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[{"key": "dc.contributor.advisor", "value": "Sipil\u00e4, Sarianna", "language": null, "element": "contributor", "qualifier": "advisor", "schema": "dc"}, {"key": "dc.contributor.author", "value": "Ollila, Elisa", "language": null, "element": "contributor", "qualifier": "author", "schema": "dc"}, {"key": "dc.date.accessioned", "value": "2016-06-02T05:36:20Z", "language": null, "element": "date", "qualifier": "accessioned", "schema": "dc"}, {"key": "dc.date.available", "value": "2016-06-02T05:36:20Z", "language": null, "element": "date", "qualifier": "available", "schema": "dc"}, {"key": "dc.date.issued", "value": "2016", "language": null, "element": "date", "qualifier": "issued", "schema": "dc"}, {"key": "dc.identifier.other", "value": "oai:jykdok.linneanet.fi:1542593", "language": null, "element": "identifier", "qualifier": "other", "schema": "dc"}, {"key": "dc.identifier.uri", "value": "https://jyx.jyu.fi/handle/123456789/50037", "language": null, "element": "identifier", "qualifier": "uri", "schema": "dc"}, {"key": "dc.description.abstract", "value": "Monet lonkkamurtuman riskitekij\u00f6ist\u00e4, kuten korkea ik\u00e4 ja heikentynyt liikkumiskyky, ovat my\u00f6s palvelujen k\u00e4yt\u00f6n todenn\u00e4k\u00f6isyytt\u00e4 lis\u00e4\u00e4vi\u00e4 tekij\u00f6it\u00e4. Lonkkamurtuma lis\u00e4\u00e4 avuntarvetta entisest\u00e4\u00e4n. Aiempien tutkimusten mukaan kotikuntoutuksella voidaan kuitenkin parantaa liikkumis- ja toimintakyky\u00e4 lonkkamurtuman j\u00e4lkeen. N\u00e4in ollen on syyt\u00e4 olettaa, ett\u00e4 kuntoutuksella voidaan vaikuttaa my\u00f6s palvelujen k\u00e4ytt\u00f6\u00f6n murtuman j\u00e4lkeen. Tutkimuksen tarkoituksena oli selvitt\u00e4\u00e4, kuinka yleist\u00e4 on lonkkamurtumasta toipuvien ik\u00e4\u00e4ntyneiden henkil\u00f6iden toimintakyky\u00e4 tukevien, ep\u00e4virallisten (sukulaiset ja tuttavat) ja virallisten (julkinen, yksityinen ja kolmas sektori), palvelujen k\u00e4ytt\u00f6. Lis\u00e4ksi selvitettiin, voidaanko kotikuntoutuksella vaikuttaa lonkkamurtumasta toipuvien palvelujen k\u00e4ytt\u00f6\u00f6n.\n\nTutkielmassa k\u00e4ytettiin Promoting mobility after hip fracture (ProMo) -tutkimusaineistoa. Tutkittavat olivat lonkkamurtumasta toipuvia, yli 60-vuotiaita ja ennen murtumaa kotona asuneita ja itsen\u00e4isesti liikkuneita miehi\u00e4 ja naisia. Tutkittavat jaettiin alkumittausten j\u00e4lkeen satunnaisesti interventioryhm\u00e4\u00e4n (n=40) ja kontrolliryhm\u00e4\u00e4n (n=41). Interventioryhm\u00e4l\u00e4iset osallistuivat vuoden kest\u00e4neeseen, yksik\u00f6lliseen ja progressiiviseen kotikuntoutusohjelmaan, joka sis\u00e4lsi lihasvoima-, tasapaino- ja k\u00e4velyharjoitteita. Kontrolliryhm\u00e4 noudatti vallitsevaa hoitok\u00e4yt\u00e4nt\u00f6\u00e4. Palvelujen k\u00e4ytt\u00f6\u00e4 mitattiin kyselylomakkeen avulla alkumittauksen yhteydess\u00e4 sek\u00e4 kolmen, kuuden ja kahdentoista kuukauden kuluttua alkumittauksesta. Palvelujen k\u00e4ytt\u00f6\u00e4 tarkasteltiin paitsi yksitt\u00e4isten palveluntarjoajien (esim. puoliso, kotisairaanhoitaja, yksityinen siivouspalvelu) mukaan, my\u00f6s ep\u00e4viralliseen ja viralliseen palveluun luokiteltuna. Kuntoutuksen vaikutuksia palvelujen k\u00e4ytt\u00f6\u00f6n analysoitiin General Estimating Equation (GEE) -menetelm\u00e4n avulla. Tulokset vakioitiin yksin asumisella.\n\nTutkittavien keski-ik\u00e4 oli 80 vuotta ja heist\u00e4 78 % oli naisia. Tutkittavista 92 % sai apua p\u00e4ivitt\u00e4isiin toimintoihinsa heti kotiuduttuaan sairaalasta tai terveyskeskuksesta. Vuoden kuluttua 64 % interventio- ja 72 % kontrolliryhm\u00e4st\u00e4 saivat ulkopuolista apua arkitoimintoihinsa. Yleisin k\u00e4ytetty palvelumuoto oli ep\u00e4virallisten ja virallisten palvelujen yhdistelm\u00e4. Ep\u00e4virallisista palveluista yleisin oli lapsilta, lapsenlapsilta ja heid\u00e4n puolisoiltaan saatu apu, jota sai 66 % tutkittavista. Virallisista palveluista yleisin oli kotisairaanhoitajan palvelu, jota sai 27 % tutkittavista. Kuntoutusinterventiolla ei ollut vaikutusta yleisell\u00e4 tasolla palvelujen k\u00e4ytt\u00f6\u00f6n. Sen sijaan yksitt\u00e4isten palveluntarjoajien mukaan tarkasteltuna kuntoutusinterventio n\u00e4ytti v\u00e4hent\u00e4v\u00e4n kotisairaanhoitajan tarjoamien palvelujen k\u00e4ytt\u00f6\u00e4, vaikka yhdysvaikutustermin merkitsevyys (p=0.089) ei ollut aivan tilastollisesti merkitsev\u00e4.\n\nTutkielman mukaan valtaosa lonkkamurtumasta toipuvista henkil\u00f6ist\u00e4 saa ulkopuolista apua murtuman j\u00e4lkeen. Yksil\u00f6llisesti suunniteltu kotikuntoutus saattaa v\u00e4hent\u00e4\u00e4 kotisairaanhoitajan palvelujen k\u00e4ytt\u00f6\u00e4 lonkkamurtuman j\u00e4lkeen. Aihe vaatii lis\u00e4tutkimusta suuremmalla aineistolla.", "language": "fi", "element": "description", "qualifier": "abstract", "schema": "dc"}, {"key": "dc.description.abstract", "value": "Many hip fracture risk factors, such as higher age and mobility limitations, predict the use of home care services. Hip fracture is also associated with increased need for assistance. However based on past research, home-based rehabilitation improves mobility and reduces functional disability after hip fracture. Hence it can be assumed that home-based rehabilitation may affect also on the use of home care services after hip fracture. The aim of the thesis was to examine the use of informal (friends, relatives) and formal (public, private and third sector) care after hip fracture. Additionally, the purpose was to examine the effects of an individually tailored home-based rehabilitation program on the use of the services.\n\nThis thesis used the data of Promoting mobility after hip fracture (ProMo) study. The participants were older than 60 years, community-dwelling men and women recovering from hip fracture. After the baseline measurements they were randomly assigned into intervention (n=40) and control (n=41) groups. The intervention group participated in a year-long individually tailored home-based exercise program that comprised of strengthening exercises for the lower limb muscles, stretching, balance training and functional exercises. Controls had standard care. Home care service use was assessed by a questionnaire at baseline, and 3, 6 and 12 months thereafter. The use of care was examined by single caregivers (e.g. spouse, home nursing, private cleaning service) and by categorizing as informal and formal care. Effects of the intervention were analyzed with generalized estimation equations (GEE). The analysis was controlled for living alone.\n\nMost of the participants were women and the average age was 80 years. 92 % of the participants got help in performing daily living activities right after hospital discharge. After 12 months, 64 % of those in the intervention group and 72 % of those in the control group were still getting help. The most common (39 % of the participants) form of help was to receive both informal and formal care. Children, grandchildren and their spouses were the most common informal caregivers and 66 % of the participants received their help. The most common formal service was home nursing that was used by 27 % of the participants. The home-based rehabilitation had no significant effects on home care service use when it was analyzed on informal and formal care level. When the single caregivers were analyzed the intervention seemed to decrease the use of home nursing. However the effect (p=0.089) was not statistically quite significant.\n\nThe findings of this thesis showed that majority of the people recovering from hip fracture get help to their everyday life right after the hospital discharge. Individually tailored home-based rehabilitation may decrease the use of home nursing after hip fracture. In the future, more research is required with larger sample.", "language": "en", "element": "description", "qualifier": "abstract", "schema": "dc"}, {"key": "dc.description.provenance", "value": "Submitted using Plone Publishing form by Elisa Ollila (elmaolli) on 2016-06-02 05:36:19.363908. Form: Pro gradu -lomake (https://kirjasto.jyu.fi/julkaisut/julkaisulomakkeet/pro-gradu-lomake). 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