Browsing by Subject "General practice"

Sort by: Order: Results:

Now showing items 1-6 of 6
  • Rapo-Pylkkö, Susanna; Haanpää, Maija; Liira, Helena (BioMed Central, 2017)
    Abstract Background Chronic, mostly musculoskeletal pain is common among older adults. Little is known about the prognosis of chronic pain and the neuropathic pain qualities in older adults. We studied a cohort of community-dwelling older adults, clinically assessed their pain states, classified their type of pain (nociceptive, neuropathic or combined) and followed them up for a year. Methods At baseline, a geriatrician clinically examined all study patients and classified their type of pain in collaboration with a pain specialist. Pain, quality of life and mental health were measured by questionnaires (BPI, GDS-15, BAI and SF-36) and reassessed after 1 year. Results Despite chronic pain, all patients from the baseline cohort continued to live independently at 1 year. A total of 92 of 106 (87%) patients returned the follow-up questionnaire. Nociceptive pain on its own was present in 48 patients, whereas 44 patients also had neuropathic pain. Most patients (96%) had several pain states at baseline, and 13 patients reported a new pain state at follow-up. On average, there were no significant changes in the pain intensity, pain interference, mood or quality of life in either group between baseline and follow-up. Changes in pain were observed at the individual level, and both intensity and interference of pain at the follow-up had a negative correlation with the baseline value. Conclusions On average, chronic pain was persistent in our patients, but they were able to live independently despite their pain. At the individual level, both relief and exacerbation of pain were observed, supporting the notion that pain is not inevitable and unremitting among older adults.
  • Rapo-Pylkkö, Susanna; Haanpää, Maija; Liira, Helena (2017)
    Background: Chronic, mostly musculoskeletal pain is common among older adults. Little is known about the prognosis of chronic pain and the neuropathic pain qualities in older adults. We studied a cohort of community-dwelling older adults, clinically assessed their pain states, classified their type of pain (nociceptive, neuropathic or combined) and followed them up for a year. Methods: At baseline, a geriatrician clinically examined all study patients and classified their type of pain in collaboration with a pain specialist. Pain, quality of life and mental health were measured by questionnaires (BPI, GDS-15, BAI and SF-36) and reassessed after 1 year. Results: Despite chronic pain, all patients from the baseline cohort continued to live independently at 1 year. A total of 92 of 106 (87%) patients returned the follow-up questionnaire. Nociceptive pain on its own was present in 48 patients, whereas 44 patients also had neuropathic pain. Most patients (96%) had several pain states at baseline, and 13 patients reported a new pain state at follow-up. On average, there were no significant changes in the pain intensity, pain interference, mood or quality of life in either group between baseline and follow-up. Changes in pain were observed at the individual level, and both intensity and interference of pain at the follow-up had a negative correlation with the baseline value. Conclusions: On average, chronic pain was persistent in our patients, but they were able to live independently despite their pain. At the individual level, both relief and exacerbation of pain were observed, supporting the notion that pain is not inevitable and unremitting among older adults.
  • Paloneva, Juha; Koskela, Sanna; Kautiainen, Hannu; Vanhala, Mauno; Kiviranta, Ilkka (2013)
  • Lautamatti, E.; Sumanen, M.; Raivio, R.; Mattila, K. J. (2020)
    Background Satisfaction is a major element in assessing quality of care. It has decreased in Finland in recent decades as well as continuity of care. We investigated which demographic, health-related, and local health care service factors, especially continuity of care, are associated with the population's satisfaction with local health care services. Methods The data are part of the Health and Social Support (HeSSup) study's follow-up questionnaire in 2012. The study is based on a random Finnish population sample. Satisfaction was studied based on the question "How satisfied are you with your local health care services?" Demographic factors, obesity, self-assessed health status, depressive mood (BDI-12 questionnaire), New York Heart Association class, and chronic diseases were asked in the questionnaire. Questions describing local health care services were also presented. We assessed the association of an assigned and named GP and the respondents' proactivity in contacting the same doctor with satisfaction. We used crosstabulation and binary logistic regression in the analyses. Results The Health and Social Support study was answered in 2012 by 15,993 participants (45.4%) and majority (61.3%) was satisfied with their local health care services. An assigned and named GP (OR 1.79; 95% CI 1.67-1.92) and the respondent's proactivity in contacting the same doctor (OR 1.23; 95% CI 1.15-1.32) were associated with satisfaction in the adjusted multivariate analysis. BDI score <19 had the strongest association with satisfaction (OR 1.91; 95% CI 1.65-2.23). Older participants, males, and those in a relationship were more likely to be satisfied. Conclusions A named GP in primary care proved to have a positive correlation with patient satisfaction. Depression was associated with decreased satisfaction. A named GP indicates continuity of care, and it should be seriously considered when planning treatment for patients with chronic conditions.
  • Niskanen, Kaisa (Helsingin yliopisto, 2019)
    Tutkimuksen tarkoitus: Tutkimuksen tavoitteena oli selvittää, miten potilaiden implanttihoidot poikkeavat toisistaan potilaan iän ja sukupuolen sekä implantoinnin syyn, implantointialueiden, leikkaustekniikan ja asennettujen implanttien lukumäärän suhteen. Materiaalit ja menetelmät: Aineisto koostui yksityisellä hammaslääkäriasemalla toimivan hammaslääkärin tekemistä hammasimplanttileikkauksista. Aineisto kerättiin Terveyden ja hyvinvoinnin laitoksen (THL) implanttirekisterin ilmoituskaavakkeista vuosilta 2001–2017. Lomakkeista kerättiin Exceliin seuraavat tiedot: ikä, sukupuoli, implantointialue, leikkaustekniikka, implanttihoidon syy ja käytettiinkö leikkauksessa luusiirteitä. Tulokset: Aineisto koostui 486 potilaasta, joista 52,5 % oli naisia ja 47,5 % miehiä. Iän keskiarvo oli 56,7 vuotta, hajonta 19‒87 vuotta ja 73 % oli 50-vuotiaita tai vanhempia. Sekä miesten että naisten osalta implantteja asennettiin yleisimmin 50–69-vuotiaiden ikäluokissa. Asennettuja implantteja oli yhteensä 681 kappaletta. Yläleukaan (61 %) tehtiin enemmän leikkauksia kuin alaleukaan. Yleisin yksittäinen korvattu hammas oli alaleuan ensimmäinen poskihammas (21,4 % kaikista implanteista). Koko hampaiston alueista premolaarialue oli yleisin hoidon kohde (42 %). Inkisiivejä ja premolaareja korvattiin eniten 60‒69-vuotiaille ja molaareja eniten 50‒59-vuotiaille. Leikkaukset tehtiin enimmäkseen yksivaiheisesti (61 %). Hoidon syy oli lähes kaikissa tapauksissa yksittäiset menetetyt hampaat (92 %). Johtopäätökset: Hammasimplanttihoidot poikkesivat eri ikäryhmien välillä siten, että hammasimplantteja asennettiin enemmän vanhemmille potilaille ja heille asennettiin keskimäärin enemmän implantteja yhdessä leikkauksessa nuorempiin potilaisiin verrattuna. Hampaistoalueiden osalta inkisiivialueen implanttihoidot olivat yleisempiä vanhempien potilaiden kohdalla, kun taas valtaosa nuorempien potilaiden implanttihoidoista kohdistui premolaari- ja molaarialueelle.
  • Gormley, Gerard J; Kajamaa, Anu; Conn, Richard L; O’Hare, Sarah (BioMed Central, 2020)
    Abstract Background The healthcare needs of our societies are continual changing and evolving. In order to meet these needs, healthcare provision has to be dynamic and reactive to provide the highest standards of safe care. Therefore, there is a continual need to generate new evidence and implement it within healthcare contexts. In recent times, in situ simulation has proven to have been an important educational modality to accelerate individuals’ and teams’ skills and adaptability to deliver care in local contexts. However, due to the increasing complexity of healthcare, including in community settings, an expanded theoretical informed view of in situ simulation is needed as a form of education that can drive organizational as well as individual learning. Main body Cultural-historical activity theory (CHAT) provides us with analytical tools to recognize and analyse complex health care systems. Making visible the key elements of an in situ simulation process and their interconnections, CHAT facilitates development of a system-level view of needs of change. Conclusion In this paper, we theorize how CHAT could help guide in situ simulation processes—to generate greater insights beyond the specific simulation context and bring about meaningful transformation of an organizational activity.