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Opinnäytetyön aiheena on tutkia henkilöstön työhön liittyvää matkustamista kestävän kehityksen sekä kustannustehokkuuden näkökulmasta. Tutkimuksessa tarkastellaan kestävää kehitystä sekä kustannustehokkuutta tukevia toimintatapoja sekä niiden edistämistä henkilöstön matkustamisessa. Lisäksi opinnäytetyössä selvitetään Ammattiopisto Lappian sekä Kemi-Tornion ammattikorkeakoulun verovapaiden matkakustannusten korvauksia sekä kustannusrakennetta vuosina 2010–2012 tehtyjen virantoimitusmatkojen osalta. Opinnäytetyö on hankkeistettu Kemi-Tornionlaakson koulutuskuntayhtymä Lappian toimesta. Tutkimus pohjautuu ensisijaisesti kvantitatiiviseen tutkimusmenetelmään, mutta tutkimusta täydentävänä menetelmänä käytettiin myös kvalitatiivista tutkimusta. Opinnäytetyön teoriaosuus pohjautuu kestävää kehitystä, kustannustehokkuutta ja työhön liittyvää matkustamista käsittelevään kirjallisuuteen sekä aihetta käsitteleviin julkaisuihin ja tutkimuksiin. Tärkeässä osassa ovat myös kuntasektoria koskevat sopimukset, säännökset sekä organisaation sisäiset ohjeistukset. Opinnäytetyön empiirinen osuus pohjautuu virantoimitusmatkojen kustannuskehityksen ja kustannusrakenteen osalta matkanhallintajärjestelmän sähköisiin dokumentteihin. Kestävää kehitystä sekä kustannustehokkuutta koskeva aineisto on kerätty matkanhallintajärjestelmän dokumenttien lisäksi aihetta koskevalla kyselyllä. Kysely kohdistettiin ammattiopiston sekä ammattikorkeakoulun henkilöstölle, joilla on oikeudet matkalaskujen sekä virkamatkamääräyksien hyväksymiseen. Tutkimus osoitti, että matkakustannusten korvausten sekä kustannusrakenteen osalta vertailuajanjakson aikana esiintyi huomattaviakin muutoksia. Matkustuskustannuksiin ovat vaikuttaneet osittain verovapaiden matkakustannusten korvausten euromääräiset muutokset sekä talouteen liittyvät säästötavoitteet. Lapin korkeakoulukonserniin sekä vuoden 2014 alussa toimintansa aloittavaan Lapin ammattikorkeakouluun liittyvä yhteistyö on lisännyt merkittävästi Rovaniemelle tapahtuvaa matkustamista. Toimeksiantajaorganisaatiossa kestävän kehityksen periaatteet sekä kustannustehokkuus matkustamisessa on huomioitu usein eri tavoin. Yleisimmät kestävää kehitystä sekä kustannustehokkuutta tukevat toimintatavat olivat yhteiskuljetukset eli kimppakyydit sekä etäyhteyksien käyttö. Tutkimuksen mukaan kestävää kehitystä ja kustannustehokkuutta matkustamisessa voidaan edistää kimppakyydeillä, etätyöllä ja etäkokouksilla, matkustamalla harkitusti sekä julkisten kulkuneuvojen käytöllä. Tehostetumpi tekniikan hyödyntäminen matkustamisen korvaamiseksi sekä yhteiskuljetusten järjestämiseksi ovat merkittäviä tutkimuksessa esille nousseita kehitysehdotuksia.
Opinnäytetyöni tarkoitus oli kuvailla pitkäaikaissairaiden lasten perheiden kokemuksia vertaistuesta. Opinnäytetyölläni halusin saada perheiden kokemuksista lisää tietoa, jotta niitä voitaisiin hyödyntää Munuais- ja Maksaliiton vertaistukitoiminnassa. Opinnäytetyön menetelmä oli kuvaileva kirjallisuuskatsaus. Tulosten mukaan vertaistuki ja vertaistoiminta koettiin tärkeän osana perheiden selviytymistä. Vertaiset koettiin tukijoina toisenlaisiksi kuin perheen läheiset, koska vertaiset ovat kokeneet saman ja he ymmärtävät tilannetta paremmin. Sopeutumisvalmennus-kurssit koetiin hyödyllisiksi, vaikka kynnys osallistumiseen oli korkea. Kursseilla tutustuttiin vertaisperheisiin, koettiin voimaantumista ja saatiin positiivisia tuntemuksia. Vertaistuen ja vertaistoiminnan toivottiin olevan helposti saatavilla ja koska varsinkin haja-asutusalueilla saatavuus on hankalaa, siksi verkossa tapahtuvan tuen ja toiminnan kysyntä on haja-asutusaluilla suurempaa. Tuloksista voidaan päätellä, että vertaistuen eri muodot ovat kaikki yhtä merkittäviä pitkäaikaissairaiden lasten perheille. Terveydenhuollossa vertaistuki tulisi huomioida yhtenä tarpeellisen tiedon lähteistä. Vertaistuki on tärkeä etenkin kokemuksellisen tiedon lähde. The purpose of this thesis was to describe the experiences of the peer support the families of children with long-term illnesses receive. The aim was to map out and describe information and results gained from families’ experiences. Furthermore, to utilize them later in the peer to peer support activities of the Kidney and Liver Association. The method of the thesis was a descriptive literature review. According to the results, peer support and peer-to-peer activities are seen as an important part of family coping and resilience. The peers are regarded to be supportive in a different way from the family's relatives because they (the peers) have similar experiences, and they understand the situation better. Adaptation courses are considered useful even though at the beginning, families found it hard to participate. The peer families who get familiar with these courses, experience empowerment and get positive feelings. It is hoped that peer support and peer-to-peer activities are easily available. Especially, in sparsely populated areas their access is perceived to be difficult. Therefore, the demand for online support and activities is higher in such areas. Results indicate, different forms of peer-support are all as significant to families of children with long-term illnesses. Peer-support should be considered in healthcare as a one source of necessary information. Peer-support is especially important source of experiential knowledge.
Background Internal motivation and good psychological capabilities are important factors in successful eating-related behavior change. Thus, we investigated whether general acceptance and commitment therapy (ACT) affects reported eating behavior and diet quality and whether baseline perceived stress moderates the intervention effects. Methods Secondary analysis of unblinded randomized controlled trial in three Finnish cities. Working-aged adults with psychological distress and overweight or obesity in three parallel groups: (1) ACT-based Face-to-face (n = 70; six group sessions led by a psychologist), (2) ACT-based Mobile (n = 78; one group session and mobile app), and (3) Control (n = 71; only the measurements). At baseline, the participants’ (n = 219, 85% females) mean body mass index was 31.3 kg/m2 (SD = 2.9), and mean age was 49.5 years (SD = 7.4). The measurements conducted before the 8-week intervention period (baseline), 10 weeks after the baseline (post-intervention), and 36 weeks after the baseline (follow-up) included clinical measurements, questionnaires of eating behavior (IES-1, TFEQ-R18, HTAS, ecSI 2.0, REBS), diet quality (IDQ), alcohol consumption (AUDIT-C), perceived stress (PSS), and 48-h dietary recall. Hierarchical linear modeling (Wald test) was used to analyze the differences in changes between groups. Results Group x time interactions showed that the subcomponent of intuitive eating (IES-1), i.e., Eating for physical rather than emotional reasons, increased in both ACT-based groups (p = .019); the subcomponent of TFEQ-R18, i.e., Uncontrolled eating, decreased in the Face-to-face group (p = .020); the subcomponent of health and taste attitudes (HTAS), i.e., Using food as a reward, decreased in the Mobile group (p = .048); and both subcomponent of eating competence (ecSI 2.0), i.e., Food acceptance (p = .048), and two subcomponents of regulation of eating behavior (REBS), i.e., Integrated and Identified regulation (p = .003, p = .023, respectively), increased in the Face-to-face group. Baseline perceived stress did not moderate effects on these particular features of eating behavior from baseline to follow-up. No statistically significant effects were found for dietary measures. Conclusions ACT-based interventions, delivered in group sessions or by mobile app, showed beneficial effects on reported eating behavior. Beneficial effects on eating behavior were, however, not accompanied by parallel changes in diet, which suggests that ACT-based interventions should include nutritional counseling if changes in diet are targeted.
Background: Internal motivation and good psychological capabilities are important factors in successful eating-related behavior change. Thus, we investigated whether general acceptance and commitment therapy (ACT) affects reported eating behavior and diet quality and whether baseline perceived stress moderates the intervention effects. Methods: Secondary analysis of unblinded randomized controlled trial in three Finnish cities. Working-aged adults with psychological distress and overweight or obesity in three parallel groups: (1) ACT-based Face-to-face (n = 70; six group sessions led by a psychologist), (2) ACT-based Mobile (n = 78; one group session and mobile app), and (3) Control (n = 71; only the measurements). At baseline, the participants' (n = 219, 85% females) mean body mass index was 31.3 kg/m2 (SD = 2.9), and mean age was 49.5 years (SD = 7.4). The measurements conducted before the 8-week intervention period (baseline), 10 weeks after the baseline (post-intervention), and 36 weeks after the baseline (follow-up) included clinical measurements, questionnaires of eating behavior (IES-1, TFEQ-R18, HTAS, ecSI 2.0, REBS), diet quality (IDQ), alcohol consumption (AUDIT-C), perceived stress (PSS), and 48-h dietary recall. Hierarchical linear modeling (Wald test) was used to analyze the differences in changes between groups. Results: Group x time interactions showed that the subcomponent of intuitive eating (IES-1), i.e., Eating for physical rather than emotional reasons, increased in both ACT-based groups (p = .019); the subcomponent of TFEQ-R18, i.e., Uncontrolled eating, decreased in the Face-to-face group (p = .020); the subcomponent of health and taste attitudes (HTAS), i.e., Using food as a reward, decreased in the Mobile group (p = .048); and both subcomponent of eating competence (ecSI 2.0), i.e., Food acceptance (p = .048), and two subcomponents of regulation of eating behavior (REBS), i.e., Integrated and Identified regulation (p = .003, p = .023, respectively), increased in the Face-to-face group. Baseline perceived stress did not moderate effects on these particular features of eating behavior from baseline to follow-up. No statistically significant effects were found for dietary measures. Conclusions: ACT-based interventions, delivered in group sessions or by mobile app, showed beneficial effects on reported eating behavior. Beneficial effects on eating behavior were, however, not accompanied by parallel changes in diet, which suggests that ACT-based interventions should include nutritional counseling if changes in diet are targeted.
Stress-related eating may be a potential factor in the obesity epidemic. Rather little is known about how stress associates with eating behavior and food intake in overweight individuals in a free-living situation. Thus, the present study aims to investigate this question in psychologically distressed overweight and obese working-aged Finns. The study is a cross-sectional baseline analysis of a randomized controlled trial. Of the 339 study participants, those with all the needed data available (n = 297, 84% females) were included. The mean age was 48.9 y (SD = 7.6) and mean body mass index 31.3 kg/m2 (SD = 3.0). Perceived stress and eating behavior were assessed by self-reported questionnaires Perceived Stress Scale (PSS), Intuitive Eating Scale, the Three-Factor Eating Questionnaire, Health and Taste Attitude Scales and ecSatter Inventory. Diet and alcohol consumption were assessed by 48-h dietary recall, Index of Diet Quality, and AUDIT-C. Individuals reporting most perceived stress (i.e. in the highest PSS tertile) had less intuitive eating, more uncontrolled eating, and more emotional eating compared to those reporting less perceived stress (p < 0.05). Moreover, individuals in the highest PSS tertile reported less cognitive restraint and less eating competence than those in the lowest tertile (p < 0.05). Intake of whole grain products was the lowest among those in the highest PSS tertile (p < 0.05). Otherwise the quality of diet and alcohol consumption did not differ among the PSS tertiles. In conclusion, high perceived stress was associated with the features of eating behavior that could in turn contribute to difficulties in weight management. Stress-related way of eating could thus form a potential risk factor for obesity. More research is needed to develop efficient methods for clinicians to assist in handling stress-related eating in the treatment of obese people.
Background Association of physiological recovery with nutrition has scarcely been studied. We investigated whether physiological recovery during sleep relates to eating habits, i.e., eating behaviour and diet quality. Methods Cross-sectional baseline analysis of psychologically distressed adults with overweight (N = 252) participating in a lifestyle intervention study in three Finnish cities. Recovery measures were based on sleep-time heart rate variability (HRV) measured for 3 consecutive nights. Measures derived from HRV were 1) RMSSD (Root Mean Square of the Successive Differences) indicating the parasympathetic activation of the autonomic nervous system and 2) Stress Balance (SB) indicating the temporal ratio of recovery to stress. Eating behaviour was measured with questionnaires (Intuitive Eating Scale, Three-Factor Eating Questionnaire, Health and Taste Attitude Scales, ecSatter Inventory™). Diet quality was quantified using questionnaires (Index of Diet Quality, Alcohol Use Disorders Identification Test Consumption) and 48-h dietary recall. Results Participants with best RMSSD reported less intuitive eating (p = 0.019) and less eating for physical rather than emotional reasons (p = 0.010) compared to those with poorest RMSSD; participants with good SB reported less unconditional permission to eat (p = 0.008), higher fibre intake (p = 0.028), higher diet quality (p = 0.001), and lower alcohol consumption (p < 0.001) compared to those with poor SB, although effect sizes were small. In subgroup analyses among participants who reported working regular daytime hours (n = 216), only the associations of SB with diet quality and alcohol consumption remained significant. Conclusions Better nocturnal recovery showed associations with better diet quality, lower alcohol consumption and possibly lower intuitive eating. In future lifestyle interventions and clinical practice, it is important to acknowledge sleep-time recovery as one possible factor linked with eating habits.