BackgroundThe evolution of health care is driving the need for specialist nursing knowledge. Spec... more BackgroundThe evolution of health care is driving the need for specialist nursing knowledge. Specialist nurses have undertaken a formal training that focuses on a specific clinical area or population and are legitimated by a professional award or legal status. Specialist nurses are better able to provide the most specific and most appropriate care for both people and populations.AimThis paper considers nursing's loose understanding of ‘specialization’ and the impact this has on those who seek employment outside their own nation but within the family of nations known as the European Union (EU). There is a lack of standardization for nursing specializations across the European Union that leads to lack of mobility across countries.Sources of evidenceReports were reviewed from within the European Union, including specialist nursing groups and regulatory nursing bodies.DiscussionNurse specialists can be regarded as operating at nursing's ‘leading edge’; however, it is here that n...
Objective Stigma towards mental illness has been described in many health professions at the unde... more Objective Stigma towards mental illness has been described in many health professions at the undergraduate level, but not in the discipline of paramedicine. The objective of this research was to describe levels of stigma towards people with mental illness as self-reported by undergraduate paramedicine students in Australia, Finland, New Zealand and South Africa. Design Using a cross-sectional design, an online survey was administered consisting of a validated instrument measuring self-reported stigma levels. Setting Four undergraduate paramedicine university programs in Australia, New Zealand, Finland and South Africa. Method The Opening Minds Scale for Health Providers (OMS-HC) is a validated, 20-item instrument measuring self-reported stigma. The 20 OMS-HC items were summed and generalised linear models with log link and Poisson family were used to examine associated factors. Results The overall level of self-reported stigma across students from all countries was 53, on a scale ranging from 20 ('least stigmatised') to 100 ('most stigmatised'). Compared with the Australian cohort, total stigma scores increased significantly by 8% in New Zealand (p=0.01), 15% (p<0.001), and 18% in South Africa (p=0.002). Subscale analysis revealed high scores for social distance as a construct of stigma more broadly. Conclusion The findings provide an important baseline that can be used by paramedicine programs to inform development of mental healthcare curricula seeking to reduce stigma during the formative undergraduate years of professional development. The findings can be applied in a teaching and learning setting as source material to stimulate discussion and promote student self-reflection in a range of teaching activities.
Background: Primary care, the principal function of the health care system, requires effort from ... more Background: Primary care, the principal function of the health care system, requires effort from all local primary health care teams. Community Paramedicine (CP) has managed to reduce the use of Emergency Medical Services (EMS) for non-emergency calls, but for the paramedic to move from traditional emergency calls to non-emergency care will mean new demands. There is a paucity of research exploring nurse-paramedics' experiences and perceptions of their novel roles as community paramedics in Finland. This study aims to explore the community nurse-paramedics' (CNP) experiences in their new sphere of practice. Methods: A descriptive ethnographic study was conducted, to collect data through participant observation (317 h total) and semi-structured interviews (N = 22) in three hospital districts (HD) where the CNPs have worked for at least 1 year. Both data sets were combined, organised, and analysed using inductive content analysis. Results: Five main categories were developed by applying inductive content analysis: the new way of thinking, the broad group of patients, the way to provide care, the diversity of multidisciplinary collaboration, and tailored support from the organisation. The CNP was identified as needing an appropriate attitude towards care and a broader way of thinking compared to the traditional practice of taking care of the patient and the family members. The diversity of multidisciplinary collaboration teams can be a sensitive but worthwhile topic for offering new possibilities. Tailored support from the organisation includes tools for future CP models. Conclusions: Our results indicate the CNPs' deep involvement in patients' and families' care needs and challenges with their skills and competencies. Their professional attitudes and eagerness to develop and maintain multidisciplinary collaboration can offer preventive and long-term caring solutions from which citizens, allied health, safety, and social care providers benefit locally and globally.
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Scandinavian Journal of Caring Sciences, Feb 8, 2019
Background: Since the beginning of 2000 the primary healthcare services around the globe are chal... more Background: Since the beginning of 2000 the primary healthcare services around the globe are challenged between demands of home care and number of staff delivering it. The delivery of healthcare needs new models to reduce the costs, patient's readmission and increase their possibilities to stay at home. Several paramedicine programs have been developed to deliver home care as an integral part of the local healthcare system. The programs varied in nature and the concept of Community Paramedicine (CP) has not been established, demanding clarity. The aim of this review was to identify and describe the core components of CP, and identify research gaps for the further study. Method: A scoping review was performed using five electronic databases: Medline; CINAHL; Academic Search Premier; PubMed and the Cochrane Library for the period 2005-June 2018. The references of articles were checked and papers were assessed against inclusion criteria and appraised for quality. Results: From 803 initial articles 21 met the criteria and were included. Inductive content analysis was carried out. Four the core components of Community Paramedicine emerged a) Community engagement, b) Multi-agency collaboration, c) Patient-centred prevention, and d) Outcomes of program: cost-effectiveness, and patients' experiences. Conclusion: The Community Paramedicine programs are perceived to be promising. However, Community Paramedicine research data are lacking. Further research is required to understand whether this novel model of healthcare is reducing costs, improving health and enhancing people's experiences.
Objective Stigma towards mental illness has been described in many health professions at the unde... more Objective Stigma towards mental illness has been described in many health professions at the undergraduate level, but not in the discipline of paramedicine. The objective of this research was to describe levels of stigma towards people with mental illness as self-reported by undergraduate paramedicine students in Australia, Finland, New Zealand and South Africa. Design Using a cross-sectional design, an online survey was administered consisting of a validated instrument measuring self-reported stigma levels. Setting Four undergraduate paramedicine university programs in Australia, New Zealand, Finland and South Africa. Method The Opening Minds Scale for Health Providers (OMS-HC) is a validated, 20-item instrument measuring self-reported stigma. The 20 OMS-HC items were summed and generalised linear models with log link and Poisson family were used to examine associated factors. Results The overall level of self-reported stigma across students from all countries was 53, on a scale ra...
Background Primary care, the principal function of the healthcare system, needs efforts from the ... more Background Primary care, the principal function of the healthcare system, needs efforts from the local primary healthcare teams. Community Paramedicine has managed to reduce the use of Emergency Medical Services (EMS) for non-emergent calls. For the paramedic to move from traditional emergency call outs to non-emergency care means new demands. There is a paucity of paramedics’ experiences and perceptions of their novel roles as community paramedics. This study aimed to explore the community nurse-paramedics experiences of their new sphere of practice. Methods A descriptive ethnographic research was conducted collecting data through participant observation (total 317 hours) and semi-structured interviews (N = 24) in three Hospital Districts where the community nurse-paramedics (CNP) have worked at least one year. Both data were combined, organized, and analyzed with inductive content analysis. Results From the inductive content analysis, five themes emerged: the CNP's new way of ...
Community paramedicine (CP) has extended the role of paramedics and the main goal is to provide n... more Community paramedicine (CP) has extended the role of paramedics and the main goal is to provide non-emergency care, which reduces the visits to emergency departments. The aim of this study was to describe the Finnish CP and examine the factors that were involved in CNPs’ decision-making processes. The study was based on data from 450 consecutive CP patient records from three hospital districts. A more detailed analysis was carried out on 339 cases in patients’ homes and elderly care homes, and the data analysis included multivariate logistic regression to examine the impact of variables on the CNPs’ decisions. These patients’ most common health issues were general weakness (15.9%) and fever (10.6%), and over half (58.7%) could remain at home after the CP visit. There were five independent factors associated with the CNPs’ decisions of the patient’s care continuum: the hospital district, if the patient could walk, whether the troponin test was performed, a physician was consulted, an...
BackgroundThe evolution of health care is driving the need for specialist nursing knowledge. Spec... more BackgroundThe evolution of health care is driving the need for specialist nursing knowledge. Specialist nurses have undertaken a formal training that focuses on a specific clinical area or population and are legitimated by a professional award or legal status. Specialist nurses are better able to provide the most specific and most appropriate care for both people and populations.AimThis paper considers nursing's loose understanding of ‘specialization’ and the impact this has on those who seek employment outside their own nation but within the family of nations known as the European Union (EU). There is a lack of standardization for nursing specializations across the European Union that leads to lack of mobility across countries.Sources of evidenceReports were reviewed from within the European Union, including specialist nursing groups and regulatory nursing bodies.DiscussionNurse specialists can be regarded as operating at nursing's ‘leading edge’; however, it is here that n...
Objective Stigma towards mental illness has been described in many health professions at the unde... more Objective Stigma towards mental illness has been described in many health professions at the undergraduate level, but not in the discipline of paramedicine. The objective of this research was to describe levels of stigma towards people with mental illness as self-reported by undergraduate paramedicine students in Australia, Finland, New Zealand and South Africa. Design Using a cross-sectional design, an online survey was administered consisting of a validated instrument measuring self-reported stigma levels. Setting Four undergraduate paramedicine university programs in Australia, New Zealand, Finland and South Africa. Method The Opening Minds Scale for Health Providers (OMS-HC) is a validated, 20-item instrument measuring self-reported stigma. The 20 OMS-HC items were summed and generalised linear models with log link and Poisson family were used to examine associated factors. Results The overall level of self-reported stigma across students from all countries was 53, on a scale ranging from 20 ('least stigmatised') to 100 ('most stigmatised'). Compared with the Australian cohort, total stigma scores increased significantly by 8% in New Zealand (p=0.01), 15% (p<0.001), and 18% in South Africa (p=0.002). Subscale analysis revealed high scores for social distance as a construct of stigma more broadly. Conclusion The findings provide an important baseline that can be used by paramedicine programs to inform development of mental healthcare curricula seeking to reduce stigma during the formative undergraduate years of professional development. The findings can be applied in a teaching and learning setting as source material to stimulate discussion and promote student self-reflection in a range of teaching activities.
Background: Primary care, the principal function of the health care system, requires effort from ... more Background: Primary care, the principal function of the health care system, requires effort from all local primary health care teams. Community Paramedicine (CP) has managed to reduce the use of Emergency Medical Services (EMS) for non-emergency calls, but for the paramedic to move from traditional emergency calls to non-emergency care will mean new demands. There is a paucity of research exploring nurse-paramedics' experiences and perceptions of their novel roles as community paramedics in Finland. This study aims to explore the community nurse-paramedics' (CNP) experiences in their new sphere of practice. Methods: A descriptive ethnographic study was conducted, to collect data through participant observation (317 h total) and semi-structured interviews (N = 22) in three hospital districts (HD) where the CNPs have worked for at least 1 year. Both data sets were combined, organised, and analysed using inductive content analysis. Results: Five main categories were developed by applying inductive content analysis: the new way of thinking, the broad group of patients, the way to provide care, the diversity of multidisciplinary collaboration, and tailored support from the organisation. The CNP was identified as needing an appropriate attitude towards care and a broader way of thinking compared to the traditional practice of taking care of the patient and the family members. The diversity of multidisciplinary collaboration teams can be a sensitive but worthwhile topic for offering new possibilities. Tailored support from the organisation includes tools for future CP models. Conclusions: Our results indicate the CNPs' deep involvement in patients' and families' care needs and challenges with their skills and competencies. Their professional attitudes and eagerness to develop and maintain multidisciplinary collaboration can offer preventive and long-term caring solutions from which citizens, allied health, safety, and social care providers benefit locally and globally.
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Scandinavian Journal of Caring Sciences, Feb 8, 2019
Background: Since the beginning of 2000 the primary healthcare services around the globe are chal... more Background: Since the beginning of 2000 the primary healthcare services around the globe are challenged between demands of home care and number of staff delivering it. The delivery of healthcare needs new models to reduce the costs, patient's readmission and increase their possibilities to stay at home. Several paramedicine programs have been developed to deliver home care as an integral part of the local healthcare system. The programs varied in nature and the concept of Community Paramedicine (CP) has not been established, demanding clarity. The aim of this review was to identify and describe the core components of CP, and identify research gaps for the further study. Method: A scoping review was performed using five electronic databases: Medline; CINAHL; Academic Search Premier; PubMed and the Cochrane Library for the period 2005-June 2018. The references of articles were checked and papers were assessed against inclusion criteria and appraised for quality. Results: From 803 initial articles 21 met the criteria and were included. Inductive content analysis was carried out. Four the core components of Community Paramedicine emerged a) Community engagement, b) Multi-agency collaboration, c) Patient-centred prevention, and d) Outcomes of program: cost-effectiveness, and patients' experiences. Conclusion: The Community Paramedicine programs are perceived to be promising. However, Community Paramedicine research data are lacking. Further research is required to understand whether this novel model of healthcare is reducing costs, improving health and enhancing people's experiences.
Objective Stigma towards mental illness has been described in many health professions at the unde... more Objective Stigma towards mental illness has been described in many health professions at the undergraduate level, but not in the discipline of paramedicine. The objective of this research was to describe levels of stigma towards people with mental illness as self-reported by undergraduate paramedicine students in Australia, Finland, New Zealand and South Africa. Design Using a cross-sectional design, an online survey was administered consisting of a validated instrument measuring self-reported stigma levels. Setting Four undergraduate paramedicine university programs in Australia, New Zealand, Finland and South Africa. Method The Opening Minds Scale for Health Providers (OMS-HC) is a validated, 20-item instrument measuring self-reported stigma. The 20 OMS-HC items were summed and generalised linear models with log link and Poisson family were used to examine associated factors. Results The overall level of self-reported stigma across students from all countries was 53, on a scale ra...
Background Primary care, the principal function of the healthcare system, needs efforts from the ... more Background Primary care, the principal function of the healthcare system, needs efforts from the local primary healthcare teams. Community Paramedicine has managed to reduce the use of Emergency Medical Services (EMS) for non-emergent calls. For the paramedic to move from traditional emergency call outs to non-emergency care means new demands. There is a paucity of paramedics’ experiences and perceptions of their novel roles as community paramedics. This study aimed to explore the community nurse-paramedics experiences of their new sphere of practice. Methods A descriptive ethnographic research was conducted collecting data through participant observation (total 317 hours) and semi-structured interviews (N = 24) in three Hospital Districts where the community nurse-paramedics (CNP) have worked at least one year. Both data were combined, organized, and analyzed with inductive content analysis. Results From the inductive content analysis, five themes emerged: the CNP's new way of ...
Community paramedicine (CP) has extended the role of paramedics and the main goal is to provide n... more Community paramedicine (CP) has extended the role of paramedics and the main goal is to provide non-emergency care, which reduces the visits to emergency departments. The aim of this study was to describe the Finnish CP and examine the factors that were involved in CNPs’ decision-making processes. The study was based on data from 450 consecutive CP patient records from three hospital districts. A more detailed analysis was carried out on 339 cases in patients’ homes and elderly care homes, and the data analysis included multivariate logistic regression to examine the impact of variables on the CNPs’ decisions. These patients’ most common health issues were general weakness (15.9%) and fever (10.6%), and over half (58.7%) could remain at home after the CP visit. There were five independent factors associated with the CNPs’ decisions of the patient’s care continuum: the hospital district, if the patient could walk, whether the troponin test was performed, a physician was consulted, an...
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