and compare these perceptions using the patients' socio-demographic characteristics and the Individualized Care Scale. The patients' socio-demographic characteristics used were: education, age, gender, type of hospital admission, previous hospitalisation and hospital length of stay. The Individualized Care Scale has two parts (1) nurses' support of individuality and (2) patients' receipt of individuality. Data (n = 599) were collected in Cyprus (n = 150), Finland (n = 158), Greece (n = 150) and Sweden (n = 141). Multivariate analysis of variance models were constructed and differences in perceptions of individualised care were analysed using the patients' socio-demographic characteristics as covariates. The level of support for individuality and receipt of individualised care was reported as moderate and good respectively. Generally, the highest assessments were made by the Swedish respondents and the lowest by those in Greece. This study revealed some between-country differences in patients' perceptions of care individualisation. These differences, for example, conceptual, educational, based in clinical practice or in the health organisation, require further research. Enquiry into the individualised care perceptions of health care providers and the families of cancer patients would also be useful.

  • 57.
    Suhonen, Riitta
    et al.
    Department of Nursing Science, University of Turku.
    Berg, Agneta
    Kristianstad University, School of Health and Society. Kristianstad University, Forskningsplattformen Hälsa i samverkan.
    Idvall, Ewa
    University of Linköping.
    Kalafati, Maria
    University of Athens, Faculty of Nursing.
    Katajisto, Jouko
    University of Turku, Department of Statistics.
    Land, Lucy
    Birmingham City University.
    Lemonidou, Chryssoula
    University of Athens, Faculty of Nursing.
    Schmidt, Lee A.
    Niehoff School of Nursing, Loyola University Chicago.
    Välimäki, Maritta
    University of Turku, Department of Nursing Science.
    Leino-Kilpi, Helena
    University of Turku, Department of Nursing Science.
    Adapting the Individualised Care Scale for cross-cultural comparison: an international study2010In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 24, no 2, p. 392-403Article in journal (Refereed)
    Abstract [en]

    Rationale:  Cross-cultural comparative studies using reliable and valid instruments can increase awareness of the differences and similarities between health worker’s ability to respond to patients’ individual needs within different health systems. This will enable a better understanding of cultural perspectives in individualized nursing care.

    Aim:  To describe the translation and adaptation process of the Individualized Care Scale (ICS) and examine its reliability and validity in a cross-cultural study.

    Design:  A cross-sectional comparative study.

    Settings:  Twenty-seven orthopaedic and trauma in-patient units at 14 hospitals in 5 countries.

    Participants:  A total of 1126 patients were included in the study: Finland (n = 425), Greece (n = 315), Sweden (n = 218), UK (n = 135) and USA (n = 33).

    Methods:  A systematic forward- and back-translation procedure using bilingual techniques, a committee approach, pretest techniques and pilot testing were used with a convenience sample to produce a valid ICS for each participating group. Psychometric evaluation of the adapted ICS was based on means, SD, missing data analysis, Cronbach’s alpha coefficients and average inter-item correlations. Construct validity was examined using sub-scale correlations to total scales and principal components analysis.

    Results:  The use of the range of options and the sub-scale mean scores ranging from 2.72 to 4.30 demonstrated the sensitivity of the scale. Cronbach’s alpha coefficients (0.77–0.97) and average inter-item correlations (0.37–0.77) were acceptable. The sub-scale correlations to total scales were high (0.83–0.97). The underlying theoretical construct of the ICS was demonstrated by the explained variances ranging from 58% to 79%.

    Conclusions:  The ICS shows promise as a tool for evaluating individualized care in European cultures. The international expansion of an existing instrument developed for one country facilitates comparative studies across countries. There is a need to further test the construct validity and appropriateness of the ICS in different settings in European and nonwestern cultures.

  • 58.
    Suhonen, Riitta
    et al.
    Health Care District of Forssa.
    Berg, Agneta
    Kristianstad University, School of Health and Society.
    Idvall, Ewa
    Kalmar County Council.
    Kalafati, Maria
    Faculty of Nursing, University of Athens.
    Katajisto, Jouko
    Department of Statistics, University of Turku.
    Land, Lucy
    Birmingham City University.
    Lemonidou, Chryssoula
    Faculty of Nursing, University of Athens.
    Schmidt, Lee A.
    Niehoff School of Nursing, Loyola University Chicago, Loyola University Medical Center, Maywood.
    Välimäki, Maritta
    Department of Nursing Science/Hospital District of South-Western Finland, University of Turku.
    Leino-Kilpi, Helena
    Department of Nursing Science/Hospital District of South-Western Finland, University of Turku.
    European orthopaedic and trauma patients' perceptions of nursing care: a comparative study2009In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 18, no 20, p. 2818-2829Article in journal (Refereed)
    Abstract [en]

    AIM: To compare English, Finnish, Greek and Swedish orthopaedic and trauma patients' perceptions of nursing care received during hospitalisation. BACKGROUND: Patient perceptions are important when evaluating nursing care delivery. Evaluations usually take place sub-nationally though European citizens may be treated throughout the European Union. International comparative studies are possible because of the universal nature and philosophical roots of quality in nursing care. They are needed to assist in improving care outcomes. DESIGN: A cross-sectional, comparative study design was used. METHOD: The Schmidt Perception of Nursing Care Survey was used to obtain data from orthopaedic and trauma patients in acute hospitals in four countries: Finland (n = 425, response rate 85%), Greece (n = 315, 86%), Sweden (n = 218, 73%) and UK (n = 135, 85%). Data were first analysed using descriptive statistics, then between-country comparisons were computed inferentially using a one-way analysis of variance and a univariate analysis of covariance. RESULTS: Between-country differences were found in patients' perceptions of the nursing care received. Over the whole Schmidt Perception of Nursing Care Survey the Swedish and Finnish patients gave their care the highest assessments and the Greek patients the lowest. The same trend was seen in each of the four sub-scales: Seeing The Individual Patient, Explaining, Responding and Watching. Responding was given the highest assessments in each participating country and Seeing the Individual Patient the lowest except in Greece. CONCLUSIONS: Further research is needed to consider whether the between-country differences found are caused by differences between cultures, nursing practices, roles of healthcare personnel or patients in the different countries. The Schmidt Perception of Nursing Care Survey is suitable for the assessment of European orthopaedic and trauma patients' perceptions of nursing care received during hospitalisation. RELEVANCE TO CLINICAL PRACTICE: The results are useful in evaluating and developing nursing care in hospitals from different European countries.

  • 59.
    Suhonen, Riitta
    et al.
    Health Care District of Forssa.
    Berg, Agneta
    Kristianstad University, Department of Health Sciences.
    Idvall, Ewa
    Kalmar County Council.
    Kalafati, Maria
    University of Athens, Faculty of Nursing.
    Katajisto, Jouko
    University of Turku, Department of Statistics.
    Land, Lucy
    University of Central England, Birmingham.
    Lemonidou, Chryssoula
    University of Athens, Faculty of Nursing.
    Välimäki, Maritta
    University of Turku, Department of Nursing Science.
    Leino-Kilpi, Helena
    University of Turku, Department of Nursing Science.
    Individualised care from the orthopaedic and trauma patients' perspective: an international comparative survey2008In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 45, no 11, p. 1586-1597Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Although individualised nursing care is considered a core value in nursing in different countries, international comparative studies in this area are rare. In Western countries, common hospitalised patients, e.g. orthopaedic patients, often perceive health care as impersonal rather than individualised; a term which may also have different connotations in different cultures. OBJECTIVES: To describe and compare orthopaedic and trauma patients' perceptions of individuality in their care in four European countries. DESIGN: A cross-sectional comparative study. SETTINGS: 24 orthopaedic and trauma wards in 13 acute care hospitals. PARTICIPANTS: Data were collected from orthopaedic and trauma patients in Finland (n=425, response rate 85%), Greece (n=315, 86%), Sweden (n=218, 73%) and UK (n=135, 58%) between March 2005 and December 2006. METHODS: Questionnaire survey data using the Individualised Care Scale (ICS) were obtained and analysed using descriptive and inferential statistics including frequencies, percentages, means, standard deviations, 95% confidence intervals (CI), one-way analysis of variance (ANOVA), chi2 statistics and univariate analysis of covariance (ANCOVA). RESULTS: Patients perceived that nurses generally supported their individuality during specific nursing interventions and perceived individuality in their care. There were some between-country differences in the results. Patients' individuality in the clinical situation and in decisional control over their care were also generally well supported and taken into account. However, patients' personal life situation was not supported well through nursing interventions and these patients perceived lower levels of individualised care. CONCLUSIONS: North-South axis differences in patients' perceptions of individualised care may be attributed to the way nursing care is defined and organised in different European countries. Differences may be due to the differences in regional samples, and so no firm conclusions can be made. Further research will be needed to examine the effect of patient characteristics' and health care organisation variables in association with patients' perceptions of individualised care.

  • 60.
    Suhonen, Riitta
    et al.
    Department of Nursing Science, University of Turku.
    Papastavrou, Evridike
    Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol.
    Efstathiou, Georgios
    Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol.
    Lemonidou, Chryssoula
    Faculty of Nursing, National and Kapodistrian University of Athens.
    Kalafati, Maria
    Faculty of Nursing, National and Kapodistrian University of Athens.
    da Luz, Maria Deolinda Antunes
    Unidade de Investigacão e Desenvolvimento em Enfermagem, Escola Superior de Enfermagem de Lisboa.
    Idvall, Ewa
    Faculty of Health and Society, Malmö University.
    Berg, Agneta
    Kristianstad University, School of Health and Society. Kristianstad University, Forskningsplattformen Hälsa i samverkan.
    Acaroglu, Rengin
    Florence Nightingale School of Nursing, Istanbul University.
    Sendir, Merdiye
    Florence Nightingale School of Nursing, Istanbul University.
    Kanan, Nevin
    Florence Nightingale School of Nursing, Istanbul University.
    Sousa, Valmi D.
    The University of Kansas School of Nursing, Kansas City.
    Katajisto, Jouko
    Department of Social Sciences, Statistics Unit, University of Turku.
    Välimäki, Maritta
    Department of Nursing Science/Hospital District of Southwest Finland, University of Turku.
    Leino-Kilpi, Helena
    Department of Nursing Science/Hospital District of Southwest Finland, University of Turku.
    Nurses' perceptions of individualized care: an international comparison2011In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 67, no 9, p. 1895-1907Article in journal (Refereed)
    Abstract [en]

    Aim. This paper is a report of a study of internationally-based differences in nurses' perceptions of individualized care in orthopaedic surgical in-patient wards. Background. Individualized care is valued in healthcare policy, practice and ethical statements as an indicator of care quality. However, nurses' assessments of individualized care are limited and comparative cross-cultural studies on individualized nursing care are lacking. Methods. A descriptive comparative survey was used to sample orthopaedic surgical nurses (n = 1163) working in 91 inpatient wards in 34 acute hospitals in Finland, Cyprus, Greece, Portugal, Sweden, Turkey and the United States of America. Data were collected between March and November 2009 using the Individualized Care Scale-Nurse and analysed using descriptive and inferential statistics. Results. Nurses in different countries perceived that they supported patients' individuality generally and provided individualized care during nursing activities. Although the highest scores were in support of patients' individuality in the clinical situation both through nursing provision and nurses' perceptions of individuality, there were between-country differences within these scores. Generally, the Greek and American nurses gave the highest scores and the Turkish, Cypriot and Portuguese nurses the lowest. Conclusions. Between-country differences found may be attributed to differing roles of nurses, care processes, healthcare systems and/or the ways nursing care is defined and organized. As this was the first time the Individualized Care Scale-Nurse was used in an international context, the results are formative and indicate the need to continue studies in this area.

  • 61.
    Suhonen, Riitta
    et al.
    Department of Nursing Science, University of Turku.
    Schmidt, Lee A.
    Niehoff School of Nursing, Loyola University Medical Center, Loyola University Chicago, Maywood.
    Katajisto, Jouko
    Department of Mathematics and Statistics, University of Turku.
    Berg, Agneta
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Forskningsplattformen Hälsa i samverkan.
    Idvall, Ewa
    Faculty of Health and Society, Malmö University.
    Kalafati, Maria
    Faculty of Nursing, University of Athens.
    Land, Lucy
    Centre for Health and Social Care Research, Birmingham City University.
    Lemonidou, Chryssoula
    Faculty of Nursing, University of Athens.
    Välimäki, Maritta
    Department of Nursing Science, University of Turku.
    Leino-Kilpi, Helena
    Department of Nursing Science, University of Turku.
    Cross-cultural validity of the Individualised Care Scale – a Rasch model analysis2013In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 22, no 5-6, p. 648-660Article in journal (Refereed)
    Abstract [en]

    Aims and objectives.  The aim of this study was to investigate, using Rasch model analysis, the measurement invariance of the item ratings of the Individualised Care Scale. Background.  Evidence of reliability is needed in cross-cultural comparative studies. To be used in different cultures and languages, the items must function the same way. Design.  A methodological and comparative design. Methods.  Secondary analysis of data, gathered in 2005–2006 from a cross-cultural survey using the Individualised Care Scale from Finnish, Greek, Swedish and English predischarge hospitalised orthopaedic and trauma patients (n = 1093), was used. The Rasch model, which produces calibrations (item locations and rank) and item fit statistics, was computed using the Winstep program. Results.  The rank of average Individualised Care Scale item calibrations (−2·26–1·52) followed a generally similar trend (Infit ≤ 1·3), but slight differences in the item rank by country were found and some item misfit was identified within the same items. There was some variation in the order and location of some Individualised Care Scale items for individual countries, but the overall pattern of item calibration was generally corresponding. Conclusions.  The Rasch model provided information about the appropriateness, sensitivity and item function in different cultures providing more in-depth information about the psychometric properties of the Individualised Care Scale instrument. Comparison of the four versions of the Individualised Care Scale – patient revealed general correspondence in the item calibration patterns although slight differences in the rank order of the items were found. Some items showed also a slight misfit. Based on these results, the phrasing and targeting of some items should be considered. Relevance to clinical practice.  The Individualised Care Scale – Patient version can be used in cross-cultural studies for the measurement of patients’ perceptions of individualised care. Information obtained with the use of the Individualised Care Scale in clinical nursing practice is important, and valid measures are needed in evaluating patients’ assessment of individualised care, one indicator of care quality.

  • 62.
    Suhonen, Riitta
    et al.
    Finland.
    Stolt, Minna
    Finland.
    Berg, Agneta
    Kristianstad University, School of Health and Society, Avdelningen för Sjuksköterskeutbildningarna. Kristianstad University, Research Platform for Collaboration for Health.
    Katajisto, Jouko
    Finland.
    Lemonidou, Chrysoula
    Grekland.
    Patiraki, Elisabeth
    Grekland.
    Sjövall, Katarina
    Lund University.
    Charalambous, Andreas
    Cypern & Finland.
    Cancer patients' perceptions of quality of care attributes: associations with age, perceived health status, gender and education.2018In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 27, no 1-2, p. 306-316Article in journal (Refereed)
    Abstract [en]

    AIM: The aim of this study was to explore the associations between patients' gender, education, health status in relation to: assessments of patient-centered quality and individuality in care and trust in nurses for those <65, (working age) and ≥65 years (older people).

    BACKGROUND: Patients' assessments of the quality of care they receive is essential for the development of the provision of patient care and services. Previous studies have revealed age of the patient is associated with their assessment of care quality attributes.

    DESIGN: The study employed a cross-sectional, multi-cultural comparative survey design.

    METHODS: The data were collected using questionnaires among hospitalised cancer patients (N=876, n=599, 68%) in four European countries: Greece, Cyprus, Sweden and Finland. The data were divided into two sub-groups based on age (cut point 65 years) and were analysed statistically.

    RESULTS: Cancer patients' age, gender and level of education were not related to their assessments of care quality attributes: person-centered care quality; individuality in care and trust in nurses. Sub-group analysis of the older adults and those of working age showed clear associations with patients' assessments of quality of care attributes and perceived health status. The lower the perceived health status the lower the assessment of care quality attributes.

    DISCUSSION: The results suggest that the cancer itself is the strongest determinant of the care delivered, rather than any patient characteristics, such as age, education or gender. Perceived health status, in association with cancer patient assessments of care quality attributes, may be useful in the development of patient-centered, individualised care strategies alongside a stronger focus on people instead of cancer-care related processes and duties.

    RELEVANCE TO CLINICAL PRACTICE: The findings of this study have implications for cancer care professionals in terms of patient assessment and care planning. The measures may be useful in assessing quality of cancer nursing care. This article is protected by copyright. All rights reserved.

  • 63. Suhonen, Rittaa
    et al.
    Land, Lucy
    Centre for Health and Social Care Research Birmingham City University.
    Välimäki, Maritta
    Department of Nursing Science/Hospital District of Southwest Finland.
    Berg, Agneta
    Kristianstad University, School of Health and Society.
    Idvall, Ewa
    Faculty of Health and Society, Malmö University.
    Kalafati, Maria
    Faculty of Nursing, University of Athens.
    Katajisto, Jouko
    Department of Social Sciences, Statistics Unit, University of Turku.
    Lemonidou, Chryssoula
    Faculty of Nursing, University of Athens.
    Schmidt, Lee A.
    Niehoff School of Nursing, Loyola University Chicago, Loyola University Medical Center, Maywood.
    Leino-Kilpi, Helena
    Department of Nursing Science/Hospital District of Southwest Finland.
    The impact of patients characteristics on orthopeadic and trauma patients perception of individualised nursing care2010In: International Journal of Evidence-Based Healthcare, ISSN 1744-1595, E-ISSN 1744-1609, Vol. 8, no 4, p. 259-267Article in journal (Refereed)
    Abstract [en]

    Rationale and objectives Relatively few studies have investigated the relationship between patient characteristics and individualised care, in relation to the improvement of care efficiency, efficacy and quality. Individualised care is a key concept in health strategy and policy in Western countries. The aim of this exploratory study was to identify orthopaedic and trauma patients' characteristics relating to their perceptions of individualised nursing care in Western hospital settings.

    Methods A cross-sectional questionnaire survey was conducted among orthopaedic and trauma patients (n = 1126) from acute care in hospitals from five countries: Finland, Greece, Sweden, the UK and the USA, in 2005–06. The data were analysed using descriptive statistics, one-way analysis of variance and a multivariate analysis of variance (manova) of the main effects.

    Results The separate examination of each background factor showed statistically significant differences between patients' perceptions of individualised care. In the multivariate analysis the statistically significant main effects, associated with patients' perceptions, were age, gender, education and type of admission. These explained 13% of the variance in the support of patient individuality in care and 19% in perceived individuality in care received.

    Conclusions These results can be used in individualising care to different patient groups and in prioritising and focusing quality programs to improve care. Detailed questions about specific aspects of patients' experiences are likely to be more useful in monitoring hospital performance from the patients' perspective.

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