Differentiating middle‐aged long‐term and short‐term frequent attenders by means of the Northern Finland Birth Cohort 1966 Study

Huhtakangas, Moona; Kyngäs, Helvi; Bloigu, Risto; Kanste, Outi

doi:10.1111/scs.12896

Cited by 5 publications

(5 citation statements)

References 28 publications

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“…Although diagnoses are not reported, we know that multimorbidity is established in the sample. Poor self-rated health is associated with frequent attendance in primary care ( 34 ). Health professionals seemed to have a good ability to select those patients suitable for social prescribing programs.…”

Section: Discussionmentioning

confidence: 99%

Targeted health promotion with guided nature walks or group exercise: a controlled trial in primary care

Kolster,

Heikkinen,

Pajunen

et al. 2023

Front. Public Health

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BackgroundContact with nature promotes wellbeing through diverse pathways, providing a potential way of supporting health especially in primary care, where patients commonly suffer from multimorbidity and poor general health. Social prescribing is a non-pharmaceutical approach for improving health as well as social inclusion. This field study explores and compares the effects of a nature-based and an exercise-based social prescribing scheme on mental wellbeing and sleep, in a primary care population.MethodsPrimary care patients identified to benefit from a general improvement to their health were recruited by nurses, doctors, or social workers to this non-randomized, intention-to-treat, pilot field-study. Participants (n = 79) chose between the group interventions, either taking part in guided walks in nature, including immersion in a forest with high biodiversity, or participating in a versatile sports program. Mental wellbeing was assessed with the Warwick-Edinburgh Mental Well-Being Scale (WEMWBS), with additional questions evaluating self-rated health and sleep. Impact on mental wellbeing was explored in relation to perceived health. The amount and quality of sleep was measured with wrist-worn accelerometers. With a focus on everyday life impacts, the assessments took place before and after the 8-week intervention. All participants lived in Sipoo, Finland, an area with abundant accessible green space.ResultsParticipants (mean age 57 years, 79% female) rated their general and mental health lower than the general population. Participation in the Nature-group resulted in improved mental wellbeing (change in WEMWBS by 3.15, p = 0.008), with a positive change for feeling relaxed, being cheerful, having energy to spare, feeling able to deal well with problems, feeling good about oneself and feeling close to other people. The Sports-group was beneficial for those initially rating their health as good. Sleep duration improved in the Sports-group, while participants in the Nature-group reported better sleep quality. Following the interventions there was improvement in perceived health and ability to function in both groups, while perceived mental health improved only in the Nature-group.ConclusionWe attest that even in areas surrounded by greenery, active interventions can further improve health in a primary care population, and that nature-based interventions are beneficial for those in poor health.Clinical trial registrationClinicalTrials.gov, Identifier NCT05893212.

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Section: Discussionmentioning

confidence: 99%

Targeted health promotion with guided nature walks or group exercise: a controlled trial in primary care

Kolster,

Heikkinen,

Pajunen

et al. 2023

Front. Public Health

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“…We determined the persistent FAs as adults who had had at least eight annual visits in outpatient care, excluding emergency care, for at least 3 of the 4 years of follow-up (2017–2020), a definition based on previous studies. 3 , 67 We obtained a random sample ( n = 100) of FAs, including their names, mail addresses, and phone numbers, from registered data of one large municipality in Finland. Participation required informed consent and the ability to independently answer the interview questions on the phone, without, for example, the assistance of a relative.…”

Section: Methodsmentioning

confidence: 99%

“…A small number of patients (1.6–3.6%) are known as persistent frequent attenders (FAs) who continue to visit outpatient care year after year and may account for 8–35% of all primary care visits. 1 – 3 Several studies have attempted to describe FAs with the conclusion that they are a highly heterogeneous group. 1 , 2 , 4 – 10 However, they have in common a chronic illness or multimorbidity, a mental health condition or disability, and the related continuous need for care due to acute exacerbations.…”

Section: Introductionmentioning

confidence: 99%

Patterns of acceptance and use of digital health services among the persistent frequent attenders of outpatient care: A qualitatively driven multimethod analysis

et al. 2023

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Objective Utilising digital health services in the treatment of patients who frequently attend outpatient care could be beneficial for patients’ health and the sustainability of health systems but carries the risk of digital exclusion. This study aimed to explore the patterns of acceptance and use of digital health services among frequent attenders (FAs), which may help in the assessment of patients’ digital suitability. Methods Persistent FAs ( N = 30) were recruited by random sampling from one Finnish municipality. The semistructured interviews were conducted in February–May 2021. We analysed the data with qualitative content analysis using the Unified Theory of Acceptance and Use of Technology (UTAUT) model. Additionally, we quantified the data for two-step cluster analyses to create separate cluster models that grouped FAs based on acceptance and use of (a) digital services for self-management of health and (b) telemedicine services. Results Based on digital self-management, FAs were defined as Self-Managers, Supported Self-Managers, and Non-Self-Managers. Based on telemedicine use, they were grouped into Telemedicine Users, Doubtful Telemedicine Users, and Telemedicine Refusers. The clusters described different opportunities, awareness, and interest in using digital health services. Referral from professionals seemed to promote digital service use. For some, digital services were not accessible. Conclusions Our findings emphasise the importance of assessing the suitability of FAs to digital health services, as their readiness to use may vary. Professionals should recommend digital services that support individual health to suitable patients. More accessible digital services could promote digital suitability despite functional limitations.

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“…Esimerkiksi korkea ikä, sukupuoli, krooniset sairaudet ja huonoksi koettu terveydentila ovat yhteydessä runsaaseen palvelutarpeeseen. (24,25.) Suomessa ja kansainvälisesti runsasta palvelutarvetta on tut kittu perusterveydenhuollon (25,26,27) ja erikoissairaanhoidon palveluissa (28,29) sekä sairaalan päivystyspalveluissa (24,30). Suomessa aihetta on tutkittu myös työterveyshuollon palveluissa (31).…”

Section: Lisääntynyt Terveyspalvelujen Tarveunclassified

Vuorovaikutus terveydenhuollon ammattihenkilöiden kanssa paljon terveyspalveluja tarvitsevien asiakkaiden arvioimana

Huhtakangas

Tolvanen

Kyngäs

et al. 2022

SLA

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Runsas palvelutarve aiheuttaa haasteita sekä asiakkaille itselleen että terveyspalvelujärjestelmälle asiakkaiden pyrkiessä saamaan tarpeitaan vastaavaa hoitoa. Vuorovaikutus on tärkeää asiakkaan ja terveydenhuollon ammattihenkilöiden kohtaamisissa. Tutkimuksen tarkoituksena oli vertailla lyhyt- ja pitkäaikaisesti paljon terveyspalveluja tarvitsevien asiakkaiden näkemyksiä vuorovaikutuksesta terveydenhuollon ammattihenkilöiden kanssa. Lisäksi tarkoituksena oli testata samalla kohderyhmällä Patient-Professional Interaction Questionnaire PPIQ-mittarin faktorirakenteen yhdenmukaisuutta. Aineisto kerättiin erään kaupungin hyvinvointipalveluiden pitkäaikaisesti (n=234) ja lyhytaikaisesti (n=261) paljon terveyspalveluja tarvitsevilta asiakkailta tammi-heinäkuussa 2020. Mittari sisälsi 16 vuorovaikutusta arvioivaa väittämää, jotka muodostavat neljä ulottuvuutta: tehokas kommunikaatio; kiinnostus asiakkaan näkemyksiä kohtaan; empatia; asiakkaan osallistaminen hoitoon. Kukin ulottuvuus sisälsi neljä väittämää. Aineisto analysoitiin Pearsonin khiin neliö -testillä, keski- ja hajontaluvuilla sekä Mann-Whitney U -testillä. Mittarin sisäistä johdonmukaisuutta arvioitiin Cronbachin alpha -reliabiliteettikertoimella ja mittausinvarianssia useamman ryhmän konfirmatorisella faktorianalyysillä. Pitkäaikaisesti paljon terveyspalveluja tarvitsevat asiakkaat arvioivat vuorovaikutuksen ammattihenkilöiden kanssa keskimäärin heikommaksi kuin lyhytaikaisesti paljon terveyspalveluja tarvitsevat asiakkaat. Asiakkaan hoitoon osallistaminen oli keskeinen vuorovaikutukseen liittyvä tekijä pitkäaikaisesti paljon terveyspalveluja tarvitsevien asiakkaiden arvioimana. Useamman ryhmän konfirmatorisen faktorianalyysin perusteella PPIQ-mittarin rakenne ja lataukset olivat samanlaiset lyhyt- ja pitkäaikaisesti paljon terveyspalveluja tarvitsevien asiakkaiden ryhmissä, mutta vastaukset eri väittämiin vaihtelivat ryhmien välillä. Paljon terveyspalveluja tarvitsevan asiakkaan ja terveydenhuollon ammattihenkilöiden välinen toimiva vuorovaikutus on tärkeä osa asiakaslähtöisiä terveyspalveluja.

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Differentiating middle‐aged long‐term and short‐term frequent attenders by means of the Northern Finland Birth Cohort 1966 Study

Cited by 5 publications

References 28 publications

Targeted health promotion with guided nature walks or group exercise: a controlled trial in primary care

Targeted health promotion with guided nature walks or group exercise: a controlled trial in primary care

Patterns of acceptance and use of digital health services among the persistent frequent attenders of outpatient care: A qualitatively driven multimethod analysis

Vuorovaikutus terveydenhuollon ammattihenkilöiden kanssa paljon terveyspalveluja tarvitsevien asiakkaiden arvioimana

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