Kokemuksia kokemusasiantuntijakoulutuksesta ja sen merkityksestä toipumisen näkökulmasta

Tässä pro gradu -tutkielmassa tarkastellaan opiskelijoiden kokemuksia kokemusasiantuntijakoulutuksesta. Lisäksi selvitetään, mitä tämä koulutus merkitsee toipumisen näkökulmasta. Tutkielmassa vastataan seuraaviin kysymyksiin: ”Mitä merkityksiä opiskelijat antavat kokemusasiantuntijakoulutukselle?” ja ”Mitä kokemusasiantuntijakoulutus merkitsee toipumisen kannalta?” Tavoitteeseen lisätä osallisuutta mielenterveys- ja päihdepalveluissa on vastattu vahvistamalla kokemusasiantuntijatoimintaa. Kokemusasiantuntijuuden voikin sanoa olevan nykypäivän trendi mielenterveys- ja päihdetyössä. Lisäksi Suomessa on yleistynyt humanistisiin arvoihin nojaava toipumisorientaatio, joka korostaa ihmisten välisen kohtaamisen tärkeyttä sekä keskittyy toivoon ja ihmisen voimavaroihin. Etnografisen tutkielmani aineisto kerättiin osallistuvan havainnoinnin sekä haastatteluiden keinoin. Olin tutkijana mukana yhdessä kokemusasiantuntijakoulutuksessa, ja kirjoitin sen pohjalta kenttäpäiväkirjaa. Lisäksi haastattelin kahdeksaa koulutuksen opiskelijaa. Litteroidut haastattelut ja kenttäpäiväkirja muodostavat yhdessä tutkimusaineiston, jonka avulla löysin vastauksia tutkimuskysymyksiin. Kokemusasiantuntijakoulutuksen saamissa merkityksissä korostui koulutusryhmä, joka koettiin vertaistuellisena, turvallisena ja uusia näkökulmia tuovana. Koulutus itsessään aiheutti tulevaisuusorientoitunutta ajattelua, mikä voidaan nähdä toiveikkuuden vahvistumisena. Koulutus tuki opiskelijoiden toipumisprosesseja, kuten sairaan roolista irtautumista, positiivisen identiteetin rakentumista sekä voimaantumista. Koulutukseen osallistuneiden näkemykset ovat tärkeitä ottaa huomioon koulutuksia kehitettäessä. Tämä tutkielma tuo esiin, että koulutuksissa kannattaa panostaa ryhmäytymiseen, sillä toimivan ryhmän myötä voidaan vahvistaa erilaisia toipumisen prosesseja. Lisäksi tutkielma osoittaa, että muiden ryhmäläisten tarinat ovat tärkeä osa koulutusta; niiden kautta voidaan kokea vertaistukea, samaistumista, keskinäistä ymmärrystä ja saada uusia näkökulmia omaan menneisyyteen

SÄHKÖINEN TALOUSHALLINTO – MIKSI SITÄ EI KÄYTETÄ?

Tilitoimisto Oy vaihtoi vuonna 2009 taloushallinto-ohjelmistonsa vastaamaan nykyajan tarpeita. Vaihdos mahdollisti sähköisten taloushallintopalveluiden tarjoamisen asiakasyrityksille. Suhtautuminen sähköistä taloushallintoa kohtaan oli, ja on yhä edelleen, kuitenkin hyvin laimeaa sekä asiakasyritysten että henkilökunnan keskuudessa. Tutkimuksen tarkoituksena olikin näiden asenteiden ja käsitteiden tarkastelu. Tutkimusongelmana oli selvittää miksi sähköistä taloushallintoa ei käytetä. Toisena tutkimusongelmana selvitettiin, mitä sähköisessä taloushallinnossa olisi oltava, jotta yrittäjät hyödyntäisivät sitä yritystoiminnassaan. Henkilökuntaan kohdistuvan tutkimuksen avulla oli tarkoitus lähinnä saada syventävää ja täsmentävää tietoa tutkimusongelmista. Tavoitteena oli tuottaa vastaukset tutkimusongelmiin. Tutkimustulosten pohjalta laadittujen kehittämisehdotusten avulla oli tarkoitus saada Tilitoimisto Oy:n asiakkaat sekä henkilökunta näkemään sähköinen taloushallinto uudenlaisena toimintatapana, mahdollisuutena. Tutkimus totutettiin kvalitatiivisena tutkimuksena ja tutkimuksessa käytettiin hyväksi myös ns. monimenetelmäkeinoa. Monimenetelmäkeinon avulla eri tutkimusmenetelmien käyttö oli mahdollista. Asiakasyrityksiä tutkittaessa aineistonkeruutavaksi valikoitui kyselylomake ja henkilökunnan kohdalla taas puolistrukturoitu haastattelu. Kyselylomakkeen ja haastattelun kysymykset koskivat tyytyväisyyttä sähköiseen taloushallintoon, ja mahdollisia ongelmia ja kehittämiskohteita sähköisessä taloushallinnossa. Tutkimustulosten mukaan Tilitoimisto Oy:n asiakasyrityksiä ja henkilökuntaa arveluttivat sähköisessä taloushallinnossa hajanaisesti erilaiset asiat. Tulosten perusteella voidaan kuitenkin määritellä suurimpia syitä siihen, miksi sähköistä taloushallintoa ei käytetä. Näitä syitä olivat hintavuus, oman osaamisen puute ja tietämättömyys. Kehitysehdotuksena tutkimustulosten perusteella olikin koulutuksen lisääminen ja aktiivinen tiedon jakaminen puolin ja toisin.In 2009, the Accounting company LLC changed their financial management software to match today’s needs. The change enabled them to provide financial management services to client businesses. However, the attitude towards electronic financial management was, and still remains to be, quite tepid among both client businesses and personnel. The purpose of this study was to examine those attitudes and notions. The research problem was to find out why electronic financial management is not used. Another research problem was to investigate what electronic financial management should include so that entrepreneurs would utilize it more in their businesses. The study directed to the personnel was mainly made to gain deeper and more precise information of the research problems. The objective was to produce answers to the research problems. The development suggestions, based on the research results, were intended to help both the clients and personnel of LLC to see electronic financial management as a new procedure, or as an opportunity. The study was qualitative and the so-called mixed mode method also used. The mixed mode method allowed the use of multiple different research methods. For gathering information about the client businesses a questionnaire was used, whereas a half-structured interview was used in order to gather data on the personnel. The questions in the questionnaire and in the interview were about the satisfaction of electronic financial management including potential problems and development points in electronic financial management. According to the research results, the client businesses and personnel of LLC are questioning a variety of different subjects concerning electronic financial management. However, based on the results, some of the greatest reasons for electronic financial management being left unused can be determined. These reasons were costliness, lack of personal know-how and unawareness. Based on the research results, the development proposals included additional education and active sharing of information on both sides

Life events as predictors for disability pension due to musculoskeletal diagnoses : a cohort study of Finnish twins

Purpose Musculoskeletal diagnoses (MSD) are one of the largest diagnostic groups for disability pensions (DP). This study investigated the associations between life events and DP due to MSD, considering sociodemographic, health, and familial factors. Methods The study sample included 18,530 Finnish twins, 24-64 years old at baseline, who responded to a questionnaire in 1981 including a 21-item life event inventory. Information on DP with diagnosis codes (ICD codes: M00-M99) were obtained from the official national pension registers. Life events were divided into family- and work-related events. "Positive change in life" was analyzed separately. Cox proportional hazards models were used to calculate hazard ratios (HR) with 95% confidence intervals (CI). Results During the follow-up of 23 years, 1273 (7%) individuals were granted DP due to MSD. In discordant pair analysis, family-related events (>= 4 events) increased (HR 1.63, 95% CI 1.31, 2.03) and the absence of such events decreased (HR 0.68, 95% CI 0.48, 0.95) the risk of DP due to MSD. For work-related events (>= 3 events), the risk estimates were non-significant when controlling for familial factors. Having had a positive change in life decreased the risk of DP due to MSD (HR 0.79, 95% CI 0.65, 0.96) while controlling for familial confounding, but were non-significant in the full model controlling for various covariates (HR 0.91, 95% CI 0.75, 1.12). Conclusions The associations between life events and the risk of DP due to MSD are complex and potentially affected by familial and other confounding factors including sociodemographics and health.Peer reviewe

Disability pension due to musculoskeletal diagnoses: importance of work-related factors in a prospective cohort study of Finnish twins

OBJECTIVES: The aim of this study was to investigate the impact of work-related risk factors for future disability pension (DP) due to musculoskeletal diagnoses and for a subgroup of these, namely, DP due to osteoarthritis. METHODS: For this prospective study of 16 028 Finnish twins born in 1911-1957 and employed at baseline, a postal questionnaire collected information in 1975 on work-related factors; follow-up data on DP was gathered through register linkages up to 2004. A series of proportional hazards (Cox) regression models were used to analyze the associations between work-related factors and the incidence of DP. RESULTS: During the 30-year follow-up, 1297 participants (8%) were granted DP due to musculoskeletal diagnoses, 376 of which were due to osteoarthritis. High stress of daily activities, monotonous work, physical workload (namely work including lifting and carrying or physically heavy work), several workplace changes, and unemployment displayed a strong association with DP due to musculoskeletal diagnoses that was not affected by familial factors, including genetics and shared environment. Additionally, standing work increased the risk for DP due to osteoarthritis. CONCLUSIONS: Uninfluenced by family background or other confounding factors, several work-related factors were identified as being strong and direct risk factors for DP due to musculoskeletal diagnoses.Peer reviewe

Computer-based Eye-tracking Analysis of King-Devick Test Differentiates Persons with Idiopathic Normal Pressure Hydrocephalus from Cognitively Unimpaired

Publisher Copyright: © 2022 Lippincott Williams and Wilkins. All rights reserved.Background: Functional defects in eye movements and reduced reading speed in neurodegenerative diseases represent a potential new biomarker to support clinical diagnosis. We investigated whether computer-based eye-tracking (ET) analysis of the King-Devick (KD) test differentiates persons with idiopathic normal pressure hydrocephalus (iNPH) from cognitively unimpaired [control (CO)] and persons with Alzheimer's disease (AD). Methods: We recruited 68 participants (37 CO, 10 iNPH, and 21 AD) who underwent neurological examination, the Consortium to Establish a Registry for Alzheimer's Disease neuropsychological test battery (CERAD-NB), and a Clinical Dementia Rating interview. The KD reading test was performed using computer-based ET. We analyzed the total time used for the reading test, number of errors, durations of fixation and saccade, and saccade amplitudes. Results: The iNPH group significantly differed from the CO group in the KD test mean total time (CO 69.3 s, iNPH 87.3 s; P≤0.009) and eye-tracking recording of the mean saccade amplitude (CO 3.6 degree, iNPH 3.2 degree; P≤0.001). The AD group significantly differed from the CO group in each tested parameter. No significant differences were detected between the iNPH and AD groups. Conclusion: For the first time, we demonstrated altered reading ability and saccade amplitudes in patients with iNPH.Peer reviewe

Shortening of Saccades as a Possible Easy-to-Use Biomarker to Detect Risk of Alzheimer's Disease

Background: Wide-ranging functional defects in eye movements have been reported in Alzheimer's disease (AD) dementia. The detection of abnormal eye movements and reading problems may identify persons at risk of AD when clear clinical symptoms are lacking. Objective: To examine whether computer-based eye-tracking (ET) analysis of King-Devick (KD) test results differentiates cognitively healthy persons from persons with minor problems in cognitive testing or diagnosed mild AD. Methods: We recruited 78 participants (57 non-demented, 21 with mild AD) who underwent neurological examination, the Consortium to Establish a Registry for Alzheimer's Disease neuropsychological test battery (CERAD-NB), and a Clinical Dementia Rating (CDR) interview. The non-demented participants were further divided into control (normal CERAD subtests, mean MMSE= 28) and objective mild cognitive impairment (MCI; decline in at least one CERAD memory score, mean MMSE= 27) groups. The KD reading test was performed using computer-based ET. The total time used for the reading test, errors made, fixation and saccade durations, and saccade amplitudes were analyzed. Results: We found significant differences between the control, objective MCI, and AD groups in regard to the mean saccade amplitude (3.58, 3.33, and 3.21 ms, respectively, p < 0.03) and duration (27.1, 25.3, and 24.8 ms, respectively, p < 0.05). The KD error scores in the AD group differed significantly (p < 0.01) from the other groups. Conclusion: Computed ET analysis of the KD test may help detect persons with objective MCI early when clear clinical symptoms are lacking. The portable device for ET is easy to use in primary health care memory clinics.Peer reviewe

Reticulation pattern without honeycombing on high-resolution CT is associated with the risk of disease progression in interstitial lung diseases

Background: The disease course of idiopathic pulmonary fibrosis (IPF) is progressive and occasionally, other types of interstitial lung disease (ILD) may progress similarly to IPF. This study aimed to evaluate risk factors for disease progression within 24 months in patients with various ILDs. Methods: This prospective study obtained 97 patients with a suspected ILD who underwent a transbronchial lung cryobiopsy. The extent of several high-resolution computed tomography (HRCT) patterns was assessed. Due to the inclusion criteria the study population presented a low extent of honeycombing and definite usual interstitial pneumonia (UIP) pattern on HRCT suggesting an early stage of ILD. Disease progression within 24 months despite treatment was defined as a relative decline of ≥ 10% in forced vital capacity (FVC), or a relative decline in FVC of ≥ 5% and one of the three additional criteria: (1) a decline in diffusion capacity to carbon monoxide (DLCO) ≥ 15%; (2) increased fibrosis on HRCT; (3) progressive symptoms, or progressive symptoms and increased fibrosis on HRCT. The same definition was utilized in patients with IPF and other ILDs. Risk factors for disease progression were evaluated in a multivariable logistic regression model. Results: Disease progression was revealed in 52% of the patients with ILD, 51% of the patients with IPF, and 53% of the patients with other types of ILD. A high extent of reticulation on HRCT (Odds ratio [OR] 3.11, 95% Confidence interval [CI] 1.21–7.98, P = 0.019) and never smoking (OR 3.11, CI 1.12–8.63, P = 0.029) were associated with disease progression whereas platelet count (OR 2.06 per 100 units increase, CI 0.96–4.45, P = 0.065) did not quite reach statistical significance. Conclusion: Higher extent of reticulation on HRCT and never smoking appeared to associate with the risk of disease progression within 24 months in ILD patients without honeycombing. Approximately half of the patients with ILD revealed disease progression, and similar proportions were observed in patients with IPF and in other types of ILD.publishedVersionPeer reviewe