Sosiaalilääketieteellinen Aikakauslehti

Terveyssosiaalityöntekijöiden näkemyksiä sosiaalityöstä erikoissairaanhoidossa

Sointu Riekkinen-Tuovinen, Anni Ylönen, Jenni Allimaa — Tue, 11 Feb 2025 00:00:00 +0200

In the article, we analyze the content of health social work and its contributions to the patient and the multidisciplinary team. Health social workers support patients in a variety of ways, from individual appointments to multi-professional working. The job description includes guiding and supporting the patient on social benefits and services, rehabilitation and functioning in everyday life, as well as collaborating with the patient's loved ones and other networks.

Health social workers accumulate knowledge and experience of patients' everyday needs and challenges, as well as good practice; often tacit information that would be good to highlight for use. There have been studies on health social work, but in our experience, it is not universally known as social work in social services, for example. It is therefore important to make more visible the content and impact of our work.

The starting point of our research was the reflection of health social workers on the role of social work in the changing environment of social care and health care reform. Our data is based on the tasks and summary of the social worker development afternoon at Kuopio University Hospital (KUH) held in November 2018.

Our research questions were:

What is the social contribution of health social work for the patient?
What is the social contribution of health social work for the working group?
How does the social contribution of health social work link to social profit?

According to the experience of social workers, the most important aspects of health social work for the patient are: 1) encounter and presence, 2.) psychosocial support, 3.) communication of information, 4.) network work, and 5.) expertise.

1) Holistic perspective (social, societal and everyday aspects), 2) professional social work skills (expertise) and 3) multiprofessional working skills, including skills in network working, are considered the most important for the working group. Finally, we compared our results with research literature that found the same themes.

Yksinäisyyden kehityspolkujen yhteys psykososiaaliseen turvallisuusilmapiiriin ja uupumusasteiseen väsymykseen koronapandemian aikaisessa etätyössä

Paula Lindholm, Anne Mäkikangas — Tue, 11 Feb 2025 00:00:00 +0200

The COVID-19 pandemic has had far-reaching effects on daily life and well-being. Remote working became more common in Finnish working life due to the pandemic, and social restrictions exacerbated feelings of loneliness. This study used a person-oriented approach to examine loneliness trajectories in remote workers (n = 521) at Tampere Universities during the pandemic. Data was collected between April 2020 and February 2021 as part of the "Safely remotely – occupational well-being and its management in telework" research project, funded by the Finnish Work Environment Fund. We examined loneliness trajectories, and how different trajectories were connected to the psychosocial safety climate and emotional exhaustion symptoms experienced by the remote workers. Three loneliness trajectories were identified among the study subjects: low loneliness (40%), medium loneliness (40%) and high loneliness (20%). All groups showed an increase in loneliness during the first year of the pandemic. However, there were between-group differences in trajectories. We also found that the psychosocial safety climate was highest in the low loneliness group. Loneliness was also connected to negative well-being at work, as the loneliest remote workers were more likely to report emotional exhaustion symptoms. Based on the findings, experiences of loneliness increased during long-term remote work and were associated with negative well-being at work. The study highlights the significance of cultivating a positive psychosocial safety climate in organizations to combat loneliness and promote well-being at work among remote workers. Overall, this study provides evidence on the importance of addressing social and psychological factors in the design of remote work arrangements.

Henkilökohtainen toipuminen psykiatristen osastojen kotiutusviesteissä

Jari Pietarinen, Kyösti Lehtola, Kirsi Myllykangas, Sirpa Tölli — Tue, 11 Feb 2025 00:00:00 +0200

Mental health services should be developed as recovery-oriented, but the transition from current practice has proved challenging. Personal recovery is commonly described using the CHIME framework, which includes five subcategories: 1) connectedness, 2) hope and optimism about the future, 3) identity, 4) meaningful living, and 5) empowerment. Safewards interventions are commonly applied in psychiatric nursing when pursuing safety and reduction of coercive practice by emphasizing respectful and compassionate communication. Discharge Messages is one of Safewards' less-studied interventions aimed at increasing patient hope and treatment adherence.

The aim of this qualitative study was to describe personal recovery in discharge messages written by patients. The aim was to provide information that could be used to support personal recovery in mental health services. The research question was: what content related to partnership, hope and optimism for the future, identity, meaningful living and empowerment did patients discharged from the wards describe in their discharge messages?

The data was collected from six psychiatric wards for adult inpatients in one Finnish hospital. Altogether, 244 discharge messages were photographed and analyzed using abductive content analysis. The analysis matrix for the deductive phase of the analysis was based on the CHIME framework.

All five subcategories of CHIME framework were recognized in the messages. Reflectivity of the messages varied quite a lot. Hope and optimism about the future, identity, and connectedness were the most described elements of personal recovery. Results of this research suggest that sharing one’s experiences with other people is experienced as an important activity. Discharge Messages provides useful platform for peer support and should be utilized actively. Results also suggest that the use of discharge messages may reduce self-stigmatization and promote personal recovery.

Homebirth midwives and peek-a-boo ultrasounds – private health services and their position in pregnancy care

Marjaana Jones, Tuulia Lahtinen — Tue, 11 Feb 2025 00:00:00 +0200

The maternal health clinics play a central role in pregnancy care in Finland. These public clinics reach nearly all expectant parents. Unlike many other social and healthcare services, maternal clinics have not been privatised or opened to competition. The services are organised by the wellbeing services counties. However, a private pregnancy care market has emerged, offering some parents to opportunity to supplement public maternity services. The aim of this article is to examine 1) the types of services currently available to expectant parents and 2) how private service providers seek to position themselves as part of pregnancy care. Our data comes from the websites of private pregnancy service providers, which are used to communicate directly with parents. Our analysis provides an overview of the private services market, which reflects the diversity of needs and desires related to pregnancy care. Private services cover the entire country but are mainly located in larger cities. Through their websites, the services are positioned both as a supplement and an alternative to public services. They are marketed by highlighting the fears related to pregnancy and birth, and by emphasising the uniqueness of this time in the life of the parents. Professionals are depicted as experts who are knowledgeable and highly skilled. Additionally, their expertise is also partly constructed on their personal experiences. The professional-parents relationship was described as free from hierarchies. Parents are clearly positioned as consumer, who are both able and responsible for creating their own individual care pathway. Private pregnancy services can respond to unmet service needs and are marketed as an option for all expectant parents and families. However, financial resources are likely to determine parents' ability to purchase additional or alternative services.

Iäkkäiden etäohjattu liikunta

Sonja Iltanen, Katja Borodulin, Eerika Saloranta, Sakari Taipale, Päivi Topo — Tue, 11 Feb 2025 00:00:00 +0200

Online exercise for older adults – Factors facilitating and hindering the implementation in municipalities

In the National Programme on Ageing 2030, a key objective is to explore ways to maintain mobility of older adults and support independent living at home. This follow-up study explored factors that facilitate or hinder the implementation of online health exercise for older adults. We examined seven municipalities, conducting elicitation interviews and an email survey with employees (n=14). In the analysis, factors influencing the implementation of remote exercise were explored: information about participants, views on older adults, management strategies, tasks executed by organizations and employees, and solutions aimed to support functional capacity of the participants. The results and process of implementation were examined from the perspectives of acceptability, adoption, appropriateness, feasibility, fidelity, costs, coverage, and sustainability. Local organizational culture, resources, and views on older adults were reflected in decisions related to online exercise. Implementation was facilitated by built-in structures, well-managed personnel changes, positive perceptions of the learning potential of older adults, and addressing problems in a solution-focused manner. Flexibility of the online exercise concept facilitated implementation in diverse municipalities and situations. Implementation was hindered due to unforeseen changes in personnel and property resources, limitations in inter-organizational collaboration, and negative perceptions of older adults as users of technology. We suggest that online exercise can contribute to solving health promotion challenges for vulnerable groups and could be considered by municipalities and wellbeing services counties. However, the challenges of implementation need to be carefully considered.

Koulun turvallisuuskulttuuria arvioimassa

Brita Somerkoski, Eila Lindfors, Julia Kokki — Tue, 11 Feb 2025 00:00:00 +0200

School safety studies usually focus on the number of safety incidents or the monitoring of injuries. We carried out a one-year school safety intervention aimed at developing the school organization's safety culture. In this article, we describe the changes we observed after the intervention in the focus group interviews safety talk in the elements of safety management, prevention, competence assurance and social safety environment.

The theoretical framework was a set of criteria for self-evaluation of the safety culture in school. This model is called [anonymisoitu]. The model included four elements of safety culture and a five-step safety culture quality scale. We analyzed the semi-structured focus group interview data of 14 schools using theory-driven content analysis.

After the intervention, a change in operating culture was observed in the safety talk of the focus groups for all four elements. The most significant change was related to safety management. This was reflected in an increase in systematicity and the introduction of safety tools. After the intervention, closer interaction was observed, as safety measures had begun to be implemented with a team structure. Involvement of students in safety issues increased.

Furthermore, resources were used to collect and process safety incident data. This allowed for a proactive approach to safety management. At the heart of the change was the school's principal, who decided on and directed safety culture activities, but also participated in solving practical safety problems. Signs of success in safety management were proactive measures, a team structure in the allocation of tasks, and crossing organizational and administrative boundaries to promote security.

Työkyvyn tuki keikkatyössä työterveyshuollon ja kulttuurialan ammattilaisten kuvaamana

Riitta Kärkkäinen, Arto Reiman, Kati Ylikahri, Anne Kärki — Tue, 11 Feb 2025 00:00:00 +0200

Work ability support of gig workers and self-employed as described by the professionals of occupational health care and cultural sector

Although gig work is well-established in Finnish working life, shortcomings have been demonstrated in the support of the work ability of people who perform gig work. Maintaining the work ability of those who perform gig work is important for the functioning of society. The purpose of this qualitative study was to describe the experiences and perceptions of occupational health care and cultural sector professionals about the factors that promote and hinder the work capacity of gig workers (fixed-term, part-time, agency workers) and self-employed workers (freelancers, sole entrepreneurs) within the framework of good occupational health care practice and occupational health and safety legislation. Data were collected in 2021 and 2022 by interviewing professionals in occupational health care (n=7) and cultural sector (n=22) in different regions of Finland and analyzed with inductive content analysis. Implementation of good occupational health care practices to support work ability was structured as a factor that promotes the work ability support of gig workers, whereas problems in the flow of information and unclear rights and responsibilities in occupational health cooperation, weaknesses in occupational health cooperation in the tripartite relationship of agency work, the unequal treatment of gig workers in support of work ability, and illness-based support appeared as factors preventing it. Factors that motivate the organization and use of occupational health care were identified as ones to promote the work ability support of self-employed workers, while it was hindered by the limited financial opportunities for sole entrepreneurs to arrange occupational health care, by primary preparation for the work disability instead of prevention, by the exclusion of cultural freelancers from occupational health services, and by the unrecognizability of work-related risks and the need for occupational health care. The study made visible the starting points for the development of work ability promoting activities in the gig work with an emphasis on preventive activities. Further studies should examine the factors that maintain inequality in the support of the work ability of gig workers, as well as the structures and practices that prevent occupational health cooperation in the tripartite relationship of agency work and the occupational health services of self-employed persons.

Sateenkaarinuorten mielenterveydellisten huolien taustalla olevat tekijät ja heidän tuen tarpeensa

Riikka Kuivaniemi, Kirsi Lindfors, Jari Kylmä — Tue, 11 Feb 2025 00:00:00 +0200

The occurrences of depressive symptoms, anxiety and suicidality are greater among LGBTQ youth than other youth. In global literature the underlying factors of mental health worries in LGBTQ youth have been recognized, however a lack of similar research in Finnish context exists. Although the status of Finnish LGBTQ persons has improved within few years, a clear disparity in health between LGBTQ youth and other youth exists. Therefore, LGBTQ youth are a vulnerable group in Finnish society.

The purpose of the research was to describe the underlying factors of mental health concerns in LGBTQ youth and their needs for support from their own perspective. The study was conducted qualitatively. The data of the study was conducted from Finnish LGBTQ youth aged 15 or more (n=22). The data was collected by using an electric survey and interviews. The data of the study was analysed by using inductive content analysis method.

The underlying factors of mental health worries in LGBTQ youth were the lack of societal knowledge and understanding, the negative self-image of LGBTQ youth, the insecure social network of LGBTQ youth, the inadequate attention of LGBTQ youth in health care system, challenges in everyday life, the vulnerable societal status of LGBTQ youth, the inappropriate treatment of LGBTQ youth and the difficulty of bringing forward own LGBTQ identity. LGBTQ youth needed support from health care professionals, surrounding people, other LGBTQ persons and from people with societal influence. LGBTQ youth needed support in everyday life and in the improvement of the societal status.

Both, broad factors in the structures of society and smaller issues visible in the daily life of LGBTQ youth were described as the causes of LGBTQ youth's mental health concerns. Changing the structures of society and legislation requires time and long-term work from the whole society. Every member of society can influence the bullying of LGBTQ youth, its intervention and prevention, and the open-minded encounter of LGBTQ youth with their own actions. More research on, for example, primary school teaching about the LGBTQ people and LGBTQ youth’s experiences of Finnish health care is needed nationwide.

Potilaiden kokema toimijuus perusterveydenhuollossa toteutetussa työkykykoordinaattoripalvelussa

Tue, 11 Feb 2025 00:00:00 +0200

The development of work disability prevention services in public primary health care is considered important since there are approximately 11,000 to 35,000 working-age persons outside the labor market and occupational health care in Finland who need work disability preventive services. Work disability prevention services in public primary health care are considered an important development to ensure the adequacy of the workforce. In addition, strengthening patients’ agency has been seen essential in the reform of services and in providing work ability support. The study examined the agency of patients who met the work ability coordinator during the work disability prevention intervention in public primary health care. The aim of this qualitative study was to investigate the patients’ experiences of the work ability coordinator’s service. Ten patients were interviewed twice: after the first appointment with the work ability coordinator and about six months after their first appointment. Using the inductive thematic analysis method, two main themes and four sub-themes were found in the data. The main themes were passivity created by the service structure and autonomy. Patients reported that visiting the work ability coordinator strengthened their agency and experience of inclusion. Work disability prevention services should be part of a working-age service package in public primary health care to secure equal access to services improving patients’ work ability and agency.

Digitaalisten terveyspalveluiden käytön haasteet ja rajoitteet 75 vuotta täyttäneiden kansalaisten kokemana

Hanna Varjakoski, Elisa Tiilikainen — Tue, 11 Feb 2025 00:00:00 +0200

Public health services have been rapidly digitalized in Finland and many other countries. This change is driven by the need to make services more accessible and to involve citizens in monitoring and managing their own health. At the same time, a significant proportion of the oldest population is at risk of being excluded from digital services. The aim of this study is to examine the challenges and constraints faced by older people aged 75 and over when using digital health services, and the factors behind them. The data include qualitative interviews (N=24) in which the media-go-alongmethod were also used. The results show that challenges and constraints in using digital health services were, in particular, related to poor website usability and accessibility, problems with online appointment booking and perceived limited interaction with the services. In addition, the lack of digital skills, tools and motivation, as well as the physical and cognitive changes associated with ageing, were individual-related factors that challenged or limited the use of digital services. The study provides new insights into how user-friendliness of public digital health services is achieved for older user groups and highlights the need to pay more attention to the usability and accessibility of digital services as part of service design and development.

Tilannetietoisuus erikoissairaanhoidon potilasturvallisuudessa:

Tuula Saarikoski, Kaisa Haatainen, Risto Roine, Hannele Turunen — Tue, 11 Feb 2025 00:00:00 +0200

Purpose and aim of the study

The purpose of the study was to describe the views of the medical and nurses supervisors on situational awareness in patient safety management. In particular, the aim was to identify and detect situations and circumstances affecting patient safety in their day-to-day management and decision-making.

Methods

The data were collected as Webropol survey in 2017. The questionnaire was addressed to all head nurses and chief physicians in the four different medical districts, as well as to the heads of the hospital district (the heads of the medical district, the chief physicians, and nursing supervisor) (N=124).

Results

The nursing supervisor paid more attention to the fact that the staff are presenting their own suggestions for improving patient safety. The results also showed that in various meetings, supervisors from a nursing background raised issues related to patient safety, while those from a medical background recognized the importance of risk assessment more frequently. Pre-meds with a medical background are less likely to use information obtained from reports of emergency situations in their management of caregivers.

Kuntosaliharjoittelu sukupolvikysymyksenä

Ilkka Pietilä, Hanna Ojala — Tue, 11 Feb 2025 00:00:00 +0200

Gym training as a generational issue: a study on men’s motivation to take part in an exercise intervention programme for prostate cancer patients

Exercise programmes for older adults aim not only to promote functional ability but also reduce the side effects of medical treatments. Participation in exercise interventions does not always remain high. In an intervention for prostate cancer patients, it turned out that engagement in gym exercise decreased substantially after the guided training period and the follow-up groups were less active throughout the programme. We studied factors that diminished men’s motivation to participate.

The data consisted of qualitative interviews (n=122) with 43 men from intervention and follow-up groups. Men were interviewed three times. The interviews were analysed using inductive content analysis.

Explanations that men gave for their decreased motivation fell into two groups. First, men had negative impressions of gyms as highly competitive training environments from their adolescence and today saw them as commercialized and appearance-centered places. Gyms were considered environments for younger people where the men interviewed did not feel they belonged. Secondly, most men preferred endurance sports and everyday physical activities as exercise. Gym training did not fit such exercise preferences well.

People’s exercise preferences relate intersectionally to gender, age and generational experiences. To promote participants’ motivation, diverse ideas related to exercise should be acknowledged in planning exercise programmes.

Chained loopings in the development of addictionss

Anja Koski-Jännes — Tue, 11 Feb 2025 00:00:00 +0200

Addiction research has thus far been mostly conducted in various disciplinary silos without considering the multiplicity of factors affecting this phenomenon. This article aims to offer a more integrated cross-disciplinary perspective on the main factors contributing to the development of addictions. To achieve this end I apply the concepts of classificatory and biolooping in the development of human behaviour by Canadian philosopher Ian Hacking. A simple four-factor model of the main factors producing addictive behaviours is then presented. Its components include sociocultural affordances, social representations and images, life stressors and the psychobiological vulnerabilities of individuals and groups. Classificatory and bioloopings help to understand how the above described factors entwine thus forming mutual feedback loops leading to the vicious circle of addiction. Any shortsighted attempts to solve this problem just deepen the trap of addiction. Yet there are also ways out of this problem. In the end I will display how the above described model can be used to promote prevention and treatment of addictions. The narratives of recovered individuals provide further clues on what kind of changes are needed for stable recovery.

Nuorten koululaisten ongelmallinen älypuhelinten käyttö ja mielenterveyskriisi

Niko Männikkö — Tue, 11 Feb 2025 00:00:00 +0200

Terveydenlukutaito on keino kaventaa terveyseroja

Tiia-Mariia Rantala, Minna Salakari — Tue, 11 Feb 2025 00:00:00 +0200

The scope and diversity of health communication extend from everyday conversations to social media and scientific publications. Critical evaluation of information and its application in daily life require health literacy, which is known to be unevenly distributed across populations, leading to health disparities. By understanding the factors influencing health communication, implementing effective health communication, and promoting health literacy among the population, we can enhance public health and reduce health disparities.

Euroopan terveyssosiologien 20. tapaaminen Antwerpenissa

Eero Lahelma — Tue, 11 Feb 2025 00:00:00 +0200

Suomalaisten näkökulmia lääkkeiden ja lääkealan ympäristökestävyyteen

Lasse Alajärvi — Tue, 11 Feb 2025 00:00:00 +0200

Aktiivinen ikääntyminen – diskurssin rakentuminen eri konteksteissa

Hilla Kiuru — Tue, 11 Feb 2025 00:00:00 +0200

Välitätkö siitä mitä ympärilläsi tapahtuu?

Ilkka Piiroinen — Tue, 11 Feb 2025 00:00:00 +0200

Masennusten määrittelyjen taustoista ja seuraamuksista

Annastiina Mäkilä — Tue, 11 Feb 2025 00:00:00 +0200

Soten vaikutus ilmastonmuutokseen, ja päinvastoin

Tue, 11 Feb 2025 00:00:00 +0200