Sosionomin osaaminen varhaiskasvatuksessa : esite varhaiskasvatuksen työntekijöille

Opinnäytetyömme tavoitteena oli tehdä sosionomin (AMK) osaamista ja vahvuuksia varhaiskasvatuksessa tunnetummaksi. Selvennämme sosionomin koulutustaustaa, kelpoisuutta toimia lastentarhanopettajan tehtävissä sekä kompetenssialueita ja varhaiskasvatuksen osaamista. Sosionomin koulutus on laaja-alainen ja antaa valmiuksia moneen eri sosiaalialan työhön, joten haluamme kuvata sosionomien valmiuksia toimia varhaiskasvatuksen työkentällä. Kyseessä on monimuotoinen opinnäytetyö, joka sisältää kirjallisen osuuden lisäksi esitteen sosionomin osaamisesta varhaiskasvatuksessa. Esite on suunnattu pääasiassa päiväkotien johtajille, mutta se on hyödyllinen kaikille päivähoidossa työskenteleville. Siinä kerrotaan sosionomin osaamisesta sosionomin koulutusta ja vahvuuksia käsittelevän kirjallisuuden kautta. Esite on hyödyksi päiväkodin johtajille, sillä näin sosionomikoulutuksen sisältö tulee tutummaksi ja he voivat hyödyntää sosionomin vahvuuksia paremmin. Taustatiedon kartoittamiseksi ja työelämän tarpeiden selville saamiseksi haastattelimme kahta päiväkodin johtajaa, jotka toimivat johtotehtävissä. Toteutimme haastattelun parihaastatteluna. Selvitimme johtajien näkemyksiä siitä, mitä tietoa he tarvitsevat sosionomin vahvuuksista päivähoidossa. Lopullinen tuotos esitteestä tallennettiin sähköiseen muotoon, jotta sitä voidaan päivittää ja muokata sekä levittää varhaiskasvatuksen työkentällä.The aim of this study was to make the strengths and competence of Bachelors of Social Services in early childhood education more well-known. The purpose was to investigate Bachelors’ of Social Services educational background, qualification to work as a kindergarten teacher, competence areas and knowledge of early childhood education. The education and degree of Bachelors of Social Services is wide-ranging, and it gives skills to work in several fields of Social Services; therefore we wanted to emphasize the Bachelors’ of Social Services skills to work in early childhood education. Our study was a practice-based thesis. In addition to the theoretical background this study included a brochure of Bachelors’ of Social Services competences in early childhood education. The brochure is primarily directed to kindergarten managers but it is also useful to all employees in daycare. It explains the competences of Bachelors of Social Services through literature which deals with the education and strengths of Bachelors of Social Services. The brochure is useful to kindergarten managers and working life so that they can become more familiar with the education of Bachelors of Social Services and can better utilize the strengths of Bachelors of Social Services. In order to get background information and find out the needs of working life we interviewed two kindergarten managers. We performed the interview as a pair interview and our purpose was to find out the kindergarten managers’ point of view about what kind of information they needed of Bachelors’ of Social Services knowledge in daycare. The final version of the brochure was saved in an electronic form so that it can be updated and modified later and it can be spread in the field of early childhood education

KINDL-R: Lasten ja nuorten terveyteen liittyvää elämänlaatua arvioiva geneerinen mittari

KINDL-R on alle 18-vuotiaiden lasten terveyteen liittyvää elämänlaatua arvioiva geneerinen mittari. Tämän katsauksen tarkoituksena oli arvioida KINDL-R-mittarin geneerisen osan validiteettia, reliabiliteettia ja käyttökelpoisuutta. Kirjallisuushaku tehtiin PubMed- ja CINAHL-tietokannoista (N = 133). Mittarin ominaisuuksia arvioitiin COSMIN-taksonomian mukaisesti aineiston 17 väestötutkimuksesta. KINDL-R-mittarissa on lapsille ja heidän vanhemmilleen omat erilliset lomakkeet, joiden tuloksista voidaan laskea lapsen terveyteen liittyvän elämänlaadun kokonaisarvio. Reliabiliteetti, validiteetti ja käyttökelpoisuus todettiin hyväksi 8–17-vuotiaiden lomakkeissa. Alle 8-vuotiaiden lomakkeista ei ole saatavilla tutkimustuloksia. KINDL-R-mittarin avulla voidaan saada kokonaisvaltainen käsitys lapsen hyvinvoinnista. Sitä voitaneen käyttää myös tuen tarpeen tunnistamiseen ja interventioiden kohdentamiseen. Mittarin soveltuvuudesta Suomessa terveydenhuollon käyttöön ja alle 8-vuotiaille tarvitaan lisätutkimusta

Psychosocial resources related to survival among non-robust community-dwelling older people : an 18-year follow-up study

Purpose Psychosocial resources have been considered to be associated with survival among frail older adults but the evidence is scarce. The aim was to investigate whether psychosocial resources are related to survival among non-robust community-dwelling older people. Methods This is a prospective study with 10- and 18-year follow-ups. Participants were 909 non-robust (according to Rockwood's Frailty Index) older community-dwellers in Finland. Psychosocial resources were measured with living circumstances, education, satisfaction with friendship and life, visiting other people, being visited by other people, having someone to talk to, having someone who helps, self-rated health (SRH) and hopefulness about the future. To assess the association of psychosocial resources for survival, Cox regression analyses was used. Results Visiting other people more often than once a week compared to that of less than once a week (hazard ratio 0.61 [95% confidence interval 0.44-0.85], p = 0.003 in 10-year follow-up; 0.77 [0.62-0.95], p = 0.014 in 18-year follow-up) and good SRH compared to poor SRH (0.65 [0.44-0.97], p = 0.032; 0.68 [0.52-0.90], p = 0.007, respectively) were associated with better survival in both follow-ups. Visiting other people once a week (compared to that of less than once a week) (0.77 [0.62-0.95], p = 0.014) was only associated with better 18-year survival. Conclusions Psychosocial resources, such as regularly visiting other people and good self-rated health, seem to be associated with better survival among non-robust community-dwelling Finnish older people. This underlines the importance of focusing also on psychosocial well-being of frail older subjects to remain or promote their resilience. Key summary pointsAim To investigate whether psychosocial resources are associated with survival among non-robust community-dwelling older Finnish people during an 18-year follow-up. Findings Psychosocial resources, such as good self-rated health and regularly visiting other people, were significantly associated with better survival of non-robust older people. Message It is important to focus also on psychological well-being, together with physical activity and nutrition, of frail older people to remain or promoting their capacity.Peer reviewe

Respiratory tract virus infections in the elderly with pneumonia

Background: In children suffering from severe lower airway illnesses, respiratory virus detection has given good prognostic information, but such reports in the elderly are scarce. Therefore, our aim was to study whether the detection of nasopharyngeal viral pathogens and conventional inflammatory markers in the frail elderly correlate to the presence, signs and symptoms or prognosis of radiographically-verified pneumonia. Methods: Consecutive episodes of hospital care of patients 65years and older with respiratory symptoms (N = 382) were prospectively studied as a cohort. Standard clinical questionnaire was filled by the study physician. Laboratory analyses included PCR diagnostics of nasopharyngeal swab samples for 14 respiratory viruses, C-reactive protein (CRP) and white blood cell count (WBC). Chest radiographs were systematically analysed by a study radiologist. The length of hospital stay, hospital revisit and death at ward were used as clinical endpoints. Results: Median age of the patients was 83years (range 76-90). Pneumonia was diagnosed in 112/382 (29%) of the studied episodes. One or more respiratory viruses were detected in 141/382 (37%) episodes and in 34/112 (30%) episodes also diagnosed with pneumonia. Pneumonia was associated with a WBC over 15 x 10(9)/L (P = .006) and a CRP value over 80 mg/l (P <.05). A virus was detected in 30% of pneumonia episodes and in 40% of non-pneumonia episodes, but this difference was not significant (P = 0.09). The presence of a respiratory virus was associated with fewer revisits to the hospital (P <.05), whereas a CRP value over 100 mg/l was associated with death during hospital stay (P <.05). Respiratory virus detections did not correlate to WBC or CRP values, signs and symptoms or prognosis of radiographically-verified pneumonia episodes. Conclusion: Among the elderly with respiratory symptoms, respiratory virus detection was not associated with an increased risk of pneumonia or with a more severe clinical course of the illness. CRP and WBC remain important indicators of pneumonia, and according to our findings, pneumonia should be treated as a bacterial disease regardless of the virus findings. Our data does not support routine virus diagnostics for the elderly patients with pneumonia outside the epidemic seasons.Peer reviewe

Frailty, walking ability and self-rated health in predicting institutionalization : an 18-year follow-up study among Finnish community-dwelling older people

Background In clinical practice, there is a need for an instrument to screen older people at risk of institutionalization. Aims To analyze the association of frailty, walking-ability and self-rated health (SRH) with institutionalization in Finnish community-dwelling older people. Methods In this prospective study with 10- and 18-year follow-ups, frailty was assessed using FRAIL Scale (FS) (n = 1087), Frailty Index (FI) (n = 1061) and PRISMA-7 (n = 1055). Walking ability was assessed as self-reported ability to walk 400 m (n = 1101). SRH was assessed by a question of general SRH (n = 1105). Cox regression model was used to analyze the association of the explanatory variables with institutionalization. Results The mean age of the participants was 73.0 (range 64.0-97.0) years. Prevalence of institutionalization was 40.8%. In unadjusted models, frailty was associated with a higher risk of institutionalization by FS in 10-year follow-up, and FI in both follow-ups. Associations by FI persisted after age- and gender-adjustments in both follow-ups. By PRISMA-7, frailty predicted a higher risk of institutionalization in both follow-ups. In unadjusted models, inability to walk 400 m predicted a higher risk of institutionalization in both follow-ups and after adjustments in 10-year follow-up. Poor SRH predicted a higher risk of institutionalization in unadjusted models in both follow-ups and after adjustments in 10-year follow-up. Discussion Simple self-reported items of walking ability and SRH seemed to be comparable with frailty indexes in predicting institutionalization among community-dwelling older people in 10-year follow-up. Conclusions In clinical practice, self-reported walking ability and SRH could be used to screen those at risk.Peer reviewe

Factors associated with institutionalization among home-dwelling patients of Urgent Geriatric Outpatient Clinic: a 3-year follow-up study

Purpose To examine the effect of predictive factors on institutionalization among older patients. Methods The participants were older (aged 75 years or older) home-dwelling citizens evaluated at Urgent Geriatric Outpatient Clinic (UrGeriC) for the first time between the 1st of September 2013 and the 1st of September 2014 (n = 1300). They were followed up for institutionalization for 3 years. Death was used as a competing risk in Cox regression analyses. Results The mean age of the participants was 85.1 years (standard deviation [SD] 5.5, range 75-103 years), and 74% were female. The rates of institutionalization and mortality were 29.9% and 46.1%, respectively. The mean age for institutionalization was 86.1 (SD 5.6) years. According to multivariate Cox regression analyses, the use of home care (hazard ratio 2.43, 95% confidence interval 1.80-3.27, p = 95 vs. 75-84; 1.65, 1.03-2.62, p = 0.036), and falls during the previous 12 months (>= 2 vs. no falls; 1.54, 1.10-2.16, p = 0.012) significantly predicted institutionalization during the 3-year follow-up. Conclusion Cognitive and/or functional impairment mainly predicted institutionalization among older patients of UrGeriC having health problems and acute difficulties in managing at home.Key summary pointsAim To examine the effect of predictive factors on institutionalization among home-dwelling patients of Urgent Geriatric Outpatient Clinic during a 3-year follow-up. Findings The rates of institutionalization and mortality were 29.9% and 46.1%, respectively. The use of home care, dementia, higher age and falls during the previous 12 months significantly predicted institutionalization during the follow-up. Message Cognitive and/or functional impairment mainly predicted institutionalization among older patients of UrGeriC having health problems and acute difficulties in managing at home.</div

The long-term prognostic value of serum 25(OH)D, albumin, and LL-37 levels in acute respiratory diseases among older adults

Background Older adults are more susceptible to respiratory tract infection than healthy working age adults. The increased susceptibility of older adults is thought to be interlinked with vitamin D status, nourishment, and immunological state in general. Data are scarce whether these parameters could serve as prognostic markers. Aim To study whether serum 25(OH)D, albumin, and LL-37 level could give prognostic value of long-term survival in the older adults with multimorbidity and acute respiratory infection. Methods Consecutive episodes of hospital care of patients 65 years and older with respiratory symptoms were prospectively studied as a cohort. Standard clinical questionnaire was filled by the study physician. Laboratory markers included serum levels of 25(OH)D, albumin and LL-37, C-reactive protein (CRP), white blood cell count (WBC) and polymerase chain reaction diagnostics for 14 respiratory viruses. Pneumonia was confirmed by chest radiographs. Respiratory illness severity, death at ward, length of hospital stays, and 5-year survival were used as outcomes. Results In total, 289 older adult patients with mean age of 83 years were included in the study. Serum 25(OH)D deficiency (< 50 nmol/liter) was present in 59% and hypoalbuminemia (< 3.5 g/dL) in 55% of the study patients. Low serum albumin level was associated to one, two- and five-year mortality after hospital stay (all P < .05). In addition, it was associated with pneumonia, dyspnea, over 13-night long stay at ward and death at ward (all P < .05). No associations were seen between serum 25(OH)D and LL-37 levels and disease severity, short-term clinical outcome, or long-term survival. Associations between serum 25(OH)D, albumin, and LL-37 levels and respiratory virus presence were not seen. Conclusions Serum albumin level on admission seems to give valuable information about the patients' general health and recovery potential in treating older adults with respiratory symptoms. Serum 25(OH)D and LL-37 had no associations with disease severity or long- and short-term prognosis among older adults hospitalized with respiratory symptoms.Peer reviewe

Subjective and objective health predicting mortality and institutionalization: an 18-year population-based follow-up study among community-dwelling Finnish older adults

cited By 0Background Objective health measures, such as registered illnesses or frailty, predict mortality and institutionalization in older adults. Also, self-reported assessment of health by simple self-rated health (SRH) has been shown to predict mortality and institutionalization. The aim of this study was to assess the association of objective and subjective health with mortality and institutionalization in Finnish community-dwelling older adults. Methods In this prospective study with 10- and 18-year follow-ups, objective health was measured by registered illnesses and subjective health was evaluated by simple SRH, self-reported walking ability (400 m) and self-reported satisfaction in life. The participants were categorized into four groups according to their objective and subjective health: 1. subjectively and objectively healthy, 2. subjectively healthy and objectively unhealthy, 3. subjectively unhealthy and objectively healthy and 4. subjectively and objectively unhealthy. Cox regression model was used in the analyses. Death was used as a competing factor in the institutionalization analyses. Results The mean age of the participants (n = 1259) was 73.5 years (range 64.0-100.0). During the 10- and 18-year follow-ups, 466 (37%) and 877 (70%) died, respectively. In the institutionalization analyses (n = 1106), 162 (15%) and 328 (30%) participants were institutionalized during the 10- and 18-year follow-ups, respectively. In both follow-ups, being subjectively and objectively unhealthy, compared to being subjectively and objectively healthy, was significantly associated with a higher risk of institutionalization in unadjusted models and with death both in unadjusted and adjusted models. Conclusions The categorization of objective and subjective health into four health groups was good at predicting the risk of death during 10- and 18-year follow-ups, and seemed to also predict the risk of institutionalization in the unadjusted models during both follow-ups. Poor subjective health had an additive effect on poor objective health in predicting mortality and could therefore be used as part of an older individual's health evaluation when screening for future adverse outcomes.Peer reviewe

Chronic conditions and multimorbidity associated with institutionalization among Finnish community-dwelling older people : an 18-year population-based follow-up study

Key summary pointsAim The aim of the study is to assess the association of chronic conditions and multimorbidity with institutionalization in older people. Findings Having dementia, mood or neurological disorder and/or five or more chronic conditions were associated with a higher risk of institutionalization. Message These risk factors should be recognized in primary care when providing and targeting care and support for home-dwelling older people. Purpose The ageing population is increasingly multimorbid. This challenges health care and elderly services as multimorbidity is associated with institutionalization. Especially dementia increases with age and is the main risk factor for institutionalization. The aim of this study was to assess the association of chronic conditions and multimorbidity with institutionalization in home-dwelling older people, with and without dementia. Methods In this prospective study with 18-year follow-up, the data on participants' chronic conditions were gathered at the baseline examination, and of conditions acquired during the follow-up period from the municipality's electronic patient record system and national registers. Only participants institutionalized or deceased by the end of the follow-up period were included in this study. Different cut-off-points for multimorbidity were analyzed. Cox regression model was used in the analyses. Death was used as a competing factor. Results The mean age of the participants (n = 820) was 74.7 years (64.0-97.0). During the follow-up, 328 (40%) were institutionalized. Dementia, mood disorders, neurological disorders, and multimorbidity defined as five or more chronic conditions were associated with a higher risk of institutionalization in all the participants. In people without dementia, mood disorders and neurological disorders increased the risk of institutionalization. Conclusion Having dementia, mood or neurological disorder and/or five or more chronic conditions were associated with a higher risk of institutionalization. These risk factors should be recognized when providing and targeting care and support for older people still living at home.Peer reviewe

Urgent Geriatric Outpatient Clinic - Easy Access to Comprehensive Geriatric Assessment for Older Home-Dwelling Persons Living with Frailty

Background: Emergency departments (ED) are not designed to meet the complex medical and social needs of older people. An easy access Urgent Geriatric Outpatient Clinic (UrGeriC) was started in order to provide rapid and more appropriate care and assistance for frail older people struggling to manage at home.Methods: Participants were older Finnish home-dwelling citizens who had presented themselves in August 2015 to Turku City Hospital UrGeriC (n = 76) or ED of Turku University Hospital (n = 216) and who were discharged home.Results: UrGeriC patients were older (85.7 +/- 5.4) (mean age +/- SD) than ED patients (83.3 +/- 5.3) (p .001). No significant differences were found in staying at home four weeks (unadjusted OR 1.69 [95% CI 0.62-4.62], p = .305; adjusted 1.42 [0.50-4.01], p = .507) or one year (unadjusted 1.53 [0.69-3.41], p = .295; adjusted 1.51 [0.65-3.50], p = .339) after discharge between UrGeriC and ED patients.Conclusions: According to our preliminary results, UrGeriC could be a suitable way to support the home care of multimorbid geriatric patients struggling to live at home. Copyright (C) 2019, Taiwan Society of Geriatric Emergency & Critical Care Medicine