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Kirjallisuusarvostelu

Woi weickon, Ne Wanhat Tauat parahimmat

Kirjallisuusarvostelu

Sai sampo valmihiksi, kirjokansi kaunihiksi

Kirjallisuusarvostelu

Seitsemän veljestä

Armas Launiksen (1884–1959) Seitsemän veljestä (1913) on ensimmäinen suomalainen koominen ooppera. Launis laati libreton teokseen Aleksis Kiven romaanin pohjalta. Ooppera oli hyvin kunnianhimoinen yritys nuorelta säveltäjältä ja Launis ryhtyi melkoisen haasteeseen. Kiven romaani on kirjoitettu osittain vuoropuheluksi ja on muodoltaan hyvin moderni. Uransa alkuvaiheessa ollut säveltäjä teki yli neljätuntisen esikoisoopperansa draamallisesti vaikeasti käsiteltävästä aiheesta. Launis onnistuikin luomaan omaperäisen musiikkidraamallisen sanonnan, jolle ei ollut suoranaista kansainvälistä vastinetta. Launis oli ensimmäinen, joka alisti suomen kielen palvelemaan luonnonmukaista resitatiivia. Vaikka Launiksen oopperalla ei ole sellaista merkitystä suomalaisessa oopperataiteessa kuin Kiven romaanilla kaunokirjallisuudessa, on annettava arvo Launiksen ennakkoluulottomalle uudistuspyrkimykselle, joka oli läpi uran näkyvillä hänen säveltäjäpersoonassaan. Sävelkielen muuntuminen oopperasta toiseen oli poikkeuksellisen huomattavaa. Oopperan kokonaisuutta on sanottu hajanaiseksi ja sen on moitittu kantavan huonosti juonellisesti ja psykologisesti loppuun asti. Aikalaisarvostelijat moittivat Seitsemän veljeksen orkesteriosuutta liian vakavahenkiseksi suhteessa hullunkurisia käänteitä sisältävään tekstiin.

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.

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