Rummet i vårdandets värld

This study is made in the context of basic research within the field ofcaring science. The aim is to make a theoretical and ontological investigation of what the space is in the world of caring. The basic proposition is that the space, as a fundamental dimension, has an impact on how the appreciation of one's mental health and suffering is shaped, and vice versa. The overall purpose is to develop a theoretical model of space from the caring science point of view andalso to offer an ideal concept of space to caring science. Guided by a theoretical horizon (Eriksson 1993, Eriksson 1995, Eriksson 2001) and methodological approach grounded in Gadamer's philosophic and existential hermeneutics a three-stage analysis and interpretation is conducted. The hermeneutic spiral of this investigation starts through a procedure in accordance with Eriksson's model (1997) of concept definition. The goal is to clarify the etymology of the concept as well as semantic differences between synonymous concepts, i.e. to identify the different extents of the concept of `space` (`rum`) in order to bring these closer for an exploration. The second phase is to analyse and interpret a sample of narratives in order to explicate the ontological nature and meaning of the space. The material used here is literary texts. The goal is to clarify the characteristics of the very inside of the space when it is shaped in relation to the human being in encountering suffering. In the third phase an interview study is taken place. The focus of the study is directed towards the phenomenon of space as it is known by a patient in a landscape of psychiatric care, i.e. what the space is in a contextual meaning. Then, a gradual hermeneutic understanding of the space is attempted by using theories from the field of caring science as well as additional theories from other disciplines. Metaphors are used as they are vivid and expressive tools for generating meaning. Different metaphoric space formations depict here a variety of purports that, although not quite the same, share extensive elements. Six metaphorically summarized entities of meaning emerged. The comprehensive form of space is pointed out as the Mobile-Immobile Room. Furthermore, the Standby, the Asylum, the Wall and the Place. In the further dialogue with the texts the understanding has deepened ontologically. The theoretical model ofthe space sums up the vertical, horizontal and the inward extent of deepness inthe movement of mental health. Three entities of ontological meaning have emerged as three significant rooms: the Common Land emerges as the ideal concept of mutual creation in the freedom of doing, being and becoming health. On the interpersonal level it means freedom, which includes sovereignty, choice and dignity of the human being. The Ice World signifies, ultimately, the space as a kind of frozenness of despair which "wallpapers" the person's entire being in the world in the drama of suffering. The Spiritual Home is shaped when the human being has acquired the very core of his/her inner and outer placeness as a kind of "at-homeness" and rootedness. Time is a central element and the inward extent of deepness of this trialectic space. Each of the metaphors is then the human being's unique, although even paradoxical, way of conceiving reality, and mastering spiritual suffering. They condense characteristic structures and patterns of dynamic scenery, which take place within the movement of health. The space encloses a contradictory spatiality constituted through the dynamic field of meaningfulness and meaninglessness. Anyway, it is not through a purging of these contradictions but through bringing them together in a drama of suffering that the space is shaped as ontologically good and meaningful in the world of caring.

Nurse-led interpersonal counselling for depressive symptoms in patients with myocardial infarction

The broad interest of this intervention study is in two worldwide remarkable diseases, myocardial infarction and depression. The purpose of the 18-month follow-up study was to evaluate the outcomes of interpersonal counselling implemented by a psychiatric nurse, and to examine the recovery experienced by the patients after myocardial infarction. The interpersonal counseling consisted of a short-term (max 6 sessions) depression-focused intervention modified for myocardial infarction patients. The main principle of interpersonal counselling is that depressive symptoms relate to interpersonal relations. The measured outcomes of the intervention consisted of changes in depressive symptoms and distress, health-related quality of life and the use of health care services. The data consisted of 103 patients with acute myocardial infarction and with sufficient knowledge of Finnish language, and they were randomized into intervention group (n=51) and control group (n=52) with standard care. Depressive symptoms were measured using Beck Depression Inventory, and distress using Symptom Checklist-25. The instrument to measure health-related quality of life was EuroQol-5 Dimensions. All instruments were used at three measurements: in hospital, at 6 months and at 18 months after hospital discharge. The Use of Health Care Services questionnaire was used during the 6- and 18-month period after hospital discharge. In addition, satisfaction with the intervention and with information received from the health-care professional was evaluated during the follow-up. To examine recovery, the patients kept diaries during a 6-month period and they were interviewed at 18 months after myocardial infarction. The number of patients with depressive symptoms decreased significantly more in the intervention group compared with the control group during 18 months of follow-up. Distress decreased significantly more among patients under 60 years in the intervention group than in the control group, but the difference was not significant between the groups. No differences in the changes of health-related quality of life were found between the groups during follow-up. However, in the group of patients under 60 years, the improvement of health-related quality of life in the intervention was significantly better in the intervention group compared with the control group during the follow-up. During the follow-up period, there was even a decline in the use of somatic specialized health care services in the intervention group and among intervention patients who had no other long-term disease. Considering recovery experienced by the patients, main categories including many supporting and inhibiting factors and subcategories were identified: clinical and physical, psychological, social, functional and professional category. No differences between the groups were found in satisfaction with information received from the professionals. The brief and easy-to-learn intervention, with which the patients were satisfied, seems to decrease depressive symptoms after myocardial infarction. Interpersonal counselling seems to be beneficial especially with younger patients. These results justify adopting depression screening and interpersonal counselling as part of routine care after myocardial infarction. The first stage evaluation of the use of health care services is interesting, and calls for more studies. From the perspective of individual patients, recovery after myocardial infarction seems to consist of many supporting and inhibiting factors. This is something that is important to take into account in developing nursing practice. The results indicate a need for further studies in outcomes of interpersonal counselling and recovery experienced by the patients after myocardial infarction. In addition, the results encourage widening the research perspective to nursing administration and educational level.

“Why share in uncertain conditions?” Factors of individual level knowledge sharing in offshoring cases

The objective of this Master’s Thesis was to research factors influencing and enhancing individual level knowledge sharing in offshore projects which often involve uncertainty of the knowledge provider’s own future. The purpose was to understand why individuals are willing to share their knowledge under these kinds of circumstances. In addition the goal was to identify obstacles to interpersonal knowledge sharing in order to understand how to mitigate their influence. The research was conducted as a qualitative multiple case study in a global IT company, and the data was gathered using semi-structured personal theme interviews within two different offshore projects. In order to a gain a wider perspective on the matter, some management representatives were interviewed as well. Data was analysed with the inductive content analysis method. Results of the study indicate that individuals are willing to share their knowledge despite of uncertainty if they are motivated, if they are provided with opportunities to do so, and if they have skills, competence and experience to share their knowledge. A strong knowledge sharing culture in the organization or team also works as a strong incentive for individual level knowledge sharing. The findings suggest that even under uncertain conditions it is possible to encourage people to share their knowledge if uncertainty can be decreased to a bearable level, a robust and personal connection and relationship between the knowledge provider and acquirer can be created and suitable opportunities for knowledge sharing are provided. In addition, based on the results the support and commitment of management and HR in addition to favourable environmental circumstances play an essential role in building a bridge between the knowledge provider and acquirer in order to create a virtual environment and space for knowledge sharing: Ba.

Development Of Interpersonal Relationships in Global Virtual Teams

This study investigates the development of relationships in same global virtual team working on different projects. The purpose is to explore how do interpersonal relationships develop in terms of characteristics of virtuality and if there is any influence of project lifespan on the development of these relationships. Since relationships are dynamic in nature and are influenced by multiple levels of variables including individual, group and organizational level, therefore characteristics of virtuality have been considered from all these aspects so as to study their influence on development of relationships. In this study, relationships have been studied at two different levels. At first, dyadic relationships between two members of a GVT have been analyzed and thereafter, focus has been on the development of relationships among the team, based on these dyads. Characteristics having influence on development of relationships include trust, physical distance, time zone difference, cultural and language differences, level of formalization in the organization and means of communication used by team members. Level of formalization and means of communication are two characteristics which emerged after empirical study and are found to have direct influence on development of relationships. Remaining characteristics have been identified through literature review. In order to conduct the study, qualitative methodology has been applied. Empirical data has been collected based on a single case study while using semi-structured interviews as data gathering technique. Data analysis has been performed by applying thematic analysis along with the utilization of company documents such as work sheets, minutes of meetings and recordings of conferences. Findings of the study indicate that development of relationships, both at dyadic level and team level, is influenced by different events taking place among different members of GVT. These events have either positive or negative influence on the characteristics of virtuality, which leads to development of the relationships. It has been found that, trust, among all factors plays a greater role in development of these relations. Contrary to the belief that most conflicts arise among members of different cultures, they are equally likely to happen among the members from same culture in GVT environment. Study suggests that relationship development is not a smooth process but it fluctuates based on different events in teams. For further research, teams within large firms shall be studied along these lines. This study is an early attempt towards bringing different characteristics of virtuality together which previously, have been studied individually. It is therefore plausible to conduct similar studies so as to generalize the findings of this study which has provided a starting point.

Changes in understorey biomass and species composition after water level drawdown on pine mires in southern Finland

Tiivistelmä: Vedenpinnan alenemisen vaikutus sararämeen pintakasvillisuuden biomassaan ja lajistoon

Effect of feeding level during autumn and winter on breeding weight and result in single and pair-housed minks

Selostus: Syys- ja talviruokinnan vaikutus yksin ja pareittain kasvatettujen minkkien lisääntymistulokseen

Impact of precipitation on the water table level of different ombrotrophic raised bog complexes, central Estonia

Sadannan vaikutus vedenpinnan tasoon kohosuolla

Effect of feeding level and diet type on the performance of crossbred suckler cows and their calves

Selostus: Ureoidun oljen soveltuvuus risteytysemojen talviruokintaan kahdella eri ruokintatasolla