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Lojander J, Welling M, Axelin A, Härkänen M, Kopra J, Lamminpää R. Obstetric claims in Finland 2012-2022-A nationwide patient insurance registry study. Acta Obstet Gynecol Scand 2024; 103:1377-1385. [PMID: 38711236 PMCID: PMC11168264 DOI: 10.1111/aogs.14869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 04/16/2024] [Accepted: 04/18/2024] [Indexed: 05/08/2024]
Abstract
INTRODUCTION Maternal and infant mortality rates in Finland are among the lowest in the world, yet preventable obstetric injuries occur every year. The aim of this study was to describe obstetric claims, their compensation rates, and temporal trends of claims reported to the Patient Insurance center. MATERIAL AND METHODS A nationwide, register-based study was conducted. Data consisted of obstetric claims reported to the Patient Insurance Center between 2012 and 2022. Data analyzed included the year of injury, compensation criteria, maternal age, birth hospital, delivery method, reported causes of injury, and maternal or neonatal injury. The data were analyzed with descriptive statistics and logistic regression models. RESULTS A total of n = 849 obstetric claims were filed during the study period, of which n = 224 (26.4%) received compensation. The rate of claims was 0.15%, and the rate of compensation was 0.04% in relation to the total volume of births during the period. Substandard care was the most common (97.3%) criterion for compensation. There was a curvilinear increase in the claims rate and a linear increase in compensation rates from 2013 to 2019. More claims were filed and compensated for cesarean and vacuum-assisted deliveries than for unassisted vaginal deliveries. Delayed delivery (18.7%) and surgical technique failure (10.9%) were the most reported causes of injuries. Retained surgical bodies were the induced cause of injury with the highest rate of compensated claims (86.7%). The most common maternal injury was infection (17.9%) and pain (11.7%). Among neonatal injuries, severe (19.2%) and mild asphyxia (16.6%) were the most frequent. Burn injuries (93.3%) and fetal or neonatal death (60.5%) had the highest rate of compensated claims. CONCLUSIONS The study provided new information on substandard care and injuries in obstetric care in Finland. An increasing trend in claims and compensation rates was found. Identifying contributors to substandard care that lead to fetal asphyxia is important for improving obstetric safety. Further analysis of the association of claims and compensation rates with operative deliveries is needed to determine their causality. Frequent review of obstetric claims would be useful in providing more recent data on substandard care and preventable injuries.
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Affiliation(s)
- Jaana Lojander
- Department of Nursing ScienceUniversity of TurkuTurkuFinland
| | - Maiju Welling
- The Finnish Patient Insurance centerHelsinkiFinland
- Mehiläinen OyHelsinkiFinland
| | - Anna Axelin
- Department of Nursing ScienceUniversity of TurkuTurkuFinland
| | - Marja Härkänen
- Department of Nursing ScienceUniversity of Eastern FinlandKuopioFinland
- Research Center for Nursing Science and Social and Health ManagementKuopio University Hospital, Wellbeing Services County of North SavoKuopioFinland
| | - Juho Kopra
- School of ComputingUniversity of Eastern FinlandKuopioFinland
| | - Reeta Lamminpää
- Department of Nursing ScienceUniversity of Eastern FinlandKuopioFinland
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Brás CPDC, Figueiredo MDCABD, Ferreira MMC. Safety culture in maternity hospital: Perception of nurse-midwives. J Adv Nurs 2024; 80:2091-2105. [PMID: 38012856 DOI: 10.1111/jan.15969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 10/26/2023] [Accepted: 11/07/2023] [Indexed: 11/29/2023]
Abstract
AIM To explore nurse-midwives' perceptions of safety culture in maternity hospitals. DESIGN A descriptive phenomenological study was conducted using focus groups and reported following the Consolidated Criteria for Reporting Qualitative Research. METHODS Data were obtained through two online focus group sessions in June 2022 with 13 nurse-midwives from two maternity hospitals in the central region of Portugal. The first focus group comprised 6 nurse-midwives, and the second comprised 7 nurse-midwives. Qualitative data were analysed using content analysis. FINDINGS Two main themes emerged from the data: (i) barriers to promoting a safety culture; (ii) safety culture promotion strategies. The first theme is supported by four categories: ineffective communication, unproductive management, instability in teams and the problem of errors in care delivery. The second theme is supported by two categories: managers' commitment to safety and the promotion of effective communication. CONCLUSION The study results show that the safety culture in maternity hospitals is compromised by ineffective communication, team instability, insufficient allocation of nurse-midwives, a prevailing punitive culture and underreporting of adverse events. These highlight the need for managers to commit to providing better working conditions, encourage training with the development of a fairer safety culture and encourage reporting and learning from mistakes. There is also a need to invest in team leaders who allow better conflict management and optimization of communication skills is essential. IMPACT Disseminating these results will provide relevance to the safety culture problem, allowing greater awareness of nurse-midwives and managers about vulnerable areas, and lead to the implementation of effective changes for safe maternal and neonatal care. PATIENT OR PUBLIC CONTRIBUTION There was no patient or public contribution as the study only concerned service providers, that is, nurse-midwives themselves.
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Affiliation(s)
| | | | - Manuela Maria Conceição Ferreira
- Higher School of Health of Viseu, Polytechnic Institute of Viseu, Health Sciences Research Unit: Nursing (UICISA: E/ESEnfC-ESSV/IPV), Viseu, Portugal
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Shi Q, Wang J, Zhao D, Gu LY. Effect of cognitive behavior therapy training and psychological nursing on the midwifery process in the delivery room. World J Psychiatry 2023; 13:1053-1060. [PMID: 38186726 PMCID: PMC10768494 DOI: 10.5498/wjp.v13.i12.1053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 10/18/2023] [Accepted: 12/02/2023] [Indexed: 12/19/2023] Open
Abstract
BACKGROUND The severe physical and psychological impact of pain on the physical and mental health of women during labor leads to increased risks and complications during childbirth, presenting a major public health concern. Some studies have shown that cognitive behavioral therapy (CBT) has a positive effect on maternal psychology during delivery, reducing stress and shortening labor time. Thus, CBT training for mothers and delivery room staff may be beneficial in minimizing complications and adverse effects during natural birth. AIM To investigate the clinical effects of CBT training and psychological care during delivery, and their therapeutic effects on women in labor. METHODS This study used a retrospective analysis and included 140 mothers admitted to the maternity ward between January 2021 and January 2023. The study subjects were randomized into two groups: control (n = 70) and observation (n = 70). Routine care, CBT training, and psychological care were provided to mothers in both groups. Psychological status scores, delivery time, and satisfaction with care pre- and post-delivery were compared, and the incidence of complications after receiving care was analyzed between the two groups. RESULTS Although the psychological state of both groups improved significantly in the late stages of labor, the psychological state scores of the mothers in the observation group were significantly lower than those of the mothers in the control group (P < 0.05). The duration of labor and incidence of complications in the observation group were significantly lower than those in the control group (P < 0.05). The mothers in the observation group were significantly more satisfied with nursing care during the course of labor than those in the control group (P < 0.05). CONCLUSION CBT training and psychological care for mothers in the midwifery process can effectively improve anxiety and depression, shorten labor duration, reduce postnatal complications, and improve nursing satisfaction and nurse-patient relationships. Its clinical application is effective and has popularization value, providing a new way to protect maternal mental health.
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Affiliation(s)
- Qin Shi
- Department of Gynaecology and Obstetrics, Dushu Lake Hospital Affiliated to Soochow University, Suzhou 215125, Jiangsu Province, China
| | - Jie Wang
- Department of Gynaecology and Obstetrics, Dushu Lake Hospital Affiliated to Soochow University, Suzhou 215125, Jiangsu Province, China
| | - Dan Zhao
- Department of Gynaecology and Obstetrics, Dushu Lake Hospital Affiliated to Soochow University, Suzhou 215125, Jiangsu Province, China
| | - Ling-Yan Gu
- Department of Gynaecology and Obstetrics, Dushu Lake Hospital Affiliated to Soochow University, Suzhou 215125, Jiangsu Province, China
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You W, Donnelly F. Greater nurse density correlates to higher level of population ageing globally, but is more prominent in developed countries. PLoS One 2023; 18:e0292371. [PMID: 37773937 PMCID: PMC10540962 DOI: 10.1371/journal.pone.0292371] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 09/19/2023] [Indexed: 10/01/2023] Open
Abstract
BACKGROUND Representing over 50% of the healthcare workforce, nurses provide care to people at all ages. This study advances, at a population level, that high levels of nursing services, measured by nurse density may significantly promote population ageing measured by the percentage of a population over 65 years of age (65yo%). METHODS Population level data was examined to explore the correlation between nurse density and 65yo%. The confounding impacts on ageing such as the effects of economic affluence, physician density, fertility rate, obesity and urban advantages were also considered. Scatter plots, bivariate correlation, partial correlation and multiple linear regression analyses were performed for examining the correlations. RESULTS Nurse density correlated to 65yo%; this relationship was independent of other influences such as fertility rate, economic affluence, obesity prevalence, physician density and urban advantages. Second to fertility rate, nursing density had the greatest influence on 65yo%. The predicting and confounding variables explain 74.4% of the total 65yo% variance. The universal correlations identified in country groupings suggest that low nurse density may be a significant global concern. CONCLUSIONS While nurse density might contribute significantly to 65yo% globally, the effect was more prominent in developed countries. Ironically, countries with higher nurse densities and therefore greater levels of 65yo%, were countries with an increased need for more nursing staff. To highlight the profound implications for the role the nursing profession plays especially at a time of global nursing shortage, further study into the effects of long-run elasticity of nurse staffing level on population ageing may be needed. For instance, what percentage of nursing staff increase would be required to meet every 1% increase of an ageing population.
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Affiliation(s)
- Wenpeng You
- Adelaide Nursing School, the University of Adelaide, Adelaide, Australia
- Heart and Lung, Royal Adelaide Hospital, Adelaide, Australia
- Adelaide Medical School, the University of Adelaide, Adelaide, Australia
| | - Frank Donnelly
- Adelaide Nursing School, the University of Adelaide, Adelaide, Australia
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You W, Donnelly F. Although in shortage, nursing workforce is still a significant contributor to life expectancy at birth. Public Health Nurs 2023; 40:229-242. [PMID: 36527363 DOI: 10.1111/phn.13158] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 11/11/2022] [Accepted: 11/27/2022] [Indexed: 12/23/2022]
Abstract
OBJECTIVES Previous studies have not fully reported the strength and independency of the correlation of nursing workforce to life expectancy. This study advances that nursing workforce is a major independent contributor to life expectancy at birth (LEB) globally and regionally. DESIGN A cross-sectional study was conducted at population level. SAMPLE Ecological data were extracted from the United Nations agencies for 215 populations. Each population is considered a research subject. MEASUREMENTS The correlation between nursing workforce and LEB was analyzed with scatter plots, bivariate correlation, partial correlation, and multiple linear regression analyses, Analysis of Variance post hoc and independent T-test. Economic affluence, urban lifestyle and obesity were included as the potential confounders in this study. INTERVENTION Not applicable RESULTS: Nursing workforce correlated to LEB and this relationship remained regardless of the competition of economic affluence, urbanization, and obesity. Second to economic affluence, nursing workforce showed the greatest influence on LEB. In total, 64.50% of LEB was explained in this study. Nursing workforce was a determinant of regional variations of LEB. CONCLUSIONS Nursing workforce may be a significant contributor to LEB globally and regionally. This contribution was independent of the potential confounding effects of economic affluence, urbanization, and obesity.
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Affiliation(s)
- Wenpeng You
- Adelaide Nursing School, the University of Adelaide, Adelaide, Australia.,Acute and Urgent Care, Royal Adelaide Hospital, Adelaide, Australia.,Adelaide Medical School, the University of Adelaide, Adelaide, Australia
| | - Frank Donnelly
- Adelaide Nursing School, the University of Adelaide, Adelaide, Australia
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Huang H, Xiao L, Chen Z, Cao S, Zheng S, Zhao Q, Xiao M. A National Study of Patient Safety Culture and Patient Safety Goal in Chinese Hospitals. J Patient Saf 2022; 18:e1167-e1173. [PMID: 35617631 PMCID: PMC9698193 DOI: 10.1097/pts.0000000000001045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVES This study aimed to measure the patient safety culture and the current practice of patient safety goals in China. METHODS This cross-sectional survey was conducted between November 2020 and November 2021. The 12-dimensions Hospital Survey on Patient Safety Culture questionnaire and the 14-items Survey on the Current Practice of Patient Safety Goal questionnaire were electronically distributed to 8164 healthcare providers across 26 provinces in China. Data were analyzed using descriptive statistics, correlation analysis, and multivariate linear regression. RESULTS A total of 8164 surveys were received, of which 7765 were valid and analyzed. The average positive response rate for the Hospital Survey on Patient Safety Culture survey was 69.68% (43.41%-91.54%). The percentage of positive responses in 5 dimensions (organizational learning, teamwork within units, feedback about error, management support for safety, and teamwork across units) was above the control limits, and 3 (nonpunitive response to error, staffing, and frequency of event reporting) were below the control limits. The average positive response rate for the Survey on the Current Practice of Patient Safety Goal survey was 96.11%. Patient safety culture was positively related to the current practice of patient safety goals ( r = 0.34, P < 0.001). CONCLUSIONS Our study concludes that although healthcare providers in China feel positively toward patient safety culture and practicably toward patient safety goals, considerable work is still needed to promote a patient safety movement.
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Affiliation(s)
- Huanhuan Huang
- From the Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing
| | - Ling Xiao
- From the Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing
- Department of Encephalopathy, Chenzhou Traditional Chinese Medicine Hospital, Hunan
| | | | - Songmei Cao
- From the Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing
| | | | - Qinghua Zhao
- From the Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing
| | - Mingzhao Xiao
- Urology, Urologist, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Liu C, Yue C, Liu L, Liu T, Wang X, Hou Y, Gao S. Mediating role of perceived social support in the relationship between perceived stress and job burnout among midwives in the post-COVID-19 era. Nurs Open 2022; 10:479-487. [PMID: 35964290 PMCID: PMC9834135 DOI: 10.1002/nop2.1313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 06/18/2022] [Accepted: 07/29/2022] [Indexed: 01/16/2023] Open
Abstract
AIM The aim of this study was to explore the mediating role of perceived social support in the association between perceived stress and job burnout in midwives. DESIGN A descriptive, cross-sectional online survey. METHODS Using the stratified cluster sampling method, 329 midwives in 20 hospitals in China were selected as the participants. They completed self-report assessment measures of job burnout, perceived stress and perceived social support. RESULTS 63.5% of the participants had job burnout. Perceived stress was negatively associated with social support (r = -.350, p < .01), while it was positively associated with job burnout (r = -.382, p < .01). Social support was negatively correlated with job burnout (r = -.569, p < .01). The total effect of perceived stress on job burnout was 0.474 (95% CI: 0.367 ~ 0.596, p < .01), the direct effect was 0.242 (95% CI: 0.142 ~ 0.355, p < .01), and the indirect effect was 0.232 (95% CI: 0.160 ~ 0.316, p < .01). Social support programmes for midwives should be implemented to control the impact of perceived stress on job burnout.
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Affiliation(s)
- Cuiping Liu
- School of NursingShandong First Medical University & Shandong Academy of Medical SciencesTaianChina
| | - Chongyu Yue
- Department of ObstetricsAffiliated Hospital of Qingdao UniversityQingdaoChina
| | - Lei Liu
- Department of ObstetricsAffiliated Hospital of Qingdao UniversityQingdaoChina
| | - Ting Liu
- School of NursingQingdao UniversityQingdaoChina
| | - Xuelei Wang
- Department of ObstetricsAffiliated Hospital of Qingdao UniversityQingdaoChina
| | - Yan Hou
- Department of ObstetricsAffiliated Hospital of Qingdao UniversityQingdaoChina
| | - Shaobo Gao
- Department of ObstetricsAffiliated Hospital of Qingdao UniversityQingdaoChina
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Amiri A. Role of social distancing in tackling COVID-19 during the first wave of pandemic in Nordic region: Evidence from daily deaths, infections and needed hospital resources. Int J Nurs Sci 2021; 8:145-151. [PMID: 33758674 PMCID: PMC7975574 DOI: 10.1016/j.ijnss.2021.03.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 03/03/2021] [Accepted: 03/16/2021] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVES To measure the effect of social distancing on reducing daily deaths, infections and hospital resources needed for coronavirus disease 2019 (COVID-19) patients during the first wave of the pandemic in Nordic countries. METHODS The observations of social distancing, daily deaths, infections along with the needed hospital resources for COVID-19 patient hospitalizations including the numbers of all hospital beds, beds needed in ICUs and infection wards, nursing staffs needed in ICUs and infection wards were collected from the Institute for Health Metrics and Evaluation (IHME) by the University of Washington. The observations of social distancing were based on the reduction in human contact relative to background levels for each location quantified by cell phone mobility data collected from IHME. The weighted data per 100,000 population gathered in a 40-day period of the first wave of the pandemic in Denmark, Finland, Iceland, Norway and Sweden. Statistical technique of panel data analysis is used to measure the associations between social distancing and COVID-19 indicators in long-run. RESULTS Results of dynamic long-run models confirm that a 1% rise in social distancing by reducing human contacts may decline daily deaths, daily infections, all hospital beds needed, beds/nurses needed in ICUs and beds/nurses needed in infection wards due COVID-19 pandemic by 1.13%, 15.26%, 1.10%, 1.17% and 1.89%, respectively. Moreover, results of error correction models verify that if the equilibriums between these series are disrupted by a sudden change in social distancing, the lengths of restoring back to equilibrium are 67, 62, 40, 22 and 49 days for daily deaths, daily infections, all hospital beds needed, nurses/beds needed in ICUs and nurses/beds needed in infection wards, respectively. CONCLUSION Proper social distancing was a successful policy for tackling COVID-19 with falling mortality and infection rates as well as the needed hospital resources for patient hospitalizations in Nordic countries. The results alert governments of the need for continuously implementing social distancing policies while using vaccines to prevent national lockdowns and reduce the burden of patient hospitalizations.
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Affiliation(s)
- Arshia Amiri
- Department of Nursing Science, University of Turku, Turku, Finland
- School of Health and Social Studies, JAMK University of Applied Sciences, Jyväskylä, Finland
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Amiri A. Nursing Graduates and Quality of Acute Hospital Care in 33 OECD Countries: Evidence From Generalized Linear Models and Data Envelopment Analysis. SAGE Open Nurs 2021; 7:23779608211005217. [PMID: 35155769 PMCID: PMC8832287 DOI: 10.1177/23779608211005217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 03/07/2021] [Indexed: 12/03/2022] Open
Abstract
Background There is a lack of cross-national research to examine the role of new
graduate nurses in improving the quality of nursing care and patient
outcomes. Purpose To measure the role and clinical effectiveness of new graduate nurses in
improving the quality of acute hospital care in the members of Organisation
for Economic Co-operation and Development (OECD). Methods The total number of nursing graduates per 100,000 population and three OECD’s
Health Care Quality Indicators (HCQI) in acute care including 30-day
in-hospital and out-of-hospital mortality rates per 100 patients based on
acute myocardial infarction (MORTAMIO), hemorrhagic stroke (MORTHSTO) and
ischemic stroke (MORTISTO) were collected in 33 OECD countries. Four control
variables including the number of medical graduates, practicing nurses and
doctors densities per 1000 population (proxies for other health professions)
and the total number of Computed Tomography scanners per one million
population (proxy of medical technology level) were added in investigations.
The statistical technique of Generalized Linear Models (GLM) and Data
Envelopment Analysis (DEA) were used in data analysis. Results Results of GLM confirm the existence of meaningful association between the
density of nursing graduates and improving the quality of acute care i.e. a
1% rise in the number of nursing graduates in year 2015 reduced MORTAMIO,
MORTHSTO and MORTISTO by 1.11%, 0.08% and 0.46%, respectively. According to
the result of DEA, clinical effectiveness of new graduate nurses – i.e.
reaching the higher clinical outcomes with the same staffing level – in
reducing mortality rates in patients with life-threatening conditions were
at highest level in Luxembourg, Finland, Japan, Italy, Norway, Sweden and
Switzerland. Conclusions Higher staffing level of new graduate nurses associates with better patient
outcomes in acute care, although the clinical effectiveness of nursing
graduates – associated with the level of education and practice – is the
determinant factor of improving the quality of acute hospital care and
patient survival rates in OECD.
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Affiliation(s)
- Arshia Amiri
- Department of Nursing Science, University of Turku, Turku, Finland.,School of Health and Social Studies, JAMK University of Applied Sciences, Jyväskylä, Finland
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