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[{"key": "dc.contributor.author", "value": "Antikainen, Anu", "language": null, "element": "contributor", "qualifier": "author", "schema": "dc"}, {"key": "dc.date.accessioned", "value": "2014-01-17T09:06:46Z", "language": null, "element": "date", "qualifier": "accessioned", "schema": "dc"}, {"key": "dc.date.available", "value": "2014-01-17T09:06:46Z", "language": null, "element": "date", "qualifier": "available", "schema": "dc"}, {"key": "dc.date.issued", "value": "2013", "language": null, "element": "date", "qualifier": "issued", "schema": "dc"}, {"key": "dc.identifier.other", "value": "oai:jykdok.linneanet.fi:1291228", "language": null, "element": "identifier", "qualifier": "other", "schema": "dc"}, {"key": "dc.identifier.uri", "value": "https://jyx.jyu.fi/handle/123456789/42812", "language": null, "element": "identifier", "qualifier": "uri", "schema": "dc"}, {"key": "dc.description.abstract", "value": "Anu Antikainen (2013). Monil\u00e4\u00e4kityksen ja kipul\u00e4\u00e4kkeiden k\u00e4yt\u00f6n yhteys liikkumiskykyyn lonkkamurtumasta toipuvilla yli 60-vuotiailla henkil\u00f6ill\u00e4. Terveystieteiden laitos, Jyv\u00e4skyl\u00e4n yliopisto, gerontologian ja kansanterveyden pro gradu -tutkielma, 58 sivua.\n\n\nLonkkamurtuma on i\u00e4kk\u00e4iden henkil\u00f6iden merkitt\u00e4v\u00e4 pitk\u00e4aikaisten liikkumiskyvyn vaikeuksien ja kipujen aiheuttaja. Ik\u00e4\u00e4ntyneen l\u00e4\u00e4kitys voi olla yksi lonkkamurtumalle altistavista tekij\u00f6ist\u00e4. Lonkkamurtuman j\u00e4lkeen toipilaiden l\u00e4\u00e4kehoito usein lis\u00e4\u00e4ntyy muun muassa kipul\u00e4\u00e4kkeiden my\u00f6t\u00e4. Riski monil\u00e4\u00e4kityksen vakavien vaikutusten, kuten kaatumisten, ilmaantumiseen lis\u00e4\u00e4ntyy ja ne voivat heikent\u00e4\u00e4 lonkkamurtumasta toipuvan liikkumiskyky\u00e4 entisest\u00e4\u00e4n. T\u00e4m\u00e4n pro gradu -tutkielman tarkoituksena oli selvitt\u00e4\u00e4 lonkkamurtumasta toipuvien i\u00e4kk\u00e4iden henkil\u00f6iden monil\u00e4\u00e4kityksen ja kipul\u00e4\u00e4kkeiden k\u00e4yt\u00f6n yhteytt\u00e4 liikkumiskykyyn mahdollisimman pian kotiutumisen j\u00e4lkeen. \nT\u00e4ss\u00e4 tutkielmassa aineistona on k\u00e4ytetty Promoting Mobility after Hip Fracture (ProMo) -tutkimuksen alkumittausaineistoa. Tutkittavat olivat vuosina 2008-2010 Keski-Suomen keskussairaalassa lonkkamurtuman takia leikattuja, yli 60 -vuotiaita, Jyv\u00e4skyl\u00e4ss\u00e4 ja sen l\u00e4hikunnissa asuvia, itsen\u00e4isesti ennen murtumaa liikkuneita ja itsen\u00e4isesti kotona tai palvelutalossa asuneita henkil\u00f6it\u00e4. Alkumittauksista tutkimukseen osallistui yhteens\u00e4 81 tutkittavaa. Alkumittauksessa liikkumiskyky\u00e4 selvitettiin Short Physical Performance Battery (SPPB) -testist\u00f6n, Bergin tasapainotestin ja Timed Up and Go (TUG) -testin avulla. Lis\u00e4ksi tutkittavilta kysyttiin itsearviota liikkumiskyvyst\u00e4\u00e4n. K\u00e4yt\u00f6ss\u00e4 olevat resepti- ja itsehoitol\u00e4\u00e4kkeet selvitettiin esit\u00e4ytetyn kyselylomakkeen ja l\u00e4\u00e4kereseptien avulla. Aineistosta muodostettiin 0-5 l\u00e4\u00e4kkeen (ei-monil\u00e4\u00e4kityt), 6-9 l\u00e4\u00e4kkeen (monil\u00e4\u00e4kityt) ja v\u00e4hint\u00e4\u00e4n kymmenen l\u00e4\u00e4kkeen (merkitt\u00e4v\u00e4sti monil\u00e4\u00e4kityt) k\u00e4ytt\u00e4jien sek\u00e4 ei-kipul\u00e4\u00e4kkeen, yhden kipul\u00e4\u00e4kkeen ja v\u00e4hint\u00e4\u00e4n kahden kipul\u00e4\u00e4kkeen k\u00e4ytt\u00e4jien ryhm\u00e4t. Lis\u00e4ksi muodostettiin ei-s\u00e4\u00e4nn\u00f6llisen ja s\u00e4\u00e4nn\u00f6llisen kipul\u00e4\u00e4kkeen k\u00e4ytt\u00e4jien ryhm\u00e4t. L\u00e4\u00e4kitysryhmien v\u00e4lisi\u00e4 eroja liikkumiskykytesteiss\u00e4 suoriutumisessa testattiin Kruskall-Wallisin testill\u00e4 ja Mann-Whitneyn U-testill\u00e4. L\u00e4\u00e4kitysryhmien v\u00e4lisi\u00e4 eroja liikkumiskyvyn itsearvioiden suhteen testattiin X2-testill\u00e4. \nTutkittavista kolmasosa (32 %) ei ollut monil\u00e4\u00e4kittyj\u00e4. Kipul\u00e4\u00e4kett\u00e4 s\u00e4\u00e4nn\u00f6llisesti tai tarvittaessa k\u00e4ytti 70 % tutkittavista ja keskim\u00e4\u00e4rin heill\u00e4 oli k\u00e4yt\u00f6ss\u00e4\u00e4n yksi kipul\u00e4\u00e4ke. Ei-monil\u00e4\u00e4kityt suoriutuivat paremmin SPPB-testist\u00f6st\u00e4 (p=0.045) ja Bergin testist\u00e4 (p=0.003) monil\u00e4\u00e4kittyihin ja merkitt\u00e4v\u00e4sti monil\u00e4\u00e4kittyihin verrattuna. Suurempi osa monil\u00e4\u00e4kityist\u00e4 ja merkitt\u00e4v\u00e4sti monil\u00e4\u00e4kityist\u00e4 arvioi liikkumiskykyns\u00e4 huonoksi (p=0.003) ei-monil\u00e4\u00e4kittyihin verrattuna. Tutkittavat, joilla ei ollut kipul\u00e4\u00e4kett\u00e4 k\u00e4yt\u00f6ss\u00e4\u00e4n, suoriutuivat paremmin Bergin testiss\u00e4 (p=0.019) kuin yhden tai useamman kipul\u00e4\u00e4kkeen k\u00e4ytt\u00e4j\u00e4t. S\u00e4\u00e4nn\u00f6llist\u00e4 kipul\u00e4\u00e4kityst\u00e4 k\u00e4ytt\u00e4v\u00e4t suoriutuivat heikommin SPPB-testist\u00f6st\u00e4 (p=0.038) ja Bergin testiss\u00e4 (p=0.011) verrattuna niihin tutkittaviin, joilla ei ollut s\u00e4\u00e4nn\u00f6llist\u00e4 kipul\u00e4\u00e4kityst\u00e4 k\u00e4yt\u00f6ss\u00e4. \nYhteenvetona tutkimuksesta voidaan todeta, ett\u00e4 lonkkamurtumasta toipuvilla monil\u00e4\u00e4kityill\u00e4 ja merkitt\u00e4v\u00e4sti monil\u00e4\u00e4kityill\u00e4 liikkumiskyky oli heikompi kuin ei-monil\u00e4\u00e4kityill\u00e4. My\u00f6s yhden ja useamman kipul\u00e4\u00e4kkeen k\u00e4ytt\u00e4jill\u00e4 ja s\u00e4\u00e4nn\u00f6llist\u00e4 kipul\u00e4\u00e4kityst\u00e4 k\u00e4ytt\u00e4vill\u00e4 liikkumiskyky oli heikompi kuin niill\u00e4 lonkkamurtumasta toipuvilla, jotka eiv\u00e4t k\u00e4ytt\u00e4neet kipul\u00e4\u00e4kkeit\u00e4 ollenkaan tai s\u00e4\u00e4nn\u00f6llisesti. Monil\u00e4\u00e4kityist\u00e4 ja merkitt\u00e4v\u00e4sti monil\u00e4\u00e4kityist\u00e4 suurempi osa arvioi liikkumiskykyns\u00e4 huonommaksi verrattuna niihin, jotka eiv\u00e4t olleet monil\u00e4\u00e4kittyj\u00e4. Tulosten perusteella n\u00e4ytt\u00e4\u00e4 silt\u00e4, ett\u00e4 erityisesti n\u00e4ill\u00e4 l\u00e4\u00e4kitysryhmill\u00e4 on lonkkamurtuman j\u00e4lkeen suuri kaatumisen ja liikkumiskyvyn heikentymisen riski, mitk\u00e4 voivat uhata kuntoutumisen onnistumista. \nJatkossa t\u00e4rke\u00e4\u00e4 olisi tutkia pitkitt\u00e4istutkimuksella monil\u00e4\u00e4kityksen ja kipul\u00e4\u00e4kityksen yhteytt\u00e4 liikkumiskykyyn lonkkamurtumasta toipuvilla ik\u00e4\u00e4ntyneill\u00e4 syy-seuraussuhteen selvitt\u00e4miseksi. T\u00e4ll\u00e4 tavoin saataisiin lis\u00e4tietoa l\u00e4\u00e4kehoidon vaikutuksesta ik\u00e4\u00e4ntyneiden liikkumiskykyyn lonkkamurtuman j\u00e4lkeen. \n\nAsiasanat: kotona asuvat ik\u00e4\u00e4ntyneet, lonkkamurtuma, liikkumiskyky, monil\u00e4\u00e4kitys, kipul\u00e4\u00e4kkeet", "language": "fi", "element": "description", "qualifier": "abstract", "schema": "dc"}, {"key": "dc.description.abstract", "value": "Anu Antikainen (2013). Association between polypharmacy, pain medication and mobility on persons over 60-years recovering from a hip fracture. Department of Health Sciences, University of Jyv\u00e4skyl\u00e4, Master\u00b4s thesis in gerontology and public health, 58 pages.\nFor older persons, hip facture is recognized as a significant cause for long-term mobility limitations and prolonged pain. Medication could turn out as a risk factor of hip fracture for elderly people. After hip fracture, the amount of total medication used often increases due to need for analgetics. Risk of adverse drug events, like falls, increases and can further deteriorate older persons\u2019 mobility. This thesis investigated the association between use of polypharmacy and pain medication and mobility among elderly people recovering from a hip fracture as soon as possible after discharged to home. \nThis thesis utilizes the baseline data of Promoting Mobility after Hip Fracture (ProMo) -study. Participants were over 60 -years old, community-dwelling, ambulatory people who were living in Jyv\u00e4skyl\u00e4 or in neighboring municipalities and were operated in Central Finland Central Hospital for hip fracture between 2008-2010. Altogether 81 persons participated in the study. Baseline mobility measurements included Short Physical Performance Battery (SPPB), Berg balance test and Timed Up and Go (TUG) -test. Self-reported mobility was assessed with a questionnaire. Self-reported use of medication was confirmed from prescriptions during the clinical examination. Participants were divided into groups based on polypharmacy. Non-polypharmacy was defined as use of 0-5 drugs, polypharmacy was defined as use of 6-9 drugs and excessive polypharmacy was defined as use of ten or more drugs. Participants were divided also into groups based on use of analgetics (non-analgetics users, users of one analgetic, users of at least two analgetics) and use of regular pain medication (users of non-regular pain medication and users of regular pain medication). Differences in mobility measurements between medication groups were tested using Kruskall-Wallis -test and Mann-Whitney U-test. Differences in self-reported disability between medication groups were tested using chi square test. \nOne third (32 %) of older persons did not use polypharmacy. 70 % used pain medication regularly or as needed and mean number of analgesics was one. Non-polypharmacy group had higher scores of SPPB (p=0.045) and Berg balance test (p=0.003) compared to polypharmacy and excessive polypharmacy groups. The larger part of polypharmacy group and of excessive polypharmacy group reported perceived difficulties compared to non-polypharmacy group. Non-analgesics users had higher scores of Berg balance test (p=0.019) than users of one or more analgesics. Users of regular pain medication had lower scores of SPPB (p=0.038) and Berg balance test (p=0.011) than users of non-regular pain medication.\nThis research indicates that older persons recovering from a hip fracture without polypharmarcy had significantly better mobility compared to persons having polypharmarcy or excessive polypharmacy. Further, older persons using one or more analgesics and using analgesics on regular basis had impared mobility compared to groups not using analgesics regular or using none of analgetics. As total number of medicines increased, reported majority of subjects perceived difficulties compared users of 0-5 drugs. As a conclusion, the group of polypharmacy and users of pain medication are at increased risk of falls and mobility limitation post hip fracture. This might be a threat to rehabilitation of older persons recovering from a hip fracture. \nFurther longitudinal studies are needed to investigate the causality between polypharmacy, especially use of analgesics, and mobility on elderly persons recovering from a hip fracture.", "language": "en", "element": "description", "qualifier": "abstract", "schema": "dc"}, {"key": "dc.description.provenance", "value": "Submitted using Plone Publishing form by Anu Antikainen (anmaanti) on 2014-01-17 09:06:45.985640. Form: Pro gradu -lomake (1 tekij\u00e4) (https://kirjasto.jyu.fi/julkaisut/julkaisulomakkeet/pro-gradu-lomake-1-tekijae). JyX data:", "language": "en", "element": "description", "qualifier": "provenance", "schema": "dc"}, {"key": "dc.description.provenance", "value": "Submitted by jyx lomake-julkaisija (jyx-julkaisija@noreply.fi) on 2014-01-17T09:06:46Z\nNo. of bitstreams: 2\nURN:NBN:fi:jyu-201401171077.pdf: 398335 bytes, checksum: b35380e212d4702d327a3db5a18ee58e (MD5)\nlicense.html: 4967 bytes, checksum: 27786cd6951df4023eda24ebfdc01598 (MD5)", "language": "en", "element": "description", "qualifier": "provenance", "schema": "dc"}, {"key": "dc.description.provenance", "value": "Made available in DSpace on 2014-01-17T09:06:46Z (GMT). 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"dc.subject.other", "value": "lonkkamurtuma", "language": "", "element": "subject", "qualifier": "other", "schema": "dc"}, {"key": "dc.subject.other", "value": "liikkumiskyky", "language": "", "element": "subject", "qualifier": "other", "schema": "dc"}, {"key": "dc.subject.other", "value": "monil\u00e4\u00e4kitys", "language": "", "element": "subject", "qualifier": "other", "schema": "dc"}, {"key": "dc.subject.other", "value": "kipul\u00e4\u00e4kkeet", "language": "", "element": "subject", "qualifier": "other", "schema": "dc"}, {"key": "dc.title", "value": "Monil\u00e4\u00e4kityksen ja kipul\u00e4\u00e4kkeiden k\u00e4yt\u00f6n yhteys liikkumiskykyyn lonkkamurtumasta toipuvilla yli 60-vuotiailla henkil\u00f6ill\u00e4", "language": null, "element": "title", "qualifier": null, "schema": "dc"}, {"key": "dc.type", "value": "master thesis", "language": null, "element": "type", "qualifier": null, "schema": "dc"}, {"key": "dc.identifier.urn", "value": "URN:NBN:fi:jyu-201401171077", "language": 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