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1.  A salutogenic approach to prevention of metabolic syndrome: a mixed methods population study 
Objective. To find a salutogenic approach for prevention of metabolic syndrome in primary care practice. Design. An explanatory sequential mixed-methods procedure was used to find salutogenic approaches for lifestyle change by assessing individual need, potential, and personal motivation. Data from a population health survey and interviews that focused on a sense of coherence were analysed. Subjects. Altogether 480 Finnish subjects participated in a population health survey, and 43 of them were interviewed. The 43 interviewees’ data were included in the final analysis. Main outcome measures. With the health survey participants’ liability for MetS was assessed, and the objective need for lifestyle intervention was determined. Through the focused interviews potential and personal motivation for lifestyle modification were explored. Finally the data of the 43 interviewed subjects were merged. Results. Four possible lifestyle intervention approaches were identified for specific intervention. First, subjects with a strong sense of coherence only need encouragement to maintain a healthy lifestyle; second, professional support was found important for subjects with gaps in health awareness to improve health understanding; third, strengthening of social support for lifestyle change is necessary for subjects with various practical constraints in their everyday life; and fourth, strengthening of stress adaptation is important for subjects with redundant concerns about their health. Conclusions. Salutogenic client-centred lifestyle modification approaches should be part of primary care practice. Further, a cross-disciplinary approach is needed in primary care research and practice to combat the exploding lifestyle illnesses.
PMCID: PMC4278397  PMID: 25424465
Finland; general practice; metabolic syndrome; mixed-methods research; salutogenesis
2.  Metabolic syndrome is associated with self-perceived depression 
To study the association between metabolic syndrome (MetS) and self-perceived depression.
A cross-sectional community-based study.
Semi-rural community of Lapinlahti in eastern Finland in 2005.
A total of 416 subjects in eight adult birth cohorts (55%) with complete Beck Depression Inventory (BDI-21) questionnaire data.
Main outcome measures
The values of the 21 BDI items and the BDI-21 total score with a cut-off point of 14/15 were used to study the association between MetS and depression. National Cholesterol Education Programme (NCEP) 2005 criteria were used for MetS classification.
The total BDI-21 score was significantly higher in the subjects with MetS than in the subjects without MetS (p=0.020). Men with MetS were significantly worse off than men without MetS in the BDI-21 items of irritability (p=0.008), work inhibition (p=0.008), fatigability (p=0.037), weight loss (p=0.045), and loss of libido (p=0.014), while women were only so on the item of loss of libido (p=0.007). In a logistic regression analysis using a BDI-21 cut-off point of 14/15 adjusted for age, marital status, vocational education, and working status, significant association was retained between perceived depression and elevated blood glucose among men (OR=1.697) and large waist circumference among women (OR=1.066).
Elevated plasma glucose in men and central obesity in women are associated with self-perceived depression. This co-occurrence deserves attention in clinical practice.
PMCID: PMC3406636  PMID: 18609254
Adult population; depression; family practice; fasting plasma glucose; metabolic syndrome; waist circumference
3.  Doctor-patient interaction in Finnish primary health care as perceived by first year medical students 
In Finland, public health care is the responsibility of primary health care centres, which render a wide range of community level preventive, curative and rehabilitative medical care. Since 1990's, medical studies have involved early familiarization of medical students with general practice from the beginning of the studies, as this pre-clinical familiarisation helps medical students understand patients as human beings, recognise the importance of the doctor-patient relationship and identify practicing general practitioners (GPs) as role models for their professional development. Focused on doctor-patient relationship, we analysed the reports of 2002 first year medical students in the University of Kuopio. The students observed GPs' work during their 2-day visit to primary health care centres.
We analysed systematically the texts of 127 written reports of 2002, which represents 95.5% of the 133 first year pre-clinical medical students reports. The reports of 2003 (N = 118) and 2004 (N = 130) were used as reference material.
Majority of the students reported GPs as positive role models. Some students reported GPs' poor attitudes, which they, however, regarded as a learning opportunity. Students generally observed a great variety of responsibilities in general practice, and expressed admiration for the skills and abilities required. They appreciated the GPs' interest in patients concerns. GPs' communication styles were found to vary considerably. Students reported some factors disturbing the consultation session, such as the GP staring at the computer screen and other team members entering the room. Working with marginalized groups, the chronically and terminally ill, and dying patients was seen as an area for development in the busy Finnish primary health care centres.
During the analysis, we discovered that medical students' perceptions in this study are in line with the previous findings about the importance of role model (good or bad) in making good doctors. Therefore, medical students' pre-clinical primary health care centre visits may influence their attitudes towards primary health care work and the doctor-patient relationship. We welcome more European studies on the role of early pre-clinical general practice exposure on medical students' primary care specialty choice.
PMCID: PMC1242232  PMID: 16162300

Results 1-3 (3)