Browsing by Subject "interview"

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  • 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.
  • Celikkayalar, Ercan; Airaksinen, Marja; Kivelä, Sirkka-Liisa; Nieminen, Jenni; Kleme, Jenni; Puustinen, Juha (2021)
    Purpose: The use of benzodiazepines and related drugs (BZD) is common among older adults although there is growing evidence of their harmful effects. This study investigated how well older people are aware of the potential risks related to the BZD they are taking and whether the risk awareness has changed in the years between 2004 and 2015. Patients and Methods: The data were collected by interviewing BZD using home-dwelling patients aged >= 65 years with normal cognitive function (MMSE >= 20) who were admitted to the hospital within a 1 month study period in the years 2004 and 2015. Patients were asked whether they were aware of the ten main potential risks related to BZD use. A risk awareness score (range 0-10) was assessed for each patient, each known potential risk yielding one point. Results: The study included 37 patients in 2004 and 31 patients in 2015. In 2004,6/37 patients (16%), while 16/31 patients (52%) in 2015 had risk awareness scores between 6 and 10. Awareness of dependence (p=0.047), interaction with alcohol (p=0.001), dizziness (p=0.002) and developing tolerance (p=0.002) had improved, while awareness of the other potential risks remained unchanged, muscle weakness being the least known (3/37 in 2004 and 4/31 in 2015 were aware of it as a potential risk). Regular BZD use had declined (p=0.043) but pro re nata (PRN; when required) BZD use had increased (p=0.003) between the years 2004 and 2015. Conclusion: Older BZD users' awareness of some potential risks related to BZD use (dependence, interaction with alcohol, dizziness and developing tolerance) had improved between 2004 and 2015, while awareness of other potential risks remained unchanged.
  • Blyth, Pascale-L. (Science Direct, 2020)
    Energy Research Social Science 70 (2020), 101574
    Arguably the most powerful artifact of the 20th century, the private car brought profound spatial, social, and cultural changes, as well as wide-ranging mobility justice implications. Autonomous mobility technologies, with the power to supplant part or all of the action of the driver by collecting and processing large quantities of fine grained data, promise to shift power away from users to engineers and create new important spatial and social implications for mobility justice, of which little are known. This research draws from Foucauldian conceptualizations adapted for the study of geographies of power to investigate how autonomous mobility technology may diagram spatial rationalities and moralities into the built environment. To that effect, it draws from 30 interviews of intermediaries in Finland–a country actively pursuing a transition to automated and shared mobility as part of an ICT-driven innovation policy. Examining autonomous mobility through a Foucauldian lens helps highlight the complex power relations it affords–in terms of changes in social structure and infrastructure, and social justice. By shedding light on how technology may structure the built environment, the Foucauldian perspective shows itself to be a valuable tool for planning and policymaking, providing insight into how autonomous mobility (in)justice may be assembled.
  • Veijalainen, Jouni; Reunamo, Jyrki; Sajaniemi, Nina; Suhonen, Eira (2019)
    Background: A large body of earlier research has focused on studying children's self-regulation (SR) skills and frustration with different methods. However, considerably less attention has been given to hearing children's own voice. The current study sought to demonstrate children's own comprehension and highlight it as a valuable and unique tendency to fill the scientific gap in the research area. Aim: This research aimed to contribute the empirical understanding of how SR, as mental ability, supported children's coping strategies and comprehensions which they will possibly use in a hypothetical frustrated context in the Finnish early childhood education and care (ECEC) environment. Setting: Self-regulation and strategies in a frustrating context were studied with mixed methods in a sample (n = 383) of 48-87-month-old children in Finland. Self-regulation was assessed by their own teachers with an evaluation form. The coping strategies of frustration were studied by interview where the children's open-ended descriptions provided the strategies told by themselves. Methods: The study's was conducted by using mixed methods. Two independent instruments to measure SR and strategies for frustration were used. Self-regulation was assessed by teacher with an evaluation form. The coping strategies of frustration were studied via child interview. Results: Good SR skills were related to persistent coping strategies and not giving up in a simulated situation. Weak SR skills related more with uncertain or withdrawal coping strategies, like giving up, or abandoning the situation. Conclusion: Self-regulation skills have an important role in guiding children with their use and narration of suitable coping strategies on overcoming the frustration effectively. The concrete strategies would allow teachers to work concretely with children in enhancing their SR skills and coping strategies further.
  • Kaipio, Johanna; Karisalmi, N.; Hiekkanen, K.; Stenhammar, H.; Lahdenne, P. (IOS PRESS, 2019)
    Studies in Health Technology and Informatics
    Patient experience (PX) is an important evaluation criterion for quality in healthcare. Compared to patient satisfaction, however less research has focused on the development of instruments to measure experiences of patients and their families. In the article, we describe the process of developing a PX questionnaire for the parents of pediatric patients in the context of children's hospital and illustrate the questionnaire items for measuring PX. The phases of the development process included retrospective interviews, description of the themes influencing PX and the metrics for measuring PX, as well as iterative development of three versions of questionnaires including data gathering and factor analysis. The final versions of the surveys suggested for implementation at the hospitals include eight PX statements for the outpatient clinic and five statements for the ward. Compared to satisfaction surveys, the developed surveys emphasize the aspects of parent's attitude towards the illness, support for families, and daily arrangements with a child patient. © 2019 American Psychological Association Inc. All rights reserved.
  • Hoffmann-Vold, Anna-Maria; Bendstrup, Elisabeth; Dimitroulas, Theodoros; Hesselstrand, Roger; Morais, Antonio; Peltomaa, Ritva; Smith, Vanessa; Welling, Joep; Vonk, Madelon C.; Wuyts, Wim A. (2021)
    Objectives Interstitial lung disease is frequent in SSc (SSc-ILD) and associates with significantly reduced quality of life. Here we aimed to analyse patient pathways, and experiences of patients and healthcare providers (HCPs) in order to identify unmet needs in the management of SSc-ILD patients. Methods Semi-structured qualitative interviews conducted in eight European countries looked at HCP (n = 95) and patient perspectives (n = 47) using two sets of 70 research questions. Pre-diagnostic, diagnostic and post-diagnostic phases of the patient pathway were systematically explored. Results (i) In the pre-diagnostic phase several gaps were identified by HCPs and patients in all participating countries: limited disease knowledge among primary care physicians and specialists, lack of accurate patient information, and delayed and/or inappropriate referral. (ii) The diagnostic phase is in most countries coordinated by rheumatologists, who are also the main point of care. Depending on the local health system, organization of multidisciplinary collaboration varies. HCPs issued lack of national guidelines, while patients stated difficulties obtaining disease-related information. (iii) In the post-diagnostic phase, HCPs and patients indicated lack of curative treatment, specialized nurses, and paramedical and psychological support. Patients and caregivers additionally expressed the need for clear information on SSc-ILD. Conclusion Lack of disease specific knowledge, gaps in national healthcare systems and insufficient information and support for patients and caregivers were identified as unmet needs to ensure timely diagnosis, provide better patient management and to improve quality of life in SSc-ILD patients.
  • Knuuttila, Sirkka (2015)
    A review of a Duras interview book (1989), translated into Finnish by Aura Sevon, 163p, Osuuskunta Poesia, 2014.
  • Tiilikainen, Elisa; Seppanen, Marjaana (2017)
    Using a qualitative approach, this article examines how the experiences of emotional loneliness are embedded in the everyday lives and relationships of older adults. Ten in-depth interviews were conducted in 2010 with older people who reported feeling lonely, often or all the time, during a cohort study in southern Finland. The research reveals the multifaceted nature of loneliness and its causes. Behind emotional loneliness, we identified lost and unfulfilled relationships, involving the loss or lack of a partner, the absence of a meaningful friendship, complex parenthood and troubling childhood experiences. Most of the interviewees have faced loneliness that only began in old age, but for some, loneliness has been present for nearly a lifetime.
  • Siltakorpi, Matleena (Helsingin yliopisto, 2021)
    Obesity is a growing health challenge in Finland. Despite the fact, that obesity is recognized as a chronic disease, it remains underdiagnosed and undertreated. In the past few years, two new anti-obesity drugs have entered the market to support the lifestyle changes Anti-obesity medication would be a natural option to support lifestyle changes, but physicians have not widely adopted the medication in their treatment patterns. The aim of this study was to understand, what are the abilities of primary care physician (PCP) to treat obesity, considering their knowledge, resources and, local care pathways. In addition, the study sought to determine the most important factors, that are involved in the initiation of anti-obesity medication. The study was conducted as a semi-structured thematic interview. A total of nine PCPs from all over Finland were interviewed for the study. Of these, three worked on the private sector and six on the public sector. The interviews were conducted during October-November 2020. The framework of the interviews was built based on the previous studies and information within a pharmaceutical company specializing in the treatment of obesity. The content was analysed with inductive content analysis. PCPs interested in the treatment of obesity raised the topic of weight quite easily in various situations and some of them mentioned that they even find it easy to bring up the subject. However, the subject is mainly brought up when the patient already has some weight-related comorbidities. Preventively, weight is less often talked about, especially because of a lack of human and time resources. Currently the most comprehensive care pathways and interdisciplinary teams are in occupational healthcare. In occupational healthcare, resources are perceived as adequate and the interdisciplinary teams works well. In most healthcare centers, a separate care pathway for the treatment of obesity had not been built. In general, knowledge of the obesity treatment was considered adequate, but education on the biological basis of obesity is needed. Most of the PCPs knew about the new anti-obesity drugs and had positive attitude towards them, but they did not prescribe the drugs themselves. The most significant barrier to prescribe the anti-obesity drugs, was the price of the products and the lack of reimbursement. In addition, experience with anti-obesity drugs is limited and the need for education is high. Currently, occupational health physicians have better abilities to treat obesity in terms of care pathways, interdisciplinary teams and, resources than PCPs in public healthcare. The conditions are also better for the implementation of pharmacotherapy as resources and care pathways enables proper lifestyle guidance alongside pharmacotherapy. Prior to reimbursement, pharmacotherapy may not be a realistic option in the public sector, and the conditions for proper lifestyle guidance alongside pharmacotherapy are not sufficient in all locations.
  • Aarnio, Emma; Huupponen, Risto; Hämeen-Anttila, Katri; Merikoski, Merja; Puhakka, Jaana; Korhonen, Maarit J. (2019)
    Direct oral anticoagulants provide an alternative to vitamin K antagonists for the anticoagulation therapy in atrial fibrillation (AF). The availability of several treatment options with different attributes makes shared decision-making appropriate for the choice of anticoagulation therapy. The aim of this study was to understand how physicians choose an oral anticoagulant (OAC) for patients with AF and how physicians view patients' participation in this decision. Semi-structured interviews with 17 Finnish physicians (eight general practitioners and nine specialists) working in the public sector were conducted. An interview guide on experience, prescribing and opinions about oral anticoagulants was developed based on previous literature. The data were thematically analysed using deductive and inductive approaches. Based on the interviews, patient's opinion was the most influential factor in decision-making when there were no clinical factors limiting the choice between OACs. Of patient's preferences, the most important was the attitude towards co-payments of OACs. Patients' opinions on monitoring of treatment, dosing and antidote availability were also mentioned by the interviewees. The choice of an OAC in AF was patient-centred as all interviewees expressed that patient's opinion affects the choice.
  • Muurman, Eeva-Maria (Helsingin yliopisto, 2017)
    This thesis examines perspectives that Christians in Western Kavango in Namibia have about Christianity and their past religious traditions. The Finnish Evangelical Lutheran Mission (former Finnish Missionary Society) has been working there since 1926. The latest Finnish missionaries left the area in 2013. The Catholic mission was already active in Kavango when the Finns arrived, but Catholicism has been more influential in the eastern part of Kavango. Nowadays new, Pentecostal type churches are attracting a lot of people. The basic research method has been interviewing people in Kavango. First, I wanted to know why they are Christians and what Christianity means to them. Second, I interviewed them about what they know or remember about old cultural traditions and how they evaluate them. I also wished to get deeper into the process of conversion, but I was not able to do so, mainly because almost all the informants had been Christians since their childhood. It seems that people in Kavango have taken Christianity as their own. Christianity in Kavango also has longer and deeper roots than I expected. All the informants said that they are Christians and all consider Christianity as important for themselves. There was more variation in how they expressed the basic meaning of Christianity: salvation to heaven after death, getting daily bread from God, or having order and purpose in life. Prayer is very important to Christians in Kavango; almost every informant spoke something about prayer although I did not ask about it. This may have something to do with the tradition of offering and praying to ancestral spirits. Now Christians feel they have direct contact to God through prayer, as there is no more need to approach him through a mediator. Early missionaries required a Christian way of life from converts. Women had to cut away their traditional hairdo, and polygamous men had to send extra wives away. Concerning the hairdo the missionaries thought that it involves a lot of magic, whereas the local people saw it only as a matter of beauty until they adopted new ideals of hygiene. Polygamy has been more common than I expected and is still found in Kavango. The church still follows the guideline on polygamy given by the missionaries. The moral code of the church is strict in particular on cohabitation before marriage. Strict morals are not, however, only a product of the mission; the traditional society used to have harsh punishments. Traditional healing divides opinions. On one hand Christians also admit there are true herbal remedies that healers know. On the other hand many healers are only cheating people to get money, and even today some point out “witches” as the cause of illness or injury, leading to blaming of innocent people. In general, it can be said that Christians in Kavango consider Christianity and traditional African religion as a continuum, not as opposites. They compare their pre-Christian era with the Old Testament. When they prayed God through their forefathers, it was like praying the God of Abraham, Isaac and Jacob. In fact, the world of the Old Testament is close to that of African traditional life in many aspects. Even so, Christians in Kavango see Christianity as something brought to them by God’s power, so they can confess faith in Jesus whom they did not previously know.
  • Hauta-alus, Helena (Helsingfors universitet, 2011)
    Humans all over the world are selecting food items from a larger pool of potentially edible foods and are creating prohibitions and preferences for certain foods. These are called food beliefs and they are an important part of the local culture. Reasoning to them often lies in health or social respect. Many food beliefs still exist in Africa and pregnant and breastfeeding women and children are often the target of these beliefs. Under the suboptimal nutritional status or food insecurity the possible food beliefs might considerably affect the nutritional status and health of these vulnerable groups. Malnutrition is still a major problem in Africa and other developing countries. The aim of this thesis was to study whether and what types of food beliefs concerning pregnant and breastfeeding women can be found in the rural area of the Zambezia province, Mozambique. Furthermore, the aim was to evaluate their possible significance on nutritional status. Five group interviews in three villages and 10 individual interviews in two villages were done. Interviewees were women of 12 to 78 years of age and all together 27 women were interviewed. Interpretation, sensitivity of the topic and the inexperience of the interviewer caused challenges in conducting the interviews. Because of this the method was altered and changed from group interview to individual interview during the study. Food beliefs differed between villages and within villages but some common characteristics can be found. There are several food beliefs concerning pregnant and breastfeeding women in the study area. Pregnant women were advised not to eat protein rich foods such meat and fish but were recommended to eat vegetables, fruits and cereal foods during pregnancy. Eggs were both recommended and forbidden during pregnancy. In addition, there was an intentional habit for pregnant women to eat less cassava porridge or less food in general („eating down?). During breastfeeding nothing was forbidden in general but coconut and vegetables were recommended. Most of the reasonings were related to the health of a mother and a child. The reasonings can be divided into the following groups: enhances breast milk production, causes stomach pain, maintains fitness and prevents stomach growth, mother will be strong and healthy and she?ll get vitamins, the child?s appearance changes, child will be strong and healthy, child?s behaviour changes, causes miscarriage, causes easy or difficult delivery. Food beliefs were partly mixed with education from health authorities. Almost all women said that they do follow these beliefs. Few women expressed their concerns about following the beliefs on recommended foods since food availability makes it sometimes difficult. Food belief that forbids good protein sources from pregnant women can increase the risk of protein deficiency. Eating down increases the risk of having not enough energy during pregnancy. The recommended foods are mainly nutritious and likely promote health. It can be stated that when starting a research in a foreign culture, it is necessary to have a flexible research method. It is be very important that the method can be adjusted during the study. The conclusion of this thesis was that individual interviews would have been the most suitable method when studying food beliefs in this area. Individual interviews should have only one interviewer, interviewee and interpreter if needed. All should be the same sex and the age group. From the health and nutrition viewpoint it is vital to be aware of the food beliefs in the society under investigation and to study these specifically in the area because these can vary markedly even in the same village or community.
  • Krannila, Elina (Helsingfors universitet, 2012)
    In pharmaceutical industry GMP compliance and quality of operations can be ensured with quality management system (QMS). QMS is an operational system, which consist of multiple different elements depending on the size of the company and nature and complexity of its operations. For the QMS to be functional, documented and defined operations need to be managed and monitored systematically. Conducting internal audits has been considered necessary with regard to QMS, though it has not always been perceived as adding value or seen as an opportunity to utilise more fully. Internal audits are mainly utilized to control compliance to requirements. However, there are possibilities to utilise it more in improving and developing operations, preparation to external audits, quality risk assessment, finding out the best practices, basis for decision making, learning experience as well as the assessment of functionality and effectiveness of the QMS. The aim of this study was to examine the utilisation of internal audits in Orion (Espoo) and find solutions to improve the utilisation of internal audits with QMS. The focus was on how internal audits can monitor and guide QMS and what is required from internal audits for monitoring and guidance of QMS. These aims were approached qualitatively by conducting semi-standardized open-ended interviews. Interviewees (n=9) were selected from both auditor and auditee side and they had their background in quality assurance or production. Data compiled from these interviews was analysed mainly by qualitative methods, using also some quantitative analysis. Monitoring of the QMS can be looked at as the starting point to guide QMS. Valuable information can be gathered with internal audits with regard to QMS. By utilising this information, internal audit process and QMS can be improved and the quality of operations can be ensured. Based on this work internal audits can be utilised to monitor and have the potential to guide QMS under certain conditions. Internal audit topics need to be systematically selected, QMS needs to be monitored and guided based on the internal audit findings, flow and distribution of information needs to be efficient and flexible, and internal audits should be better utilised and managed. Further research is needed on the development and deployment of tools to aid better utilisation of internal audits in the control of QMS. Also ways to measure the effects of internal auditing should be further investigated.
  • Johansson, Anna (Helsingin yliopisto, 2018)
    Artificial light that produces some adverse effects is called light pollution. Light pollution has only recently been recognized as an environmental problem – it has been noticed to have adverse effects to organisms, ecosystems, human health and their well-being. The purpose of this study is to combine two aspects of light pollution that have so far gained little attention: the public’s point of view and the lighting solutions of municipalities and forest industry enterprises. These two aspects can be connected to each other through a concept called condition of lighting. Here the conditions of lighting consist of three areas with notable differences in lighting: city centers, countryside and forest industry production plants along with their surroundings. The study was conducted in South Karelia, Finland, and it was divided into two sections. The first section dealt with the public’s point of view on light pollution. The objective was to find out how South Karelians perceive the effects and obtrusiveness of artificial light both generally and also within areas of differing conditions of lighting. In addition, the intention was to uncover other factors that might influence the opinions of people. The second section of the study concerned the lighting solutions of municipalities and forest industry enterprises. The objective was to examine their lighting planning and implementation as well as the role of light pollution in the process. Interview was selected as the method of research in both sections of the study. The public considered electronic billboards and car headlights as the most obtrusive sources of light pollution. Bright lights and glare, on the other hand, were considered the most obtrusive types of light pollution. Most valued benefits of artificial light were its influence on safety, crime prevention and its positive effect on mood. Not being able to see the stars or experience natural darkness were considered as the biggest disadvantages of artificial light. The conditions of lighting in different areas also influenced the respondents’ experiences: people living in the countryside did not feel insecure in dark places outside the cities and did not consider abundant lighting pleasant. They also felt that being able to experience natural darkness was important. Among other factors, nature orientedness, light sensitivity, environmental attitudes and gender strongly affected the views of the respondents. In the municipalities and forest industry enterprises, the lighting planning concentrated on territorial plans. All but one of the municipalities and enterprises had taken light pollution into consideration at some level at least, but the forms and means varied. In the future both municipalities and forest industry enterprises will invest more in LED technology. The results show that artificial light can cause inconvenience to people who live outside the brightly lighted areas and who were not particularly interested in light pollution. Behind the inconvenience and disturbance were mostly the experiences, habits, values and attitudes of the respondents. The municipalities and enterprises have a lot to improve when it comes to light pollution. They should, for example, invest in comprehensive lighting planning, avoid over-illumination and pay attention to suitable direction and positioning of the light fixtures. In the future, it is important to examine the public’s opinion and to map the landscape of lights at a local scale. This would help in finding the most suitable lighting solutions for different areas. In the opinion polls, the subjective characteristics affecting the views of the respondents should be taken into consideration. Research regarding the municipalities and enterprises should be directed to the areas where light pollution is not regulated, in order to gather information on motivation and implementation of the voluntary activities reducing light pollution.