Leikkaukseen kotoa: potilaiden tyytyväisyys LEIKO-toimintaan

Tutkimuksen tarkoituksena oli selvittää leikkaukseen kotoa tulevien potilaiden tyytyväisyyttä LEIKO-toimintaan Vaasan keskussairaalan preoperatiivisella poliklinikalla. Tutkimuksessa selvitettiin myös miten hyvin potilasturvallisuus toteutui LEIKO-toiminnassa. Tutkimuksen tavoitteena oli, että tämän opinnäytetyön ja tutkimuksen tuloksien perusteella voidaan LEIKO-toimintaa kehittää edelleen potilaslähtöisemmäksi toiminnaksi. Tutkimuksen teoreettisessa osassa käsitellään leikkaukseen kotoa -toimintaa, potilasturvallisuutta ja potilastyytyväisyyttä. Tutkimuksen kohderyhmänä oli Vaasan keskussairaalan preoperatiivisen poliklinikan potilaat. Tämän tutkimuksen tutkimusaineisto koostui (n=71) potilaan potilaspalautekyselyiden vastauksista, jotka oli kerätty kahden viikon aikana toukokuussa 2011 preoperatiivisella poliklinikalla Vaasan keskussairaalan omilla potilaspalautelomakkeilla. Tutkimuksessa käytetty aineisto saatiin Vaasan keskussairaalan preoperatiiviselta poliklinikalta, joka on myös tutkimusaineiston kerännyt. Tutkimus on toteutettu kvantitatiivisesti ja tutkimusaineiston analysointi on tehty tilastollisin menetelmin. Tutkimustulosten mukaan voidaan todeta potilaiden olevan hyvin tyytyväisiä LEIKO-toimintaan. Potilaat ovat olleet tyytyväisiä hyvään kohteluun, tiedotukseen, hienotunteiseen asioiden käsittelyyn, palvelun saamiseen omalla äidinkielellään sekä asiantuntevaan henkilökuntaan. Kehitettävää toiminnassa on vaikuttamismahdollisuudessa käyntiajankohtaan ja aikataulun mahdollisesta viivästymisestä tiedottamisessa. Potilasturvallisuus toteutui LEIKO-toiminnassa hyvin. Potilasturvallisuuteen vaikuttavana tekijänä tutkimuksessa arvioitiin potilaan saamaa tiedotusta. Kokonaisuudessaan tiedotus toteutui hyvin, mutta kehitettävää on etenkin lääkkeistä ja niiden vaikutuksista tiedottamisessa.The purpose of this study was to find out how satisfied patients are with From Home To Operation activities in Vaasa Central Hospital preoperative clinic. A further aim was to find out how well patient safety was implemented in FHTO-activities. The aim of the study was that this thesis and the research results can be used to further develop the patient-centered approach in FHTO-activities. The theoretical part of the bachelor's thesis deals with From Home To Operation activities, patient safety and patient satisfaction. The target group included the patients of the preoperative clinic in Vaasa Central Hospital. The study data consisted of (n=71) responses to patient feedback survey. They were collected during two weeks in May 2011 in the preoperative clinic at Vaasa Central Hospital. The hospital's own patient feedback survey was used. The data used in the study came from the Vaasa Central Hospital preoperative clinic, which also had collected the data. The study is quantitative and the research data has been analysed using statistical methods. The study results showed that the patients can be said to be very content with FHTO-activities. The patients were content with good treatment, the flow of information, the sensitive approach, with receiving service in their mother tongue as well as with a professional staff. Development suggestions were related to the patient's possibilities to influence the time and date of the appointment and to giving information about delays in the schedule. Patient safety was implemented well in FHTO-activities. A factor affecting the patient safety was the information received by the patient. The flow of information as a whole was on a good level, but improvement is needed especially with medicines and giving information about the effects of the medicines

Comparison of heart rate monitoring accuracy between chest strap and vest during physical training and implications on training decisions

Heart rate (HR) and heart rate variability (HRV) based physiological metrics such as Excess Post‐exercise Oxygen Consumption (EPOC), Energy Expenditure (EE), and Training Impulse (TRIMP) are widely utilized in coaching to monitor and optimize an athlete’s training load. Chest straps, and re-cently also dry electrodes integrated to special sports vests, are used to monitor HR during sports. Mechanical design, placement of electrodes, and ergonomics of the sensor affect the measured signal quality and artefacts. To evaluate the impact of the sensor mechanical design on the accuracy of the HR/HRV and further on to estimation of EPOC, EE, and TRIMP, we recorded HR and HRV from a chest strap and a vest with the same ECG sensor during supervised exercise protocol. A 3‐lead clinical Holter ECG was used as a reference. Twenty‐five healthy subjects (six females) participated. Mean absolute percentage error (MAPE) for HR was 0.76% with chest strap and 3.32% with vest. MAPE was 1.70% vs. 6.73% for EE, 0.38% vs. 8.99% for TRIMP and 3.90% vs. 54.15% for EPOC with chest strap and vest, respectively. Results suggest superior accuracy of chest strap over vest for HR and physiological metrics monitoring during sports.publishedVersionPeer reviewe

Acute Effect of Alcohol Intake on Cardiovascular Autonomic Regulation During the First Hours of Sleep in a Large Real-World Sample of Finnish Employees : Observational Study

Background: Sleep is fundamental for good health, and poor sleep has been associated with negative health outcomes. Alcohol consumption is a universal health behavior associated with poor sleep. In controlled laboratory studies, alcohol intake has been shown to alter physiology and disturb sleep homeostasis and architecture. The association between acute alcohol intake and physiological changes has not yet been studied in noncontrolled real-world settings. Objective: The aim of this study was to assess the effects of alcohol intake on the autonomic nervous system (ANS) during sleep in a large noncontrolled sample of Finnish employees. Methods: From a larger cohort, this study included 4098 subjects (55.81%, 2287/4098 females; mean age 45.1 years) who had continuous beat-to-beat R-R interval recordings of good quality for at least 1 day with and for at least 1 day without alcohol intake. The participants underwent continuous beat-to-beat R-R interval recording during their normal everyday life and self-reported their alcohol intake as doses for each day. Heart rate (HR), HR variability (HRV), and HRV-derived indices of physiological state from the first 3 hours of sleep were used as outcomes. Within-subject analyses were conducted in a repeated measures manner by studying the differences in the outcomes between each participant’s days with and without alcohol intake. For repeated measures two-way analysis of variance, the participants were divided into three groups: low (≤0.25 g/kg), moderate (>0.25-0.75 g/kg), and high (>0.75 g/kg) intake of pure alcohol. Moreover, linear models studied the differences in outcomes with respect to the amount of alcohol intake and the participant’s background parameters (age; gender; body mass index, BMI; physical activity, PA; and baseline sleep HR). Results: Alcohol intake was dose-dependently associated with increased sympathetic regulation, decreased parasympathetic regulation, and insufficient recovery. In addition to moderate and high alcohol doses, the intraindividual effects of alcohol intake on the ANS regulation were observed also with low alcohol intake (all P<.001). For example, HRV-derived physiological recovery state decreased on average by 9.3, 24.0, and 39.2 percentage units with low, moderate, and high alcohol intake, respectively. The effects of alcohol in suppressing recovery were similar for both genders and for physically active and sedentary subjects but stronger among young than older subjects and for participants with lower baseline sleep HR than with higher baseline sleep HR. Conclusions: Alcohol intake disturbs cardiovascular relaxation during sleep in a dose-dependent manner in both genders. Regular PA or young age do not protect from these effects of alcohol. In health promotion, wearable HR monitoring and HRV-based analysis of recovery might be used to demonstrate the effects of alcohol on sleep on an individual level.peerReviewe

Physical activity, body mass index and heart rate variability-based stress and recovery in 16 275 Finnish employees : a cross-sectional study

Background: Physical inactivity, overweight, and work-related stress are major concerns today. Psychological stress causes physiological responses such as reduced heart rate variability (HRV), owing to attenuated parasympathetic and/or increased sympathetic activity in cardiac autonomic control. This study’s purpose was to investigate the relationships between physical activity (PA), body mass index (BMI), and HRV-based stress and recovery on workdays, among Finnish employees. Methods: The participants in this cross-sectional study were 16 275 individuals (6863 men and 9412 women; age 18–65 years; BMI 18.5–40.0 kg/m2 ). Assessments of stress, recovery and PA were based on HRV data from beat-to-beat R-R interval recording (mainly over 3 days). The validated HRV-derived variables took into account the dynamics and individuality of HRV. Stress percentage (the proportion of stress reactions, workday and working hours), and stress balance (ratio between recovery and stress reactions, sleep) describe the amount of physiological stress and recovery, respectively. Variables describing the intensity (i.e. magnitude of recognized reactions) of physiological stress and recovery were stress index (workday) and recovery index (sleep), respectively. Moderate to vigorous PA was measured and participants divided into the following groups, based on calculated weekly PA: inactive (0 min), low (0 < 150 min), medium (150–300 min), and high (>300 min). BMI was calculated from self-reported weight and height. Linear models were employed in the main analyses. Results: High PA was associated with lower stress percentages (during workdays and working hours) and stress balance. Higher BMI was associated with higher stress index, and lower stress balance and recovery index. These results were similar for men and women (P < 0.001 for all). Conclusion: Independent of age and sex, high PA was associated with a lower amount of stress on workdays. Additionally, lower BMI was associated with better recovery during sleep, expressed by a greater amount and magnitude of recovery reactions, which suggests that PA in the long term resulting in improved fitness has a positive effect on recovery, even though high PA may disturb recovery during the following night. Obviously, several factors outside of the study could also affect HRV-based stress.peerReviewe