Distinct age-related patterns of overweight development to guide school healthcare interventions

Aim We aimed to identify groups of primary school children with similar overweight development, reveal age-related patterns of overweight development in the resulting groups and analyse overweight-related school healthcare interventions. Methods This retrospective longitudinal register study utilised electronic health records from six primary school years. From a random sample of 2000 sixth graders, we derived a study cohort of 508 children meeting criteria for overweight at least once during primary school. We investigated how many different groups (latent classes) of children with similar weight development would emerge by applying flexible latent class mixed models on body mass index standard deviation score. We also explored the resulting groups with respect to offered overweight-related interventions. Results Per child, the data consisted in median 7 growth measurements over 5.4 years. We identified five overweight development groups for girls and four for boys. The groups converged temporarily around age 10 after which only some continued into obesity. School nurses and physicians offered overweight-related interventions to children with obesity, less to children gaining weight or with overweight. Conclusion Obesity prevention might benefit from awareness of typical overweight development patterns when designing intervention studies or planning and timing multidisciplinary school health check programmes.Peer reviewe

Usability Factors Associated With Physicians' Distress and Information System-Related Stress: Cross-Sectional Survey

BACKGROUND: Constantly changing and difficult-to-use information systems have arisen as a significant source of stress in physicians' work. Physicians have reported several usability problems, system failures, and a lack of integration between the systems and have experienced that systems poorly support the documentation and retrieval of patient data. This stress has kept rising in the 21st century, and it seems that it may also affect physicians' well-being. OBJECTIVE: This study aimed to examine the associations of (1) usability variables (perceived benefits, technical problems, support for feedback, and user-friendliness), (2) the number of systems in daily use, (3) experience of using information systems, and (4) participation in information systems development work with physicians' distress and levels of stress related to information systems (SRIS) levels. METHODS: A cross-sectional survey was conducted among 4018 Finnish physicians (64.82%, 2572 out of 3968 women) aged between 24 and 64 years (mean 46.8 years) in 2017. The analyses of covariance were used to examine the association of independent variables with SRIS and distress (using the General Health Questionnaire) adjusted for age, gender, employment sector, specialization status, and the electronic health record system in use. RESULTS: High levels of technical problems and a high number of systems in daily use were associated with high levels of SRIS, whereas high levels of user-friendliness, perceived benefits, and support for feedback were associated with low levels of SRIS. Moreover, high levels of technical problems were associated with high levels of psychological distress, whereas high levels of user-friendliness were associated with low distress levels. Those who considered themselves experienced users of information systems had low levels of both SRIS and distress. CONCLUSIONS: It seems that by investing in user-friendly systems with better technical quality and good support for feedback that professionals perceive as being beneficial would improve the work-related well-being and overall well-being of physicians. Moreover, improving physicians' skills related to information systems by giving them training could help to lessen the stress that results from poorly functioning information systems and improve physicians' well-being.Peer reviewe

Tietojärjestelmät ja työhyvinvointi – terveydenhuollon ammattilaisten näkemyksiä

Usability of clinical information and communication technology (ICT) systems is essential for professionals working in labour-intensive health care. We examined healthcare professionals’ experiences of ICT and their stressfulness and associations on well-being at work. We performed focus group interviews, and analysed data with content analysis. Technical problems, such as downtime and slowness, multiple sign-in required for multiple systems, and the use of several systems simultaneously, caused stress. In the inter-organizational co-operation, the lack of electronic patient information slowed down work. Incomplete documentation of medication caused stress for professionals and concern for patient safety. Lack of time for documentation was reported, and the professionals attempted to record patient data either briefly or at the end of the workshift. The interruptions and the need to use multiple views while recording patient data, were considered disruptive. The professionals hoped that functionalities between programs were improved in order to save time from recording. Overall, however, recording was not considered to be the major stress factor for the work. The burden of patient work or occasional excessive workload was the priority for many employees. Approaching work related wellbeing connected in some respects gaps in the ICT knowledge. Healthcare professionals reflected that their potential for feedback from ICT was limited. In order to ensure the smoothness of work-processes (efficiency and quality) the well-being of healthcare professionals should be focused on. The toolkit for promoting the ICT-related well-being of healthcare professionals should include: improving the stability of information systems, developing single sign-on, developing usability of documentation and retrieval of patient data, providing a peaceful documentation environment, and improving access to comprehensive and timely patient data from other organizations. Feedback from professionals should be reflected in the development of ICTs, and ICT skills should be systematically developed in organizations.Potilastietojärjestelmien toimivuus on terveydenhuollon ammattilaisten työn sujuvuuden kannalta tärkeää. Tutkimme fokusryhmähaastattelujen avulla ammattilaisten työprosesseja, tietojärjestelmien käyttökokemuksia ja stressaavuutta, sekä niiden vaikutuksia työhyvinvointiin. Haastattelujen analyysi toteutettiin käyttäen sisällön analyysiä. Tekniset ongelmat kuten käyttökatkokset ja hitaus, moniin järjestelmiin vaadittava kirjautuminen ja monien järjestelmien yhtäaikaiskäyttö aiheuttivat terveydenhuollon ammattilaisille stressiä. Organisaatioiden välistä yhteistyötä hidasti sähköisen potilastiedon puuttuminen. Puutteelliset lääkitysmerkinnät aiheuttivat stressiä työntekijöille sekä huolen potilasturvallisuudesta. Potilastiedon kirjaamiseen ei aina tuntunut riittävän aikaa, jolloin yritettiin kirjata lyhyesti tai työvuoron päätteeksi. Työn keskeytysten ja eri näkymien välillä hyppelyn koettiin häiritsevän kirjaamista. Ohjelmien välisiä toiminnallisuuksia toivottiin lisää, jotta kirjaamiseen käytetty aika vähenisi ja kertakirjaaminen riittäisi. Kokonaisuudessaan tietojärjestelmiä ja niihin kirjaamista ei kuitenkaan pidetty työn suurimpana stressitekijänä, vaan potilastyöstä tai ajoittaisesta työryppäästä aiheutuva rasitus oli monen työntekijän kohdalla ensisijaista. Erääksi työhyvinvoinnin parantamismahdollisuudeksi nimettiin koulutus, joka antaisi valmiuksia muuttuvaan digityöhön. Terveydenhuollon ammattilaiset kokivat, että palautteen antamisen mahdollisuudet tietojärjestelmistä olivat vähäiset. Työn sujuvuuden (tehokkuuden ja laadun) ja alan houkuttelevuuden kannalta olisi keskeistä, että terveydenhuollon työntekijöiden työhyvinvoinnista huolehdittaisiin poistamalla tunnistettuja stressitekijöitä: parantamalla tietojärjestelmien vakautta, kehittämällä kertakirjautumista sekä tiedonhaun ja kirjaamisen käytettävyyttä, tarjoamalla kirjaamiseen rauhallinen työympäristö ja parantamalla luotettavan, kattavan ja ajantasaisen tiedon saatavuutta muista organisaatioista. Ammattilaisten antaman palautteen tulisi näkyä järjestelmien kehittämisessä, ja järjestelmien käyttötaitoa ja digityötapoja pitäisi kehittää organisaatioissa systemaattisesti. Jatkotutkimuksissa on tarpeen seurata terveydenhuollon ammattilaisten kokemuksia organisaatioiden välisen tiedonkulun kehittymisestä

Tiedon käyttö palvelujärjestelmän arvioinnissa : THL:n arviointitoiminto ja Tietoikkuna

Työpaperissa tarkastellaan THL:n sote-arviointiyksikössä tehtävää palvelujärjestelmän arviointitoimintaa ja sen indikaattoreista muodostuvaa tietopohjaa. Lisäksi tarkastellaan verkkopalvelu Tietoikkunaa, joka tukee tietopohjan ajantasaisuutta, avoimuutta ja hyödynnettävyyttä

Usability Factors Associated With Physicians' Distress and Information System-Related Stress: Cross-Sectional Survey

Background: Constantly changing and difficult-to-use information systems have arisen as a significant source of stress in physicians' work. Physicians have reported several usability problems, system failures, and a lack of integration between the systems and have experienced that systems poorly support the documentation and retrieval of patient data. This stress has kept rising in the 21st century, and it seems that it may also affect physicians' well-being.Objective: This study aimed to examine the associations of (1) usability variables (perceived benefits, technical problems, support for feedback, and user-friendliness), (2) the number of systems in daily use, (3) experience of using information systems, and (4) participation in information systems development work with physicians' distress and levels of stress related to information systems (SRIS) levels.Methods: A cross-sectional survey was conducted among 4018 Finnish physicians (64.82%, 2572 out of 3968 women) aged between 24 and 64 years (mean 46.8 years) in 2017. The analyses of covariance were used to examine the association of independent variables with SRIS and distress (using the General Health Questionnaire) adjusted for age, gender, employment sector, specialization status, and the electronic health record system in use.Results: High levels of technical problems and a high number of systems in daily use were associated with high levels of SRIS, whereas high levels of user-friendliness, perceived benefits, and support for feedback were associated with low levels of SRIS. Moreover, high levels of technical problems were associated with high levels of psychological distress, whereas high levels of user-friendliness were associated with low distress levels. Those who considered themselves experienced users of information systems had low levels of both SRIS and distress.Conclusions: It seems that by investing in user-friendly systems with better technical quality and good support for feedback that professionals perceive as being beneficial would improve the work-related well-being and overall well-being of physicians. Moreover, improving physicians' skills related to information systems by giving them training could help to lessen the stress that results from poorly functioning information systems and improve physicians' well-being

Dyslipidemiat : KÄYPÄ HOITO -SUOSITUS (Päivitystiivistelmä)

Käypä hoito -suositus. Päivitystiivistelm

ARCH 14 - International Conference on Research on Health Care Architecture - November 19-21, 2014, Espoo, Finland - Conference Proceedings

Healthcare Architecture has grown rapidly in recent years. However, there are still many questions remaining. The commission, therefore, is to share the existing research knowledge and latest results and to carry out research projects focusing more specifically on the health care situation in a variety of contexts. The ARCH14 conference was the third conference in the series of ARCH conferences on Research on Health Care Architecture initiated by Chalmers University. It was realized in collaboration with the Nordic Research Network for Healthcare Architecture .It was a joint event between Aalto University, Finnish Institute of Occupational Health (FIOH) and National Institute of Health and Welfare (THL International).The conference gathered together more than 70 researchers and practitioners from across disciplines and countries to discuss the current themes