Browsing by Subject "EXPECTATIONS"

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Now showing items 1-15 of 15
  • MacKay, C.; Webster, F.; Venkataramanan, Natarajan S.; Bytautas, J.; Perruccio, A. V.; Wong, R.; Carlesso, L.; Davis, A. M. (2017)
    Objectives: Studies show limited improvement in the frequency of engaging in life activities after joint replacement. However, there is a paucity of research that has examined factors, including other life events, which influence engagement following total hip replacement (THR). This research sought to identify factors associated with engaging in life activities following THR. Methods: A prospective cohort study was conducted with 376 people who had a THR for osteoarthritis (OA). Data were collected pre-surgery and 1 year post-surgery. The primary outcome was change in frequency in engagement in life activities (Late Life Disability Index (LLDI): higher scores indicate higher frequency of engagement (range 0e80)). Analyses included multivariable regression. Factors considered included: positive/negative life events, a new comorbidity, another joint replacement and complications post-surgery. Results: Participants' mean age was 64 years; 46% were male. 68% of participants had at least one comorbidity pre-surgery; 36% reported at least one new comorbidity after surgery. The mean change in LLDI frequency was an increase of 6.29 (+/- 8.10). 36% reported one or more positive impact life events in the year following surgery; 63% reported one or more negative life events. The number of positive life events (beta=1.24; 95% CI: 0.49, 1.99) was significantly associated with change in LLDI frequency after adjusting for age, sex, education, body mass index (BMI), comorbidities pre-surgery, number of symptomatic joints and pre-surgery pain and function, LLDI limitations and depression. Conclusions: These findings highlight the significant influence of social factors and life circumstances on engagement in life activities following THR. (C) 2017 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.
  • Perander, Katarina; Londen, Monica; Holm, Gunilla (2020)
    Efforts to reach gender equality in education in Finland have been extensive. Both teacher education and policy documents for schools have focused on gender equality and gender-neutral treatment of students. The aim of this study is to explore if and how these efforts are manifested in upper secondary school teachers' and study counsellors' perceptions of students' self-belief, academic emotions, study habits and behaviour at school. Twenty-three interviews were conducted and analysed qualitatively through inductive content analysis. The results revealed that teachers and study counsellors perceive that girls' low self-belief and high achievement expectations affected their academic performance, while boys' insecurity or need for support was rarely mentioned. The teachers ascribed the students several gender-stereotypical attributes: girls were perceived as diligent and hard-working while boys were perceived as being indifferent towards school and achievements. The implications of these results for students' self-belief and for teacher education are discussed.
  • Kujala, Sari; Ammenwerth, Elske; Kolanen, Heta; Ervast, Minna (2020)
    Background: The number of public eHealth services that support patient self-management is rapidly increasing. However, the implementation of these eHealth services for self-management has encountered challenges. Objective: The purpose of this paper was to analyze the challenges and opportunities of implementing eHealth services for self-management by focusing on the fit between the technical solution and clinical use. Methods: We performed in-depth interviews with 10 clinical project coordinators and managers who were responsible for developing and implementing various eHealth services for self-management interventions in five university hospitals in Finland The results were analyzed using content analysis and open coding. The Fit between Individuals, Task, and Technology (FITT) framework was used to interpret the findings. Results: The implementation of self-management services involved many challenges related to technical problems, health professional acceptance, patient motivation, and health organization and management. The implementers identified practices to manage the identified challenges, including improving the design of the technology, supporting health professionals in the adoption of the eHealth services, changing the work processes and tasks, involving patients, and collectively planning the implementation inside an organization. The findings could be mostly attributed to the dimensions of the FITT framework. Conclusions: The FITT framework helped to analyze the challenges related to the implementation, and most of them were related to poor fit. The importance of patients as stakeholders in eHealth services for patient self-management needs to be highlighted. Thus, we propose that patients should be added as a different type of individual dimension to the FITT framework. In addition, the framework could be extended to include organization and management in a new context dimension.
  • Skålen, Per; Fougère, Martin (Emerald Group Publishing Ltd, 2007)
  • Grön, Kirsikka (2021)
    In recent years, scholars studying data-intensive healthcare have argued that data-driven technologies bind together new actors and goals as part of healthcare. By combining the expectation studies with justification theory, this article adopts a novel theoretical perspective to understand how these actors and goals are enroled in healthcare. Drawing on a case study of Apotti, a Finnish social services and healthcare information system renewal project, the article shows how new emerging health data assemblages stress the aims of producing the common good in public healthcare. The project is studied by analysing interviews of the project's key actors and various documents produced in the project. The paper shows how, in the collective expectations, the new information system is justified by multiple understandings of the common good, which might be contradictory with each other. Along with the established goals of improving public healthcare operations, the new information system is expected to empower clients and patients, audit and manage personnel, promote national digital social and healthcare service markets, provide better data and tools for research, and promote Finnish research and business in international competition. These expectations are not all based on the settled understanding of the common good of public healthcare as promoting health; the common good is also defined in other terms such as improving research, promoting markets and business, and making Finland famous and a leading country in the digital social services and healthcare field. These goals and expectations are purposely ambiguous to be loose enough to gain attention and maintain it even when the promises are not met. The paper identifies the ambiguity and plurality of the common good as strategies of data-intensive healthcare and raises concerns of how this might shape public healthcare in the future. As the plural understandings of the common good might not support each other, the paper calls for further assessments of how this will affect public healthcare's core objectives and for seeking solutions that carefully balance the goals of the current and evolving multi-stakeholder environment of data-intensive healthcare.
  • Sipila, Reetta M.; Haasio, Lassi; Meretoja, Tuomo J.; Ripatti, Samuli; Estlander, Ann-Mari; Kalso, Eija A. (2017)
    The aim of this study was to identify clinical risk factors for unfavorable pain trajectories after breast cancer surgery, to better understand the association between pain expectation, psychological distress, and acute postoperative pain. This prospective study included 563 women treated for breast cancer. Psychological data included questionnaires for depressive symptoms and anxiety. Experimental pain tests for heat and cold were performed before surgery. The amount of oxycodone needed for satisfactory pain relief after surgery was recorded. Pain intensity in the area of operation before surgery and during the first postoperative week and expected intensity of postoperative pain were recorded using the Numerical Rating Scale (NRS 0-10). Pain trajectories were formed to describe both initial intensity (the intercept) and the direction of the pain path (the slope). Factors associated with higher initial pain intensity (the intercept) were the amount of oxycodone needed for adequate analgesia, psychological distress, type of axillary surgery, preoperative pain in the area of the operation, and expectation of postoperative pain. The higher the pain initially was, the faster it resolved over the week. Expectation of severe postoperative pain was associated with higher scores of both experimental and clinical pain intensity and psychological factors. The results confirm that acute pain after breast cancer surgery is a multidimensional phenomenon. Psychological distress, pain expectation, and the patients' report of preoperative pain in the area to be operated should be recognized before surgery. Patients having axillary clearance need more efficient analgesic approaches.
  • Mäkelä, Marja-Liisa; Kalalahti, Mira (2020)
    This article concentrates on the transition from comprehensive school to the upper secondary level from the viewpoint of migrant background girls. Emphasis is on understanding the bounded agency and the ways in which gender and family background are expressed in the modalities of the agency. Previous studies show that ethnic minorities have more difficulties in school, and they continue to higher education less frequently than the majority of students. We are interested in the aspirations of migrant background girls (n = 34) concerning their post-comprehensive transition. Our focus is on the experienced agency during the last year of comprehensive school. Our research questions are: What kinds of modalities do migrant background girls use when considering their educational choices? How do these modalities reflect their bounded agency? The study shows that although the experienced agency is universal among the age group, there are specific ethnic and gender connotations.
  • Dobewall, Henrik; Lindfors, Pirjo; Karvonen, Sakari; Koivusilta, Leena; Vainikainen, Mari-Pauliina; Hotulainen, Risto; Rimpelä, Arja (2019)
  • Laukka, Elina; Kujala, Sari; Gluschkoff, Kia; Kanste, Outi; Hörhammer, Iiris; Heponiemi, Tarja (2021)
    Online symptom checkers (SCs) are eHealth solutions that offer healthcare organizations the possibility to empower their patients to independently assess their symptoms. The successful implementation of eHealth solutions, such as SCs, requires a supportive organizational culture and leadership. However, there is limited knowledge about the factors associated with leaders' support for the use of SCs. The aim of the study was to identify the factors associated to primary care leaders' support for SCs in triage and their experiences of the benefits and challenges related to the use of SCs. An online survey was used to collect data from 84 Finnish primary care leaders. The data were analyzed using statistical analysis methods and content analysis. Vision clarity, perceiving efficiency improvements, and considering the service to be beneficial for patients were associated with leaders' support for the service (beta ranging from 0.41 to 0.44, p < 0.001). Leaders' support for the service was also associated with how well the leaders provided information about the service to their subordinates (beta =0.22, p < 0.048). SCs present slightly more challenges than benefits regarding health professionals' work. The developers of SCs should focus more on features that decrease health professionals' workload as well as how the solution can benefit patients.
  • Tang, Xin; Wang, Ming-Te; Parada, Filomena; Salmela-Aro, Katariina (2021)
    Grit has recently been challenged for its weak predictive power and the incompleteness of its measurement. This study addressed these issues by taking a developmental, person-oriented approach to study academic-related goal commitment and grit and their effects on academic achievement. Using longitudinal data among Finnish eighth and ninth graders (n = 549, 59.4% female, age = 14–16), the longitudinal changes in grit and academic goal commitment profiles were investigated through latent profile and latent transition analyses. Four profiles were identified across two grades: High committed-persistent and moderate consistency (~ 17%), Moderate (~ 60%), Low committed-persistent and moderate-low consistency (~ 8%) and Extremely low committed-persistent and moderate-low consistency (~ 12%). The students in the High committed-persistent and moderate consistency profile had the highest academic achievement of all the profiles when controlled for gender, socioeconomic status, conscientiousness, and academic persistence. The results revealed that students’ profiles changed between the eighth and ninth grades, with more than one-third of the High committed-persistent and moderate consistency adolescents dropping from this group. Further analysis showed that the profiles varied by educational aspiration, gender, and socioeconomic status. These findings imply that the combination of grit and academic goal commitment influences academic achievement; however, this combination is less common, unstable, and affected by internal and external factors. The study provided important implications on the weak grit effect and the ways to improve it.
  • Yli-Kauhaluoma, Sari Susanna; Pantzar, Mika (2018)
    Objective Self-tracking technologies have created high hopes, even hype, for aiding people to govern their own health risks and promote optimal wellness. High expectations do not, however, necessarily materialize due to connective gaps between personal experiences and self-tracking data. This study examines situations when self-trackers face difficulties in engaging with, and reflecting on, their data with the aim of identifying the specificities and consequences of such connective gaps in self-tracking contexts. Methods The study is based on empirical analyses of interviews of inexperienced, experienced and extreme self-trackers (in total 27), who participated in a pilot study aiming at promoting health and wellness. Results The study shows that people using self-tracking devices actively search for constant connectivity to their everyday experiences and particularly health and wellness through personal data but often become disappointed. The results suggest that in connective gaps the personal data remains invisible or inaccurate, generating feelings of confusion and doubt in the users of the self-tracking devices. These are alarming symptoms that may lead to indifference when disconnectivity becomes solidified and data ends up becoming dead, providing nothing useful for the users of self-tracking technologies. Conclusions High expectations which are put on wearables to advance health and wellness may remain unmaterialised due to connective gaps. This is problematic if individuals are increasingly expected to be active in personal data collection and interpretation regarding their own health and wellness.
  • Kesanen, Jukka; Leino-Kilpi, Helena; Lund, Teija; Montin, Liisa; Puukka, Pauli; Valkeapaa, Kirsi (2016)
    Objective: To assess the impact of a preoperative educational intervention on the knowledge level of patients with spinal stenosis. Methods: One hundred spinal stenosis patients were randomized into a preoperative educational intervention group (IG, n = 50) or a control group (CG, n = 50). All the patients received routine preoperative education. In addition, the IG went through an empowering telephone discourse based on a knowledge test performed before admission to hospital. Data on patients' knowledge level were collected at baseline (after the treatment decision), admission to hospital, discharge from hospital and at 3 and 6 months follow-up. Results: At baseline, there was no difference in the knowledge level of the study groups. At admission, the knowledge level was significantly higher in five of six dimension of empowering knowledge in the IG compared to the CG. During follow-up, the knowledge level within the study groups remained stable. Conclusion: A preoperative KTFI significantly increased the patients' knowledge level in most dimensions of empowering knowledge. Practice implication: KTFI is an effective method of preoperative education in patients with spinal stenosis. (C) 2016 Elsevier Ireland Ltd. All rights reserved.
  • Tupasela, Aaro; Snell, Karoliina; Tarkkala, Heta (2020)
    The Nordic countries aim to have a unique place within the European and global health data economy. They have extensive nationally maintained and centralized health data records, as well as numerous biobanks where data from individuals can be connected based on personal identification numbers. Much of this phenomenon can be attributed to the emergence and development of the Nordic welfare state, where Nordic countries sought to systematically collect large amounts of population data to guide decision making and improve the health and living conditions of the population. Recently, however, the so-called Nordic gold mine of data is being re-imagined in a wholly other context, where data and its ever-increasing logic of accumulation is seen as a driver for economic growth and private business development. This article explores the development of policies and strategies for health data economy in Denmark and Finland. We ask how nation states try to adjust and benefit from new pressures and opportunities to utilize their data resources in data markets. This raises questions of social sustainability in terms of states being producers, providers, and consumers of data. The data imaginaries related to emerging health data markets also provide insight into how a broad range of different data sources, ranging from hospital records and pharmacy prescriptions to biobank sample data, are brought together to enable "full-scale utilization" of health and welfare data.
  • Tuononen, Tarja; Parpala, Anna; Lindblom-Ylänne, Sari (Routledge - Taylor & Francis Group, 2017)
    New Perspectives on Learning and Instruction
  • Mölsä, Mulki Elmi; Tiilikainen, Marja; Punamäki, Raija-Leena (2019)
    Objectives: The aims of the study were, first, to describe and analyze healthcare services utilization patterns of older immigrants in Finland, and particularly to compare the availability and accessibility of health services between older Somalis and Finns. The second aim was to examine the preferences for mental healthcare within the group of Somalis. The third aim was to test the existence of a service usage gap expected to be characteristic of the Somali group, in which high levels of mental health problems occur alongside simultaneous low levels of mental health service usage. Design: The participants were 256 men and women between the ages of 50–85; half were Somali migrants and the other half Finnish matched pairs. The participants were surveyed regarding their usage of somatic, mental, and preventive health services, as well as symptoms of depression, general distress, and somatization. The Somali participants were also surveyed regarding their usage of traditional healing methods and preferences for mental healthcare. Results: The Somali group had significantly lower access to personal/family doctors at healthcare centers as well as a lower availability of private doctors and occupational health services than the Finns. Instead, they used more nursing services than Finnish patients. The Somali participants attended fewer age-salient preventive check-ups than the Finns. The majority of the Somalis preferred traditional care, most commonly religious healing, for mental health problems. The hypothesized service gap was not substantiated, as a high level of depressive symptoms was not associated with a low usage of health services among the Somalis, but it was found unexpectedly among the Finns. Conclusion: Our findings call for culturally appropriate general and mental health services for older immigrants, which requires awareness of clients’ preferences, needs, and alternative healing practices. Somali participants encountered institutional barriers in accessing healthcare, and they preferred informal mental healthcare, especially religious healing instead of Western practices.