Noviisiopettajien kokemuksia työympäristön hyvinvointia heikentävistä tekijöistä ja keinoja työhyvinvoinnin ylläpitämiseen

Tiivistelmä. Tutkimuksen tavoitteena on selvittää, mitkä tekijät työympäristössä heikentävät noviisiopettajien työhyvinvointia sekä millä keinoin he edesauttavat ja ylläpitävät omaa työhyvinvointiaan. Tarkastelun kohteena ovat työuransa alkutaipaleella olevat opettajat, heidän kokemuksensa työympäristön, työyhteisön ja opettajan työn hyvinvointia heikentävistä tekijöistä sekä keinoja edesauttaa ja ylläpitää työhyvinvointia niin työympäristössä kuin vapaa-ajalla. Teoreettinen viitekehys rakentuu alan aiempaan kirjallisuuteen ja tutkimukseen, jotka käsittelevät pääosin suomalaisia opettajia kotimaisen koulujärjestelmän ainutlaatuisuuden vuoksi globaalilla mittapuulla. Alan aiemman tutkimuksen ohella tarkastellaan tuoretta kirjallisuutta opettajien työhyvinvointitekijöistä. Myös aihepiirin termistöä, kuten kuormitusta tarkastellaan teoreettisessa viitekehyksessä. Tutkimus on kvalitatiivinen tutkimus ja se noudattaa fenomenologista lähestymistapaa. Aineisto kerättiin sähköisellä kyselylomakkeella loppusyksyn 2022 aikana kymmeneltä pääosin perusopetuksessa työskentelevältä noviisiopettajalta. Perusopetuksen opettajien lisäksi tutkimukseen osallistui yliopisto-opettaja ja erityisluokan opettaja. Tutkimuksen aineisto analysoitiin aineistolähtöisen sisällönanalyysin keinoin. Tutkimuksen tuloksista tehdyt johtopäätökset osoittavat, että noviisiopettajien työympäristöstä kumpuavat työhyvinvoinnin haittatekijät muodostuvat ensisijaisesti opettajan työnkuvan muutoksesta, jatkuvasta kiireestä ja opetustyön ulkopuolisten tehtävien suuresta määrästä, ryhmäkokojen kasvusta, erityisen tuen piirissä olevista oppilaista, resursseista sekä työyhteisöstä. Erityisesti vajavaisten resurssien koettiin olevan yhteydessä useimpiin muihin työhyvinvointia heikentäviin tekijöihin. Työhyvinvointia edesauttavat ja ylläpitävät tekijät koostuvat suurilta osin kollegoiden, rehtorin ja työn ulkopuolisen sosiaalisen verkoston tuesta, omasta asennoitumisesta työhön sekä järkevistä valinnoista ja elintavoista. Laadullisen tutkimuksen ominaisuudet ja suhteellisen pieni otoskoko vaikuttavat tutkimuksen luotettavuuteen, jonka vuoksi yleistäminen ei ole relevanttia. Tutkimuksen kulku on kuitenkin suunniteltu huolellisesti, raportoitu johdonmukaisesti ja lähdekirjallisuus on tarkasti valittua. Tämä tutkimus syventää noviisiopettajien työhyvinvoinnista aiemmin saatua tietoa sekä antaa pohjan esimerkiksi aiheen jatkotutkimukselle

Työhyvinvointi ja työuupumus opettajan työssä

Tiivistelmä. Tämä kandidaatintyö käsittelee opettajien työuupumusta aiheuttavia ja työssä jaksamista edesauttavia tekijöitä kuvailevan kirjallisuuskatsauksen keinoin. Opettajan työhyvinvointia on tutkittu laajalti jo aiemmin, mutta jatkuvan koulun muutosprosessin ja vaatimusten keskellä syntyy uusia tilanteita, joihin opettajan tulee pystyä mukautumaan. Tämän tutkielman kohteena ovat ensisijaisesti suomalaiset eri alojen opettajat, mutta myös ulkomaisen tutkimuksen näkökulma on huomioitu. Työn epäkohdat ja voimavarat esitetään pääasiallisesti opettajien henkilökohtaisesta näkökulmasta. Aineistonkeruu keskittyy lähes yksinomaan suomalaisia opettajia ja kouluja käsittelevään kirjallisuuteen, koska kotimainen koululaitos on globaalilla mittapuulla ainutlaatuinen. Aineisto on rajattu tutkimuksen kannalta keskeisimpien käsitteiden ympärille. Tutkimuskysymykset ovat: 1. Mitkä tekijät heikentävät opettajan hyvinvointia? 2. Mitkä tekijät ylläpitävät tai edesauttavat opettajan työssä jaksamista? Käsitteiden määrittelyn ja metodologisen osion jälkeen käsittelyssä ovat aiemmat tutkimukset opettajien työhyvinvoinnista. Tähän työhön valitut tutkimukset on toteutettu kysely- ja haastattelututkimuksina. Ne sisältävät luokanopettajien, aineenopettajien sekä ammatillisen koulutuksen opettajien kokemuksia. Tutkielman tulosten perusteella ylimitoitetut odotukset työtä kohtaan, epätasa-arvo, heikosti toteutetut organisaatiomuutokset sekä työyhteisön sisäiset ristiriidat ovat keskeisimmät työuupumusta ja heikkoa hyvinvointia ennustavat tekijät. Vastaavasti hyvä johtaminen, kollegoiden vertaistuki, toimiva ryhmädynamiikka sekä avoin palaute- ja keskustelukulttuuri ovat hyvinvoivan työntekijän ja työyhteisön kulmakiviä. Jatkotutkimuksen kannalta aiheita on runsaasti. Uusia tutkimuskohteita syntyy jatkuvasti, koska koulumaailma ja opettajan työnkuva kehittyy yhteiskunnan mukana. Työuupumuksen ehkäisemisen kannalta jatkotutkimuskohteiksi kannattaa valita ongelmallisia työyhteisöjä

Traumatic Microbleeds in Mild Traumatic Brain Injury Are Not Associated with Delayed Return to Work or Persisting Post-Concussion Symptoms

The main objective of this prospective cohort study was to evaluate whether traumatic microbleeds (TMBs) are a significant prognostic factor of return to work (RTW), post-traumatic symptoms, and overall recovery in patients with mild traumatic brain injury (mTBI). One hundred and thirteen patients with mTBI were recruited from the Helsinki University Hospital emergency units. All patients underwent multi-contrast 3T magnetic resonance imaging (MRI) 3-17 days after mTBI. Patients were evaluated in the Traumatic Brain Injury Outpatient Clinic of Helsinki University Hospital 1 month after injury. Post-concussion symptoms were assessed with the Post-Concussion Symptom Questionnaire (RPQ) and overall recovery was assessed with the Glasgow Outcome Scale Extended (GOS-E). Their time to RTW was continuously measured up to 1 year after TBI. Median RTW was 9 days (interquartile range [IQR] 4-30) after mTBI and full RTW rate after 1 year was 98%. Patients with TMBs (n = 22) did not have more post-concussion symptoms (median RPQ 10.0 vs. 7.0, p = 0.217) or worse overall recovery (58% vs. 56% with GOS-E = 8, p = 0.853) than patients without TMBs (n = 91). There was no significant difference in time to RTW (13.5 vs. 7.0 days, p = 0.063). In this study, patients with TMBs did not have delayed RTW or more post-concussion symptoms than other patients with mTBI. TMBs in mTBI do not seem to be a significant prognostic factor of RTW.Peer reviewe

Return to work after mild traumatic brain injury : association with positive CT and MRI findings

Background Return to work (RTW) might be delayed in patients with complicated mild traumatic brain injury (MTBI), i.e., MTBI patients with associated traumatic intracranial lesions. However, the effect of different types of lesions on RTW has not studied before. We investigated whether traumatic intracranial lesions detected by CT and MRI are associated with return to work and post-concussion symptoms in patients with MTBI. Methods We prospectively followed up 113 adult patients with MTBI that underwent a brain MRI within 3-17 days after injury. Return to work was assessed with one-day accuracy up to one year after injury. Rivermead Post-Concussion Symptoms Questionnaire (RPQ) and Glasgow Outcome Scale Extended (GOS-E) were conducted one month after injury. A Kaplan-Meier log-rank analysis was performed to analyze the differences in RTW. Results Full RTW-% one year after injury was 98%. There were 38 patients with complicated MTBI, who had delayed median RTW compared to uncomplicated MTBI group (17 vs. 6 days), and more post-concussion symptoms (median RPQ 12.0 vs. 6.5). Further, RTW was more delayed in patients with multiple types of traumatic intracranial lesions visible in MRI (31 days, n = 19) and when lesions were detected in the primary CT (31 days, n = 24). There were no significant differences in GOS-E. Conclusions The imaging results that were most clearly associated with delayed RTW were positive primary CT and multiple types of lesions in MRI. RTW-% of patients with MTBI was excellent and a single intracranial lesion does not seem to be a predictive factor of disability to work.Peer reviewe

Post-traumatic headache after mild traumatic brain injury in a one-year follow up study - risk factors and return to work

Background Post-traumatic headache (PTH) is a common symptom following mild traumatic brain injury (mTBI). Patients at risk to develop acute PTH (aPTH) and further persistent PTH (pPTH) need to be recognized. Methods This is a one-year follow-up of 127 patients with mTBI, aged 18 to 68, referred to outpatient clinic in the Helsinki University Hospital. Symptoms were assessed at the emergency department (ED), with structured interview at outpatient clinic visit and with Rivermead post-concussion symptom questionnaire at one, three, and 12 months after injury. Psychiatric disorders were assessed with Structured Clinical Interview for DSM-IV Axis I disorders at 3-4 months and return to work (RTW) from patient records. Results At one month, 77/127 patients (61%) had aPTH. According to multiple logistic regression analysis, risk factors for aPTH were headache at the emergency department (ED) (OR 5.43), other pain (OR 3.19), insomnia (OR 3.23), and vertigo (OR 5.98). At three months, 17 patients (22% of aPTH patients) had developed pPTH, and at one year, 4 patients (24% of pPTH patients) still presented with pPTH. Risk factors for pPTH at three months were older age (OR 1.06) and current insomnia (OR 12.3). The frequency of psychiatric disorders did not differ between the groups. pPTH patients performed worse on their RTW. Conclusions Risk factors for aPTH were insomnia, headache at ED, other pain, and vertigo and for pPTH, insomnia and older age. RTW rate was lower among pPTH patients.Peer reviewe

Perceived Injustice After Mild Traumatic Brain Injury

Objective: To examine perceived injustice and its associations with self-reported symptoms and return to work at 3months after injury in a prospectively recruited sample of patients with mild traumatic brain injury (mTBI). Design: Observational study. Setting: TBI outpatient unit. Participants: Adult patients aged 18 to 68 years with mTBI (n = 100) or orthopedic injury ([OI]; n = 34). Main Measures: The Injustice Experience Questionnaire (IEQ) and its associations with the Rivermead Post Concussion Questionnaire (RPQ), Beck Depression Inventory-Second Edition (BDI-II), PTSD Checklist-Civilian Version (PCL-C), and Pain Visual Analog Scale (PVAS). Information on injury-related characteristics, compensation seeking and litigation, and return-to-work status was also collected. Results: Median IEQ total score was 3 (range, 0-23) in the mTBI group and 2.5 (range, 0-25) in the OI group. In the mTBI group, IEQ was significantly correlated with RPQ (rs = 0.638, PPeer reviewe

Synonymous Codons and Hydrophobicity Optimization of Post-translational Signal Peptide PelB Increase Phage Display Efficiency of DARPins

DsbA leader peptide targets proteins for cotransla-tional translocation by signal recognition particle (SRP) pathway and has been the standard signal sequence for filamentous phage display of fast-folding Designed Ankyrin Repeat Proteins (DARPins). In contrast, translocation of DARPins via the post-translational pathway, for example, with the commonly used PelB leader, has been reported to be highly inefficient. In this study, two PelB signal sequence libraries were screened covering different regions of the leader peptide for identifying mutants with improved display of DARPins on phage. A PelB variant with the most favorable combination of synonymous mutations in the n-region and hydrophobic substitutions in the h-region increased the display efficiency of a DARPin library 44-and 12-fold compared to PelBWT and DsbA, respectively. Based on thioredoxin-1 (TrxA) export studies the triple valine mutant PelB DN5 V3 leader was capable of more efficient cotranslational translocation than PelBWT, but the overall display efficiency improvement over DsbA suggests that besides increased cotranslational translocation other factors contribute to the observed enhancement in DARPin display efficiency

Prognosis after Mild Traumatic Brain Injury: Influence of Psychiatric Disorders

Background: We evaluated the prevalence of psychiatric disorders in mild traumatic brain injury (MTBI) patients and investigated psychiatric comorbidity in relation to subjective symptoms and return to work (RTW). Methods: We recruited 103 MTBI patients (mean age 40.8 years, SD 3.1) prospectively from University Hospital. The patients were followed up for one year. The Rivermead Post-Concussion Symptom Questionnaire (RPQ) and Extended Glasgow Outcome Scale (GOSE) were administered one month after MTBI. Three months after MTBI, any psychiatric disorders were assessed using the Structured Clinical Interview for DSM-IV Axis I Disorders. Results: Psychiatric disorders were diagnosed in 26 patients (25.2%). The most common disorders were previous/current depression. At three months, there was no difference between patients with psychiatric disorders versus those without them in RTW (95.7% vs. 87.3%, p = 0.260) or at least in part-time work (100% vs. 94.4%, p = 0.245). In Kaplan–Meier analysis, the median time to RTW was 10 days for both groups. The median RPQ score was 13.0 (Interquartile range (IQR) 6.5–19.0) in patients with a psychiatric disorder compared to 8.5 (IQR 2.3–14.0) in those without one (p = 0.021); respectively, the median GOSE was 7.0 (IQR 7.0–8.0) compared to 8.0 (IQR 7.0–8.0, p = 0.003). Conclusions: Approximately every fourth patient with MTBI had a psychiatric disorder. These patients reported more symptoms, and their functional outcome measured with GOSE at one month after MTBI was worse. However, presence of any psychiatric disorder did not affect RTW. Early contact and adequate follow-up are important when supporting the patient’s return to work

Prognosis after Mild Traumatic Brain Injury: Influence of Psychiatric Disorders

Background: We evaluated the prevalence of psychiatric disorders in mild traumatic brain injury (MTBI) patients and investigated psychiatric comorbidity in relation to subjective symptoms and return to work (RTW). Methods: We recruited 103 MTBI patients (mean age 40.8 years, SD 3.1) prospectively from University Hospital. The patients were followed up for one year. The Rivermead Post-Concussion Symptom Questionnaire (RPQ) and Extended Glasgow Outcome Scale (GOSE) were administered one month after MTBI. Three months after MTBI, any psychiatric disorders were assessed using the Structured Clinical Interview for DSM-IV Axis I Disorders. Results: Psychiatric disorders were diagnosed in 26 patients (25.2%). The most common disorders were previous/current depression. At three months, there was no difference between patients with psychiatric disorders versus those without them in RTW (95.7% vs. 87.3%, p = 0.260) or at least in part-time work (100% vs. 94.4%, p = 0.245). In Kaplan–Meier analysis, the median time to RTW was 10 days for both groups. The median RPQ score was 13.0 (Interquartile range (IQR) 6.5–19.0) in patients with a psychiatric disorder compared to 8.5 (IQR 2.3–14.0) in those without one (p = 0.021); respectively, the median GOSE was 7.0 (IQR 7.0–8.0) compared to 8.0 (IQR 7.0–8.0, p = 0.003). Conclusions: Approximately every fourth patient with MTBI had a psychiatric disorder. These patients reported more symptoms, and their functional outcome measured with GOSE at one month after MTBI was worse. However, presence of any psychiatric disorder did not affect RTW. Early contact and adequate follow-up are important when supporting the patient’s return to work