This article examines naturehealth effects through the functioning of autonomic nervous system. Article aims to bring together various sub-processes that are related to nature forming a more holistic theoretical model. Observations here show how diversely nature can support people's survival in challenging life situations. In conclusion, nature offers a diverse rehabilitation environment, with several starting points to support a person's positive development spiral. It is particularly suitable for client-oriented work, where, in addition to factual issues, more extensive methods are needed to support the client's wellbeing.
Digitaaliset mielenterveys- ja hyvinvointi-interventiot (Digital mental health intervention, DMHI) voisivat osaltaan toimia ratkaisuna mielenterveyspalveluiden eriarvoiseen saatavuuteen. Vaikka niiden vaikuttavuudesta kontrolloiduissa olosuhteissa on kertynyt yhä enemmän näyttöä, interventioiden vakiintunut käyttöönotto arjen olosuhteissa on yhä harvinaista, ja saavutettavuus on epätasaista erityisesti heikommassa asemassa olevien ryhmissä, joissa toisaalta hoidontarve on suurin. Tässä kirjoituksessa esitämme, että DMHI:den kehittämisessä tulisi jo hankkeen alkuvaiheessa integroida kaksi metodologista lähestymistapaa, joita on toistaiseksi sovellettu pääosin erillään: implementaatiotutkimuksen viitekehykset sekä yhteiskehittäminen heikommassa asemassa olevien ryhmien kanssa. Implementaatiotutkimuksen viitekehykset määrittävät, minkä kontekstuaalisten ehtojen on täytyttävä, jotta DMHI:t voivat juurtua sote-palvelujärjestelmään. Yhteiskehittäminen määrittää, kenen tiedon pohjalta interventiota luodaan ja kehitetään, jotta se tarjoaisi hyötyjä yhdenvertaisesti. Ehdotamme neljää periaatetta lähestymistapojen integroimiseen sekä tarkastelemme digitaalista tutkimukseen rekrytointia ja tutkittavan suostumusta operatiivisina solmukohtina, joissa heikommassa asemassa olevien ryhmien yhdenvertaisuus joko toteutuu tai pettää. Esitämme neljä konkreettista suositusta tutkimusyhteisölle, hyvinvointialueille ja tutkimusrahoittajille, jotka tukevat vaikuttavien DMHI:den juurtumista suomalaiseen palvelujärjestelmään tavalla, joka edistää mielenterveyden tasa-arvoa väestöryhmien välillä.
The prevention and treatment of incontinence within maternity clinic services is significant from both individual and societal perspectives. Incontinence causes health and social disadvantages for individuals, but it also contributes to environmental burden and economic costs for society. These negative impacts can be reduced by investing in measures of early prevention and treatment. In this article, we examine how health care professionals working in maternity clinics describe the prevention and treatment of incontinence. The data consists of individual and group thematic interviews (n = 17) conducted in 2024 with maternity clinic professionals. The data were analyzed using thematic analysis. Based on the analysis, we identified three themes that illustrate the prevention and treatment of incontinence in the maternity clinic context. The results showed that the initiation of discussion regulates prevention and access to care, pelvic floor health is grounded in knowledge, and the multidisciplinary care pathway for incontinence appears inconsistent. Pregnant and postpartum individuals should have access to preventive pelvic floor physiotherapy services in accordance with recommendations, as well as to high-quality care at an early stage. Preventing and treating incontinence promotes the health of pregnant and postpartum individuals and may also reduce the national economic costs of incontinence and the waste generated by incontinence products. The results can be utilized in the multidisciplinary development of maternity clinic services.
Nurse shortages are a serious and growing challenge both in Finland and internationally. According to a survey by Tehy (2023), 93% of nurses under 30 in specialised healthcare are considering leaving the profession, and the social and healthcare sector is estimated to need up to 200,000 new employees by 2035. This article examines generation-aware human resource management as a means of improving nursing staff commitment and reducing turnover. Finnish working life currently includes four simultaneous generations; Baby Boomers, Generation X, Generation Y and Generation Z, each with differing values, attitudes and expectations regarding work. Drawing on international peer-reviewed literature, the article addresses generational awareness from a strategic human resource management perspective, focusing on recruitment, rewards, and competence development and transfer. The findings suggest that an organisational culture acknowledging the needs of different generations enhances wellbeing at work, improves patient safety and reduces staff turnover. Transformational leadership is identified as the most suitable style for managing multigenerational teams, as it recognises each employee's individual values and strengths. Generational awareness does not mean reinforcing stereotypes but rather meeting each employee as an individual while leveraging the unique strengths of every generation.
In this article, I use a narrative analysis to explore the perceptions and meanings of food and diet in illness narratives of people with coronary heart disease. My data consists of responses from two questionnaires for people with coronary heart disease (n= 23). My data reveals both the cultural perceptions of food and eating, and the uncertainty and stigma associated with food. Through analysis, I identified three narrative themes that focused on 1) changes in signifying the food, 2) the dividing of food into good and bad, and 3) food choices as a way to escape the stigma associated with illness. In this study, food narratives are understood as performative narratives, i.e., reality-constructing storytelling that allows us to explore food-related meanings and cultural interpretations. The narratives reveal that patients experience moral judgment and stigma related to food and eating. Respondents strive to fulfill the role of a good patient and distance themselves from stereotypes of the illness by creating food narratives that align with official nutritional guidance. My research suggests that listening to the food narratives of patient groups with different backgrounds opens opportunities to broaden the interpretation of lived illness and develop the nutritional guidance. Food narrative research has the opportunity to develop guidance into a direction that supports and recognizes the diverse backgrounds of patients undergoing rehabilitation and dietary changes.
A variety of routes may lead to a disability pension. Some disability pension applicants receive a positive decision directly without previous benefit or preliminary decisions granted by the pension insurance company. The aim of the study was to investigate whether social and health-related factors are related to a direct permanent disability pension compared to having previous earnings-related pension benefits. In addition, we studied what factors increase the likelihood of ending up on a full disability pension instead of a partial disability pension for those who have received a direct disability pension. The research data (n= 13,084) consists of disability pension applications submitted to one of the private Finnish pension insurance companies for the years 2015–2022. As a modeling method, we used logistic regression. Our study showed that approximately one third (n=5 019) of the total data were recipients of a direct disability pension, of whom 1,574 received a partial disability pension and 3,445 received a full disability pension. Many sociodemographic, socioeconomic and health-related factors were associated with receiving a direct disability pension. The probability of receiving a direct disability pension was increased most by the age of over 55, the severity of the illness, and the diagnoses of nervous system diseases and neoplasms. When we studied only those who received a direct disability pension, the likelihood of a full disability pension was increased especially by the male sex, the severity of the illness assessed as severe, and more than two previous benefit rejections before the disability pension. An applicant with a mental health diagnosis or neoplasms was more likely to end up on a full direct disability pension than others. A significant number of people end up on a disability pension directly. It is important to address the factors associated with disability as early as possible to support the return to work instead of ending up on a disability pension.
Patient participation in their own care is an essential part of patient safety and quality of care. This study examined patient participation in psychiatric hospital care. The data consisted of patient injury notices submitted to the Patient Insurance Centre between 2010 and 2021 (n=81) and decisions made by the Patient Insurance Centre. The research method was document analysis, and the data was analysed using a combination of inductive content analysis and thematisation as suitable for document analysis. According to the results, participation in care in patient injury notices was related to communication, decision-making, and limitations on activities and opportunities. Communication appeared to be a challenge in interaction, and patients did not feel that they had been heard or had received appropriate information about their care. There were obstacles to participating in the decision-making regarding one’s own care planning. On the other hand, patients also hoped that the nursing staff would take responsibility for decision-making when the patient was unable to make decisions due to their illness. Restrictions on activities or opportunities were linked to various restrictive measures and patients' descriptions of power relations in which patients were not treated equally. A quantitative overview of the data highlighted content of medication, involuntary treatment, inappropriate treatment, and somatic illness as issues related to participation in care. Of the decisions made by the Patient Insurance Centre on notices of patient injury, 95% (n=77) were negative and 5% (n=4) were positive. There has been limited research on patient participation in psychiatric hospital care, and patient injury notices have not previously been utilised in research on patient participation. The results can be used to develop the participation of patients in psychiatric hospital care and thus also strengthen patient safety. Attention should be paid to treating patients with respect and interacting with them on an equal footing without power dynamics, as well as enabling patient participation by listening, taking the patient's opinion into account, providing information, and motivating the patient to participate in decision-making. Further research is needed on the issues that promote patient participation in psychiatric hospital care, from the perspective of both patients and healthcare professionals.
This multidisciplinary article examines embodied experiences, their formation, and their impact on physical activity. The body is conceptualized both as a biological entity governed by physiological principles and as a lived body – an embodied subjectivity that generates and carries lived experience within social and cultural orders. The article integrates individual-psychological and neurobiological perspectives with cultural and structural dimensions shaped by societal power relations. Negative emotions and bodily sensations, such as shame or feelings of inadequacy, may foster experiential avoidance of physical activity or lead to forms of movement that do not support wellbeing. Under stress, the central nervous system may become sensitized, interpreting ordinary situations as threatening. Meanings attributed to the body emerge through social interaction, social comparison, and media representations, where the body is often framed as an object to be improved and evaluated against external norms. Because a person’s relationship with their body is socially and culturally shaped, individual-level solutions alone are insufficient. Structural interventions are also needed to create safe and inclusive environments for physical activity. The article clarifies mechanisms underlying experiential avoidance and argues that physical activity promotion should more systematically recognize embodied experience as a basis for ethically sustainable practice.
The purpose of this study was to describe ward nurses’ experiences of discharging older patients from hospital. In this study, the term nurses referred to registered nurses and licensed practical nurses. The data were collected through individual semi structured interviews in spring 2024 from ward nurses who had participated in a discharge development project (n = 7) and analysed using inductive content analysis. According to the nurses’ experiences, three key aspects characterised the discharge of older adults from hospital wards: (1) interprofessional collaboration and knowledge of the care environment, (2) gerontological nursing competence, and (3) challenges related to the discharge process. Interprofessional collaboration and understanding of the care environment were associated with cooperation between different actors, structural challenges within wellbeing services counties, the use of digital client and patient information systems, and the need for consistent procedures and care pathways. Ensuring gerontological nursing competence was linked to education on the care of gerontological patients, as well as to the strengthening of nurses’ experience and professional skills. Challenges in the discharge process were mainly related to insufficient resources and the complexity of discharge situations. This study provides new knowledge on key factors influencing the discharge of older adults in hospital ward settings and offers guidance for the development of social and health care education, discharge practices and leadership.
Extending working careers and supporting labour market participation have been key objectives of labour market policy in the face of sociodemographic changes. At the same time, digitalisation is changing working life and the labour market. Digital competence has become a key factor in the labour market. We explore what we actually know about the labour policy implications of digital competence of end-of-career health professionals and what factors hinder and promote digital competence of end-of-career health professionals. The study was conducted as a scoping review, following the guidelines of the Joanna Briggs In-stitute. Literature was searched in Scopus, ABI/Inform, EBSCO, Web of Science, CINAHL and PubMed databases, in addition to a manual search from Finnish literature. The database search was conducted in October 2024 and updated in January 2026. The database search yielded a total of 3,863 references. Inductive content analysis was used to analyse the results. We found nine relevant research articles and a large amount of relevant research that either did not deal with labour policy or the health sector. Our results show that digital competence is a key factor for career continuity, well-being and labour market retention among older health professionals. In particular, the use of older workers' professional experience in the provision of digital services and adult education that supports informal work emerged as key factors in promoting digital competence. Previous research suggests that the barriers to digital competence are both psychological and experiential, and that age management practices and the labour market system in the health sector does not actively support the digital competence of older health professionals. The most significant finding of this review was that there is surprisingly little research on the labour market dimension of digital competence in the health sector. In the future, the health sector should look at digital competence beyond the individual perspective, as the development of the social and health care services will require a more detailed analysis and consideration of workforce policy in organisational development.
The reform of social and health services represents one of the most significant recent structural and operational changes in Finland and involves extensive utilisation of digitalisation. In the wellbeing services counties, the development of digital solutions in older adults care is highly topical, and it is essential to provide frontline managers with support and new tools for leading this work. The aim of the GeroDigiLead project (2023–2026) was to strengthen the readiness of frontline managers working in elderly care organisations in the wellbeing services counties of North Ostrobothnia and Lapland to lead digitalisation-related change processes within the context of rehabilitation‑oriented care. The project was funded by the European Social Fund Plus (ESF+) and the Centre for Economic Development, Transport and the Environment of North Ostrobothnia. It was implemented through multidisciplinary collaboration between the University of Lapland, Lapland University of Applied Sciences, and the University of Oulu. Within the University of Oulu’s sub‑project, a three‑credit online course Leadership of Digital Transformation Processes in Elderly Care within Reablement‑Oriented Practice was developed and delivered in the Moodle learning environment in 2024–2025. A total of 65 frontline managers participated in the course, and its effectiveness was assessed using the ReCCA self‑assessment instrument and participant feedback. Based on the ReCCA self‑assessment, managers’ competence increased particularly in leading the implementation of digital solutions, assessing older adults’ functional capacity, and applying the reablemet‑oriented care model. Improvements were also observed in leadership related to supporting physical, psychological, and social functioning. The training was well‑received: 76% of participants reported that the online course supported their learning, and 88% considered the learning materials fully appropriate. Open‑ended responses emphasised a reduced threshold for digitalisation, strengthened managerial roles in digital transformation, and the practical applicability of the training. The results indicate that the online course is highly suitable for strengthening digital competence in elderly care and leadership of reablement‑oriented practice. After the project ends, the course will be offered free of charge through the Open University beginning in autumn 2026.
This study investigated reasons why medicine users experience pharmacotherapy monitoring as insufficient, and the factors associated with the most reported reason for experienced insufficiency. In addition, the prevalence of drug-related problems among those who experience monitoring of their pharmacotherapies as insufficient was studied. An online survey was conducted via Kanta services in October 2021. The data were analyzed using qualitative content analysis, frequencies, cross tabulation, and logistic regression analysis. In total, 1695 prescription medicine users responded to the survey. Of them, 33.0% (n=559) explained their view on why they experience pharmacotherapy monitoring as insufficient. The most reported reasons for experienced insufficiency of pharmacotherapy monitoring were the lack of regular pharmacotherapy monitoring (47.8%), not being encountered in healthcare (21.6%) and the lack of resources for pharmacotherapy monitoring in healthcare (19.6%). Gender, place of residence, certain long-term illnesses, lack of knowledge of the aims of used pharmacotherapies and certain healthcare units responsible for pharmacotherapy monitoring were associated with the most common reason for insufficient pharmacotherapy monitoring (lack of regular monitoring). Drug-related problems were more common if a medicine user experienced pharmacotherapy monitoring as insufficient. This study shows that medicine users experience pharmacotherapy monitoring as insufficient, mainly because there is no regular monitoring. Monitoring policies and practices in healthcare and between healthcare and pharmacies should be developed to ensure regular pharmacotherapy monitoring. This would also enable earlier detection of drug-related problems.
The number of the oldest old people will grow in Finland as longevity is increasing. The provision of care went through a major transformation in Finland during the 2000s, at the same time as the number of the oldest old people grew intensively. The ageing-in-place policy has led to reductions in residential care, yet the coverage of home care has not increased. We examined the development of chronic disease morbidity and functional ability between 2001 and 2022 in different living and care arrangements among people aged over 90 years. We used the Vitality 90+ survey data collected seven times between 2001 and 2022 in Tampere, Finland, with altogether 6,876 respondents. The proportion of respondents living in long-term care decreased and the proportion of respondents having regular home care stayed stable. The number of people living in long-term care or having regular home care increased during the study period. The proportion of participants living at home without home care increased. Despite a relative improvement in functioning and a decrease in the prevalence of dementia among those without home care, the number of dependent people and those with dementia increased. The proportion of people reporting dementia increased among participants having regular home care and among those living in long-term care. The number of diseases increased in all groups. To conclude, an increasing number of people with multimorbidity, dementia, and functional dependency live at home without formal care. Home care and long-term care have concentrated on the oldest people with dementia and a high level of functional limitations.
