Young Registered Nurses’ Intent to Leave the Profession in Finland - A Mixed-Method Study

The purpose of this study was to examine and expand understanding concerning young Finnish registered nurses (RN) with an intention to leave the profession and the related variables, specifically when that intention has emerged before the age of 30. The overall goal of the study was to develop a conceptual model in relation to young RNs’ intention to leave the profession. Suggestions for policymakers, nurse leaders and nurse managers are presented for how to retain more young RNs in the nursing workforce. Suggestions for future nursing research are also provided. Phase I consists of two sequential integrative literature reviews of 75 empirical articles concerning nurses’ intention to leave the profession. In phase II, data had been collected as part of the Nurses’ Early Exit (NEXT) study, using the BQ-12 structured postal questionnaire. A total of 147 young RNs participated in the study. The data were analysed with statistical methods. In phase III, firstly, an in-depth interpretive case study was conducted in order to understand how young RNs explain and make sense of their intention to leave the profession. The data in this study consisted of longitudinal career stories by three young RNs. The data was analysed by using narrative holistic-content and thematic methods. Secondly, a total of 15 young RNs were interviewed in order to explore in-depth their experiences concerning organizational turnover and their intent to leave the profession. The data was analysed using conventional content analysis. Based on earlier research, empirical research on the young RNs intention to leave the profession is scarce. Nurses’ intention to leave the profession has mainly been studied with quantitative descriptive studies, conducted with survey questionnaires. Furthermore, the quality of previous studies varies considerably. Moreover, nurses’ intention to leave the profession seems to be driven by a number of variables. According to the survey study, 26% of young RNs had often considered giving up nursing completely and starting a different kind of job during the course of the previous year. Many different variables were associated with an intention to leave the profession (e.g. personal burnout, job dissatisfaction). According to the in-depth inquiries, poor nursing practice environments and a nursing career as a ‘second-best’ or serendipitous career choice were themes associated with young RNs’ intention to leave the profession. In summary, young RNs intention to leave the profession is a complex phenomenon with multiple associated variables. These findings suggest that policymakers, nurse leaders and nurse managers should enable improvements in nursing practice environments in order to retain more young RNs. These improvements can include, for example, adequate staffing levels, balanced nursing workloads, measures to reduce work-related stress as well as possibilities for advancement and development. Young RNs’ requirements to provide high-quality and ethical nursing care must be recognized in society and health-care organizations. Moreover, sufficient mentoring and orientation programmes should be provided for all graduate RNs. Future research is needed into whether the motive for choosing a nursing career affects the length of the tenure in the profession. Both quantitative and in-depth research is needed for the comprehensive development of nursing-turnover research.

Before internationalisation : reflections of lateral rigidity on managerial decision making

The purpose of the study is to analyse lateral rigidity in the framework of pre-internationalisation to find out its reflections on managerial decision making. The interest of the study lies in the intersection of the meaningful but relatively stagnant concept of lateral rigidity, and the pre-internationalisation phase of companies that has received only a limited amount of research attention. The theoretical basis for the study is drawn from managerial decision making and internationalisation literatures. Firstly, the study aims to define the concept of lateral rigidity in order to secondly find out how it influences managers’ pre-internationalisation decision making. The study is theoretical in nature, and is based solely on literature examination. Concept analysis method is used to determine the attributes of lateral rigidity for the purpose of recognising the concept in the pre-internationalisation framework. The attributes that are found to comprise lateral rigidity are culture, know-how, uncertainty and attitude. Furthermore, these attributes are more specifically found to consist of environmental, personal and operational matters. Through the analysis of the pre-internationalisation literature it is discovered that all the attributes appear there, and present a variety of influences on pre-internationalisation decision making that can be characterised as being negative. The study finds that culture influences managers’ decision making via subjective reasoning and behaviour that stem from a domestic inclination, and via unfamiliarity with foreign markets. Against assumption, home cultural factors, e.g. values and customs, do not appear to have an influence. Know-how is found to influence decision making via managers’ previous experiences, subjective abiding perceptions, and the usage of previous operation patterns. Uncertainty, then again, influences managers’ risk perception, unfamiliarity avoidance, and the scope of potential international operations. Attitude is found to have a robust influence on managerial decision making via the usage of familiar processes and decision regimes, subjective preference of convention, and plausible results of operations. Ergo, the effects of lateral rigidity on managers show to represent an encumbrance in the pre-internationalisation phase; even though internationalisation would take place, the related decisions and actions are highly constrained. Especially the subjectivity of managers is seen to have a meaningful role in the decision making process.

Virtual communities : a virtual treasure trove for end-user developers

End-user development is a very common but often largely overlooked phenomenon in information systems research and practice. End-user development means that regular people, the end-users of software, and not professional developers are doing software development. A large number of people are directly or indirectly impacted by the results of these non-professional development activities. The numbers of users performing end-user development activities are difficult to ascertain precisely. But it is very large, and still growing. Computer adoption is growing towards 100% and many new types of computational devices are continually introduced. In addition, other devices not previously programmable are becoming so. This means that, at this very moment, hundreds of millions of people are likely struggling with development problems. Furthermore, software itself is continually being adapted for more flexibility, enabling users to change the behaviour of their software themselves. New software and services are helping to transform users from consumers to producers. Much of this is now found on-line. The problem for the end-user developer is that little of this development is supported by anyone. Often organisations do not notice end-user development and consequently neither provide support for it, nor are equipped to be able to do so. Many end-user developers do not belong to any organisation at all. Also, the end-user development process may be aggravating the problem. End-users are usually not really committed to the development process, which tends to be more iterative and ad hoc. This means support becomes a distant third behind getting the job done and figuring out the development issues to get the job done. Sometimes the software itself may exacerbate the issue by simplifying the development process, deemphasising the difficulty of the task being undertaken. On-line support could be the lifeline the end-user developer needs. Going online one can find all the knowledge one could ever need. However, that does still not help the end-user apply this information or knowledge in practice. A virtual community, through its ability to adopt the end-user’s specific context, could surmount this final obstacle. This thesis explores the concept of end-user development and how it could be supported through on-line sources, in particular virtual communities, which it is argued here, seem to fit the end-user developer’s needs very well. The experiences of real end-user developers and prior literature were used in this process. Emphasis has been on those end-user developers, e.g. small business owners, who may have literally nowhere to turn to for support. Adopting the viewpoint of the end-user developer, the thesis examines the question of how an end-user could use a virtual community effectively, improving the results of the support process. Assuming the common situation where the demand for support outstrips the supply.

Issues with Fedora & Hydra, experiences from a research-data-driven implementation

Presentation at Open Repositories 2014, Helsinki, Finland, June 9-13, 2014

Gamification as a means for employee motivation, personal engagement and behavioral outcomes: a gamification system developers’ perspective

A major challenge faced by companies today is the engagement gap at the workplace and how to motivate employees to engage in less intrinsically motivating work activities that are valuable for the organization. The objective of this study is to investigate gamification as a means for employee motivation and personal engagement that result in behavioral outcomes from the gamification developers’ perspective. Theories of work motivation and engagement are viewed in relation to gamification. The empirical part conducts a qualitative multiple-case study. The data is analyzed with the CAQDAS NVivo. The empirical findings suggest that gamification can enhance employee motivation, but careful consideration of extrinsic motivators is necessary to avoid their detrimental effect on intrinsic motivation. Employee self-determination is built through internalization of gamified system’s goals reaching autonomous motivation to engage in the target behavior. Employee engagement is built by fulfilling the psychological conditions of meaningfulness, safety and availability. The results suggest that gamification can build employee motivation and engagement leading to behavior change if designed with the business objectives in mind. Moreover, the gamified system needs to be renewed to address the changes in the business environment and reflect them in the employee behavior.

Potilaan tiedollinen yksityisyys heräämössä

Tutkielman tarkoituksena oli kuvata potilaan kokemuksia tiedollisesta yksityisyydestään sekä tiedollista yksityisyyttä edistäviä ja estäviä tekijöitä heräämössä. Tämän tiedon pohjalta on mahdollista kehittää heräämön hoitotyötä potilaiden tiedollisen yksityisyyden osalta. Tutkimus toteutettiin kuvailevana haastattelututkimuksena. Aineisto kerättiin puolistrukturoidun teemahaastattelun avulla. Tutkimuksessa haastateltiin yhden suomalaisen yliopistosairaalan korva-, nenä- ja kurkkutautien (KNK) klinikan heräämössä hoidettuja aikuispotilaita 1-2 tunnin kuluessa heräämöhoidon päättymisestä. Haastatteluaineisto koostui 17:stä päiväkirurgisen – tai vuodeosastopotilaan haastattelusta. Tallennetut haastattelut litteroitiin ja aineisto analysoitiin induktiivisella sisällönanalyysillä. Potilaat kuvasivat tiedollista yksityisyyttä potilaan tietojen hallintana: potilaan tietojen luottamuksellisena käsittelynä ja oikeutena omiin tietoihin. Tiedollista yksityisyyttä pidettiin tärkeänä, mutta potilaat eivät olleet erityisen huolissaan tämän toteutumisesta heräämössä. Tiedollinen yksityisyys toteutui potilaiden mielestä melko hyvin heräämössä lukuun ottamatta tilanteita, joissa henkilökunta vaihtoi suullisesti tietoja potilaasta keskenään. Suurin osa potilaista totesi KNK-vaivojen olevan niin neutraaleja, ettei niiden joutuminen ulkopuolisten tietoon ollut heistä merkityksellistä. Tieto leikkauksesta kiinnosti potilaita ja he olivat tyytyväisiä saatuaan siitä tietoa heräämössä. Tiedollisen yksityisyyden toteutumista edistivät potilaan uppoutuminen omaan maailmaansa, mahdollisuus kontrolloida ja saada tietoa asioistaan, kahdenkeskinen vuorovaikutus, tieto tiedollisesta yksityisyydestä, heräämön tilajärjestelyt ja tiedollista yksityisyyttä koskevien sääntöjen noudattaminen. Muiden potilaiden uteliaisuus, potilaan kyvyttömyys suojata omia tietojaan ja ulkopuolisuus omissa asioissaan, kahdenkeskeisen vuorovaikutuksen mahdottomuus, yksityisen tilan puute ja tiedollista yksityisyyttä koskevan sääntelyn noudattamattomuus koettiin tietojen luottamuksellisen käsittelyn esteiksi heräämössä. Potilaiden tietojen luottamuksellista käsittelyä voitaisiin parantaa kiinnittämällä huomiota raportointimenetelmiin ja -paikkaan heräämössä. Käytettävissä olevia keinoja, kuten sermejä ja potilaiden sijoittelu heräämössä, kannattaa käyttää hyödyksi potilaan tiedollisen yksityisyyden suojaamiseksi. Tiedollisen yksityisyyden määritelmää tulisi jatkossa täsmentää käsiteanalyysin avulla. Lisäksi tiedollista yksityisyyttä olisi hyvä tutkia hoitotyön ympäristöissä, joissa potilaiden hoitoon liittyy mahdollisesti arkaluonteisempia tietoja kuin KNK- potilailla.

User-generated experiences: how automated platforms for content creation and sharing has transformed information access

Esitys KDK-käytettävyystyöryhmän järjestämässä seminaarissa: Miten käyttäjien toiveet haastavat metatietokäytäntöjämme? / How users' expectations challenge our metadata practices? 30.9.2014.

Transition : en betydelsefull fas i den långtidssjuka ungas vård

The aim of this caring science thesis is to deepen the understanding for the long-term ill adolescents care. In particular it aims to reach a better understanding of transition in health care, with a focus on how young people perceive health care. The goal is to build a model, a consistent theoretical framework that makes it possible to listen to the adolescent´s own voice, providing a better understanding of what good care consists in from their point of view. This Master's thesis consists of a literature overview on the concept of transition and a themed interview with young patients regarding transition of health care. The overall issue is 1. What is good care during the transition according to the adolescents themselves? 2. How does transition affect the young people's health and lives? The theoretical perspective of this thesis lies in the caring science tradition that has been developed at the Åbo Akademi University department of caring science with the caritative nursing theory as a basis. The epistemological and ontological assumptions are based on the caritative nursing theory, which in itself is ethical. Understanding of the concept of transition is based on A. Meleis transitions theory. The methodological approach is hermeneutical. The theme interview has been analyzed by using S. Kvales method. The material consists of a thematic interview with 10 long-term ill adolescents, about their views of the care received. This thesis research even in how NOBABs standards appears in the litterature as well as how they are implemented from the point of view of young people. The findings of this thesis shows that good care for the adolescent is a true presence with the young and an understanding of the direction in which the young move toward during the transition of care. Good care for an adolescent consists in being recognized as a person who is seen, known, appreciated and understood. Good care for the young involves recognizing her strength and joy of life including the contrast she experiences between health and suffering. To recognize their personal strength and courage supports the adolescents during the process of transitions of care Good care for the young involves responsibility for the individual person and humility in approaching her, giving attention to her view of life and aspirations. Openness and humility in the approach lays the foundation for a trusting relation during the transition of care. A unified theoretical framework is needed to promote the long-term ill adolescents care during transition of care. When the young and her individual needs is the centerpiece of healthcare creates this the basis for empowering care that supports the young in her quest for health. This master thesis adds a given model to the long-term ill adolescents` healthcare.

Store experiences and their influence on store performance and brand strength: Case Samsung Experience Store

Experiential marketing is increasingly seen as a new magical key to consumers’ hearts. Brands are turning brick-and-mortar stores into state of the art retail spaces where memorable experiences and strong brand relationships are hoped to be born. Around the globe, several brands have opened up a special format of stores – the experience store. Although many speculations on the positive effects of experiences have been presented, few studies have provided empirical, quantified evidence for the link between store experiences and brand success. In consequence, research was needed to find out whether experience stores truly are so special. The purpose of this thesis was to investigate whether store experiences are capable of building brands and influencing store performance. For this purpose, empirical research was conducted in the Samsung Experience Store Helsinki. As main constructs of the study, store experience, brand equity, store performance, and product class involvement were measured, along with relevant background variables. Data was collected with an electronic survey from actual customers of the store, resulting in a sample of 131 respondents. Partial least squares structural equations modeling (PLS) was used for the analysis of the research model. Also, regression analysis was conducted to account for mediation and moderation effects. The results showed that store experiences do positively influence first, store performance, and second, separate dimensions of brand equity (that is, brand awareness, brand personality, and brand loyalty). Also, the effect of store experiences on store performance was found to be mediated by brand equity. Interestingly, customers’ product class involvement was detected to moderate the effect of store experience on store performance. That is, those who were highly involved with electronics had greater store experiences, and also displayed a stronger linkage between store experience and store performance. The results encourage marketers to continue with efforts to create great experiences for their customers. Experience stores can – and should be seen – as both powerful brand building tools and profitable sales channels. The creation of exceptional experiences can act as an important function of physical stores in the face of severe online competition.

Westerners in search of the legendary potion : ayahuasca travel in the borderland between tourism and pilgrimage

The thesis examines the phenomenon most commonly known as “ayahuasca tourism” – i.e. the practice of westerners traveling to South America and partaking in ceremonies in which a powerful entheogenic brew, ayahuasca, is consumed. While this popular phenomenon has been steadily increasing during the last decades, it has, however, been insufficiently studied by scholars. An important question which has not been properly addressed in earlier studies is how ayahuasca tourism relates to the wider occurrence of travel and how it should be perceived with reference to the theoretical frameworks on the subject of travel. Drawing on theories regarding pilgrimage and tourism, the main purpose of this thesis is to examine the relationship between ayahuasca tourism and the broader spectrum of travel. In particular, the study tests the designations “pilgrimage”, “religious tourism” and “spiritual tourism” with reference to ayahuasca tourism. Utilizing earlier literature as well as ayahuasca tourists‟ reports obtained from an Internet forum as a basis for analysis, I search for a suitable terminology to be used for the phenomenon. The study lays special emphasis on the protagonists‟ motivations, experiences and outcomes in order to take note of various aspects of the wide-ranging occurrence of ayahuasca tourism. Key findings indicate that ayahuasca tourism is best understood as a combination of pilgrimage and tourism. On the basis of the analysis I argue that ayahuasca tourism should be labeled as “pilgrimage” and/or “spiritual tourism”, and the tourists respectively as “pilgrims” and/or “spiritual tourists”. The category of “religious tourism/tourist”, on the other hand, turns out to be an inappropriate designation when describing the phenomenon. In general, through my study I show that the results are consistent with the present trend in the study of travel to perceive pilgrimage and tourism as theoretically similar phenomena. The study of ayahuasca tourism serves thus as living proof of contemporary travel, in which the categories of pilgrimage and tourism are often indistinguishable. I suggest that ayahuasca tourism is by no means exceptional on this point, but can rather be used as an illustration of modern travel forms on a general level. Thus, the present study does not only add to the research of ayahuasca tourism, but also provides additional insights into the study of travel.

Yksilö ja ympäristö: Maalari Frans Lindin (1903–1988) elinikäinen ympäristösuhde muistitietohaastattelujen ja maisemamaalausten valossa

Tekijänoikeudellisten syiden vuoksi teoksen kokotekstissä olevien kuvien teknistä laatua on jouduttu heikentämään. ---- Tutkin yhden työläisen, maalari Frans Lindin (1903–1988) ympäristösuhdetta lapsuudesta viimeisiin elinvuosiin asti eli kirjoitan hänen ympäristöelämäkertaansa. Tarkastelen hänen suhdettaan luontoon ja kulttuuriympäristöön hänen vapaa-aikanaan. Tutkimukseen kuuluu johdanto-osan lisäksi yksi suomenkielinen ja neljä eng¬lanninkielistä artikkelia. Tutkin erityisesti Lindin paikkoja ja ympäristökokemuksia; tarkastelen hänen kotejaan ja muita tärkeitä paikkojaan; käsittelen hänen suhdettaan veteen ja vesistöihin; selvitän hänen maalausharrastustaan ja ympäristökokemustensa ulottuvuuksia sekä osoitan muistitiedon tärkeyden kokemusten tulkinnassa. Keskeiset lähteeni ovat vuosina 1985–2004 tekemäni Lindin ja 15 muun henkilön muistitietohaastattelut sekä puolensataa Lindin maalaamaa maisemaa, jotka dokumentoivat luontoa, yksityistaloja, julkisia rakennuksia ja kaupunkinäkymiä. Lisäksi käytän asiakirjoja, sanomalehtiaineistoa ja historiateoksia sekä omia havaintojani. Lähestyn Lindin ympäristösuhdetta kulttuurihistoriallisen ympäristötutkimuksen, henkilöhistorian ja muistitietohistorian näkökulmasta. Ympäristösuhde tarkoittaa kaikkea, mitä ihminen tekee ympäristössään, ympäristölleen ja ympäristönsä vaikutuksesta tai innoittamana. Se on sosiaalinen, historiallinen ja kulttuurinen ilmiö, joka kehittyy varhaislapsuudesta lähtien kodista käsin ja muotoutuu elämän loppuun asti. Lindin ympäristösuhde kehittyi eri ihmisten vaikutuksesta, eri aikoina ja eri toiminnoissa ja konkretisoitui paikoissa, jotka olivat koettuja, muistettuja ja kerrottuja. Ne olivat myös lyhyt- tai pitkäaikaisia tai ainut-kertaisia, aktiivisia tai passiivisia, nykyisiä tai menneitä. Laatimani Lindin paikkojen luokituksen perustalta voidaan tutkia muidenkin ihmisten paikkasuhdetta. Lindin ympäristösuhteen moniulotteisuus ja rikkaus ilmeni sekä haastatteluissa että maisemamaalauksissa. Hänen ympäristökokemuksensa olivat arkisia, mutta niissä ilmenivät myös tunteiden, tiedon, nostalgian, edistyksen, omistamisen ja liikkumisen ulottuvuudet. Tutkimukseni antaa lähtökohdan kenen tahansa, varsinkin elossa olevan henkilön, ympäristösuhteen tutkimiselle.