Vaikeasti määrittyvät kohtalottaret

Kirjallisuusarvostelu

Knowledge Sharing between Generations in an Organisation - Retention of the Old or Building the New?

The study explores knowledge transfer between retiring employees and their successors in expert work. My aim is to ascertain whether there is knowledge development or building new knowledge related to this organisational knowledge transfer between generations; in other words, is the transfer of knowledge from experienced, retiring employees to their successors merely retention of the existing organisational knowledge by distributing it from one individual to another or does this transfer lead to building new and meaningful organisational knowledge. I call knowledge transfer between generations and the possibly related knowledge building in this study knowledge sharing between generations. The study examines the organisation and knowledge management from a knowledge-based and constructionist view. From this standpoint, I see knowledge transfer as an interactive process, and the exploration is based on how the people involved in this process understand and experience the phenomenon studied. The research method is organisational ethnography. I conducted the analysis of data using thematic analysis and the articulation method, which has not been used before in organisational knowledge studies. The primary empirical data consists of theme interviews with twelve employees involved in knowledge transfer in the organisation being studied and five follow-up theme interviews. Six of the interviewees are expert duty employees due to retire shortly, and six are their successors. All those participating in the follow-up interviews are successors of those soon to retire from their expert responsibilities. The organisation in the study is a medium-sized Finnish firm, which designs and manufactures electrical equipment and systems for the global market. The results of the study show that expert work-related knowledge transfer between generations can mean knowledge building which produces new, meaningful knowledge for the organisation. This knowledge is distributed in the organisation to all those that find it useful in increasing the efficiency and competitiveness of the whole organisation. The transfer and building of knowledge together create an act of knowledge sharing between generations where the building of knowledge presupposes transfer. Knowledge sharing proceeds between the expert and the novice through eight phases. During the phases of knowledge transfer the expert guides the novice to absorb the knowledge to be transferred. With the expert’s help the novice gradually comes to understand the knowledge and in the end he or she is capable of using it in his or her work. During the phases of knowledge building the expert helps the novice to further develop the knowledge being transferred so that it becomes new, useful knowledge for the organisation. After that the novice takes the built knowledge to use in his or her work. Based on the results of the study, knowledge sharing between generations takes place in interaction and ends when knowledge is taken to use. The results I obtained in the interviews by the articulation method show that knowledge sharing between generations is shaped by the novices’ conceptions of their own work goals, knowledge needs and duties. These are not only based on the official definition of the work, but also how the novices find their work or how they prioritise the given objectives and responsibilities. The study shows that the novices see their work primarily as maintenance or development. Those primarily involved in maintenance duties do not necessarily need knowledge defined as transferred between generations. Therefore, they do not necessarily transfer knowledge with their assigned experts, even though this can happen in favourable circumstances. They do not build knowledge because their view of their work goals and duties does not require the building of new knowledge. Those primarily involved in development duties, however, do need knowledge available from their assigned experts. Therefore, regardless of circumstances they transfer knowledge with their assigned experts and also build knowledge because their work goals and duties create a basis for building new knowledge. The literature on knowledge transfer between generations has focused on describing either the knowledge being transferred or the means by which it is transferred. Based on the results of this study, however, knowledge sharing between generations, that is, transfer and building is determined by how the novice considers his or her own knowledge needs and work practices. This is why studies on knowledge sharing between generations and its implementation should be based not only on the knowledge content and how it is shared, but also on the context of the work in which the novice interprets and shares knowledge. The existing literature has not considered the possibility that knowledge transfer between generations may mean building knowledge. The results of this study, however, show that this is possible. In knowledge building, the expert’s existing organisational knowledge is combined with the new knowledge that the novice brings to the organisation. In their interaction this combination of the expert’s “old” and the novice’s “new” knowledge becomes new, meaningful organisational knowledge. Previous studies show that knowledge development between the members of an organisation is the prerequisite for organisational renewal which in turn is essential for improved competitiveness. Against this background, knowledge building enables organisational renewal and thus enhances competitiveness. Hence, when knowledge transfer between generations is followed by knowledge building, the organisation kills two birds with one stone. In knowledge transfer the organisation retains the existing knowledge and thus maintains its competitiveness. In knowledge building the organisation developsnew knowledge and thus improves its competitiveness.

The Use of Nervous System Drugs and the Risk of Fractures in Old Adults

Hermostoon vaikuttavien lääkkeiden käyttö on yleistä iäkkäässä väestössä. Erityisen yleistä käyttö on pitkäaikaisessa laitoshoidossa asuvilla iäkkäillä. Hermostoon vaikuttavien lääkkeiden haittavaikutuksia on tutkittu paljon, ja useat hermostoon vaikuttavat lääkeaineryhmät on tunnistettu murtumien riskitekijöiksi. Aikaisemmin ei ole kuitenkaan tutkittu usean hermostoon vaikuttavan lääkkeen yhteiskäytön yhteyksiä murtuman riskiin 65 vuotta täyttäneillä. Väitöskirjatutkimuksessa havaittiin, että usean hermostoon vaikuttavan lääkeaineen yhtäaikainen käyttö oli hyvin yleistä Porin kaupunginsairaalan viidellä pitkäaikaisen laitoshoidon osastolla (n = 154) vuosien 2004 ja 2005 vaihteessa. Kolmasosa tutkituista käytti säännöllisesti kolmea tai useampaa hermostoon vaikuttavaa lääkettä samanaikaisesti. Kun huomioitiin myös tarvittaessa otettavat lääkkeet, vastaava luku oli 53 %. Tutkimuksessa havaittiin myös viitteitä lääkkeiden epäasianmukaisesta käytöstä, kun potilaiden käyttämiä lääkkeitä verrattiin heidän kognitiiviseen ja fyysiseen suorituskyynsä sekä asetettuihin diagnooseihin. Liedon kunnassa 1990-luvulla toteutettuun väestöpohjaiseen Liedon Iäkkäät -seurantatutkimukseen osallistui 1177 lietolaista 65 vuotta täyttänyttä. Lääkitystietoja sekä seuranta-aikana tapahtuneita murtumia analysoimalla havaittiin, että kahden tai useamman bentsodiatsepiinin sekä kahden tai useamman psykoosilääkkeen käyttö oli yhteydessä murtuman riskiin 65 vuotta täyttäneillä miehillä. Opioidin ja psykoosilääkkeen yhteiskäyttö sekä opioidin ja bentsodiatsepiinin yhteiskäyttö oli yhteydessä iäkkäiden miesten murtuman riskiin. Naisilla vastaavia tilastollisesti merkitseviä yhteyksiä ei havaittu. Väitöskirjatutkimuksen uusin osa-aineisto perustui Porissa vuosina 2009–2010 toteutetun Satauni-tutkimuksen aineistoon. Tutkimuksessa osoitettiin 89 potilaan aineistossa, että hallittu, yhden kuukauden aikana lääkärin ja hoitajan tuella toteutettu bentsodiatsepiinivieroitus paransi merkitsevästi 55 vuotta täyttäneiden naisten käden puristusvoimaa kuuden kuukauden seuranta-aikana. Vastaavaa yhteyttä ei havaittu miehillä. Bentsodiatsepiinivieroituksella ei ollut yhteyttä osallistujien tasapainotestin tulosten paranemiseen kuuden kuukauden seurantaaikana. Murtumilla on vakavia seurauksia sekä yksilötasolla että yhteiskunnallisesti iäkkäässä väestössä. Murtumien ehkäisy on hyvin tärkeää. Siinä tulee kiinnittää huomiota potilaan käyttämään lääkitykseen ja arvioida erityisesti usean hermostoon vaikuttavan lääkkeen yhteiskäytön tarpeellisuutta.

Confronting a victim of intimate partner violence in nursing care : a literature review

Intimate partner violence is a growing problem in health care. The purpose of this thesis was to find ways of confronting a victim of intimate partner violence in nursing care and methods how nurses can encourage the victim to disclose the abuse. The aim of this thesis was to help the health care professionals to understand the issue and the need of the victims better, and that way provide a better care. This thesis is a literature review of previously made research articles about intimate partner violence. The research material consisted of 10 published articles, which were collected from different databases. The articles were published within 10 years. A content analysis method was used to examine the articles by making descriptive summary tables according to each questions. The results of this study showed multiple factors which the health care providers should take into consideration when caring the patients. Asking with a non-judgemental attitude, in a safe, confidential setting without the partner present and prioritizing the abuse was mentioned to be important for the victims. Routinely screening and different kind of brochures was considered as good methods to encourage the victims to disclose the abuse. The need for better training and counselling of the health care providers was also discovered. The results of this thesis, did answer to the chosen study questions and that way the purpose of the thesis was filled. Hopefully, in the future this problem can be minimized and prevented in advanced. Further studies are needed to examine whether these caring methods are actually being used in clinical settings and do they have any effect.