Digitaalinen murros kunnan palveluissa : huomioidaanko kuntalainen hyvinvoinnin toimijana?

Patients' readiness for dietary change at the beginning of counselling: a transtheoretical model-based assessment.

Background  The purpose of this study was to explore patients' readiness for dietary change within a theoretical framework of the transtheoretical model. The patients were recently diagnosed to have type 2 diabetes or impaired glucose tolerance. We discuss the theoretical aspects of appropriate dietary counselling strategies from a standpoint of patient-specific stages of change. Methods  The data included 32 audiotaped diabetes counselling sessions with 16 patients conducted by two nurses. The transcribed data was analysed by using deductive content analysis. Results  The patients were at different stages of change of diabetes-affected dietary behaviour. Their stages of change varied in di…

Community-based oral health promotion practices targeted at children and adolescents in Finland--developing an assessment tool.

Objectives To develop an assessment tool for evaluating oral health promotion practices and to evaluate community-based oral health promotion practices targeted at children and adolescents with this tool. Methods A theoretical framework about health promotion planning, implementation and evaluation was made on the basis of a literature review. Then, information about Finnish community-based oral health promotion practices (n = 12) targeted at children and adolescents was collected using semi-structured interviews. Also, related documents, for example action plans and reports, were collected when available. Next, an assessment tool based on the theoretical framework was developed, and the re…

Terveyskäyttäytyminen terveystiedon opetuksessa

High-risk individuals’ perspective on risk of Type 2 Diabetes and physical activity in the prevention of diabetes. A qualitative study

Implementation and Outcomes of Lay Health Worker–led Self-management Interventions for Long-Term Conditions and Prevention: A Systematic Review

The aim of this study was to systematically review lay health worker (LHW)–led self-management interventions for adults with long-term conditions to see how the interventions have been implemented and to compose a synthesis of research findings, taking into consideration the intervention components that have been applied. We conducted systematic searches for articles published between January 2010 and December 2015 in five databases: Cochrane, MEDLINE, CINAHL, PsycINFO, and Web of Science. Forty original studies were found that met the inclusion criteria: self-management with diabetes (n = 29), cardiovascular diseases (n = 8), and those at risk of cardiovascular diseases (n = 3). These cons…

Readiness for health behavior changes among low fitness men in a Finnish health promotion campaign.

Men have been a hard-to-reach population in health behavior programs and it has been claimed that they are less interested in health issues than women. However, less is known about that how ready men are to adopt new health behaviors. This study examined readiness for change in physical activity (PA) and eating behavior (EB) among low fitness and overweight working-aged Finnish men who participated in a PA campaign. Associations among perceived health knowledge, health behaviors, psychosocial factors and readiness for change were studied. Data comprised 362 men aged 18–64. Physical fitness was assessed with a body fitness index constructed on the basis of the Polar OwnIndex Test, a hand gri…

Psychometric Properties of a Short Measure for Psychosocial Factors and Associations With Phase of Physical Activity Change Among Finnish Working-Aged Men

Insufficient physical activity (PA) and poor physical fitness are risks for several noncommunicable diseases among working-aged men. PA programs have been launched to increase activity levels in the population but working-aged men have been underrepresented in these programs. The aim of the present cross-sectional study was to evaluate validity of a short scale for psychosocial factors among Finnish working-aged men who participated in a PA campaign. The study examined also the associations between psychosocial factors and phase of PA change across fitness groups. Physical fitness was assessed with a body fitness index constructed on the basis of a handgrip test, the Polar OwnIndex Test, a…

Variation in assessing the need for change of snacking habits in schoolchildren's oral health counselling

Objectives.  This study examined counselling communication activities that were used for assessing schoolchildren's need for change of snacking habits. In addition, the schoolchildren's assessment of their need for change was explored after a follow-up year (2002–2003). Material and methods.  The follow-up research data included 66 counselling sessions in 2002 and 31 counselling sessions in 2003, with 31 schoolchildren. The sessions were conducted by four dental hygienists. The audio-taped data were analysed qualitatively by using content analysis. Results.  In 2002, the needs assessment was realized in three ways. Infrequently, the schoolchildren either disclosed their need for change or t…

Dietary and physical activity counselling on Type 2 diabetes and impaired glucose tolerance by physicians and nurses in primary healthcare in Finland

To investigate the initiation of dietary and physical activity counselling and the arguments used when discussing physical activity and the type and consumption of dietary fats, during nurse-patient and physician-patient diabetic lifestyle counselling.This study is a part of a larger follow-up research project focusing on diabetes counselling. The data include 129 videotaped counselling sessions between 17 patients and their physicians and nurses. Content analysis was carried out by identifying the verbal comments and reactions of participants concerning both physical activity and the type and consumption of dietary fats.The physicians and nurses spent little time on dietary and physical ac…

'I saw what the future direction would be...' : Experiences of diabetes risk and physical activity after diabetes screening

Objectives To improve understanding of how individuals at high risk of type 2 diabetes experience the risk of diabetes and how these experiences relate to the adoption of physical activity as a protective behaviour. Design A qualitative study using semi-structured interview with individuals identified by screening as at high risk of type 2 diabetes. Methods Fourteen individuals, aged 40–64, were interviewed twice, with a 2-year interval between. Participants' experiences of their risk of diabetes and physical activity were assessed. The transcribed interview data were analysed using inductive qualitative content analysis. Results Two themes emerged from the data: a threatening risk percepti…

Changes in Psychosocial Factors and Physical Activity Among Finnish Working-Age Men in the Adventures of Joe Finn Campaign

This study evaluated changes in psychosocial factors and self-reported physical activity (PA) among the sample of Finnish men who underwent the fitness tests during the national health campaign. Another aim was to examine whether the fitness test feedback was a meaningful experience for PA change. Baseline data were collected in 2011 by fitness test and questionnaire. Men who had low/moderate fitness along with overweight ( n = 361) were recruited to the postcampaign study in 2014. Data were analyzed with nonparametric tests, logistic regression analysis, and content analysis. The postcampaign survey was completed by 102 men. Positive PA change was associated with high goals, planning skil…

Hoitotyön opiskelijoiden terveyden edistämisajattelun kehitys koulutuksen aikana

Cultural and communicational traits of oral health care: results of a Finnish case study.

This paper aims to describe the cultural and communicational traits of Finnish oral health care. First, employees' views and experiences regarding their organization and their position within it are investigated and, second, relations between different individual and organizational factors are analyzed. Finally, a conceptual framework of organizational coherence is constructed.The paper shows that data collection (n = 58, 84 percent response rate) was carried out in 2002 at a Finnish dental clinic by using a semi-structured questionnaire. The data were analyzed statistically by using, among other things, non-parametric tests and a structural equation model (LISREL) and qualitatively by usin…

Oral health counselling in changing schoolchildren's oral hygiene habits: a qualitative study.

Abstract –  Objective:  This study explored oral health counselling concerning changes of oral hygiene habits in 11- to 13-year-old schoolchildren within a theoretical framework of the transtheoretical model and the motivational interview. Methods:  The follow-up data (2002–2003) formed two sequential parts: the first part comprised 66 counselling sessions in 2002; the second part included 31 counselling sessions in 2003. Thirty-one (n = 31) schoolchildren were included in the counselling sessions that were conducted by four dental hygienists. The audiotaped and transcribed data were analysed qualitatively by using content analysis. Results:  In 2002, nearly every schoolchild needed to esta…

Transtheoretical model-based dietary interventions in primary care: a review of the evidence in diabetes

The objective of this study was to review the evidence concerning stage-based dietary interventions in primary care among persons with diabetes or an elevated diabetes risk. Search strategies were electronic databases and manual search. Selection criteria were randomized controlled studies with stage-based dietary intervention, conducted in primary care with at least 6 months of follow-up, and participants with either type 2 diabetes or with an elevated risk. The researchers evaluated trials for inclusion, extracted data and assessed study quality. Seven articles, based on five data sets, were included. These studies concentrated on cardiovascular diseases and being overweight, not diabetes…

Mistä elämäntapamuutoksessa on kyse?

The gap between behavioral risk status and willingness to change behavior among healthcare professionals

Aims: This study explored behavioral health risk factors among healthcare professionals and investigated the at-risk persons’ satisfaction with their health habits and ongoing change attempts. Methods: The study was based on a cross-sectional web-based survey directed at the nurses and physicians ( N = 1233) in Finnish healthcare. Obesity, low physical activity, smoking, and risky alcohol drinking were used as behavioral health risk factors. Results: In all, 70% of the participants had at least one behavioral risk factor, and a significant number of at-risk persons were satisfied with their health habits and had no ongoing change process. Good self-rated health and good self-rated work abil…

Hyvinvointivalmennus : trendikäs käsite vai jotain muutakin?

Organisational culture: pursuing a theoretical foundation within the Finnish public oral health-care context.

At the moment, Finnish oral health care is undergoing many changes. Little attention has been paid to issues of organisational culture and communication in Finnish oral health care. Yet the question of culture is of primary importance for changes in an organisation and for planning and reconstructing the rational functioning of an organisation. The purpose of this paper is to examine Finnish public oral health care within a theoretical framework of organisational culture and to identify the various cultural traits that appear to characterise Finnish oral health care. Using a cultural point of view, we develop an orientation for understanding more profoundly and specifically the processes co…

Schoolchildren's oral health counselling within the organisational context of public oral health care : applying and developing theoretical and empirical perspectives

The purpose of the present series of studies was to examine the counselling communication activities in schoolchildren`s oral health counselling and the organisational context of public oral health care. Four studies based on two datasets were carried out. The counselling follow-up audiotaped data (2002–2003) comprised 97 counselling encounters. Thirty-one 11–13-year-old schoolchildren (n = 31, 15 girls and 16 boys) were included in the counselling sessions that were conducted by four dental hygienists. The organisation data collection (n = 58) was carried out by using a semi-structured questionnaire in 2002. Methods of qualitative content analysis and statistical analysis were applied for …

Kokemustieto yhteiskehittämisessä : hyppy asiakaslähtöisyyteen terveyspalveluissa

A cross-sectional study of low physical fitness, self-rated fitness and psychosocial factors in a sample of Finnish 18- to 64-year-old men

Background. The biological risk factors of inactivity and poor cardiorespiratory fitness are well established. However, risk groups are hard to reach and they may have misperceptions of their need for change. This study explored self-ratings of physical fitness (PF) and the relationship between objectively estimated physical fitness (PFI) and psychosocial factors among Finnish men of working-age. Methods. Cross-sectional data on 899 Finnish men (aged 18–64) were collected in 2011. Health- related physical fitness was evaluated with a physical fitness index calculated from the results of selected fitness tests. The men were subsequently classified into three groups: low, moderate and high PF…

Individual differences in processes of lifestyle changes among people with obesity: an acceptance and commitment therapy (ACT) intervention in a primary health care setting

Abstract Aim: To explore what thoughts, feelings, and learning processes were involved in obese participants’ lifestyle change during an acceptance and commitment therapy (ACT) lifestyle intervention delivered in primary health care. Background: Previous studies have revealed that lifestyle interventions are effective at promoting initial weight loss, but reduced weight is often difficult to sustain because of the failure to maintain healthy lifestyle changes. Achieving and maintaining lifestyle changes requires to learn self-regulation skills. ACT-based lifestyle interventions combine many self-regulatory skill factors, and the results from previous studies are promising. Research on the i…

Implementation and Outcomes of Lay Health Worker-Led Self-Management Interventions for Long-Term Conditions and Prevention: A Systematic Review.

The aim of this study was to systematically review lay health worker (LHW)–led self-management interventions for adults with long-term conditions to see how the interventions have been implemented and to compose a synthesis of research findings, taking into consideration the intervention components that have been applied. We conducted systematic searches for articles published between January 2010 and December 2015 in five databases: Cochrane, MEDLINE, CINAHL, PsycINFO, and Web of Science. Forty original studies were found that met the inclusion criteria: self-management with diabetes ( n = 29), cardiovascular diseases ( n = 8), and those at risk of cardiovascular diseases ( n = 3). These …

Yhteisöt terveyden edistäjinä : miten toimintaa voitaisiin edistää arvioida ja tehostaa?

Tässä artikkelissa esitellään suomenkielinen versio yhteisölähtöisen terveyden edistämisen arviointimittarista (Blomqvist ym. 2014). Yhteisölähtöisellä terveyden edistämisellä tarkoitetaan yhteisöjen (mm. päiväkoti, koulu, harrasteryhmä, työpaikka, koti, kylä, kunta/kaupunki) kanssa työskentelyä, jonka tavoitteena on yhteisöjen kehittyminen, voimaantuminen ja sitoutuminen hyvinvointia ja terveyttä edistävään toimintaan (Green & Tones 2010, 401-2). Toiminta on kokonaisvaltaista ja monialaista ihmisten elinpiiriin vaikuttamista. Yhteisölähtöinen terveyden edistäminen kiteytyy ajatukseen ”Terveyttä luodaan ja ylläpidetään siellä, missä ihmiset viettävät jokapäiväistä elämäänsä, eli siellä miss…

Lifestyle counseling in type 2 diabetes prevention: a case study of a nurse's communication activity to produce change talk.

As a case study, this article describes a nurse's communication activity, focusing on change talk during lifestyle counseling in primary healthcare. All videotaped counseling sessions with a single patient within a period of two years were transcribed verbatim. In the analysis, an emphasis was placed on the nurse's communication activity that produced change talk, how the nurse initiated change talk, and how the patient received it. The observations provide evidence that the dilemma of simultaneously maintaining professional authority and patient perspective leads to sensitivity in lifestyle counseling. Three categories of change talk were identified: rejected, restrictive, and expansive ch…

Can peer-tutored psychological flexibility training facilitate physical activity among adults with overweight?

Objective An increase in psychological flexibility has been found to be associated with health behavior changes. Peer-led interventions have been advantageous in improving physical activity among individuals at health risk. This study aimed to discover whether an ACT-based peer-tutored online intervention can increase self-reported physical activity participation and psychological flexibility among adults with overweight. Design The study was a non-randomized longitudinal intervention study. The intervention participants (N = 177) were primary health care clients with overweight. They participated in a 24-month program provided by health services, including three online modules of ACT of si…

Tunnesidonnainen toiminnan säätely ja kokemusasiantuntijoiden sisäänpääsy sairaalaorganisaatioon. Päiväkirja-analyysin yhtymäkohdat Norbert Eliasin teoriaan

Sosiaali- ja terveyspalvelujen parissa kokeillaan yhä useammin uudenlaisia kokemusasiantuntija­käytäntöjä, jotka asettavat asiantuntijaorganisaatioita uuteen tilanteeseen. Tutkimuksessa selvitettiin kuuden kehittämiskumppanuuskokeiluun osallistuneen kokemusasiantuntijan päiväkirjojen avulla kokemusasiantuntijoiden sairaalaorganisaatioon astumisen ensivaiheita ja organisaatioon sisään pää­semistä. Tulosten mukaan kokemusasiantuntijatoiminnan aloittamiseen sairaalassa liittyy sosiaalisesti ja kulttuurisesti muodostuvia tunteita. Toiminnan ulkoinen säätely sekä subjektiivisten ja sosiaalisten tunnekokemusten itsesäätely ovat organisaatioon sisäänpääsemisen prosesseissa keskeisiä. Tuloksia on m…

Opiskelijoiden hyvinvointia edistävän verkkosivuston luominen opiskelijajohtoisella projektilla

Opiskelijoiden hyvinvointiin ja opiskelukykyyn vaikuttavat useat tekijät, joista moniin opiskelijalla on avaimet omissa käsissään. Opiskeluelämää aloittaessaan nuori aikuinen alkaa itse vastata omista ravitsemus-, liikunta- ja unitottumuksistaan. Miten käy näiden tottumusten, kun muutto uuteen kaupunkiin, uusien ihmissuhteiden luominen ja akateemisten opiskelutaitojen kehittäminen vaativat paljon opiskelijan voimavaroja? Tutkimusten mukaan korkeakouluopiskelijoiden terveystottumuksissa on parannettavaa. Vuoden 2016 aikana Jyväskylän yliopistossa toteutettiin opiskelijajohtoinen projekti, jossa luotiin hyvinvoinnista huolehtimiseen kannustava Hyvinvoiva minä -verkkosivusto (Hyvinvoiva minä).…

Terveysliikunnan lukutaidon yhteys vapaa-ajan liikunta-aktiivisuuteen ja fyysiseen kuntoon työikäisillä miehillä

Tutkimuksen tarkoituksena oli selvittää, onko työikäisten (25–64-vuotiaiden) miesten terveysliikunnan lukutaito yhteydessä vapaa-ajan liikunta-aktiivisuuteen ja fyysiseen kuntoon. Aineisto oli osa Jyväskylän yliopiston Terveyden edistämisen tutkimuskeskuksen ja LIKES-tutkimuskeskuksen yhteistyössä toteuttamaa ”Sisältääkö suomalaisen miehen liikunnan terveyden lukutaito tajua ja toimintaa?” -tutkimusta (2008–2009). Aineisto kerättiin kolmelta paikkakunnalta terveyskäyttäytymiskyselyillä, Polar OwnIndex-kuntomittauksilla ja Inbody 720-kehon koostumusmittauksilla. Tutkimukseen osallistui vuoden 2009 keväällä 104 työikäistä miestä. Tilastollisissa analyyseissa käytettiin ristiintaulukointeja ja…