Publications by authors named "Kia Gluschkoff"

21 Publications

  • Page 1 of 1

Nursing informatics competences of Finnish registered nurses after national educational initiatives: A cross-sectional study.

Nurse Educ Today 2021 Jul 20;106:105060. Epub 2021 Jul 20.

Finnish Institute for Health and Welfare, P.O. Box 30, FI-00271 Helsinki, Finland. Electronic address:

Background: Nursing informatics competences (ie. knowledge and skills in electronic and structured documentation) have become a necessary prerequisite for nurses to carry out their professional roles. Therefore, there is a global need to integrate nursing informatics into nursing curricula. In Finland, the requirements to increase nursing informatics education were noted in eHealth strategies in 2015. However, it is not known whether these educational initiatives have succeeded in increasing nursing informatics competences of recent nursing graduates.

Objectives: To examine whether nurses who graduated after the Finnish educational initiatives have higher nursing informatics competences than nurses who graduated before the initiatives. Additionally, the associations of age, gender, work setting and geographical area with the nurses' informatics competences were examined.

Design: Cross-sectional study.

Settings: The study was carried out between October-December 2018 in Finland.

Participants: Registered nurses who graduated before (n = 931) and after (n = 712) the 2015 educational initiatives.

Methods: Nursing informatics competences were measured by four items: (1) terminology-based documentation, (2) patient-related digital work, (3) general IT competency and (4) electronic documentation according to structured national headings. The associations of the year of the graduation and demographic background variables with nurses' overall nursing informatics competence and also separately with four specific competence items were examined with analysis of covariance.

Results: Nurses' graduation year was associated with their overall nursing informatics competence and the specific competence related to terminology-based documentation. Nurses who had graduated after the initiatives had higher competence than nurses with earlier graduation years. Associations were also found between age and work setting with the nursing informatics competences. Younger nurses and nurses working in specialised healthcare and elderly care had the highest competence.

Conclusions: The national eHealth strategies with educational initiatives seem to have affected favorably on nursing informatics education in Finnish nursing programs and have potentially led to increased nursing informatics competences of recent nursing graduates. The results of this study highlight the importance of educational policies stating the directions and objectives of education programs.
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http://dx.doi.org/10.1016/j.nedt.2021.105060DOI Listing
July 2021

The Association Between Using a Mobile Version of an Electronic Health Record and the Well-Being of Nurses: Cross-sectional Survey Study.

JMIR Med Inform 2021 Jul 6;9(7):e28729. Epub 2021 Jul 6.

Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland.

Background: Mobile devices such as tablets and smartphones are increasingly being used in health care in many developed countries. Nurses form the largest group in health care that uses electronic health records (EHRs) and their mobile versions. Mobile devices are suggested to promote nurses' workflow, constant updating of patient information, and improve the communication within the health care team. However, little is known about their effect on nurses' well-being.

Objective: This study aimed to examine the association between using a mobile version of the EHR and nurses' perceived time pressure, stress related to information systems, and self-rated stress. Moreover, we examined whether mobile device use modifies the associations of EHR usability (ease of use and technical quality), experience in using EHRs, and number of systems in daily use with these well-being indicators.

Methods: This was a cross-sectional population-based survey study among 3610 Finnish registered nurses gathered in 2020. The aforesaid associations were examined using analyses of covariance and logistic regression adjusted for age, gender, and employment sector (hospital, primary care, social service, and other).

Results: Nurses who used the mobile version of their EHR had higher levels of time pressure (F=14.96, P<.001) and stress related to information systems (F=6.11, P=.01), compared with those who did not use mobile versions. Moreover, the interactions of mobile device use with experience in using EHRs (F=14.93, P<.001), ease of use (F=10.16, P=.001), and technical quality (F=6.45, P=.01) were significant for stress related to information systems. Inexperience in using EHRs, low levels of ease of use, and technical quality were associated with higher stress related to information systems and this association was more pronounced among those who used mobile devices. That is, the highest levels of stress related to information systems were perceived among those who used mobile devices as well as among inexperienced EHR users or those who perceived usability problems in their EHRs.

Conclusions: According to our results, it seems that at present mobile device use is not beneficial for the nurses' well-being. In addition, mobile device use seems to intensify the negative effects of usability issues related to EHRs. In particular, inexperienced users of EHRs seem to be at a disadvantage when using mobile devices. Thus, we suggest that EHRs and their mobile versions should be improved such that they would be easier to use and would better support the nurses' workflow (eg, improvements to problems related to small display, user interface, and data entry). Moreover, additional training on EHRs, their mobile versions, and workflow related to these should be provided to nurses.
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http://dx.doi.org/10.2196/28729DOI Listing
July 2021

Socioeconomic inequalities in impairment associated with depressive symptoms: Evidence from the National Survey on Drug Use and Health.

J Psychiatr Res 2021 Jun 21;141:74-80. Epub 2021 Jun 21.

Department of Psychology and Logopedics, University of Helsinki, Finland.

Objective: Individuals with low socioeconomic status have higher rates of depression, but it is unknown whether the socioeconomically disadvantaged also have more disabling depressive symptoms. We examined (1) the associations of three indicators of socioeconomic status with depression-related severe role impairment, and (2) whether socioeconomic factors moderate the association between individual depression symptoms and depression-related severe role impairment.

Methods: We used data from the National Survey on Drug Use and Health (NSDUH). Depressive symptoms, role impairment and socioeconomic indicators (poverty, participation in workforce, educational attainment) were self-reported by participants. The analytic sample consisted of participants who screened positive for a depressive episode during past 12 months (n = 32 661). We used survey-weighted logistic models to examine the associations of depressive symptoms with severe role impairment and the modifying effects of socioeconomic indicators.

Results: The association between depression symptom count and severe role impairment was stronger among those not in workforce (OR = 1.12[1.02-1.23]). The association between specific depression symptoms and severe role impairment was stronger for conditions of poverty (fatigue, OR = 2.97 [1.54-5.73]; and anhedonia, OR = 1.93[1.13-3.30]), workforce non-participation (inability to concentrate/indecisiveness, OR = 1.54[1.12-2.12]), and lower educational attainment (anhedonia, OR = 0.77 [0.59-0.99]). Feelings of worthlessness was the only symptom with independent associations for all socioeconomic groups (adjusted OR = 1.91[1.35-2.70]).

Conclusion: Depression was more frequent and also more disabling for socioeconomically disadvantaged groups, especially when assessed with workforce participation. Additionally, some specific symptoms showed socioeconomic differences. Our findings highlight the need to prioritize population groups with more severe impairment associated with depressive symptoms.
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http://dx.doi.org/10.1016/j.jpsychires.2021.06.029DOI Listing
June 2021

Subclinical hypothyroidism and symptoms of depression: Evidence from the National Health and Nutrition Examination Surveys (NHANES).

Compr Psychiatry 2021 Jun 12;109:152253. Epub 2021 Jun 12.

Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland.

Background: Subclinical hypothyroidism has been associated with increased risk for depression, yet the findings remain controversial. It is possible that subclinical hypothyroidism is associated with some, but not all symptoms of depression. We examined symptom-specific associations between depression and subclinical hypothyroidism.

Methods: Participants (N = 7683 adults) were from the National Health and Nutrition Examination Surveys of 2007-2008, 2009-2010, and 2011-2012 We included participants who had data on their thyroid profile and depressive symptoms (measured using Patient Health Questionnaire), and excluded those with overt hypothyroidism or hyperthyroidism, and those on thyroid hormone replacement therapy. Logistic regression with sampling weights was used to examine the association between subclinical hypothyroidism and depression symptoms. We also ran sensitivity analysis using different cut-off points for defining subclinical hypothyroidism.

Results: Of all the participants, 208 (2.7%) had subclinical hypothyroidism and of them only six had depression. Subclinical hypothyroidism was not associated with depression (OR = 0.61, 95% CI 0.20-1.87) nor with the specific depression symptoms. Using lower criteria for subclinical hypothyroidism diagnosis resulted in similar findings.

Conclusions: In a nationally representative sample of US adults, we observed no association between subclinical hypothyroidism and overall depression risk or any of the individual symptoms of depression.
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http://dx.doi.org/10.1016/j.comppsych.2021.152253DOI Listing
June 2021

Behavior change techniques to promote healthcare professionals' eHealth competency: A systematic review of interventions.

Int J Med Inform 2021 05 23;149:104432. Epub 2021 Feb 23.

Finnish Institute for Health and Welfare, Helsinki, Finland.

Introduction: The use of eHealth is rapidly -->increasing; however, many healthcare professionals have insufficient eHealth competency. Consequently, interventions addressing eHealth competency might be useful in fostering the effective use of eHealth.

Objective: Our systematic review aimed to identify and evaluate the behavior change techniques applied in interventions to promote healthcare professionals' eHealth competency.

Methods: We conducted a systematic literature review following the Joanna Briggs Institute's Manual for Evidence Synthesis. Published quantitative studies were identified through screening PubMed, Embase, and CINAHL. Two reviewers independently performed full-text and quality assessment. Eligible interventions were targeted to any healthcare professional and aimed at promoting eHealth capability or motivation. We synthesized the interventions narratively using the Behavior Change Technique Taxonomy v1 and the COM-B model.

Results: This review included 32 studies reporting 34 heterogeneous interventions that incorporated 29 different behavior change techniques. The interventions were most likely to improve the capability to use eHealth and less likely to enhance motivation toward using eHealth. The promising techniques to promote both capability and motivation were action planning and participatory approach. Information about colleagues' approval, emotional social support, monitoring emotions, restructuring or adding objects to the environment, and credible source are techniques worth further investigation.

Conclusions: We found that interventions tended to focus on promoting capability, although motivation would be as crucial for competent eHealth performance. Our findings indicated that empathy, encouragement, and user-centered changes in the work environment could improve eHealth competency as a whole. Evidence-based techniques should be favored in the development of interventions, and further intervention research should focus on nurses and multifaceted competency required for using different eHealth systems and devices.
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http://dx.doi.org/10.1016/j.ijmedinf.2021.104432DOI Listing
May 2021

Health Care Professionals' Experiences of Patient-Professional Communication Over Patient Portals: Systematic Review of Qualitative Studies.

J Med Internet Res 2020 12 8;22(12):e21623. Epub 2020 Dec 8.

Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland.

Background: The popularity of web-based patient-professional communication over patient portals is constantly increasing. Good patient-professional communication is a prerequisite for high-quality care and patient centeredness. Understanding health care professionals' experiences of web-based patient-professional communication is important as they play a key role in engaging patients to use portals. More information is needed on how patient-professional communication could be supported by patient portals in health care.

Objective: This systematic review of qualitative studies aims to identify how health care professionals experience web-based patient-professional communication over the patient portals.

Methods: Abstract and full-text reviews were conducted by 2 reviewers independently. A total of 4 databases were used for the study: CINAHL (EBSCO), ProQuest (ABI/INFORM), Scopus, and PubMed. The inclusion criteria for the reviewed studies were as follows: the examination of health care professionals' experiences, reciprocal communication between patients and health care professionals, peer-reviewed scientific articles, and studies published between 2010 and 2019. The Joanna Briggs Institute's quality assessment criteria were used in the review process. A total of 13 included studies were analyzed using a thematic synthesis, which was conducted by 3 reviewers.

Results: A total of 6 analytical themes concerning health care professionals' experiences of web-based patient-professional communication were identified. The themes were related to health care professionals' work, change in communication over patient portals, patients' use of patient portals, the suitability of patient portals for communication, the convenience of patient portals for communication, and change in roles.

Conclusions: Health care professionals' experiences contain both positive and negative insights into web-based patient-professional communication over patient portals. Most commonly, the positive experiences seem to be related to the patients and patient outcomes, such as having better patient engagement. Health care professionals also have negative experiences, for example, web-based patient-professional communication sometimes has deficiencies and has a negative impact on their workload. These negative experiences may be explained by the poor functionality of the patient portals and insufficient training and resources. To reduce health care professionals' negative experiences of web-based patient-professional communication, their experiences should be taken into account by policy makers, health care organizations, and information technology enterprises when developing patient portals. In addition, more training regarding web-based patient-professional communication and patient portals should be provided to health care professionals.
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http://dx.doi.org/10.2196/21623DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7755533PMC
December 2020

Specific symptoms of the General Health Questionnaire (GHQ) in predicting persistence of psychological distress: Data from two prospective cohort studies.

J Psychiatr Res 2020 Nov 12. Epub 2020 Nov 12.

Department of Psychology and Logopedics, University of Helsinki, Finland; Finnish Institute for Health and Welfare, Helsinki, Finland.

Persistent psychological distress is more harmful than transient psychological distress, but little is known about the development of persistent distress. We examined whether some specific symptoms of the 12-item General Health Questionnaire (GHQ-12) were more important than others in predicting the persistence of psychological distress over a 3-year follow-up period among individuals who had at least moderate psychological distress at baseline (GHQ≥3). Participants were from the UK Household Longitudinal Study (UKHLS; n = 6430) and British Household Panel Survey (BHPS; n = 5954). Sense of worthlessness, loss of self-confidence, loss of sleep over worry, and feelings of strain were associated with increasingly persistent distress. General happiness, feelings of unhappiness or depressed mood, and enjoyment of activities showed no such increasing associations. Symptoms of social functioning (capability of making decisions, concentration problems, feelings of usefulness, ability to face problems) showed some but not consistent associations. These results suggest that feelings of worthlessness, loss of self-confidence, loss of sleep over worry, and strain may be particularly important markers for persistent psychological distress.
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http://dx.doi.org/10.1016/j.jpsychires.2020.11.026DOI Listing
November 2020

The Associations of Electronic Health Record Usability and User Age With Stress and Cognitive Failures Among Finnish Registered Nurses: Cross-Sectional Study.

JMIR Med Inform 2020 Nov 18;8(11):e23623. Epub 2020 Nov 18.

Finnish Institute for Health and Welfare, Helsinki, Finland.

Background: Electronic health records (EHRs) are expected to provide many clinical and organizational benefits. Simultaneously, the end users may face unintended consequences, such as stress and increased cognitive workload, due to poor EHR usability. However, whether the effects of usability depend on end user characteristics, such as career stage or age, remains poorly understood.

Objective: The objective of this study was to examine the associations of EHR usability and user age with stress related to information systems and cognitive failures among registered nurses.

Methods: A cross-sectional survey design was employed in Finland in 2017. A total of 3383 registered nurses responded to the nationwide electronic survey. Multiple linear regression was used to examine the associations of EHR usability (eg, how easily information can be found and a patient's care can be documented) and user age with stress related to information systems and cognitive failures. Interaction effects of EHR usability and age were also tested. Models were adjusted for gender and employment sector.

Results: Poor EHR usability was associated with higher levels of stress related to information systems (β=.38; P<.001). The strength of the association did not depend on user age. Poor EHR usability was also associated with higher levels of cognitive failures (β=.28; P<.001). There was a significant interaction effect between age and EHR usability for cognitive failures (β=.04; P<.001). Young nurses who found the EHR difficult to use reported the most cognitive failures.

Conclusions: Information system stress due to poor EHR usability afflicts younger and older nurses alike. However, younger nurses starting their careers may be more cognitively burdened if they find EHR systems difficult to use compared to older nurses. Adequate support in using the EHRs may be particularly important to young registered nurses, who have a lot to learn and adopt in their early years of practice.
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http://dx.doi.org/10.2196/23623DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7710446PMC
November 2020

Association of depressive symptoms with health care utilization in older adults: Longitudinal evidence from the Survey of Health, Aging, and Retirement in Europe.

Int J Geriatr Psychiatry 2021 04 26;36(4):521-529. Epub 2020 Oct 26.

Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland.

Objectives: Many older adults with depression do not receive adequate treatment. Differences in treatment utilization may reflect the heterogeneous nature of depression, encompassing multiple distinct symptoms. We assessed whether depressive symptoms are differentially associated with subsequent health care utilization with respect to three outcomes as follows: (1) contact with a medical doctor (MD), (2) depression-specific treatment, and (3) inpatient psychiatric admission.

Methods/design: Longitudinal analyses were based on data from three follow-up cycles conducted between 2004 and 2013 among 53,139 participants from the Survey of Health, Aging, and Retirement in Europe. Depressive symptoms were self-reported at baseline of each follow-up cycle using the 12-item EURO-D scale. Health care utilization was self-reported at the end of each follow-up cycle.

Results: After adjustment for sex, age, country of interview, follow-up time, educational attainment, presence of a partner in household, body-mass index, the number of chronic diseases, disability, average/prior frequency of contact with an MD, and all other depressive symptoms, people with more frequent contact with an MD had most often reported sleep problems (IRR = 1.10) and fatigue (IRR = 1.10), followed by sad/depressed mood, tearfulness, concentration problems, guilt, irritability, and changes in appetite. Those treated for depression had most often reported sad/depressed mood (OR = 2.18) and suicidal ideation (OR = 1.72), but also sleep problems, changes in appetite, fatigue, concentration problems, hopelessness, and irritability. Sad/depressed mood (OR = 2.87) was also associated with psychiatric inpatient admission. Similarly to other outcomes, appetite change, fatigue, and sleep problems were associated with inpatient admission.

Conclusions: Specific symptoms of depression may determine utilization of different types of health care among elderly.
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http://dx.doi.org/10.1002/gps.5447DOI Listing
April 2021

Network dynamics of depressive symptoms in antidepressant medication treatment: secondary analysis of eight clinical trials.

Mol Psychiatry 2020 Sep 16. Epub 2020 Sep 16.

Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland.

Depression can be viewed as a network of depressive symptoms that tend to reinforce each other via feedback loops. Specific symptoms of depression may be differently responsive to antidepressant treatment, and some symptoms may be more important than others in the overall improvement of depression associated with treatment. We pooled prospective data from eight industry-sponsored placebo-controlled trials for paroxetine, fluoxetine and imipramine (total n = 3559) to examine whether improvements in specific depressive symptoms were more strongly related to improvements in other depressive symptoms among patients on active antidepressant treatment as compared to placebo. Depressive symptoms were assessed with the 17-item Hamilton Depression Rating Scale. Data on treatment was dichotomized into active treatment (receiving any antidepressant agent) vs. placebo. Time-lagged longitudinal analyses suggested that improvement in three symptoms-depressed mood, insomnia, and suicidality-had a broader overall impact on subsequent improvement in other depressive symptoms in the antidepressant condition compared to placebo (i.e., greater out-strength). Moreover, improvements in depressed mood and insomnia were more likely to follow the improvements in other symptoms in the antidepressant condition compared to placebo (i.e., greater in-strength). These results from clinical trial data suggest that depressed mood, insomnia, and suicidality may be particularly important in accounting for the remission and recovery in response to antidepressant treatment.
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http://dx.doi.org/10.1038/s41380-020-00884-3DOI Listing
September 2020

General psychopathology factor and borderline personality disorder: Evidence for substantial overlap from two nationally representative surveys of U.S. adults.

Personal Disord 2021 01 25;12(1):86-92. Epub 2020 Jun 25.

Department of Psychology and Logopedics.

A general psychopathology factor reflects an underlying liability for a wide range of mental disorders. There is suggestive evidence that borderline personality disorder (BPD) may be strongly associated with the general psychopathology factor, but there are no detailed data on the degree of overlap between the general psychopathology factor and BPD or its individual symptoms. This study examined the overlap between the general psychopathology factor and BPD using cross-sectional survey data from two nationally representative samples of U.S. adults, the National Comorbidity Survey Replication ( = 5,692) and the National Comorbidity Survey follow-up ( = 5,001). Structural equation modeling was used to fit a bifactor general psychopathology model and to examine the general psychopathology factor's associations with (a) a series of Clusters A, B, and C personality disorder symptoms including BPD symptoms and (b) a latent BPD. Results showed that the shared variance between the general psychopathology factor and a latent BPD was 56% in the National Comorbidity Survey Replication and 71% in the National Comorbidity Survey follow-up. The correlation between the general factor and BPD could be set to unity without worsening model fit, suggesting that BPD closely reflects a general liability to psychopathology. The affective features of BPD were particularly strongly associated with the general psychopathology factor. Findings are discussed with respect to the nosology of BPD and the treatment of mental disorders. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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http://dx.doi.org/10.1037/per0000405DOI Listing
January 2021

Connectivity of depression symptoms before and after diagnosis of a chronic disease: A network analysis in the U.S. Health and Retirement Study.

J Affect Disord 2020 04 29;266:230-234. Epub 2020 Jan 29.

Medicum, University of Helsinki, Helsinki, Finland.

Background: Many chronic diseases increase the risk of depressive symptoms, but few studies have examined whether these diseases also affect the composition of symptoms a person is likely to experience. As the risk and progression of depression may vary between chronic diseases, we used network analysis to examine how depression symptoms are connected before and after the diagnosis of diabetes, heart disease, stroke, and cancer.

Methods: Participants (N = 7779) were from the longitudinal survey of the Health and Retirement Study. Participants were eligible if they had information on depression symptoms two and/or four years before and after the diagnosis of either diabetes, heart disease, cancer or stroke. We formed a control group with no chronic disease that was matched on age, sex and ethnic background to those with a disease. We constructed depression symptom networks and compared the overall connectivity of those networks, and depression symptom sum scores, for before and after the diagnosis of each disease.

Results: Depression symptom sum scores increased with the diagnosis of each disease. The connectivity of depression symptoms remained unchanged for all the diseases, except for stroke, for which the connectivity decreased with the diagnosis.

Limitations: Comorbidity with other chronic diseases was not controlled for as we focused on the onset of specific diseases.

Conclusions: Our results suggest that although the mean level of depression symptoms increases after the diagnosis of chronic disease, with most chronic diseases, these changes are not reflected in the network structure of depression symptoms.
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http://dx.doi.org/10.1016/j.jad.2020.01.170DOI Listing
April 2020

Associations Between Early Childcare Environment and Different Aspects of Adulthood Sociability: The 32-Year Prospective Young Finns Study.

Front Psychol 2019 10;10:2060. Epub 2019 Sep 10.

Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland.

Sociability is a widely studied trait that has been linked both with individual well- and ill-being. Although early childcare has been shown to affect social competence in children, its role in the development of different aspects of adulthood sociability is poorly understood. Using a longitudinal population-based sample ( = 464), this study investigated whether childcare arrangements at ages 3 or 6 are associated with self-reported adulthood sociability at ages 20 to 35 years. A total of five aspects of sociability were measured using three well-established personality inventories (EAS, NEO-FFI, and TCI). Multilevel modeling was applied to examine the association between early care and adulthood sociability, adjusting for several sources of random variation (between-individual variance, within-individual variance between measurement times, variance between used sociability indicators, and error variance that cannot be attributed to the previously mentioned) and potential confounders (disruptive behavior in childhood, parental socio-economic status, parent-child relationship quality, maternal age, and the number of children in the family). Based on our results, in comparison to home care, family daycare and center-based daycare at age 3 and center-based daycare at age 6 were associated with higher sociability later in life. The association was strongest for aspects of sociability that emphasize the willingness to be surrounded by other people and to be attached to them. In other words, characteristics of early care may contribute uniquely to the development of these aspects of sociability with effects that persist into adult life.
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http://dx.doi.org/10.3389/fpsyg.2019.02060DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6746937PMC
September 2019

The General Psychopathology Factor: Structural Stability and Generalizability to Within-Individual Changes.

Front Psychiatry 2019 30;10:594. Epub 2019 Aug 30.

Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland.

Although cross-sectional investigations have found a bifactor structure of psychiatric comorbidity that includes a general psychopathology factor plus more specific factors, prospective evidence supporting the bifactor structure is still limited. We evaluated the structural stability (i.e., longitudinal invariance) of the bifactor model in comparison to an alternative structure, a correlated factors model without a general psychopathology factor. We also investigated the models' generalizability to change processes in psychopathology. The analyses were conducted on 10-year follow-up data from 5,001 respondents in the US National Comorbidity Survey. Invariance was evaluated through a series of nested invariance tests using confirmatory factor analysis, and the models' generalizability to change processes was investigated using change scores of disorder status. The bifactor model and the correlated factors model exhibited an equal degree of strong structural stability over time. Only the bifactor model satisfactorily characterized the structure of temporal changes in psychopathology. The bifactor structure with a general psychopathology factor is stable over time and describes temporal changes in psychopathology. The findings support the notion that the general psychopathology factor describes a transdiagnostic etiology and may therefore provide a useful target for intervention and treatment.
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http://dx.doi.org/10.3389/fpsyt.2019.00594DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6728891PMC
August 2019

Health behaviors and psychological distress: changing associations between 1997 and 2016 in the United States.

Soc Psychiatry Psychiatr Epidemiol 2020 Mar 26;55(3):385-391. Epub 2019 Jul 26.

Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, PO Box 63, 00014, Helsinki, Finland.

Objectives: Smoking rates have declined with a slower pace among those with psychological distress compared to those without. We examined whether other health behaviors (heavy alcohol consumption, physical inactivity, short sleep duration) showed similar trends associated with psychological distress. We also examined differences by age and birth cohort.

Methods: Data were from the annually repeated cross-sectional U.S. National Health Interview Surveys (NHIS) of 1997-2016 (total n = 603,518). Psychological distress was assessed with the 6-item Kessler Psychological Distress Scale (K6).

Results: Psychological distress became more strongly associated with smoking (OR 1.09 per 10 years; 95% CI 1.07, 1.12), physical inactivity (OR 1.08; 1.05, 1.11), and short sleep (OR 1.12; 1.06, 1.18), but less strongly associated with heavy alcohol consumption (OR 0.93; 0.89, 0.98). The associations of smoking and alcohol consumption attenuated with age, whereas the association with physical inactivity strengthened with age. Compared to older birth cohorts, smoking became more strongly associated with psychological distress among younger birth cohorts up to those born in the 1980s.

Conclusions: The strength of associations between psychological distress and health behaviors may vary by time period, age, and birth cohort.
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http://dx.doi.org/10.1007/s00127-019-01741-7DOI Listing
March 2020

Psychosocial work environment and cross-cultural competence among native and foreign-born registered nurses.

Res Nurs Health 2019 10 16;42(5):349-357. Epub 2019 Jul 16.

Department of Social and Health Systems Research, National Institute for Health and Welfare, Helsinki, Finland.

Cross-cultural competence is an essential component of the nursing profession, but little is known about the specific psychosocial work characteristics that potentially promote or hinder such competence. In the present study, psychosocial work characteristics were based on Karasek's Job Demand-Control Model. The researchers examined whether Karasek's psychosocial work characteristics, such as high-strain jobs, high-strain isolated jobs, active jobs, and active collective jobs, are associated with cross-cultural competence (empathy, skills, positive attitudes, and motivation), and whether there are differences between native and foreign-born registered nurses (RN) in these potential associations. A random sample of 744 native RNs (91.0% women) and a total sample (n = 212) of foreign-born RNs (94.3% women) working in Finland were used. Data were collected using a questionnaire and analyzed with a series of multiple linear regression analyses. High-strain and high-strain isolated jobs were negatively associated with all four dimensions of cross-cultural competence. Active collective jobs, but not active jobs, were positively associated with cross-cultural skills. There were no differences between native and migrant nurses in these associations. The psychosocial work environment is associated with cross-cultural competence in both native and migrant nurses. Improvements in psychosocial working conditions, especially minimizing negative factors in the work environment, such as high-strain and high-strain isolated jobs, may need to be considered as a part of the efforts aimed to enhance cross-cultural competence among nursing personnel.
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http://dx.doi.org/10.1002/nur.21970DOI Listing
October 2019

Chronic diseases and social risk factors in relation to specific symptoms of depression: Evidence from the U.S. national health and nutrition examination surveys.

J Affect Disord 2019 05 22;251:242-247. Epub 2019 Mar 22.

Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Finland; Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway.

Background: Depression is a heterogeneous mental disorder with multiple symptoms, but only few studies have examined whether associations of risk factors with depression are symptom-specific. We examined whether chronic diseases and social risk factors (poverty, divorce, and perceived lack of emotional support) are differently associated with somatic and cognitive/affective symptoms of depression.

Methods: Cross-sectional analyses were based on individual-level data from the 31,191 participants of six cross-sectional U.S. National Health and Nutrition Examination Surveys (NHANES) carried out between 2005 and 2016. Depressive symptoms were assessed using the 9-item Patient Health Questionnaire. Information on chronic diseases and social risk factors was self-reported by participants.

Results: After adjustment for sex, age, race/ethnicity, and all the of other symptoms besides the outcome symptom, higher number of chronic diseases was independently related to fatigue, psychomotor retardation/agitation, and sleep problems in a dose-response pattern (range of odds ratios: 1.21 to 2.59). Except for concentration problems, social risk factors were associated with almost all of the cognitive/affective symptoms (range of odds ratios: 1.02 to 2.09) but only sporadically with somatic symptoms.

Limitations: All measures were self-reported by the participants, which may have introduced bias to the associations. Cross-sectional data did not allow us to study temporal dynamics.

Conclusions: Specific symptoms of depression may be useful in characterizing the heterogeneous etiology of depression with respect to somatic versus social risk factors.
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http://dx.doi.org/10.1016/j.jad.2019.03.074DOI Listing
May 2019

Parent-child-relationship quality predicts offspring dispositional compassion in adulthood: A prospective follow-up study over three decades.

Dev Psychol 2019 Jan 15;55(1):216-225. Epub 2018 Nov 15.

Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki.

Compassion is known to predict prosocial behavior and moral judgments related to harm. Despite the centrality of compassion to social life, factors predicting adulthood compassion are largely unknown. We examined whether qualities of parent-child-relationship, namely, emotional warmth and acceptance, predict offspring compassion decades later in adulthood. We used data from the prospective population-based Young Finns Study. Our sample included 2,761 participants (55.5% women). Parent-child-relationship qualities were reported by each participant's parents at baseline in 1980 (T0) when participants were between 3 and 18 years old. Compassion was self-reported 3 times: in 1997 (T1), 2001 (T2), and 2012 (T3) with the Temperament and Character Inventory (Cloninger, Przybeck, Svrakic, & Wetzel, 1994). By using age at the assessment as a time-variant variable, we applied multilevel modeling for repeated measurements to examine developmental trajectories of compassion from the ages of 20 (the age of the youngest cohort at T1) to 50 (the age of the oldest cohort at T3). On average, compassion increased in a curvilinear pattern with age. Higher acceptance (p = .013) and higher emotional warmth (p < .001) were related to higher compassion in adulthood. After adjusting for childhood confounds (i.e., participant gender, birth cohort, externalizing behavior, parental socioeconomic status, and parental mental health problems), only emotional warmth (p < .001) remained a significant predictor of compassion. Quality of the parent-child-relationship has long-term effects on offspring compassion. An emotionally warm and close relationship, in particular, may contribute to higher offspring compassion in adulthood. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
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http://dx.doi.org/10.1037/dev0000633DOI Listing
January 2019

Is It Good To Be Good? Dispositional Compassion and Health Behaviors.

Ann Behav Med 2019 06;53(7):665-673

Unit of Psychology, Faculty of Education, University of Oulu, Oulu, Finland.

Background: Despite the documented importance of dispositional compassions for a range of health-related outcomes, its role in predicting health behaviors remains unclear.

Purpose: This study examined the associations between dispositional compassion and three domains of health behavior, including physical activity, alcohol use, and smoking.

Methods: The participants (N = 1,279-1,913) were from the Finnish population-based Young Finns study. We collected self-reports of compassion in 1997 and 2011 and health behaviors in 2001, 2007, and 2011. In addition, an objective pedometer measure of physical activity was collected in 2011. Linear and logistic regression models were fitted to estimate the cross-sectional and longitudinal associations between compassion and the health behavior outcomes.

Results: In a cross-sectional analysis, compassion was associated with having never smoked and a reduced likelihood of at-risk alcohol use and binge drinking. There was no robust association between compassion and physical activity. In longitudinal analyses over a 14-year period, the associations remained for at-risk alcohol use and binge drinking.

Conclusions: Dispositional compassion may have a protective effect against unhealthy behaviors, especially excessive alcohol consumption.
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http://dx.doi.org/10.1093/abm/kay075DOI Listing
June 2019

Organisational justice protects against the negative effect of workplace violence on teachers' sleep: a longitudinal cohort study.

Occup Environ Med 2017 07 15;74(7):511-516. Epub 2017 Mar 15.

Finnish Institute of Occupational Health, Turku, Finland.

Objectives: This study aimed to examine the longitudinal association of workplace violence with disturbed sleep and the moderating role of organisational justice (ie, the extent to which employees are treated with fairness) in teaching.

Methods: We identified 4988 teachers participating in the Finnish Public Sector study who reported encountering violence at work. Disturbed sleep was measured in three waves with 2-year intervals: the wave preceding exposure to violence, the wave of exposure and the wave following the exposure. Data on procedural and interactional justice were obtained from the wave of exposure to violence. The associations were examined using repeated measures log-binomial regression analysis with the generalised estimating equations method, adjusting for gender and age.

Results: Exposure to violence was associated with an increase in disturbed sleep (RR 1.32 (95% CI 1.15 to 1.52)) that also persisted after the exposure (RR 1.26 (95% CI 1.07 to 1.48)). The increase was higher among teachers perceiving the managerial practices as relatively unfair (RR 1.46 (95% CI 1.01 to 2.09) and RR 1.59 (95% CI 1.04 to 2.42) for interactional and procedural justice, respectively). By contrast, working in high-justice conditions seemed to protect teachers from the negative effect of violence on sleep.

Conclusion: Our findings show an increase in sleep disturbances due to exposure to workplace violence in teaching. However, the extent to which teachers are treated with justice moderates this association. Although preventive measures for violence should be prioritised, resources aimed at promoting justice at schools can mitigate sleep problems associated with workplace violence.
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http://dx.doi.org/10.1136/oemed-2016-104027DOI Listing
July 2017

Hostile parenting, parental psychopathology, and depressive symptoms in the offspring: a 32-year follow-up in the Young Finns study.

J Affect Disord 2017 Jan 10;208:436-442. Epub 2016 Nov 10.

Unit of Psychology, Faculty of Education, University of Oulu, Finland; Institute of Behavioural Sciences, University of Helsinki, Finland. Electronic address:

Background: Both hostile parenting and parental psychopathology have been shown to predict depression in the offspring. However, whether and how they interact in predicting the longitudinal course of depression from adolescence to adulthood remains unclear.

Methods: Participants were from the prospective Cardiovascular Risk in Young Finns study, aged 3-18 years at baseline in 1980. We used multilevel modeling for repeated measurements to examine the associations of hostile parenting (i.e., parental intolerance and emotional distance) and parental history of psychopathology with trajectories of depressive symptoms across five study phases from 1992 to 2012.

Results: On average, depressive symptoms decreased in a curvilinear pattern with age. A relatively steep decreasing trend was also observed among offspring of parents with a history of psychopathology but low intolerance. By contrast, among the offspring of parents with a history of psychopathology and high intolerance there was a rising trend in depressive symptoms starting from young adulthood. There was no similar interaction between parental history of psychopathology, emotional distance, and age.

Limitations: Non-standardized, parental self-report scales were used to measure hostile parenting. The observed effects were small, and the depressive symptoms scale applied in the study may not be used for measuring clinical depression.

Conclusions: Parental psychopathology might render individuals sensitive to the unfavorable characteristics of the caregiving environment. Intolerance towards the child can exacerbate the effects of parental psychopathology and have a long-term significance on the developmental trajectory of depressive symptoms over the life-course.
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http://dx.doi.org/10.1016/j.jad.2016.11.002DOI Listing
January 2017
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