Irma Virjo

More women enter medicine: young doctors' family origin and career choice.

Summary. This study is part of the Finnish Junior Physicians 88 Study, the purpose of which was to shed light on the life situation, career choice and future plans of young doctors and their views on medical education. The survey population included all the medical doctors registered during the years 1977‐1986 in Finland (n = 5208). A postal questionnaire was sent to a sample of 2632 doctors born on odd‐numbered days. After a reminder letter, 1745 questionnaires (66%) were returned. Forty‐nine per cent of the respondents were women. Typically both men and women doctors had a father who was an upper‐level white‐collar worker and a mother who was a housewife. More men than women had a father who was a doctor or other health professional. More women than men mentioned that a lifelong calling (42% vs 30%), success at school (58% vs 47%) and an interest in helping people (78% vs 71%) had considerable influence on their decision to become a doctor. Men more often than women emphasized the medical profession being regarded as a highly paid (56% vs 47%) and a high status profession (64% vs 56%) and also that a family member was a doctor (15% vs 11%).

Use and knowledge of hormonal emergency contraception.

Hormonal emergency contraception (EC) is an acceptable means of postcoital prevention of pregnancy, but potential users should have information and education about it before they need it. The aim of this study was to establish how many women and how many mens partners have used hormonal EC and how well the respondents know the correct time to take EC pills. Random samples (393 women and 395 men) were drawn from the Finnish population register. Response rates were 56% for women and 45% for men. Of all responding women and men, 12% had themselves or together with their partners used EC. The proportion of EC users was highest in the younger age group among both women and men. It was greater among single and cohabiting women than among married women. Only a minority of respondents knew that EC pills could be taken up to 72 h after unprotected intercourse. Women who had used EC were most knowledgeable, as were also the younger age groups among both women and men. Awareness of the availability of EC and of its correct use should be further promoted to avoid unwanted pregnancies.

Evaluation of undergraduate medical education in Finnish community‐oriented and traditional medical faculties: a 10‐year follow‐up

This study focused on Finnish physicians’ views of their undergraduate medical education. Differences between traditional and community‐oriented medical faculties were examined and changes which had taken place during a 10‐year follow‐up period were also assessed.

Personal values of male and female doctors: gender aspects.

The aim of this study was to elucidate the personal values of physicians. It was part of the Physician 93 Study, the purpose of which was to shed light on the life situation, career and future plans of young doctors and their views on medical education. The survey population included all the medical doctors registered during the years 1982-1991 in Finland (N = 4671). In the spring of 1993 a postal questionnaire was sent to a random sample of 2341 doctors. After two reminder letters, 1818 questionnaires (78%) were returned. 59% of the respondents were women. Subjects were asked to rate on a 4-point scale each of a set of 17 potentially important values listed in the questionnaire, five of which were seen by the majority of physicians as very important. These values were: family life, health, close friends, success in work or in studies and childrens success. The potentially important values were conceptualized as indicative of eight important dimensions of the values of physicians: close friends, health. self actualization, success, universal values, well-being, family and ideology. Women doctors rated close friends, health, success, universalism and ideology as more important than men doctors.

Childbearing and the desire to have children among university students in Finland

Background. The fertility rate in Europe is low and there is concern over the low birth rate in relation to the aging population. The age of childbearing women has increased and infertility is a growing problem. Highly educated women in Finland suffer from childlessness more often than less educated women. The aim of this study was to establish Finnish university students’ actual and desired number of children, and compare the economic and educational situations of students with and without children. Methods. The study population consisted of Finnish undergraduate students under 35 years of age. The randomly selected sample was 5,030 subjects. The data were collected by postal questionnaire, the response rate being 62.7%. Frequency distributions, cross‐tabulations, and descriptive statistics were used. Categorical variables were tested by the Cochran‐Mantel‐Haenzel test. Results. 7.5% of students had children. Almost 90% desired to have children. Parenthood did not correlate negatively with satisfaction with financial situation or completed studies. Conclusion. University students are seldom parents, though they are at the ideal age for childbearing and the majority desire to have children. The risk of unintended childlessness exists, when pregnancies are postponed because of unfinished studies.

Who receives anticoagulant treatment with warfarin and why? A population-based study in Finland

Abstract Objective. To ascertain the age and gender distribution of patients receiving anticoagulant (AC) treatment with warfarin, and to establish the prevalence of AC treatment and its indications among the Finnish population. Design. A cross-sectional study in which the patients were identified from the patient records of health centres. Setting. Primary health care in the Hospital District of South Ostrobothnia in Finland. Patients. Those inhabitants of 15 municipalities in the study area who received AC treatment with warfarin on 1 April 2004. The total number of inhabitants was 132 621 at the end of 2003. Main outcome measures. Patient age and gender distributions, the prevalence of AC treatment in the study area, and indications for AC treatment. Results. Altogether 2389 patients were identified, 51.4% of them men. The mean age of the patients was 72.4 years. The prevalence of AC treatment was 1.8%; when age-adjusted to match the Finnish population it was 1.64%. The proportion of men receiving AC treatment was higher than that of women in all age groups. Atrial fibrillation (AF) was the most common main (60.2%) and second (7.2%) indication for AC treatment. Conclusion. Compared with Finnish figures 12 years earlier the prevalence of AC treatment has more than doubled, and the proportion of AF among indications has increased from 47% to 67%. New current care guidelines on AF and the increasing proportion of the elderly among the population are probable explanations.

Electronic patient record systems and the general practitioner: an evaluation study.

We studied how well electronic patient record (EPR) systems meet the needs of general practitioners (GPs) and other healthcare professionals for specific information. GPs in eight health centres in the South-Ostrobothnia region of Finland were invited to participate. They used three types of EPR system. They were asked to access EPRs to obtain 20 types of information for patients receiving anticoagulant treatment. In total 2389 patient cases were studied. All of the information requested was available for 73% of the cases (range 55–93%). There was a significant difference between the type of EPR system and the percentage of patients for whom information was available through the EPR. However, further analysis showed that differences in performance between EPR systems probably reflected differences in the way EPRs were used by different organizations. Great care should be taken in attempts to rank EPR systems based on their performance.

Why do university students use hormonal emergency contraception

Objectives: To establish why university students in Finland, who have easy access to well-affordable health services, still use hormonal emergency contraception. Method: All students who sought emergency contraception in the Tampere Student Health Station during the period from 1 September 2000 to 31 December 2001 received a questionnaire on their use of it. Of the total, 114 (67%) were returned. Results: Two-thirds of respondents experienced condom failure, and the remainder used no contraception. In open answers, respondents gave many explanations as to why they had used no contraception, e.g. having been over-passionate or drunk. Conclusion: Finnish students use emergency contraception, but to no great extent. Our results indicate that service providers should pay attention to sexual health in the full sense but not omit to give detailed advice on condom use during counselling.

ANTICOAGULANT TREATMENT OF PATIENTS WITH ATRIAL FIBRILLATION IN PRIMARY HEALTH CARE

OBJECTIVE To determine the prevalence of anticoagulant (AC) treatment of patients with atrial fibrillation in primary health care. To identify complications in the same patients during 1 year. DESIGN Cross-sectional study and 1-year follow-up. SETTING Seven health centres with a total population of 164093. SUBJECTS Five hundred and twenty-two anticoagulated patients with atrial fibrillation. RESULTS The age-adjusted prevalence of AC treated patients with atrial fibrillation was 0.30%. Of the 522 patients, 240 were men, mean age 69.6 years; and 282 women, mean age 75.1 years. At the beginning of the study 85% and after 1 year 81% of the latest prothrombin time values were within recommended range. After 1 year 414 out of the 522 patients continued AC treatment. During the 1-year follow-up 62 patients had minor or major complications. Eleven patients (2.1%) had to discontinue AC treatment because of complications. Prothrombin tests were mainly taken at 3-4 week intervals. CONCLUSION High quality AC treatment is possible in the hands of general practitioners.

Anticoagulant treatment in primary health care in Finland

OBJECTIVE To establish the prevalence of anticoagulant (AC) treatment, the indications, and the quality of care in primary health care. DESIGN A cross-sectional study, in which patients on AC treatment were identified from laboratory records. The main and second indications for AC treatment and the last value of the AC-test were taken from medical records. SETTING Eight Finnish health centres with a total population of 182091 inhabitants. RESULTS A total of 1255 patients on AC treatment were identified, 48% of them men. The mean age was 68.9 years. The age-adjusted prevalence of AC treatment was 0.65%. The commonest main indication was atrial fibrillation (38%). It was the main or second indication in 591 patients (age-adjusted prevalence 0.30%). The next commonest main indication was deep vein thrombosis (15%), followed by pulmonary embolism (8%). A total of 274 (22%) patients were anticoagulated for cerebral circulatory disturbances. 86% of the latest prothrombin time values fell within recommended ranges. CONCLUSION The prevalence of AC treatment in Finland seems to be high. The proportion of patients with atrial fibrillation is high, differing from the results in other countries. The monitoring of AC-treatment as the general practitioners responsibility functions well. The quality of care is good, even in older age groups.