| fullrecord |
[{"key": "dc.contributor.advisor", "value": "H\u00e4kkinen, Arja", "language": "", "element": "contributor", "qualifier": "advisor", "schema": "dc"}, {"key": "dc.contributor.advisor", "value": "Aukee, Pauliina", "language": "", "element": "contributor", "qualifier": "advisor", "schema": "dc"}, {"key": "dc.contributor.author", "value": "Lehosmaa, Johanna", "language": "", "element": "contributor", "qualifier": "author", "schema": "dc"}, {"key": "dc.date.accessioned", "value": "2018-11-29T06:40:31Z", "language": null, "element": "date", "qualifier": "accessioned", "schema": "dc"}, {"key": "dc.date.available", "value": "2018-11-29T06:40:31Z", "language": null, "element": "date", "qualifier": "available", "schema": "dc"}, {"key": "dc.date.issued", "value": "2018", "language": "", "element": "date", "qualifier": "issued", "schema": "dc"}, {"key": "dc.identifier.uri", "value": "https://jyx.jyu.fi/handle/123456789/60377", "language": null, "element": "identifier", "qualifier": "uri", "schema": "dc"}, {"key": "dc.description.abstract", "value": "Raskaus ja synnytys altistavat lantionpohjan toimintah\u00e4iri\u00f6ille. Raskauden aikana virtsankarkailua esiintyy jopa yli 60 % naisista ja ensimm\u00e4isen kolmen kuukauden kuluessa synnytyksest\u00e4 kolmasosalla. Lantionpohjan lihasten harjoittaminen on ensisijainen, vaikuttavaksi todettu virtsankarkailun ehk\u00e4isy- ja hoitomuoto. K\u00e4yp\u00e4hoitosuosituksen mukaan sen pit\u00e4isikin olla osa normaalia raskauden aikaista ja synnytyksen j\u00e4lkeist\u00e4 neuvolatoimintaa. Erityisesti suurimmassa toimintah\u00e4iri\u00f6iden riskiss\u00e4 olevat naiset voisivat hy\u00f6ty\u00e4 harjoittelusta. T\u00e4ss\u00e4 pro gradu -tutkielmassa selvitettiin synnytyksen j\u00e4lkeisen virtsankarkailun esiintyvyytt\u00e4 ja riskitekij\u00f6it\u00e4 sek\u00e4 saatua lantionpohjan lihasharjoitteiden ohjausta ja harjoitteiden omatoimista toteuttamista. Riskitekij\u00f6it\u00e4 lukuun ottamatta tuloksia verrattiin vastaaviin raskauden aikaisiin tuloksiin.\n\nKaksivaiheinen kyselytutkimus toteutettiin vuosina 2012\u20132014 Keski-Suomen sairaanhoitopiirin (KSSHP) alueella synnytt\u00e4neille naisille (N = 547). Kyselytutkimus oli osa laajempaa tutkimus- ja kehitt\u00e4mishanketta (GRAPE). Ensimm\u00e4isen vaiheen kyselyyn vastattiin raskauden keskivaiheessa (keskim\u00e4\u00e4rin raskausviikolla 22\u00b12) ja toisen vaiheen kyselyyn kolme kuukautta synnytyksen j\u00e4lkeen. Tutkittavat olivat i\u00e4lt\u00e4\u00e4n keskim\u00e4\u00e4rin 30\u00b15 vuotta ja ensisynnytt\u00e4jien osuus oli 41 %. Kyselyill\u00e4 selvitettiin raskauden aikaisten ja synnytyksen j\u00e4lkeisten lantionpohjan toimintah\u00e4iri\u00f6iden esiintymist\u00e4, saatua lantionpohjan lihasharjoitteiden ohjausta ja ohjauksen sis\u00e4lt\u00f6\u00e4 sek\u00e4 omatoimisten harjoitteiden toteuttamista ja harjoittelun sis\u00e4lt\u00f6\u00e4. Lis\u00e4ksi kartoitettiin tutkittavien fyysist\u00e4 aktiivisuutta. \n\nTulokset osoittivat virtsankarkailua esiintyv\u00e4n 56 %:lla raskauden aikana ja 16 %:lla synnytyksen j\u00e4lkeen (Kappa 0.175, p<.001). Synnytyksen j\u00e4lkeisist\u00e4 tapauksista 85 %:lla oireilu oli alkanut jo raskauden aikana. \u00c4idin korkeampi ik\u00e4 (OR 1,09; 95 % LV 1,02\u20131,16) ja suurempi synnytyksen j\u00e4lkeinen BMI (OR 1,08; 95 % LV 1,01\u20131,14) nostivat virtsankarkailun riski\u00e4. Sektio toimi suojaavana tekij\u00e4n\u00e4 alatiesynnytykseen verrattuna (OR 0,39; 95 % LV 0,18\u20130,86). Synnytyksen j\u00e4lkeen 57 % ja raskauden keskivaiheeseen menness\u00e4 33 % sai lantionpohjan lihasharjoitteiden ohjausta (Kappa 0.046, p=.226). L\u00e4hes joka kolmas j\u00e4i ilman ohjausta. Virtsankarkailuoireilla ei ollut yhteytt\u00e4 synnytyksen j\u00e4lkeen saatuun ohjaukseen (p\u2265.05). S\u00e4\u00e4nn\u00f6llisi\u00e4 omatoimisia harjoitteita toteutti synnytyksen j\u00e4lkeen 43 % ja raskauden keskivaiheeseen menness\u00e4 33 % (Kappa 0.444, p<.001). L\u00e4hes joka toinen j\u00e4tti s\u00e4\u00e4nn\u00f6lliset harjoitteet tekem\u00e4tt\u00e4. Sek\u00e4 heti (p<.001) ett\u00e4 kolme kuukautta (p=.035) synnytyksen j\u00e4lkeen esiintynyt virtsankarkailu ja saatu ohjaus (p=.018) olivat yhteydess\u00e4 s\u00e4\u00e4nn\u00f6llisesti toteutettuun harjoitteluun.\n\nTehokkaampaan ja systemaattisempaan lantionpohjan lihasharjoitteiden ohjaukseen tulisi panostaa toimintah\u00e4iri\u00f6iden ennaltaehk\u00e4isemiseksi ja hoitamiseksi. Terveydenhuollon ammattilaisten lis\u00e4koulutus voisi olla tarpeen, jotta voitaisiin parantaa suurimmassa virtsankarkailun riskiss\u00e4 olevien naisten tunnistamista, ja kehitt\u00e4\u00e4 kattava ohjauksen hoitopolku.", "language": "fi", "element": "description", "qualifier": "abstract", "schema": "dc"}, {"key": "dc.description.abstract", "value": "Pregnancy and childbirth expose women to pelvic floor dysfunctions (PFDs). Over 60 % of women during pregnancy and one third within three months after childbirth have urinary incontinence (UI). Pelvic floor muscle training (PFMT) is considered the primary, effective way to prevent and treat UI. According to Finnish Current Care Guidelines, PFMT should be a part of routine care given in maternity clinic during pregnancy and after childbirth. Especially women who are at a major risk for PFD could benefit from PFMT. The aim of this master\u2019s thesis was to study the prevalence and risk factors of UI after childbirth. Also received PFMT guidance and self-administered PFMT were explored. Apart from risk factors, results were compared to corresponding results from pregnancy. \n\nDouble-phased survey was conducted to women who gave birth at the area of Central Finland Hospital District between 2012\u20132014 (N = 547). The survey was a part of broader study and development project (GRAPE). The first phase questionnaire was answered in midpregnancy (the mean gestational age 22\u00b12 weeks) and the second phase questionnaire three months after childbirth. The mean age of the participants was 30\u00b15 years and the proportion of nulliparous women was 41 %. The questionnaires captured PFDs, received PFMT guid-ance and self-administered PFMT during pregnancy and after childbirth. Additionally, physical activity of the participants was studied. \n\nThe results showed that 56 % of the women during pregnancy and 16 % after childbirth had UI (Kappa 0.175, p<.001). Eighty-five percent of the women who had UI after childbirth had symptoms already during pregnancy. The higher maternal age (OR 1,09; 95 % CI 1,02\u20131,16) and BMI after childbirth (OR 1,08; 95 % CI 1,01\u20131,14) were identified as risk factors of UI. Caesarean section was found to protect against UI compared to vaginal delivery (OR 0,39; 95 % CI 0,18\u20130,86). After childbirth 57 % and by midpregnancy 33 % of the women received PFMT guidance (Kappa 0.046, p=.226). Almost one third of the women did not receive any guidance. UI symptoms were not in relation to received PFMT guidance after childbirth (p\u2265.05). After childbirth 43 % and by midpregnancy 33 % of the women per-formed regular PFMT (Kappa 0.444, p<.001) but almost every other did not. UI both immediately (p<.001) and three months (p=.035) after childbirth and received PFMT guidance (p=.018) were in relation to regularly performed PFMT.\n\nIn the future, attention should be paid to more efficient and more systematic PFMT guidance so that PFDs could be prevented and treated more properly. Targeted education to health care professionals could be useful in order to improve the identification of women who are at a major risk for UI, and to develop a comprehensive path for PFMT guidance.", "language": "en", "element": "description", "qualifier": "abstract", "schema": "dc"}, {"key": "dc.description.provenance", "value": "Submitted by Paivi Vuorio (paelvuor@jyu.fi) on 2018-11-29T06:40:30Z\nNo. of bitstreams: 0", "language": "en", "element": "description", "qualifier": "provenance", "schema": "dc"}, {"key": "dc.description.provenance", "value": "Made available in DSpace on 2018-11-29T06:40:31Z (GMT). No. of bitstreams: 0\n Previous issue date: 2018", "language": "en", "element": "description", "qualifier": "provenance", "schema": "dc"}, {"key": "dc.format.extent", "value": "89", "language": "", "element": "format", "qualifier": "extent", "schema": "dc"}, {"key": "dc.format.mimetype", "value": "application/pdf", "language": null, "element": "format", "qualifier": "mimetype", "schema": "dc"}, {"key": "dc.language.iso", "value": "fin", "language": null, "element": "language", "qualifier": "iso", "schema": "dc"}, {"key": "dc.rights", "value": "In Copyright", "language": "en", "element": "rights", "qualifier": null, "schema": "dc"}, {"key": "dc.subject.other", "value": "virtsankarkailu", "language": "", "element": "subject", "qualifier": "other", "schema": "dc"}, {"key": "dc.subject.other", "value": "lantionpohjan lihasharjoittelu", "language": "", "element": "subject", "qualifier": "other", "schema": "dc"}, {"key": "dc.title", "value": "Lantionpohja synnytyksen j\u00e4lkeen : virtsankarkailun esiintyvyys ja riskitekij\u00e4t sek\u00e4 lantionpohjan lihasharjoitteiden ohjaus ja omatoiminen toteuttaminen", "language": "", "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-201811294921", "language": "", "element": "identifier", "qualifier": "urn", "schema": "dc"}, {"key": "dc.type.ontasot", "value": "Pro gradu -tutkielma", "language": "fi", "element": "type", "qualifier": "ontasot", "schema": "dc"}, {"key": "dc.type.ontasot", "value": "Master\u2019s thesis", "language": "en", "element": "type", "qualifier": "ontasot", "schema": "dc"}, {"key": "dc.contributor.faculty", "value": "Liikuntatieteellinen tiedekunta", "language": "fi", "element": "contributor", "qualifier": "faculty", "schema": "dc"}, {"key": "dc.contributor.faculty", "value": "Faculty of Sport and Health Sciences", "language": "en", "element": "contributor", "qualifier": "faculty", "schema": "dc"}, {"key": "dc.contributor.department", "value": "Liikunta- ja terveystieteet", "language": "fi", "element": "contributor", "qualifier": "department", "schema": "dc"}, {"key": "dc.contributor.department", "value": "Sport and Health Sciences", "language": "en", "element": "contributor", "qualifier": "department", "schema": "dc"}, {"key": "dc.contributor.organization", "value": "Jyv\u00e4skyl\u00e4n yliopisto", "language": "fi", "element": "contributor", "qualifier": "organization", "schema": "dc"}, {"key": "dc.contributor.organization", "value": "University of Jyv\u00e4skyl\u00e4", "language": "en", "element": "contributor", "qualifier": "organization", "schema": "dc"}, {"key": "dc.subject.discipline", "value": "Fysioterapia", "language": "fi", "element": "subject", "qualifier": "discipline", "schema": "dc"}, {"key": "dc.subject.discipline", "value": "Physiotherapy", "language": "en", "element": "subject", "qualifier": "discipline", "schema": "dc"}, {"key": "yvv.contractresearch.funding", "value": "0", "language": "", "element": "contractresearch", "qualifier": "funding", "schema": "yvv"}, {"key": "dc.type.coar", "value": "http://purl.org/coar/resource_type/c_bdcc", "language": null, "element": "type", "qualifier": "coar", "schema": "dc"}, {"key": "dc.rights.accesslevel", "value": "restrictedAccess", "language": null, "element": "rights", "qualifier": "accesslevel", "schema": "dc"}, {"key": "dc.type.publication", "value": "masterThesis", "language": null, "element": "type", "qualifier": "publication", "schema": "dc"}, {"key": "dc.subject.oppiainekoodi", "value": "50422", "language": "", "element": "subject", "qualifier": "oppiainekoodi", "schema": "dc"}, {"key": "dc.subject.yso", "value": "voimaharjoittelu", "language": null, "element": "subject", "qualifier": "yso", "schema": "dc"}, {"key": "dc.subject.yso", "value": "potilasneuvonta", "language": null, "element": "subject", "qualifier": "yso", "schema": "dc"}, {"key": "dc.subject.yso", "value": "riskitekij\u00e4t", "language": null, "element": "subject", "qualifier": "yso", "schema": "dc"}, {"key": "dc.subject.yso", "value": "virtsanpid\u00e4tyskyvytt\u00f6myys", "language": null, "element": "subject", "qualifier": "yso", "schema": "dc"}, {"key": "dc.subject.yso", "value": "synnytys", "language": null, "element": "subject", "qualifier": "yso", "schema": "dc"}, {"key": "dc.subject.yso", "value": "raskaus", "language": null, "element": "subject", "qualifier": "yso", "schema": "dc"}, {"key": "dc.format.content", "value": "fulltext", "language": null, "element": "format", "qualifier": "content", "schema": "dc"}, {"key": "dc.rights.url", "value": "https://rightsstatements.org/page/InC/1.0/", "language": null, "element": "rights", "qualifier": "url", "schema": "dc"}, {"key": "dc.rights.accessrights", "value": "The author has not given permission to make the work publicly available electronically. Therefore the material can be read only at the archival workstation at Jyv\u00e4skyl\u00e4 University Library (https://kirjasto.jyu.fi/en/workspaces/facilities).", "language": "en", "element": "rights", "qualifier": "accessrights", "schema": "dc"}, {"key": "dc.rights.accessrights", "value": "Tekij\u00e4 ei ole antanut lupaa avoimeen julkaisuun, joten aineisto on luettavissa vain Jyv\u00e4skyl\u00e4n yliopiston kirjaston arkistoty\u00f6semalta. Ks. https://kirjasto.jyu.fi/fi/tyoskentelytilat/laitteet-ja-tilat..", "language": "fi", "element": "rights", "qualifier": "accessrights", "schema": "dc"}, {"key": "dc.type.okm", "value": "G2", "language": null, "element": "type", "qualifier": "okm", "schema": "dc"}]
|