Browsing by Subject "lääkäri"
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(2011)The Ministry of Social Affairs and Health published a report on development needs of elder care and geriatric pharmacotherapy in 2006. The major concern in this report was related to several challenges in pharmacotherapy of the aged, such as deficiencies in medical knowledge of nurses working with elderly people. One way to improve the medication expertise of those various parties involved in caring elderly people is continuing education (CE). The aim of this study was to explore pharmacotherapy-related training needs of health care professionals involved in the home care services for the elderly in the Social and Health Care Cooperation Region of Lohja, Siuntio, Inkoo and Karjalohja (the LOST Region). This study was started by conducting a survey among nurses working in home care services for the elderly in the LOST Region in 2009 (response rate 47%). To deepen understanding of the key findings of the survey, focus group discussions (FGDs) and face-to-face interviews were conducted among nurses, nursing aids, their managers and physicians (1 FGD among nurses, n=6; 1 FGD among their managers, n=6; and face-to-face interviews with 4 physicians). The survey data were analyzed separately for nurses (n=9), practical nurses (n=53) and home aids (n=9), but results were the same in every group. Of the theoretical training needs, topics related to pharmacokinetics and special characteristics of using medicines in the elderly, effects, adverse effects and interactions of medicines, were most important. In addition, the theoretical training needs covered professional ethics issues, such as accuracy and carefulness of nursing practice. The main training needs related to collaborative practice in pharmacotherapy concerned monitoring medicine user's condition and medication, and dosing medicines (right medicine, dose, strength, dosage) in the right time, and administration routes of medicines. Focus group discussions and face-to-face interviews of the physicians provided a deeper understanding of the results of the survey. One of the main findings of this qualitative part of the study was challenges in cooperation in home care services in the LOST Region. Implementation and monitoring geriatric pharmacotherapy can be improved by improving multiprofessional cooperation and training for nurses and physicians working in home care services. The most important diseases and disorders for which the nurses would like to have shared operational guidelines were diabetes, cardiovascular diseases, pain, memory and psychiatric disorders. Training needs also covered special characteristics of pharmacotherapy for the elderly, and formulations and administration routes of medicines. Finally, a synthesis was made of the results of the survey, focus group discussions and face-to-face interviews. On the basis of the synthesis, a proposal for a multiprofessional training was developed for the LOST Region. The training plan includes topics related to geriatric pharmacotherapy and improving collaborative practices and communication as identified by those involved in different stages of the study.
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(2022)The price competition of biological medicines induced by biosimilars has started slower than expected in Europe. One of the main reasons has been the differences in physicians’ attitudes toward biosimilars. Switching biological medicines to clinically comparable alternatives is an important way to enhance the cost-effectiveness of using biological medicines. The focus of the conversation has shifted from the general similarity of biosimilars and the originators to whether frequent switching involves additional risks. The purpose of this master’s thesis was to investigate factors influencing physicians’ prescribing of biological medicines. In addition, their perceptions of the automatic substitution of biological medicines in Finland were explored. The study was based on structured personal interviews of rheumatologists and gastroenterologists including specialising physicians who work at HUS Helsinki University Hospital in the Hospital District of Helsinki and Uusimaa (n=48). They had a chance to comment on their responses at any time freely. The interview consisted of four sections: demographics, general attitudes toward biosimilars, factors affecting prescribing biological medicines, and perceptions of the automatic substitution of biological medicines. Study participants had a chance to comment on their structured responses during the interview. The interviews were recorded for further analysis of the comments. The results are based on a descriptive quantitative analysis and an inductive analysis of the comments. The interviewed physicians’ (n=27, response rate 56,3%) attitudes toward biosimilars were highly positive. Most of the physicians (21/27, 78%) also strive to motivate patients to switch biological medicines to clinically comparable but lower-cost options despite the challenges associated with switching, for example the differences in the administration devices. Of the previously determined factors, the ones affecting prescribing biological medicines the most were the willingness to support the price competition between the biological medicines, reimbursement status, and the hospital’s drug formulary when initiating the biological treatment in the hospital. The attitudes toward the automatic substitution of the biological medicines were positive among 13/27 (48 %) physicians. Our study results are in line with the results of earlier studies, but the open responses especially to the automatic substitution of biological medicines might indicate more positive perceptions on the subject among physicians in Finland.
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(2019)Aims. Examining job demands and recourses has become central to the study of occupational well-being. Two phenomena emerging from this framework, work engagement and job crafting, have been found to be linked to the well-being of employees. However, previous studies have largely overlooked the possible effects of personality on these relationships. In addition, studies examining the impact of work engagement and job crafting specifically on the well-being of physicians are scarce. The aim of this study was to examine the work engagement and job crafting of Finnish physicians, how these phenomena relate to the physicians’ well-being and whether personality traits affect these relationships. Methods. The sample (N = 2932) consisted of Finnish physicians, who had filled out the “Working Conditions and Health of Physicians” 2015 survey by The Finnish Medical Association, The National Institute for Health and Welfare and the Finnish Institute of Occupational Health. In this study, personality was assessed using the Big Five traits of the Five Factor Model and well-being with self-reported work ability, health, psychological stress and sleep symptoms. The relationships between work engagement, job crafting, personality traits and well-being were examined using linear regression. Results. Finnish physicians often felt engaged in their work but crafted their jobs only sometimes. Work engagement was consistently and fairly strongly related to better well-being, whereas for job crafting the results were mixed and the effects weak. Personality traits had hardly any effect on these relationships. Out of the Big five traits, neuroticism had the most notable effect; it somewhat weakened the connection between work engagement and well-being, was a stronger predictor than work engagement for some of the well-being indicators and added significantly to the proportion of variance explained by those models. Some weak interactions were also observed between work engagement and some personality traits, where the link between engagement and well-being differed in strength depending on the personality trait. Conclusions. These findings support previous observations that work engagement is linked to the well-being of employees. It points to the fact that besides preventing and treating burnout, the promotion of work engagement may have significant positive effects on the well-being of physicians. Regarding the role of personality traits in occupational well-being, at least neuroticism should be taken into account in future studies as a possible risk factor for the well-being of employees.
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(2019)Tavoitteet. Työhyvinvoinnin tutkimuksessa keskeiseksi on noussut työn vaatimusten ja voimavarojen tarkastelu. Tämän viitekehyksen merkittävien tutkimuskohteiden, työn imun ja työn tuunaamisen on havaittu olevan yhteydessä työntekijöiden hyvinvointiin. Aiemmissa tutkimuksissa ei kuitenkaan ole juuri huomioitu työntekijöiden persoonallisuuden mahdollisia vaikutuksia näihin yhteyksiin. Lisäksi työn imun ja työn tuunaamisen merkitystä spesifisti lääkäreiden hyvinvoinnille on tutkittu vasta hyvin vähän. Tässä tutkimuksessa tarkasteltiin suomalaislääkäreiden työn imua ja työn tuunaamista, niiden yhteyttä hyvinvointiin sekä persoonallisuuspiirteiden vaikutuksia näihin yhteyksiin. Menetelmät. Otos (N = 2932) koostui suomalaislääkäreistä, jotka olivat vastanneet Suomen Lääkäriliiton, Terveyden ja hyvinvoinnin laitoksen ja Työterveyslaitoksen Lääkärin työolot ja terveys 2015 -kyselyyn. Tässä tutkimuksessa lääkäreiden persoonallisuutta arvioitiin viidellä suurella piirteellä ja hyvinvointia neljällä indikaattorilla: työkyky, terveys, psyykkinen kuormittuneisuus ja unioireet. Työn imun, tuunaamisen, persoonallisuuspiirteiden ja hyvinvoinnin yhteyksiä tarkasteltiin lineaarisella regressioanalyysilla. Tulokset. Suomalaislääkärit kokivat työn imua usein, mutta tuunasivat työtään vain joskus. Työn imu oli johdonmukaisesti ja melko voimakkaasti yhteydessä parempaan hyvinvointiin, kun taas työn tuunaamisen suhteen tulokset olivat ristiriitaisia ja yhteydet heikkoja. Persoonallisuuspiirteet eivät juuri vaikuttaneet näihin yhteyksiin. Vaikuttavin piirteistä oli neuroottisuus, joka hieman heikensi työn imun yhteyksiä hyvinvointiin, oli työn imua vahvempi ennustaja osalle hyvinvointi-indikaattoreista ja lisäsi näiden mallien selitysasteita huomattavasti. Työn imun ja persoonallisuuspiirteiden välillä havaittiin myös joitain heikkoja yhdysvaikutuksia, joissa työn imun ja hyvinvoinnin väliset yhteydet olivat persoonallisuuspiirteestä riippuen voimakkuudeltaan erilaiset. Johtopäätökset. Tämä tutkimus vahvistaa aiempia tuloksia työn imun yhteydestä työntekijöiden parempaan hyvinvointiin ja antaa viitteitä siitä, että työuupumuksen ennaltaehkäisyn ja hoidon lisäksi työn imun tukemisella voisi olla merkittäviä myönteisiä vaikutuksia lääkäreiden hyvinvoinnin kannalta. Persoonallisuuspiirteistä ainakin neuroottisuus on jatkossa syytä huomioida mahdollisena hyvinvoinnin heikentymisen riskitekijänä.
Now showing items 1-4 of 4