Browsing by Subject "potilastyytyväisyys"
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(2013)Prostate cancer is the most common cancer among men in Finland. Today, new prostate cancers are diagnosed in an early phase of the disease when the cancer is still local and effectiveness of the treatments good. There are many effective treatment options for localised prostate cancer but all of them cause multiple side effects. No comprehensive information about prostate cancer patients' experiences, treatment consequences and outcomes has been available. National Institute for Health and Welfare (THL) carried out a nationwide survey to prostate cancer patients diagnosed in 2004. The questionnaire was sent by mail in 2009. Patients were asked to report their experiences during the diagnosis and treatment selection (prostatectomy, hormone therapy, external beam radiation, brachytherapy, surveillance). They were asked about amount and harmfulness of side effects and satisfaction with outcome of the treatment. An association between the side effects and satisfaction with the treatment outcome was also studied. A total of 1239 responses were accepted for the study (response rate 73%). All treatments caused several side effects, and up to half of the patients had some adverse effect still present at the time of the survey. Most of the side effects concerned urinary or sexual dysfunction, in external beam radiation also bowel dysfunction. All treatments caused sexual dysfunction, but radiation therapy less than the other treatments. Side effects caused by hormone therapy were specific for this treatment, like hot flashes and mood disturbances. Patients treated with prostatectomy were least satisfied with the outcome of the treatment and dissatisfaction was mostly associated with sexual and urinary dysfunction. Patients treated with radiation therapy were most satisfied with the outcome. Urinary and bowel dysfunction impaired the satisfaction in patients treated with external beam radiation. All prostate cancer treatments cause plenty of potentially harmful side effects that may be challenging for psychological and psychosocial well-being of the patients. Thus, both treatment modalities and means to support well-being of the patients should be developed further. Actions that enhance well-being and prevent and relieve side effects should be an essential part of standard clinical procedures for every prostate cancer patient.
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(2019)Background Gallstones are common in the Western adult population: their incidence is 10-20 %. Half of the patients are asymptomatic when the gallstones are diagnosed. Uncomplicated, symptomatic cholecystolithiasis means that the gallstones generate pain, but the disease has not developed any complications. The treatment for symptomatic patients is cholecystectomy which is normally made in laparoscopy. Despite the operation, pain continues in 28 % of the electively operated patients. The purpose of this systematic review is to find out based on literature whether there is a patient group that does not benefit from the operation or what the characteristics of such patients are. Methods The source of the literature is Ovid Medline database. The research question has been divided into PICO keywords and 790 results have been found. The results have been reviewed by title, abstract, and by the whole text, and the articles that do not fulfil the inclusion criteria have been ruled out. The articles have to concern people minimum of 18 years old that have had their gallbladder removed because of symptomatic, uncomplicated cholecystolithiasis. In addition, some symptom and quality of life parameters must have been asked before and after operation. Eventually, there are 22 articles left that the systematic review is based on. These articles have been reviewed with the Newcastle-Ottawa scale. Results There is no research on the patient group that does not benefit from the cholecystectomy, but there are parameters found that have an impact on the benefit. High-level anxiety increases the risk of continuous pain up to three times higher. Alexithymia and psychologic distress are more common in patients that have continuous abdominal symptoms after the operation. High pain frequency is linked to worse postoperative pain relief. To get the best benefit from the operation, pain symptoms need to be typical and intense, but pain frequency low. Female gender and functional gastrointestinal disorder are connected to worse outcome. Pain duration more than a year, high score in preoperative quality of life questionnaire, and episodic pain predict pain relief after the operation. Discussion According to the systematic review, there is no research on who should not be operated because of symptomatic, uncomplicated cholecystolithiasis. However, some parameters that predict worse operation outcome have been found. Further research on the topic is needed to find out the parameters that determine whether the patients get benefit from the operation.
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(2019)Background Gallstones are common in the Western adult population: their incidence is 10-20 %. Half of the patients are asymptomatic when the gallstones are diagnosed. Uncomplicated, symptomatic cholecystolithiasis means that the gallstones generate pain, but the disease has not developed any complications. The treatment for symptomatic patients is cholecystectomy which is normally made in laparoscopy. Despite the operation, pain continues in 28 % of the electively operated patients. The purpose of this systematic review is to find out based on literature whether there is a patient group that does not benefit from the operation or what the characteristics of such patients are. Methods The source of the literature is Ovid Medline database. The research question has been divided into PICO keywords and 790 results have been found. The results have been reviewed by title, abstract, and by the whole text, and the articles that do not fulfil the inclusion criteria have been ruled out. The articles have to concern people minimum of 18 years old that have had their gallbladder removed because of symptomatic, uncomplicated cholecystolithiasis. In addition, some symptom and quality of life parameters must have been asked before and after operation. Eventually, there are 22 articles left that the systematic review is based on. These articles have been reviewed with the Newcastle-Ottawa scale. Results There is no research on the patient group that does not benefit from the cholecystectomy, but there are parameters found that have an impact on the benefit. High-level anxiety increases the risk of continuous pain up to three times higher. Alexithymia and psychologic distress are more common in patients that have continuous abdominal symptoms after the operation. High pain frequency is linked to worse postoperative pain relief. To get the best benefit from the operation, pain symptoms need to be typical and intense, but pain frequency low. Female gender and functional gastrointestinal disorder are connected to worse outcome. Pain duration more than a year, high score in preoperative quality of life questionnaire, and episodic pain predict pain relief after the operation. Discussion According to the systematic review, there is no research on who should not be operated because of symptomatic, uncomplicated cholecystolithiasis. However, some parameters that predict worse operation outcome have been found. Further research on the topic is needed to find out the parameters that determine whether the patients get benefit from the operation.
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(2020)In this study, we set out to gain insight into women’s childbirth experiences in Helsinki University Central Hospital. We examined the effect the mode of delivery has on maternal satisfaction. Additionally, we aimed to identify other possible factors influencing the maternal childbirth experience. The childbirth experiences of 600 randomly selected women who gave birth in Helsinki University Hospital between 2018-2019 were analysed. The data was collected from patient record system Obstetrix, and it comprised of 100 women from each of the following groups: spontaneous vaginal delivery, induced vaginal delivery, vaginal delivery by vacuum extraction, elective caesarean section, emergency caesarean section and crash caesarean section. Maternal satisfaction was assessed from scores women had given on the Visual Analogue Scale and how they had described their experience to midwives. Microsoft Excel was used for the recording of the data and statistical software IBM SPSS Statistics 24 was used for statistical analysis. We found the mode of delivery to significantly affect maternal satisfaction with childbirth. Spontaneous vaginal delivery is the fulfilling mode of delivery, followed by elective caesarean section and induced vaginal delivery. Maternal satisfaction decreased with unplanned interventions, with crash caesarean section being the least satisfying mode of delivery. However, several other factors influenced the childbirth experience, too. Caregiver behavior has a significant effect women’s satisfaction. Women who suffer from fear of childbirth during pregnancy experience childbirth more negatively. We suggest further research on the treatment of fear of childbirth.
Now showing items 1-4 of 4