Taina Mäntyranta

Feelings related to first patient experiences in medical school: A qualitative study on students’ personal portfolios

Feelings and thoughts of medical students related to first patient experiences during the first clinical year were examined. Twenty-two volunteer third and fourth year medical students (15 women and 7 men) of the University of Helsinki participated in a portfolio course for 1 year. Their reflective learning diaries and writings on specific themes were analyzed by qualitative content analysis. First patient encounters were strong emotional experiences for medical students. The first patient examination was often described as an anxiety-provoking and confusing incident. Other emotionally significant encounters included helplessness when faced with serious illness and death, and role confusion when examining patients of ones own age but opposite sex. Students felt guilty for using patients for their own learning purposes. Portfolios as learning tools may help in recognizing key experiences and support professional development of medical students.

A Survey on the use of Alternative Drugs During Pregnancy

Objective. To describe the use of alternative drugs during pregnancy. Design. A trial including 3 surveys on drug use during pregnancy in maternity centers in one area of Finland in 1985–86 (study 1), and a retrospective survey in 2 maternity hospitals in Finland in 1988 (study 2). Patients and methods. Study 1: 2912 pregnant women (about 94% of pregnant women in the area during the study period); 97–88% returned questionnaires. Study 2: 180 out of 181 consecutive women giving birth. In study 1, drug use (including drug-like products) in the last two weeks was asked by questionnaires around 12th, 28th, and 36th gestation weeks. In study 2, women were interviewed 2–3 days after birth asking about any drugs used during pregnancy. Due to the method of asking, our studies underestimate the level of using alternative drugs. Results. In study 1, a total of 97 (3.6%) pregnant women reported use of alternative drugs. Most drugs were dietary supplements, and by current knowledge harmless. But a few women had used (potentially) dangerous drugs. The users were from the higher social class and they had also used pharmaceutical specialties more often than non-users. In study 2, 14% had used alternative drugs at some time during pregnancy. Conclusion. Because our surveys showed that alternative drugs are used, possibly with increasing frequency, during pregnancy, further studies on safety are needed.

Alternative drug use for the climacteric in Finland

OBJECTIVES To investigate the use of alternative drugs for the climacteric in Finland, which products are used, and who are the women using them. METHODS The study was based on a population-based survey conducted in 1989 among 2000 Finnish women aged 45-64 (response rate 86%). RESULTS 11% of the women reported the use of alternative drugs for the climacteric. Food supplements and bee products were the most common types of alternative drugs used. Some of them may have allergic or other side effects. Users differ little from other women judging by health habits and the utilization of health care services. The best predictors for alternative drug use were urban residence, more than 9 years of general education, and among 50 54-year olds, the use of prescription or OTC drugs for menopause. Over half of the users of alternative drugs had also used hormone therapy. CONCLUSIONS Women using alternative drugs during and after the climacteric represent a large group. More information is needed about the clinical effects of alternative drugs, and the characteristics of alternative drug users.

Use of alternative drugs in Finland

The purpose of this study was to assess the use of alternative drugs among the adult population in Finland, especially to find out how the health status, health behaviour and use of licensed drugs and health care services are related to the use of alternative drugs.

A system of key indicators for needs assessment at local level: The Finnish network of information producers

Healthcare needs assessment of a local population combines national and local health registries with practice-based data, surveys and qualitative methods. A working group in Finland has developed a system of key indicators for local needs assessment based on a comparative approach. It uses 45 key indicators within four different fields: demography, health behaviour, health status and use of health services. Indicators had to: describe an aspect of health affecting large groups; be available and accessible in existing data files; and be valid, reliable and easy to interpret. A user interface is needed to extract the indicators via the Internet. An educational package of instructions and exercises will be prepared. The use of evidence in health service planning needs to be strengthened. The project offers a new toolkit for healthcare needs assessment, planning of local health services and public health development.

Success of the patient-alternative therapist relationship

Factors affecting the success of the patient-alternative therapist relationship were studied. The study subjects consisted of a random sample of adult Finns (n = 2,134) who were interviewed by telephone or in person during the spring of 1992. One hundred and fifty-nine of those interviewed had visited an alternative therapist during the preceding year. They were divided into two groups on the basis of their subjective assessment of the outcome: those who had benefited from treatment (n - 125) and those who had not benefited from treatment (n = 34). The patients age, sex, education, place of residence, or religiousness were not connected with the success of treatment. Those who had benefited from treatment given by an alternative therapist were more often single than the others. Reported health, smoking, drinking, and symptoms of illness did not differentiate between the two groups. According to a univariate analysis, those who had benefited from treatment had experienced more safety and security in the t...

Serving primary health care: a national action programme for primary care in Finland

Abstract In Finland, municipalities are responsible for organizing primary health care (PHC). Current challenges include recruitment problems, especially concerning physicians and dentists; system-centred planning; and overall focus in specialized care and problems in access to care. A national action programme for primary care was launched in 2008 to respond to the challenges. Legislative amendments were carried out. Local and regional development projects were endorsed with financial support from a national development programme for social and health care. The action programme consists of 24 actions, focusing on three domains: Mission clarification: The value of PHC is in the health gain it produces. The main action is the national implementation of the chronic care model. Patient to the centre: A new legislation increasing patient choice was approved by Parliament. Support for better self-management and empowerment is implemented. Personnel: Changes in education and division of responsibilities between physicians, nurses, and allied health professionals are implemented. Evaluation of the programme will take place in 2011. Professional societies were involved in the PHC programme from the beginning as partners. This has created a strong commitment to the programme among professionals. The current economic depression is a challenge, but also an opportunity for the programme.