Potilasohjaus suun terveydenhuollossa : apuna erillinen potilaan ohjaustila

Opinnäytetyön tarkoituksena oli selvittää tutkitun tiedon avulla, millaista on suuhygienistin toteuttama potilasohjaus ja millainen on hyvä potilaan ohjaustila suun terveydenhuollossa. Tavoitteena on kehittää potilasohjausta ohjaustilaa hyödyntäen ja korostaen omahoidon ohjauksen tärkeyttä sekä yksilö- että väestötasolla. Työ toteutettiin kirjallisuuskatsauksena ja aineisto analysoitiin induktiivisen sisällönanalyysin avulla. Tutkimustulokset osoittavat, että suuhygienistillä on merkittävä rooli hammassairauksien varhaisdiagnostiikassa ja ehkäisyssä. Suuhygienistin tulee tarjota potilasohjausta, joka kannustaa potilaita ottamaan aktiivisen roolin sairauksien ehkäisyssä ja oman suuhygienian ylläpidossa. Ohjauksella voidaan vaikuttaa potilaan asennoitumiseen ja potilaan hoitoon sitoutumiseen. Tulosten mukaan ohjauksen kulmakivi on potilaslähtöisyys: jokainen potilas tulee kohdata yksilönä ja huomioida kokonaisvaltaisesti. Hoitohenkilöstö ja potilaat mainitsivat potilasohjauksen kehittämiskohteiksi ohjaustilat, henkilöstöresurssit, ohjaukseen käytettävän ajan sekä ohjausmateriaalin ja -välineet. Lisäksi erilaisia ohjausmenetelmiä tulisi käyttää nykyistä enemmän. Suuhygienistin työssä erityisesti työnkuvan laajuus ja monet erilaiset työtehtävät potilashoidon ohella rajoitti eettisen ohjauksen toteuttamista. Myös ympäristön puitteet vaikuttivat potilasohjauksen toteuttamiseen. Yksityisyys ja meluttomuus nostettiin esille tärkeimpinä potilastyytyväisyyteen vaikuttavina seikkoina. Tulokset osoittavat, että ympäristön laadun vaikutus potilaan tyytyväisyyteen oli merkittävä. Fyysisen hoitoympäristön todettiin vaikuttavan potilaiden käytökseen, tunteisiin, ajatuksiin ja hyvinvointiin monin eri tavoin. Opinnäytetyön tuloksia voidaan hyödyntää tulevaisuudessa; potilasohjauksen ollessa keskeinen osa hoitoprosessia, tulee sille antaa nykyistä suurempi painoarvo uusia suun terveydenhuollon tiloja suunniteltaessa. Opinnäytetyöllä halutaan korostaa ympäristön merkitystä potilasohjauksessa. Suomessa ei ole juurikaan tehty ohjausympäristöä koskevia tutkimuksia. Aihetta olisi tärkeä tutkia enemmän, jotta potilasohjausta ja ohjaustiloja voidaan kehittää.The aim of the thesis was to produce new knowledge about the quality of the patient education performed by the dental hygienist and to find out, which environmental elements could improve the quality of the patient's guidance room in oral health care. The aim of this thesis was to develop patient guidance by utilizing the guidance room and emphasizing the importance of self-care at both the individual and the population level. The research strategy used was a literature review. The results were analyzed with the inductive content analysis. The results show that dental hygienists play an important role in early diagnosis and prevention of dental diseases. Dental hygienists should provide patient education that encourages patients to take an active role in preventing illness and maintaining their own oral hygiene. Patient education can influence the patient's attitude and adherence. According to the results, the cornerstone of guidance is patient centeredness: each patient has to be faced individually and compherensively. Guidance rooms, human resources, time used for guidance, guidance material and equipment were mentioned as development targets by both nursing staff and patients. In addition, different control methods should be used more in the future. Dental hygienists have extensive job description and many different tasks besides the patient care. These additional tasks can limit the implementation of ethical values and quality of patient education. According to the results, the environment also had an influence in the implementation of high quality patient guidance. Privacy and noiseless environment were mentioned as the most important aspects of patient satisfaction. The results show that the impact of environmental quality on patient satisfaction was significant. Physical environment was found to affect the behavior, feelings, thoughts and well-being of patients in many different ways. The results of the thesis can be used in the future; patient guidance is a key part of the treatment process so it should be paid more attention to. The thesis aims to emphasize the importance of the environment in patient guidance. There are only few Finnish studies concerning the health care environments. Additional researches aimed at this subject should be conducted so that patient guidance and guidance rooms can be developed

The majority of type 2 diabetic patients in Finnish primary care are at very high risk of cardiovascular events : A cross-sectional chart review study (STONE HF)

Publisher Copyright: © 2021 The AuthorsAims: To characterize clinical profiles, prevalence of chronic kidney disease (CKD), and treatment patterns in type 2 diabetes (T2D) and heart failure (HF) patients in Finnish primary care. Methods: A total of 1385 patients (1196 with T2D, 50 with HF, and 139 with T2D and HF) in 60 Finnish primary care centers were recruited to this cross-sectional study. Data on demographic and clinical characteristics, laboratory measurements, and medications were collected retrospectively from medical records. T2D patients were classified according to their risk of cardiovascular (CV) events as very high-risk (62%) and other patients (38%). Results: Of the T2D patients, 10% (139/1335) had a diagnosis of HF and 42% (457/1090) had stage 3–5 CKD and/or albuminuria based on laboratory measurement. Of the HF patients, 74% (139/189) had T2D and 78% (114/146) had stage 3–5 CKD and/or albuminuria. Metformin was the most frequently used medication in both very high-risk patients (74%) and other patients (86%). SGLT2 inhibitors and/or GLP-1 analogues were used by 37% of very high-risk patients compared to 42% in other patients. Conclusions: The majority of T2D patients in Finnish primary care are at very high risk of cardiovascular events. However, the implementation of treatments with proven cardioprotective effects in very high-risk patients is currently suboptimal.Peer reviewe

The majority of type 2 diabetic patients in Finnish primary care are at very high risk of cardiovascular events: A cross-sectional chart review study (STONE HF).

AimsTo characterize clinical profiles, prevalence of chronic kidney disease (CKD), and treatment patterns in type 2 diabetes (T2D) and heart failure (HF) patients in Finnish primary care.MethodsA total of 1385 patients (1196 with T2D, 50 with HF, and 139 with T2D and HF) in 60 Finnish primary care centers were recruited to this cross-sectional study. Data on demographic and clinical characteristics, laboratory measurements, and medications were collected retrospectively from medical records. T2D patients were classified according to their risk of cardiovascular (CV) events as very high-risk (62%) and other patients (38%).ResultsOf the T2D patients, 10% (139/1335) had a diagnosis of HF and 42% (457/1090) had stage 3-5 CKD and/or albuminuria based on laboratory measurement. Of the HF patients, 74% (139/189) had T2D and 78% (114/146) had stage 3-5 CKD and/or albuminuria. Metformin was the most frequently used medication in both very high-risk patients (74%) and other patients (86%). SGLT2 inhibitors and/or GLP-1 analogues were used by 37% of very high-risk patients compared to 42% in other patients.ConclusionsThe majority of T2D patients in Finnish primary care are at very high risk of cardiovascular events. However, the implementation of treatments with proven cardioprotective effects in very high-risk patients is currently suboptimal.</p

Quo Vadis Architectura? 7. Mixing the Private and the Public in the City

In this book, experts from different fields discuss the changing boundaries between private and public city life, both from historical as well as contemporary perspectives. The publication is based on the 13th Quo Vadis Architectura? Nils Erik Wickberg Lectures, held at Aalto University in 2017. The seminar was organized by the chairs of History of Architecture, Housing and Urban and Regional Planning

Raskausdiabeteksen hoidon kulmakivet : opas raskausdiabeteksen ennaltaehkäisystä ja hoidosta Liperin terveysneuvontaan

Tämän toiminnallisena kehittämistyönä tehdyn opinnäytetyön tarkoituksena oli tuottaa opas raskaana oleville naisille, jotka ovat saaneet raskausdiabetesdiagnoosin tai joilla on riski saada raskausdiabetes. Opinnäytetyön tavoitteena on edistää odottavan äidin ja sikiön terveyttä, ehkäistä raskausdiabeteksesta johtuvien haittojen riskejä ja motivoida äitiä pitämään raskausdiabetes hoitotasapainossa. Opinnäytetyön toimeksiantajana oli Liperin terveysneuvonta. Opinnäytetyöhön haettiin näyttöön perustuvaa tietoa raskausdiabeteksesta ja oppaan tekemisestä. Tiedonhakuun käytettiin kirjallisuuskatsausta ja sähköisiä tietokantoja. Opinnäytetyö sisältää tietoa raskausdiabeteksesta, sen seulomisesta, diagnosoinnista ja seurannasta, raskausdiabeteksen lyhyt- ja pitkäaikaisvaikutuksista, raskausdiabeteksen hoidosta sekä hoidon ohjauksesta. Tiedon pohjalta suunniteltiin ja toteutettiin kirjallinen opas. Oppaan ensimmäinen versio oli Liperin terveysneuvonnassa arvioitavana, jossa terveydenhoitajat ja äidit antoivat palautetta tätä varten laaditulla palautelomakkeella. Palautteiden perusteella opasta muokattiin lopulliseen versioon. Oppaasta muodostui tiivis ja monipuolinen A5-kokoinen lehtinen, joka sisälsi tietoa raskausdiabeteksen hoidosta ja ennaltaehkäisystä. Opas vastasi toimeksiantajan tarpeisiin. Liperin neuvolassa työntekijät, jotka antavat raskausdiabeteksen hoidon ja ennaltaehkäisyn ohjausta, voivat käyttää opasta ohjauksen tukena ja antaa oppaan ohjaustilanteessa asiakkaalle. Oppaan avulla voidaan myös yhtenäistää Liperin neuvolan alueella annettavaa raskausdiabetesohjausta. Liperin terveysneuvonnan on lupa päivittää oppaan tietoja ajankohtaisiksi. Jatkossa oppaan käyttöä voidaan laajentaa ja jakaa sitä muuallakin Suomen neuvoloissa. Opinnäytetyön jatkotutkimusaiheena voisi tutkia asiakkaiden kokemuksia oppaan käytöstä ja oppaan avulla saamastaan ohjauksesta.This thesis was made as a functional development work the aim of which was to design a brochure for pregnant women who are at the risk of developing gestational diabetes or diagnosed gestational diabetes. The aim of this thesis is to promote the health of an expecting mother and the fetus, prevent the risks of gestational diabetes and to motivate the mother to keep her blood glucose normal. The client organisation of this thesis was Municipality of Liperi. The thesis was made with evidence-based studies about gestational diabetes and how to design the brochure. Information retrieval was carried out by using a review of the literature and electronic databases. The thesis in- cludes information about gestational diabetes, screening, diagnosis and follow-up during the pregnancy and short- term and long-term effects, treatment and guidance. Based on these pieces of informations, the brochure was designed and produced. The first version of the brochure was reviewed in Liperi health care unit, and health care nurses and mothers gave feedback on the brochure with the special feedback form which was made to this use. Based on the feedback the brochure was edited to this final form. The brochure is a compact and versatile A5-sized booklet that contains information about the treatment and the prevention of gestational diabetes. The brochure matches the client’s needs. Workers of the maternity clinic in Liperi can use the brochure as a sup- port in their guidance of the treatment and the prevention of gestational diabetes and give the brochure to the mother after that. The brochure of gestational diabetes can be used to unify the guidance in Liperi maternity clin- ics. Maternity clinics are authorized to update the information to be more relevant. The use of the brochure can be expanded and it can be shared in other maternity clinics in Finland in the future. Further studies of this thesis could be customers’ experiences of using the brochure and the guidance they had with the use of the brochure

Väinö Vähäkallio and His Office – an Architect's Life Work and Networks

Väinö Vähäkallio (1886-1959) was one of Finland's most prolific and recognized architects of the 1920s and 1930s. Of his realized projects, a full 150 remain. This monograph is based primarily on an analysis of Vähäkallio's buildings themselves and the various documents pertaining to them. The central questions of the study are the fundamental questions about modernity and modernization in Finland. The study asks: In what way did Vähäkallio's commissions reflect the modernization of Finnish society itself? Was there something modern about his professionalism even if his artistic work was not in the avant-garde? These questions are answered through an analysis of the architect's professional image, his networks and his artistic production. The study aims to expand the notion of the architect's role and style by examining his designs for several building types, especially from the 1920s and 1930s. The modernization of Finnish society provided Vähäkallio with his most important professional opportunities in education, business, industry, and the increasingly important area of leisure. Many factors made Vähäkallio a successful architect: good networks, responsiveness to the changing tastes of different types of clients, a sensitivity to fashion, his rational designs and his expertise in new building technologies. Despite his importance Vähäkallio has been ignored in the histories of modern Finnish architecture. When "pure functionalism" was taken up as the modernist ideal from the 1950s Vähäkallio's stylistic diversity became a liability.reviewe

Patruunoiden ja arkkitehdin yhteistyössä syntyivät metsäteollisuuden yhdyskunnat

Väitöskirja-arvio teoksesta Johanna Björkman, Metsäteollisuuden jälki ark- kitehtuurissa. Arkkitehti W.G. Palmqvistin ja yhtiöiden yhteistyö tehdasyhdyskunnissa 1920- ja 1930-luvulla (Helsingin yliopisto, 2019), 233 s