Nursing student-patient relationship and associated factors

The purpose of this study was to analyse the nursing student-patient relationship and factors associated with this relationship from the point of view of both students and patients, and to identify factors that predict the type of relationship. The ultimate goal is to improve supervised clinical practicum with a view to supporting students in their reciprocal collaborative relationships with patients, increase their preparedness to meet patients’ health needs, and thus to enhance the quality of patient care. The study was divided into two phases. In the first phase (1999-2005), a literature review concerning the student-patient relationship was conducted (n=104 articles) and semi-structured interviews carried out with nursing students (n=30) and internal medicine patients (n=30). Data analysis was by means of qualitative content analysis and Student-Patient Relationship Scales, which were specially developed for this research. In the second phase (2005-2007), the data were collected by SPR scales among nursing students (n=290) and internal medicine patients (n=242). The data were analysed statistically by SPSS 12.0 software. The results revealed three types of student-patient relationship: a mechanistic relationship focusing on the student’s learning needs; an authoritative relationship focusing on what the student assumes is in the patient’s best interest; and a facilitative relationship focusing on the common good of both student and patient. Students viewed their relationship with patients more often as facilitative and authoritative than mechanistic, while in patients’ assessments the authoritative relationship occurred most frequently and the facilitative relationship least frequently. Furthermore, students’ and patients’ views on their relationships differed significantly. A number of background factors, contextual factors and consequences of the relationship were found to be associated with the type of relationship. In the student data, factors that predicted the type of relationship were age, current year of study and support received in the relationship with patient. The higher the student’s age, the more likely the relationship with the patient was facilitative. Fourth year studies and the support of a person other than a supervisor were significantly associated with an authoritative relationship. Among patients, several factors were found to predict the type of nursing student-patient relationships. Significant factors associated with a facilitative relationship were university-level education, several previous hospitalizations, admission to hospital for a medical problem, experience of caring for an ill family member and patient’s positive perception of atmosphere during collaboration and of student’s personal and professional growth. In patients, positive perceptions of student’s personal and professional attributes and patient’s improved health and a greater commitment to self-care, on the other hand, were significantly associated with an authoritative relationship, whereas positive perceptions of one’s own attributes as a patient were significantly associated with a mechanistic relationship. It is recommended that further research on the student-patient relationship and related factors should focus on questions of content, methodology and education.

Handwriting and pre-frailty in the Lausanne cohort 65+ (Lc65+) study

BACKGROUND: Frailty is detected by weight loss, weakness, slow walking velocity, reduced physical activity or poor endurance/exhaustion. Handwriting has not been examined in the context of frailty, despite its functional importance. OBJECTIVE: Our goal was to examine quantitative handwriting measures in people meeting 0, 1, and 2 or more (2+) frailty criteria. We also examined if handwriting parameters were associated with gait performance, weakness, poor endurance/exhaustion and cognitive impairment. METHODS: From the population-based Lc65+, 72 subjects meeting 2+ frailty criteria with complete handwriting samples were identified. Gender-matched controls meeting 1 criterion or no criteria were identified. Cognitive impairment was defined by a Mini-Mental State Examination score of 25 or less or the lowest 20th percentile of Trail Making Test Part B. Handwriting was recorded using a writing tablet and measures of velocity, pauses, and pressure were extracted. RESULTS: Subjects with 2+ criteria were older, had more health problems and need for assistance but had higher education. No handwriting parameter differed between frailty groups (age and education adjusted). Writing velocity was not significantly slower among participants from the slowest 20th percentile of gait velocity but writing pressure was significantly lower among those from the lowest 20th percentile of grip strength. Poor endurance/exhaustion was not associated with handwriting measures. Low cognitive performance was related to longer pauses. CONCLUSIONS: Handwriting parameters might be associated with specific aspects of the frailty phenotype, but not reliably with global definitions of frailty at its earliest stages among subjects able to perform handwriting tests.

Why do university graduates regret their study program? A comparison between Spain and the Netherlands

[cat] En aquest article investiguem els factors que porten a universitaris espanyols i holandesos a lamentar els estudis cursats. Espanya i Holanda tenen un sistema educatiu molt diferent en termes de la rigidesa de l’educació secundària i el vincle entre l’educació i el mercat laboral. Comparant Espanya i Holanda ens permet aprendre sobre les conseqüències de dos sistemes educatius molt diferenciats a la probabilitat de lamentar els estudis cursats. Basant-nos en la literatura psicològica sobre l’arrepentiment/lamentació, derivem unes hipòtesis de partida que contrastem empíricament. Els resultats mostren que tant la rigidesa de l’educació secundària com el desajustament entre educació i ocupació són factors importants per explicar la lamentació dels estudis universitaris cursats. L’article conclou amb recomenacions sobre el sistema educatiu universitari.

Why do university graduates regret their study program? A comparison between Spain and the Netherlands

[cat] En aquest article investiguem els factors que porten a universitaris espanyols i holandesos a lamentar els estudis cursats. Espanya i Holanda tenen un sistema educatiu molt diferent en termes de la rigidesa de l’educació secundària i el vincle entre l’educació i el mercat laboral. Comparant Espanya i Holanda ens permet aprendre sobre les conseqüències de dos sistemes educatius molt diferenciats a la probabilitat de lamentar els estudis cursats. Basant-nos en la literatura psicològica sobre l’arrepentiment/lamentació, derivem unes hipòtesis de partida que contrastem empíricament. Els resultats mostren que tant la rigidesa de l’educació secundària com el desajustament entre educació i ocupació són factors importants per explicar la lamentació dels estudis universitaris cursats. L’article conclou amb recomenacions sobre el sistema educatiu universitari.

Challenges for the New Century Schools for All and Narrowing Gaps through Transformation Pedagogies

La pedagogia ha tractat la qüestió de gènere i d’educació? I si és el cas, de quina manera? Quins han estat els resultats? Tant el valor de l’educació com el de gènere foren qüestionats i revisats al començament del segle XX. Els resultats d’aquelles reflexions i les batalles lluitades per millorar les condicions, comencen a sentir-se cent anys més tard. Aquest article inclourà primerament una visió general de la situació de la dona en l’educació en l’àmbit mundial. En segon lloc, se centrarà en els enfocaments pedagògics transformacionals que de manera gradual comencen a introduir-se en els sistemes educatius convencionals —també en algunes universitats i programes de traducció—, secundats d’una banda pels principis de democràcia, diàleg, carnaval, experimentació i (socio) constructivisme, i per la neurociència i la psicologia de l’altra. És evident que aquests enfocaments desafien la discriminació i afavoreixen la creació de ponts, no tan sols entre gèneres, sinó també entre etnicitats i classes social

Los enfoques de aprendizaje en estudiantes universitarios Catalanes mediante el approaches and study skills inventory for students (ASSIST) = Learning Approaches of Catalan University Students Measured with the Approaches and Study Skills Inventory for Students (ASSIST)

The aim of this study is to measure the psychometric properties of a Catalan translation of the Approaches and Study Skills Inventory for Students (ASSIST), and to analyse the different learning styles used by university students, considering the influence of gender and type of studies. The instrument was administered to 834 students at the University of Girona. The results showed that most students interviewed had a deep approach to learning, although the analysis by gender showed that females tended to use a more strategic approach, while males used a deep approach predominantly. As to whether the type of studies influenced learning styles, a prevalence of deep approach was found among Science and Technology students, while a more strategic approach was found among Humanities and Education students

Quality of Life in Swiss Paediatric Inflammatory Bowel Disease Patients: Do Patients and Their Parents Experience Disease in the Same Way?

BACKGROUND AND AIMS: Inflammatory bowel diseases (IBDs) may impair quality of life (QoL) in paediatric patients. We aimed to evaluate in a nationwide cohort whether patients experience QoL in a different way when compared with their parents. METHODS: Sociodemographic and psychosocial characteristics were prospectively acquired from paediatric patients and their parents included in the Swiss IBD Cohort Study. Disease activity was evaluated by the Paediatric Crohn's Disease Activity Index (PCDAI) and the Paediatric Ulcerative Colitis Activity Index (PUCAI). We assessed QoL using the KIDSCREEN questionnaire. The QoL domains were analysed and compared between children and parents according to type of disease, parents' age, origin, education and marital status. RESULTS: We included 110 children and parents (59 Crohn's disease [CD], 45 ulcerative colitis [UC], 6 IBD unclassified [IBDU]). There was no significant difference in QoL between CD and UC/IBDU, whether the disease was active or in remission. Parents perceived overall QoL, as well as 'mood', 'family' and 'friends' domains, lower than the children themselves, independently of their place of birth and education. However, better concordance was found on 'school performance' and 'physical activity' domains. Marital status and age of parents significantly influenced the evaluation of QoL. Mothers and fathers being married or cohabiting perceived significantly lower mood, family and friends domains than their children, whereas mothers living alone had a lower perception of the friends domain; fathers living alone had a lower perception of family and mood subscores. CONCLUSION: Parents of Swiss paediatric IBD patients significantly underestimate overall QoL and domains of QoL of their children independently of origin and education.

Factors associated with active aging in Finland, Poland, and Spain

BACKGROUND: Continuous population aging has raised international policy interest in promoting active aging (AA). AA theoretical models have been defined from a biomedical or a psychosocial perspective. These models may be expanded including components suggested by lay individuals. This paper aims to study the correlates of AA in three European countries, namely, Spain, Poland, and Finland using four different definitions of AA. METHODS: The EU COURAGE in Europe project was a cross-sectional general adult population survey conducted in a representative sample of the noninstitutionalized population of Finland, Poland, and Spain. Participants (10,800) lived in the community. This analysis focuses on individuals aged 50 years old and over (7,987). Four definitions (two biomedical, one psychosocial, and a complete definition including biomedical, psychosocial, and external variables) of AA were analyzed. RESULTS: Differences in AA were found for country, age, education, and occupation. Finland scored consistently the highest in AA followed by Spain and Poland. Younger age was associated with higher AA. Higher education and occupation was associated with AA. Being married or cohabiting was associated with better AA compared to being widowed or separated in most definitions. Gender and urbanicity were not associated with AA, with few exceptions. Men scored higher in AA only in Spain, whereas there was no gender association in the other two countries. Being widowed was only associated with lower AA in Poland and not being married was associated with lower AA in Poland and Finland but not Spain. CONCLUSIONS: Associations with education, marital status, and occupation suggest that these factors are the most important components of AA. These association patterns, however, seem to vary across the three countries. Actions to promote AA in these countries may be addressed at reducing inequalities in occupation and education or directly tackling the components of AA lacking in each country.

WOMAN IN CHEMISTRY. JANE MARCET, A RELEVANT FIGURE IN CHEMISTRY EDUCATION

A historiographical study of Jane Marcet’s role in spreading chemistry knowledge to a wider audience in the 19th century is presented here. Her efforts to spread scientific knowledge were crucial to sharing the most important theories of chemistry among different audiences, particularly women and young people. Through her book, “Conversations on Chemistry,” which was published in several editions from 1806 to 1853, she contributed significantly to chemistry education. Despite controversy over the large number of editions, this text is a strong witness to the active participation of women in science. Her scientific rigor and contribution to narrative strategies in chemistry pedagogy have given Jane Marcet consideration not only as an important woman in the scientific community of England during the first half of the 19th century but also as a central figure in the early development of chemistry diffusion and education.

Nursing Ethics Education in Finland from the Perspective of Codes of Ethics

The purpose of this study was to analyze nursing ethics education from the perspective of nurses’ codes of ethics in the basic nursing education programmes in polytechnics in Finland with the following research questions: What is known about nurses’ codes in practice and education, what contents of the codes are taught, what teaching and evaluation methods are used, which demographic variables are associated with the teaching, what is nurse educators’ adequacy of knowledge to teach the codes and nursing students’ knowledge of and ability to apply the codes, and what are participants’ opinions of the need and applicability of the codes, and their importance in nursing ethics education. The aim of the study was to identify strengths and possible problem areas in teaching of the codes and nursing ethics in general. The knowledge gained from this study can be used for developing nursing ethics curricula and teaching of ethics in theory and practice. The data collection was targeted to all polytechnics in Finland providing basic nursing education (i.e. Bachelor of Health Care). The target groups were all nurse educators teaching ethics and all graduating nursing students in the academic year of 2006. A total of 183 educators and 214 students from 24 polytechnics participated. The data was collected using a structured questionnaire with four open-ended questions, designed for this study. The data was analysed by SPSS (14.0) and the open-ended questions by inductive content analysis. Descriptive statistics were used to summarize the data. Inferential statistics were used to estimate the differences between the participant groups. The reliability of the questionnaire was estimated with Cronbach’s coefficient alpha. The literature review revealed that empirical research on the codes was scarce, and minimal in the area of education. Teaching of nurses’ codes themselves and the embedded ethical concepts was extensive, teaching of the functions of the codes and related laws and agreements was moderate, but teaching of the codes of other health care professions was modest. Issues related to the nurse-patient relationship were emphasised. Wider social dimensions of the codes were less emphasized. Educators’ and students’ descriptions of teaching emphasized mainly the same teaching contents, but there were statistically significant differences between the groups in that educators assessed their teaching to be more extensive than what students had perceived it had been. T he use of teaching and evaluation methods was rather narrow and conventional. However, educators’ and students’ descriptions of the used methods differed statistically significantly. Students’ knowledge of the codes and their ability to apply them in practice was assessed as mediocre by educators and by students themselves. Most educators assessed their own knowledge of the codes as adequate to teach the codes, as did most of the students. Educators who regarded their knowledge as adequate taught the codes more extensively than those who assessed their knowledge as less adequate. Also students who assessed their educators’ knowledge as adequate perceived the teaching of the codes to be more extensive. Otherwise educators’ and students’ demographic variables had little association with their descriptions of the teaching. According to the participants, nurses need their own codes, and they are also regarded as applicable in practice. The codes are an important element in nursing ethics education, but their teaching needs development. Further research should focus on the organization of ethics teaching in the curricula, the teaching process, and on the evaluation of the effectiveness of ethics education and on educators’ competence. Also the meaning and functions of the codes at all levels of nursing deserve attention. More versatile use of research methods would be beneficial in gaining new knowledge.

Proactive and Preventive Student Welfare Activities in Finnish Preschool and Elementary School: Handling of Transition to Formal Schooling and a National Anti-Bullying Program as Examples

Prerequisites and effects of proactive and preventive psycho-social student welfare activities in Finnish preschool and elementary school were of interest in the present thesis. So far, Finnish student welfare work has mainly focused on interventions and individuals, and the voluminous possibilities to enhance well-being of all students as a part of everyday school work have not been fully exploited. Consequently, in this thesis three goals were set: (1) To present concrete examples of proactive and preventive psycho-social student welfare activities in Finnish basic education; (2) To investigate measurable positive effects of proactive and preventive activities; and (3) To investigate implementation of proactive and preventive activities in ecological contexts. Two prominent phenomena in preschool and elementary school years—transition to formal schooling and school bullying—were chosen as examples of critical situations that are appropriate targets for proactive and preventive psycho-social student welfare activities. Until lately, the procedures concerning both school transitions and school bullying have been rather problem-focused and reactive in nature. Theoretically, we lean on the bioecological model of development by Bronfenbrenner and Morris with concentric micro-, meso-, exo- and macrosystems. Data were drawn from two large-scale research projects, the longitudinal First Steps Study: Interactive Learning in the Child–Parent– Teacher Triangle, and the Evaluation Study of the National Antibullying Program KiVa. In Study I, we found that the academic skills of children from preschool–elementary school pairs that implemented several supportive activities during the preschool year developed more quickly from preschool to Grade 1 compared with the skills of children from pairs that used fewer practices. In Study II, we focused on possible effects of proactive and preventive actions on teachers and found that participation in the KiVa antibullying program influenced teachers‘ self-evaluated competence to tackle bullying. In Studies III and IV, we investigated factors that affect implementation rate of these proactive and preventive actions. In Study III, we found that principal‘s commitment and support for antibullying work has a clear-cut positive effect on implementation adherence of student lessons of the KiVa antibullying program. The more teachers experience support for and commitment to anti-bullying work from their principal, the more they report having covered KiVa student lessons and topics. In Study IV, we wanted to find out why some schools implement several useful and inexpensive transition practices, whereas other schools use only a few of them. We were interested in broadening the scope and looking at local-level (exosystem) qualities, and, in fact, the local-level activities and guidelines, along with teacherreported importance of the transition practices, were the only factors significantly associated with the implementation rate of transition practices between elementary schools and partner preschools. Teacher- and school-level factors available in this study turned out to be mostly not significant. To summarize, the results confirm that school-based promotion and prevention activities may have beneficial effects not only on students but also on teachers. Second, various top-down processes, such as engagement at the level of elementary school principals or local administration may enhance implementation of these beneficial activities. The main message is that when aiming to support the lives of children the primary focus should be on adults. In future, promotion of psychosocial well-being and the intrinsic value of inter- and intrapersonal skills need to be strengthened in the Finnish educational systems. Future research efforts in student welfare and school psychology, as well as focused training for psychologists in educational contexts, should be encouraged in the departments of psychology and education in Finnish universities. Moreover, a specific research centre for school health and well-being should be established.

Education export as a form of knowledge transfer : The potential of Finnish education export in Chile

Knowledge transfer is a complex process. Knowledge transfer in the form of exporting education products from one system of education to another is particularly complicated, because each system has been developed in a particular context to meet the requirements seen as relevant at each time. National innovation systems are often seen to form an essential framework within which the development of a country, its economy and level of knowledge are considered and promoted. These systems are orientated towards the future, and as such they also provide a framework for the knowledge transfer related to the development of education. In the best of circumstances they are able to facilitate and boost this transfer both from the viewpoint of the provider and the recipient. The leading thought and the idea of the study is that education export is a form of knowledge transfer, which is illustrated by the existing models included. The purpose of this study is to explore, analyze and describe the factors and phenomena related to education export, and more specifically, those related to the experiences and potential of Finnish education export to Chile. For better understanding, of the multiplicity of the issue involved, the current status of education export between Finland and Chile and he existing efforts within the Finnish innovation network will be outlined as well as new forms of co-operation between Finland and Chile in educational matters explored. Several countries have started to commercialize their education system in order to establish themselves as emerging education exporters. Moreover, the demand for education reform is accurate in many developing countries. This offers a good match between Finland and Chile to be the example countries of the research. The main research findings suggest that there are several business areas in education export. These include degrees in education, training services and education technologies for example The factors that influence education export can be divided into four groups, including academic, cultural, political and economic aspects. Challenges to overcome include the lack of product or services to be sold, lack of market and cultural knowledge of the buyer country, financing and lack of suitable pricing model. National innovation systems could be seen as enabling entities for successful education export. The extensive networks that national innovation systems aim to form, could operate as a basis for joining the forces in selling knowledge as well as receiving knowledge in a constructive way.

Long-term efficacy of a rural community-based integrated intervention for prevention and management of chronic obstructive pulmonary disease: a cluster randomized controlled trial in China's rural areas

This study aimed to assess the efficacy of a rural community-based integrated intervention for early prevention and management of chronic obstructive pulmonary disease (COPD) in China. This 18-year cluster-randomized controlled trial encompassing 15 villages included 1008 patients (454 men and 40 women in the intervention group [mean age, 54 ± 10 years]; 482 men and 32 women in the control group [mean age, 53 ± 10 years]) with confirmed COPD or at risk for COPD. Villages were randomly assigned to the intervention or the control group, and study participants residing within the villages received treatment accordingly. Intervention group patients took part in a program that included systematic health education, smoking cessation counseling, and education on management of COPD. Control group patients received usual care. The groups were compared after 18 years regarding the incidence of COPD, decline in lung function, and mortality of COPD. COPD incidence was lower in the intervention group than in the control group (10% vs 16%, <0.05). A decline in lung function was also significantly delayed in the intervention group compared to the control group of COPD and high-risk patients. The intervention group showed significant improvement in smoking cessation compared with the control group, and smokers in the intervention group had lower smoking indices than in the control group (350 vs 450, <0.05). The intervention group also had a significantly lower cumulative COPD-related death rate than the control group (37% vs 47%, <0.05). A rural community-based integrated intervention is effective in reducing the incidence of COPD among those at risk, delaying a decline in lung function in COPD patients and those at risk, and reducing mortality of COPD.

Fish consumption preferences and factors influencing it

Fish consumption preferences are affected by individuals’ socioeconomic characteristics. The aims of the present paper were (i) to obtain information on fish consumption level and frequency; (ii) to investigate the associations between the socioeconomic characteristics of consumers and their preferences; and (iii) to examine the influence of determinants on fish consumption. Data were gathered through a questionnaire completed by a total of 127 randomly selected individuals from different socioeconomic backgrounds from the Antakya, Turkey. The average consumption was found to be 2.98 kg/person/year for fish. Anchovies, gilt-head sea bream, and sea bass were reported as the most consumed three species, respectively. Significant differences in fish consumption were found among age groups, gender groups, and education groups, as well as between marital statuses. A majority of the consumers eat fish once a month throughout the year or only during the winter months. Fish consumption level and frequency were significantly positively correlated with education (p<0.01), income (p<0.05) and total meat consumption (p<0.01). The stepwise multiple regression model explained 41.7% (p<0.01) of the total variance for fish consumption. The amount and frequency of the consumption in the region, which is very far below the world and Turkey average especially for lower socioeconomic groups and for less-consumed fish species, can be increased by certain policies, such as training, advertising and different marketing strategies. Moreover, consumption should be distributed equally throughout the year instead of consuming only in certain seasons.

Tourism and the precautionary principle : a survey of academic and government stakeholders

The purpose of this exploratory investigation was to provide a more precise understanding and basis from which to assess the potential role of the precautionary principle in tourism. The precautionary principle, analogous to the ideal of sustainable development, is a future-focused planning and regulatory mechanism that emphasizes pro-action and recognizes the limitations of contemporary scientific methods. A total of 100 respondents (80 tourism academics, 20 regional government tourism officials) from Canada, United States, United Kingdom, Australia and New Zealand completed the webbased survey between May and June 2003. Respondents reported their understanding of the precautionary principle, rated stakeholder involvement and education strategies, assessed potential barriers in implementation, and appraised steps of a proposed fi-amework for implementation. Due to low sub sample numbers, measures of central tendency were primarily used to compare groups, while inferential statistics were applied when warranted. Results indicated that most respondents (79%) felt the principle could be a guiding principle for tourism, while local and regional government entities were reported to have the most power in the implementation process. Findings suggested close links between the precautionary principle and sustainability, as concern for future generations was the most critical element of the principle for tourism. Overall, tourism academics were more supportive of the precautionary principle in tourism than were regional government tourism officials. Only minor variation was found in responses among regional groups across all variables. This study established basic ground for understanding the precautionary principle in tourism and has been effective in formulating more precise questions for future research.