Service user involvement (SUI) is a principal and a guideline in social and health care and also in mental health and substance abuse work. In practice, however, there are indicators of SUI remaining rhetoric rather than reality. The purpose of this study was to analyse and describe service users' conceptions of SUI in mental health and substance abuse work. The following study question was addressed: what are service users' conceptions of service user involvement in mental health and substance abuse work? In total, 27 users of services participated in the study, and the data was gathered by means of interviews. A phenomenographic approach was applied in order to explore the qualitative variations in participants' conceptions of SUI. As a result of the data analysis, four main categories of description representing service users' conceptions of service user involvement were formed: service users have the best expertise, opinions are not heard, systems make the rules, and courage and readiness to participate. In mental health and substance abuse work, SUI is still insufficiently achieved and there are obstacles to be taken into consideration. Nurses are in a key position to promote and encourage service user involvement.

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Patient-centred care and user involvement in healthcare services are much emphasised globally. This study was the first step in a multicentre research project in Finland to improve service users' and carers' opportunities to be more involved in mental health services. The aim of the study was to assess attitudes of professionals towards service user involvement. The data were collected via an online questionnaire from 1069 mental health professionals in four hospital districts. Altogether, 351 professionals responded. Data were analysed using appropriate statistical methods. According to the results, attitudes of healthcare professionals were more positive towards service users' involvement in their own treatment than in other levels of services. There were also differences in gender, age groups, working places and experiences in the attitudes of professionals concerning service users' involvement in their own treatment. These should be taken into account in the future when planning education for mental health professionals. In spite of governmental guidance on service user involvement and the growing body of knowledge of the benefits associated with it, change in attitudes towards user involvement is slow. Special attention should be paid to the attitudes of professionals working in inpatient care and of those with less working experience.

Background The Ostrobothnia Depression Programme (ODP) in Finland was intended to implement two evidence-based brief psychotherapy interventions, namely motivational interview and behavioural activation, in several regional psychiatric teams. A simultaneous effectiveness study was conducted. Considerable tension was encountered between these two arms, causing resistance to change. We conducted a qualitative case study to better understand this tension and to discuss how managerial and executive practices may ensure the successful running of a hybrid design programme. Methods We conducted focus group interviews to evaluate the phases of preparation and practical execution of the ODP from the perspectives of management and the programme executives. To gather the data, we applied the revised Socratic approach for health technology assessment and focus group interviews. We analysed the data deductively according to the Normalization Process Theory. Results We identified two main critical issues: (1) The ODP programme plan ignored the team leaders’ crucial role in influencing the implementation climate and mobilizing organizational strategies. The ODP had a simplistic top-down design with minimal and delayed collaboration with its target groups in the preparation phase. (2) Incongruence occurred between what the project group had explicitly communicated about being the spearhead of the ODP and what they then actually enacted. These two issues caused tension between the implementation efforts and the effectiveness study as well as resistance to change among the staff. Conclusion Early, open collaboration with all prospective stakeholders towards a shared understanding about the programme is the first action the programme administrators should take. Agreement on goals and the means to achieve them would lower tension between the two arms of a hybrid design programme, thereby reducing resistance to change. Congruence between the goals communicated and the actual managerial and executive actions is of paramount importance in getting the programme recipients on board.

The findings confirm that many obstacles need to be removed in ward practice before patient involvement can really be made a part of the daily routine. K E Y W O R D Sfocus group, patient involvement, professional, psychiatric ward 1 | BACKGROUND Promoting patient involvement is an important aspect of personcentered care 1 and recovery-oriented practice, 2 and is emphasized in many strategies, plans, and policies internationally. [3][4][5][6] In many countries, recovery-oriented working has become the guiding prin-

Väestön entistä nopeampi ikääntyminen haastaa sosiaali- ja terveydenhuollon ja sen koulutuksen. Hoitoalan opiskelijoiden valmistaminen yhä kasvavan ikääntyvän väestön hoitoon koetaan sairaanhoitajakoulutuksessa haasteena. Tutkimuksessa analysoitiin temaattisen analyysin avulla sairaanhoitajaopiskelijoiden kokemuksia gerontologisen hoitotyön simulaatio-opetuksesta. Lisäksi kartoitettiin sitä, mitä opiskelijat arvioivat oppineensa kokonaisuudessaan gerontologisen hoitotyön opintojaksolla. Aineisto kerättiin Webropol-verkkokyselyllä hoitotyön opiskelijoilta (N=39), jotka osallistuivat simulaatioihin syksyllä 2021 ja keväällä 2022. Tulokset osoittivat, että sairaanhoitajaopiskelijat kokivat simulaatiot turvalliseksi ja realistiseksi oppimisympäristöksi, jossa myös virheiden tekeminen ja niistä oppiminen oli mahdollista. Jotkut opiskelijat kokivat ahdistusta tai pelkoa simulaatioiden yhteydessä. Simulaatioiden tekniseen toteutukseen ja opiskelijoiden huolelliseen valmisteluun tulee kiinnittää huomiota. On tärkeää varmistaa simulaatiopedagogiikan ja erilaisten simulaatio-opetukseen liittyvien työvälineiden osaaminen. Simulaatio-opetusta tulisi kehittää edelleen huomioiden oppilaiden tunteiden, stressin ja jännityksen vaikutus oppimiseen. Hyvä valmistautuminen ja suunnittelu voivat auttaa opiskelijoita orientoitumaan simulaatioon ja siten mahdollisesti vähentämään siihen kohdistuvaa stressiä ja jännitystä. Gerontological nursing – Nursing students experiences of simulation teaching in a University of Applied Sciences The population is aging much faster than before, which challenges social and health care and its education. Preparing nursing students to care for the increasing aging population is seen as a challenge in nursing education. In this research, nursing students’ experiences of gerontological nursing simulation teaching are analyzed using thematic analysis. In addition, the contents of simulation teaching in gerontological nursing are examined. The data was collected from nursing students (N=39) who participated in the simulations in autumn 2021 and spring 2022 using the Webropol online survey. The results showed that the nursing students experienced the simulations as a safe and realistic learning environment, where it was also possible to make mistakes and learn from them. Some students experienced anxiety or fear during the simulations. It is important to pay attention to the technical implementation of the simulations and the careful preparation of the students. It is important to ensure knowledge of simulation pedagogy and various tools related to simulation teaching. Simulation teaching should be developed further, taking into account the effect of students’ emotions, stress and tension on learning. Good preparation and planning can help students orient themselves to the simulation and thus potentially reduce the stress and tension associated with it.

Background The Ostrobothnia Depression Programme (ODP) in Finland was intended to implement two evidence-based brief psychotherapy interventions, namely motivational interview and behavioural activation, in several regional psychiatric teams. A simultaneous effectiveness study was conducted. Considerable tension was encountered between these two arms, causing resistance to change. We conducted a qualitative case study to better understand this tension and to ascertain how managerial and executive practices may ensure the successful running of a hybrid design programme. Methods We conducted focus group interviews to evaluate the phases of preparation and practical execution of the ODP from the perspectives of management and the programme executives. To gather the data, we applied the revised Socratic approach for health technology assessment and the rapid assessment process model. We analysed the data deductively according to Normalization Process Theory. Results We identified two main critical issues: 1) Incongruence occurred between what the project group had explicitly communicated about being the spearhead of the ODP and what they then actually enacted. 2) The ODP programme plan ignored the team leaders' crucial role in influencing the implementation climate and mobilizing organizational strategies. The ODP had a simplistic top-down design with minimal and delayed collaboration with its target groups in the preparation phase. These caused tension between the implementation efforts and the effectiveness study as well as resistance to change among the staff. Conclusion Early, open collaboration with all prospective stakeholders towards a shared understanding about the programme is the first action the programme administrators should take. Agreement on goals and the means to achieve them would lower tension between the two arms of a hybrid design programme, thereby reducing resistance to change. Congruence between the goals communicated and the actual managerial and executive actions is of paramount importance in getting the programme recipients on board.

Background The Ostrobothnia Depression Programme (ODP) in Finland was intended to implement two evidence-based brief psychotherapy interventions, namely motivational interview and behavioural activation, in several regional psychiatric teams. A simultaneous effectiveness study was conducted. Considerable tension was encountered between these two arms, causing resistance to change. We conducted a qualitative case study to better understand this tension and to discuss how managerial and executive practices may ensure the successful running of a hybrid design programme. Methods We conducted focus group interviews to evaluate the phases of preparation and practical execution of the ODP from the perspectives of management and the programme executives. To gather the data, we applied the revised Socratic approach for health technology assessment and focus group interviews. We analysed the data deductively according to Normalization Process Theory. Results We identified two main critical issues: 1) The ODP programme plan ignored the team leaders' crucial role in influencing the implementation climate and mobilizing organizational strategies. The ODP had a simplistic top-down design with minimal and delayed collaboration with its target groups in the preparation phase. 2) Incongruence occurred between what the project group had explicitly communicated about being the spearhead of the ODP and what they then actually enacted. These two issues caused tension between the implementation efforts and the effectiveness study as well as resistance to change among the staff. Conclusion Early, open collaboration with all prospective stakeholders towards a shared understanding about the programme is the first action the programme administrators should take. Agreement on goals and the means to achieve them would lower tension between the two arms of a hybrid design programme, thereby reducing resistance to change. Congruence between the goals communicated and the actual managerial and executive actions is of paramount importance in getting the programme recipients on board.