Papers by Sanna Salanterä
The purpose of this study was to describe the content and structure of documentation of health ch... more The purpose of this study was to describe the content and structure of documentation of health checkups in occupational health care. A two phase study with the Delphi-group technique was used. Participants were a purposive sample of 20 occupational health nurses. Measurements: Semi structured interviews were conducted and a questionnaire for second round which was based on the interviews. Principally the occupational health nurses did not have a clear uniform opinion of the content areas of the health checkups. It was noticeable that counseling was not mentioned as a content area of the health check up. Occupational health nurses considered the present documentation system extremely heterogeneous. The most important issue to be improved is the documentation of the health plan and summary. A structured body of documentation with the combination of free text would clarify the content of documentation of health checkups in occupational health care. Also it would ease the evaluating of the effectiveness of the care given.
International Journal of Serious Games
A theory-based exergame was developed for tweens to promote their self-efficacy towards physical ... more A theory-based exergame was developed for tweens to promote their self-efficacy towards physical activity and increase their physical activity levels. We used protocols from both health science and gamification research in piloting the exergame. First, we assessed the usability and feasibility of the exergame and conducted a preliminary exploration of its effectiveness. After technical improvements were made based on our findings, we reiterated the pilot study and analysed the gamification elements of the exergame by using Octalysis analysis. The overall findings suggest that a theory-based exergame can positively influence the self-efficacy of tweens towards physical activity. The exergame showcased theoretical strength, achieved using diverse gamification elements but its overall game design and usability can be further improved. The study concludes that health-related components of the purpose of intervention must be incorporated in parallel with the engaging design of the game, ...
The Use of Nursing Diagnoses in Perioperative Documentation
International Journal of Nursing Terminologies and Classifications, 2010
To clinically validate the nursing diagnoses of the first Finnish version of Perioperative Nursin... more To clinically validate the nursing diagnoses of the first Finnish version of Perioperative Nursing Data Set (PNDS) by using them in perioperative documentation. Nursing diagnoses were used in documentation in four operating departments with 250 patients. In analysis, nonparametric tests were applied. While intraoperatively nursing diagnoses focused on physiological concerns, postoperatively the focus shifted to that of recovery. The findings revealed the importance of safety-related routines in perioperative care. Nursing diagnoses in the Finnish version of PNDS are sensitive in describing the rationales for perioperative care. Nursing classifications illustrate the nursing process in a structured form. Nursing diagnosis is an early step in the decision-making process that aims to achieve expected outcomes in nursing care.
Vaikuttavuuden mittaaminen ja palvelujärjestelmätutkimus
Scandinavian Journal of Caring Sciences, 2013
Background: Non-communicative adult ICU patients are vulnerable to inadequate pain management wit... more Background: Non-communicative adult ICU patients are vulnerable to inadequate pain management with potentially severe consequences. In German-speaking countries, there is limited availability of a validated pain assessment tool for this population. Aim: The aim of this observational study was to test the German version of the Critical-Care Pain Observation Tool (CPOT) in a heterogeneous adult ICU population. Methods: The CPOT's feasibility for clinical use was evaluated via a questionnaire. For validity and reliability testing, the CPOT was compared with the Behavioural Pain Scale (BPS) and patient's self-report in 60 patients during 480 observations simultaneously performed by two raters. Results: The feasibility evaluation demonstrated high satisfaction with clinical usability (85% of responses 4 or 5 on a 5-point Likert scale). The CPOT revealed excellent criterion validity [agreement between CPOT and BPS 94.0%, correlation of CPOT and BPS sum scores r = 0.91 (P < .05), agreement of CPOT with patient self-report 81.4%], good discriminant validity [mean difference of CPOT scores between at rest and non-painful stimulus 0.33 (P < .029), mean difference of CPOT scores between at rest, and painful stimulus 2.19 (P < .001)], for a CPOT cutoff score of >2 a high sensitivity and specificity (93% and 84%), high positive predictive value (85%), and a high negative predictive value (93%). The CPOT showed acceptable internal consistency (Cronbach's α 0.79) and high inter-rater reliability [90% agreement, no differences in CPOT sum scores in 64.2% of observations, and correlation for CPOT sum scores r = 0.72 (P < .05)]. Self-report obtained in patients with delirium did not correlate with the CPOT rating in 62% of patients. Conclusion: This is the first validation study of the CPOT evaluating all of the described validity dimensions, including feasibility, at once. The results are congruent with previous validations of the CPOT with homogeneous samples and show that it is possible to validate a tool with a heterogeneous sample. Further research should be done to improve pain assessment and treatment in ICU patients with delirium.
BMC Palliative Care, 2012
Background: Hypoventilation due to respiratory insufficiency is the most common cause of death in... more Background: Hypoventilation due to respiratory insufficiency is the most common cause of death in amyotrophic lateral sclerosis (ALS) and non-invasive ventilation (NIV) can be used as a palliative treatment. The current guidelines recommend performing spirometry, and recording nocturnal oxyhemoglobin saturation and arterial blood gas analysis to assess the severity of the hypoventilation. We examined whether the respiratory rate and thoracic movement were reliable preliminary clinical signs in the development of respiratory insufficiency in patients with ALS. Methods: We measured the respiratory rate and thoracic movement, performed respiratory function tests and blood gas analysis, and recorded subjective hypoventilation symptoms in 42 ALS patients over a 7-year period. We recommended NIV if the patient presented with hypoventilation matching the current guidelines. We divided patients retrospectively into two groups: those to whom NIV was recommended within 6 months of the diagnosis (Group 1) and those to whom NIV was recommended 6 months after the diagnosis (Group 2). We used the Mann Whitney U test for comparisons between the two groups. Results: The mean partial pressure of arterial carbon dioxide in the morning in Group 1 was 6.3 (95% confidence interval 5.6-6.9) kPa and in Group 2 5.3 (5.0-5.6) kPa (p = 0.007). The mean respiratory rate at the time of diagnosis in Group 1 was 21 (18-24) breaths per minute and 16 (14-18) breaths per minute in Group 2 (p = 0.005). The mean thoracic movement was 2.9 (2.2-3.6) cm in Group 1 and 4.0 (3.4-4.8) cm in Group 2 (p = 0.01). We observed no other differences between the groups. Conclusions: Patients who received NIV within six months of the diagnosis of ALS had higher respiratory rates and smaller thoracic movement compared with patients who received NIV later. Further studies with larger numbers of patients are needed to establish if these measurements can be used as a marker of hypoventilation in ALS.
Kokeellinen tutkimus ja sen haasteet hoitotieteellisessä tutkimuksessa
To evaluate and improve medical information retrieval, benchmarking data sets need to be created.... more To evaluate and improve medical information retrieval, benchmarking data sets need to be created. Few benchmarks have been focusing on patients’ information needs. There is a need for additional benchmarks to enable research into effective retrieval methods. In this paper we describe the manual creation of patient queries and investigate their automatic generation. This work is conducted in the framework of a medical evaluation campaign, which aims to evaluate and improve technologies to help patients and laypeople access eHealth data. To this end, the campaign is composed of different tasks, including a medical information retrieval (IR) task. Within this IR task, a web crawl of medically related documents, as well as patient queries are provided to participants. The queries are built to represent the potential information needs patients may have while reading their medical report. We start by describing typical types of patients’ information needs. We then describe how these queri...
University of Turku, Department of Nursing Science, Lemminkaisenkatu 1, 20520 Turku, Finland Hosp... more University of Turku, Department of Nursing Science, Lemminkaisenkatu 1, 20520 Turku, Finland Hospital District of Southwest Finland, Kiinamyllynkatu 4-8, 20520 Turku, Finland Norwegian University of Science and Technology, Department of Computer and Information Science, 7491 Trondheim, Norway University of Turku, Department of Information Technology, Joukahaisenkatu 3-5 A, 20520 Turku, Finland lmemur@utu.fi, anloka@utu.fi, hans.moen@idi.ntnu.no, hklula@utu.fi, tapio.salakoski@utu.fi, sansala@utu.fi
This paper presents the results of task 3 of the ShARe/CLEF eHealth Evaluation Lab 2013. This eva... more This paper presents the results of task 3 of the ShARe/CLEF eHealth Evaluation Lab 2013. This evaluation lab focuses on improving access to medical information on the web. The task objective was to investigate the eect of using additional information such as the discharge summaries and external resources such as medical ontologies on the IR eectiveness. The participants were allowed to submit up to seven runs, one mandatory run using no additional information or external resources, and three each using or not using discharge summaries.
ArXiv, 2016
Capabilities to exchange health information are critical to accelerate discovery and its diffusio... more Capabilities to exchange health information are critical to accelerate discovery and its diffusion to healthcare practice. However, the same ethical and legal policies that protect privacy hinder these data exchanges, and the issues accumulate if moving data across geographical or organizational borders. This can be seen as one of the reasons why many health technologies and research findings are limited to very narrow domains. In this paper, we compare how using and disclosing personal data for research purposes is addressed in Australian, Austrian, Finnish, Swiss, and US policies with a focus on text data analytics. Our goal is to identify approaches and issues that enable or hinder international health information exchanges. As expected, the policies within each country are not as diverse as across countries. Most policies apply the principles of accountability and/or adequacy and are thereby fundamentally similar. Their following requirements create complications with re-using a...
Gareth Jones is a Principal Investigator with the Centre for Next Generation Localisation and a f... more Gareth Jones is a Principal Investigator with the Centre for Next Generation Localisation and a faculty member of the School of Computing, Dublin City University (DCU), Ireland. He holds B.Eng and PhD degrees from the University of Bristol. His research focuses on areas of information retrieval including multimedia, multilingual and personal search. He has published more than 250 research papers describing his work. He has been involved as a task participant and coordinator at CLEF and other evaluation benchmarks, and in 2010 co-founded MediaEval which seeks to develop evaluation benchmarks for innovative multimedia search tasks. He is currently a principal investigator in the EU FP7 Khresmoi medical information management project for which DCU is responsible for coordination of evaluation activities.
The automatic detection of facial expressions of pain is needed to ensure accurate pain assessmen... more The automatic detection of facial expressions of pain is needed to ensure accurate pain assessment of patients who are unable to self-report pain. To overcome the challenges of automatic systems for determining pain levels based on facial expressions in clinical patient monitoring, a surface electromyography method was tested for feasibility in healthy volunteers. In the current study, two types of experimental gradually increasing pain stimuli were induced in thirty-one healthy volunteers who attended the study. We used a surface electromyography method to measure the activity of five facial muscles to detect facial expressions during pain induction. Statistical tests were used to analyze the continuous electromyography data, and a supervised machine learning was applied for pain intensity prediction model. Muscle activation of corrugator supercilii was most strongly associated with self-reported pain, and the levator labii superioris and orbicularis oculi showed a statistically si...
Children
Children with cancer are dealing with different side and long-term effects caused by cancer and i... more Children with cancer are dealing with different side and long-term effects caused by cancer and its treatments, like vinca-alkaloids, which may have negative effects on motor performance. However, the affected areas of motor performance (aiming and catching, balance, manual dexterity) and the differences in these areas between boys and girls and diagnoses are not frequently reported in a longitudinal design. Therefore, the aim of this study was to investigate how motor performance changes over the course of cancer treatment. The study was conducted with 3-to 16-year-old children with cancer (N = 36) in 2013–2017. The five assessment points were 0, 2, 6, 12 and 30 months from diagnosis. Movement-ABC2 was used to assess motor performance. We found that aiming and catching skills decreased significantly during the follow-up (p < 0.05). Balance was affected at the 2-month measurement point (p < 0.05) and more in children with acute lymphoblastic leukemia than in children with othe...
Nursing Research and Practice
Patient classification systems generate information for staff allocation based on a patient’s car... more Patient classification systems generate information for staff allocation based on a patient’s care needs. This study aims to test further the instrument for assessing nursing intensity (NI) in perioperative settings. Nine operating departments from five university hospitals were involved. The perioperative nurses gathered data from patients (N=876) representing different fields of surgery. Reliability was tested by parallel classifications (n=144). Also, the users’ (n=40) opinions were surveyed. The results support the predictive validity and interrater reliability of the instrument. The nurses considered the instrument feasible to use. The patients’ low ASA class did not automatically signify low NI; however, high ASA class was more frequently associated with high intraoperative NI. Intraoperative NI indicated the length of the postanaesthesia care and the type of the follow-up unit. Parallel classifications ensured the homogenous use of the instrument. The use of the instrument is...
Intensive & critical care nursing, Jan 18, 2017
To evaluate the impact of video education on critical care nurses' knowledge and skills in us... more To evaluate the impact of video education on critical care nurses' knowledge and skills in using a behavioural pain assessment tool for intensive care patients and to explore the nurses' experiences with video education. Forty-eight nurses in one intensive care unit watched an educational video on the use of the Critical-Care Pain Observation Tool, then assessed pain in two patients with the tool and took a knowledge test. The researcher made parallel pain assessments. Interrater reliability of patients' pain assessment between nurses and the researcher was determined to examine nurses' skills in using the tool after education. Twenty nurses were interviewed about their experiences with the video education. Interviews were analysed with deductive thematic analysis. The knowledge test scores indicated that the nurses learned the principles of how to use the tool. The interrater reliability of pain assessments reached a moderate level of agreement during the painful pr...
Predictors of Breastfeeding Initiation and Frequency for Preterm Infants in the NICU
Journal of obstetric, gynecologic, and neonatal nursing : JOGNN / NAACOG
To determine factors that predict the initiation and frequency of breastfeeding, attitudes about ... more To determine factors that predict the initiation and frequency of breastfeeding, attitudes about breastfeeding, and the self-efficacy of mothers of preterm infants in a neonatal intensive care unit. A structured survey using two measurement points. A university hospital in Finland. Mothers (N = 124) and their infants born at less than 35 weeks gestation. Structured questionnaires were used during the first week postpartum and at discharge of infants from the hospital. Neonatal and breastfeeding data were collected from patient records. Preterm infants initiated breastfeeding at the median postnatal age of 4 days (range = 0-70 days). The factors that predicted earlier initiation of breastfeeding were greater gestational age, no ventilator treatment, early physical contact, and greater maternal education level. Greater gestational age, early physical contact, and a breastfeeding-favorable attitude also predicted the frequency of breastfeeding. The attitudes of the mothers regarding br...
Nursing research
lectronic documentation is gaining ground in both public and private health services globally. Ma... more lectronic documentation is gaining ground in both public and private health services globally. Many health organizations, health systems, and whole countries already have 100% of their health records in electronic form. Governments and healthcare services have taken action toward harmonizing documentation systems and providing standard vocabulary, language, and structures for documenting and storing information. Electronic healthcare systems are expensive, and a large portion of the health sector's money is invested in the systems. It is important that we continue to develop these systems to their full capacity in patient care and in research. Nursing notes are a critical part of the electronic health records. These notes are based on continuous monitoring of a patient's condition and are usually composed partly of structured responses and partly of free text. Nursing notes reflect each patient's individual health, health problems, and care. They also reflect the reasoning processes of the nurse and actions taken based on the patient's health problems. Research is necessary in many aspects of nursing documentation for us to be prepared for the big data analysis and active use of nursing information for the good and safety of the patients as well as for the decision support of nurses and nurse leaders. The newest push for data analytics of large sets challenges health professionals to gather, process, and analyze massive amounts of data in meaningful ways for improving patient care. Nursing researchers need to be involved in this now. Data mining-that means analyzing data from several different angles and summarizing it to meaningful informationof structured data alone is not enough. Not all nursing can be turned into numbers and structured data. A patient's condition, emotions, and daily care can sometimes be best described with freely chosen words, and this should be allowed also in the future. However, our capacity to handle this nuanced rich freely written text and recognize patterns and trends in it is still limited. Text mining has great potential in detecting and understanding nursing observations concerning symptoms and emotions. With analyzing large amounts of free text nursing notes, we could, for example, see patterns in how certain types of symptoms are described, how patients react to different care interventions, and how effective the nursing interventions are. Free text nursing notes are not structured and often contain inconsistent syntax and semantics, abbreviations, Latin,
BioMed Research International, 2015
The literature shows that delayed admission to the intensive care unit (ICU) and discharge delays... more The literature shows that delayed admission to the intensive care unit (ICU) and discharge delays from the ICU are associated with increased adverse events and higher costs. Identifying factors related to delays will provide information to practice improvements, which contribute to better patient outcomes. The aim of this integrative review was to explore the incidence of patients’ admission and discharge delays in critical care and to identify organisational factors associated with these delays. Seven studies were included. The major findings are as follows: (1) explanatory research about discharge delays is scarce and one study on admission delays was found, (2) delays are a common problem mostly due to organisational factors, occurring in 38% of admissions and 22–67% of discharges, and (3) redesigning care processes by improving information management and coordination between units and interdisciplinary teams could reduce discharge delays. In conclusion, patient outcomes can be i...
Testing an Instrument for Assessing Nursing Intensity in Perioperative Settings: Construct Validity
International Journal of Nursing Knowledge, 2015
To test the construct validity of an instrument to assess nursing intensity in perioperative sett... more To test the construct validity of an instrument to assess nursing intensity in perioperative settings. A survey based on 24 core elements of perioperative nursing was used. A total of 652 assessments were performed on 308 patients. Principal component analysis was used. A model with four principal components was suggested. Patients&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; care needs appear to vary as they progress along the perioperative continuum. Thus, a given instrument&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s content differs from the intraoperative to postoperative phases. More testing is needed to achieve a valid tool for allocating nursing staff in operating departments. Reliable tools are needed to match patients&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; care needs with available nursing resources.
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Papers by Sanna Salanterä