Browsing by Subject "patient"

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  • Koivuniemi, Raili; Hakkarainen, Tiina; Kiiskinen, Jasmi; Kosonen, Mika; Vuola, Jyrki; Valtonen, Jussi; Luukko, Kari; Kavola, Heli; Yliperttula, Marjo (2020)
    Objective: Skin graft donor site management is a concern particularly for elderly patients and patients with poor wound healing competence, and also because donor sites are a source of pain and discomfort. Although different types of dressings exist, there is no consensus regarding optimal dressing type on donor site care to promote healing, reduce pain, and improve patients' comfort. Approach: This prospective, single-center clinical trial evaluated the performance of nanofibrillar cellulose (NFC) wound dressing (FibDex (R) by UPM-Kymmene Corporation) for treatment of donor sites compared with a polylactide-based copolymer dressing. The study enrolled 24 patients requiring skin grafting with mean age of 49 +/- 18. The primary outcome measure was wound healing time. Secondary outcomes, the epithelialization, subjective pain, the scar appearance assessed using the Patient and Observer Scar Assessment Scale (POSAS), and skin elasticity and transepidermal water loss (TEWL), were evaluated at 1 and 6 months postoperatively. Results: No statistically significant differences were observed between NFC and copolymer dressings regarding wound healing time, epithelialization, experience of pain, or TEWL. Significant differences were observed in the POSAS results for thickness and vascularity in the Observer score, in the favor of NFC over copolymer dressing. Moreover, skin elasticity was significantly improved with NFC dressing in terms of viscoelasticity and elastic modulus at 1 month postoperatively. Innovation: NFC dressing is a new, green sustainable product for wound treatment without animal or human-origin components. Conclusion: NFC dressing provides efficient wound healing at skin graft donor sites and is comparable or even preferable compared with the copolymer dressing.
  • Hujala, Anneli; Oksman, Erja (2018)
    Cross-boundary collaboration, both multiprofessional and interorganizational, is needed when providing integrated care for people with multiple problems, who need services at the same time from diverse care providers. Multiple problems of clients also pose extra challenges for interaction between care professionals and clients. Emotional dynamics are always present in everyday interaction between human beings, but seldom explicitly addressed in research on integrated care. The aim of this reflective paper is to illustrate the emotional dimensions of integrated care in light of the experiences of care professionals in the context of care for people with multiple complex problems. The paper draws on a Finnish study on integrated care reflecting its findings from the perspective of emotional labor. The difficult life situations of people with multiple complex problems form an emotional burden, which is mirrored in the interaction between clients and professionals and affects relational dynamics among professionals. Professionals' fear of emotions and the different feeling rules' of care professions and sectors pose extra challenges to professionals' collaboration in this emotionally loaded context. Alongside the structural and functional aspects of integrated care, it is important that emotions embedded in everyday cross-boundary collaboration are recognized and taken into account in order to ensure the success of integrated care.