Intuboidun hengityslaitehoitoa saavan aikuisen tehohoitopotilaan suunhoidon kirjaaminen

Tutkimuksen tarkoituksena oli tutkia potilastietojärjestelmien suunhoitosivut kaikilla suomalaisilla teho-osastoilla, joissa oli käytössä Clinisoft® -potilastietojärjestelmä ja, joilla hoidettiin intuboituja, hengityslaitehoitoa saavia aikuisia tehohoitopotilaita. Lisäksi tutkimuksessa analysoitiin yhden yliopistosairaalan teho-osaston hoitajien suunhoidon kirjauksia potilastietojärjestelmän vuorohuomioraporteista. Tutkimusosion 1 aineisto koostui aikuispotilaita hoitavien teho-osastojen (N=15) Clinisoft® -potilastietojärjestelmien suunhoitosivuista. Tutkimusosion 2 aineisto koostui yhden yliopistosairaalan teho-osaston intuboitujen, hengityslaitehoitoa saaneiden aikuisen tehohoitopotilaiden suunhoidon kirjauksista (n=97). Vuonna 2008–2009 hoidetuista intuboiduista, hengityslaitehoitoa saaneista tehohoitopotilaista (N=1180) valittiin satunnaisotannalla 100 potilasta, joiden suunhoitoon liittyvät potilasasiakirjat otettiin mukaan analyysiin. Aineistot analysoitiin sisällön erittelyllä. Suunhoitosivujen aihesisällöistä muodostettiin 14 sisältöluokkaa. Vuorohuomiokirjaukset oli kirjattu yleensä hengitys tai happeutuminen otsakkeiden alle, josta löytyi yhteensä 589 alkuperäislausumaa. Hoitajat kirjasivat ensin potilaan hengityslaitehoidosta ja happeutumisesta. Alkuperäislausumista tehohoitopotilaan suunhoitoon liittyviä lausumia oli 61 % (n=357). Vuorohuomiokirjauksista muodostettiin 11 sisältöluokkaa. Potilastietojärjestelmän suunhoitosivujen rakenne ei ohjannut VAP:a ehkäisevään suunhoitoon ja tehohoitopotilaan suunhoitoa kirjattiin usealle sivulle. Kaikkien tehohoito-osastojen suunhoitosivupohjissa oli kohdat suun kunnon arvioinnille ja suunhoidolle, mutta sivuilta ei aina selvinnyt tehohoito-osaston suunhoitoon käytättämiä välineitä. Sivuissa oli nähtävissä yksittäisiä VAP:n ehkäisyyn liittyviä interventioita. Vuorohuomioraportteihin kirjaaminen oli päällekkäistä suunhoitosivuun kirjattavien tietojen kanssa. Hoitajat kirjasivat tehohoitopotilaan hengityslaitehoidosta ja potilaan happeutumisesta. Suunhoidosta hoitajat kirjasivat eniten eritteiden määrää ja laatua ja vähiten suunhoidossa käytetyistä välineistä sekä suunhoitoon liittyvästä arvioinnista. Tehohoitopotilaan suuta hoidettiin keskimäärin 2.93 kertaa vuorokaudessa, eniten aamuvuoroissa. Suun kuntoa arvioitiin 1.12 kertaa vuorokaudessa. Pro gradu -tutkielma tuo uutta tietoa intuboidun, hengityslaitehoidossa olevan aikuisen tehohoitopotilaan näyttöön perustuvasta suunhoidosta, potilastietojärjestelmien suunhoitosivujen rakenteesta ja tehohoitopotilaan suunhoidon kirjaamisesta Suomessa. Tutkimustulosten ja kansainvälisten suositusten avulla kehitettiin Clinisoft® -potilastietojärjestelmän mallisivu tehohoitopotilaan suunhoidon tarpeen määrittämisen, suunnittelun, toteutuksen ja arvioinnin tueksi.

Effects of obtained benefits on willingness to pay and word-of-mouth behavior in newspaper industry

The purpose of this master’s thesis was to investigate the effects which benefits obtained from reading a newspaper and using its website have on behavioral outcomes such as word-of-mouth behavior and willingness to pay. Several other antecedents of willingness to pay have been used as the control variables. However, their interrelations haven’t been hypothesized. The empirical part focused on a case company – Finnish regional newspaper. Empirical research has been conducted using a quantitative method and data was collected via online survey placed on newspaper’s website during 2010. 1001 responses have been collected. The results showed that benefits obtained both from traditional printed newspaper and from online one have positive effects on the word-of-mouth about this newspaper and its website. However, it has been revealed that benefits obtained from reading the newspaper don’t have effect on the willingness to pay for this newspaper. Additionally, only interpersonal and convenience benefits obtained from using the newspaper’s website influence on the willingness to pay for it. Finally, willingness to pay for the bundle of printed newspaper and its website access is affected positively only by the information/learning benefits obtained from reading the newspaper and by the interpersonal benefits obtained from using the newspaper’s website.

Probiotic lactobacilli and bifidobacteria in the mouth – in vitro studies on saliva-mediated functions and acid production

Probiotic lactobacilli and bifidobacteria in the mouth – in vitro studies on saliva-mediated functions and acid production Probiotics are viable bacteria which, when used in adequate amounts, are beneficial to the health of the host. Although most often related to intestinal health, probiotic bacteria can be found also in the mouth after consumption of products that contain them. This study aimed at evaluating the oral effects of probiotic bacteria already in commercial use. In a series of in vitro studies, the oral colonisation potential of different probiotic bacteria, their acid production and potential saliva-mediated effects on oral microbial ecology were investigated. The latter included effects on the salivary pellicle, the adhesion of other bacteria, and the activation of the peroxidase system. Streptococcus mutans, Streptococcus gordonii, Aggregatibacter actinomycetemcomitans and Helicobacter pylori were used as bacterial indicators of the studied phenomena. There were significant differences between the probiotic strains in their colonisation potential. They all were acidogenic, although using different sugars and sugar alcohols. However, their acid production could be inhibited by the peroxidase system. Based on the results, it can be suggested that probiotic bacteria might influence the oral microbiota by different, partly species or strain-specific means. These include the inhibition of bacterial adhesion, modification of the enamel pellicle, antimicrobial activity, and activation of the peroxidase system. To conclude, probiotic strains differed from each other in their colonisation potential and other oral effects as evaluated in vitro. Both positive and potentially harmful effects were observed, but the significance of the perceived results needs to be further evaluated in vivo.

How to increase brand quality perception with audiovisual content? : Exploring the role of emotions in B2C and B2B contexts

This study discusses how audiovisual content can influence brand quality perceptions. The purpose of this study is to explore how audiovisual content creation can increase brand quality perceptions. This research problem is addressed with three sub questions, which aim at clarifying the role of emotions between content marketing and brand quality perception, explaining how different functions of audiovisual content can increase brand quality perception, and by identifying and comparing the key differences in content creation in business-to-consumer and business-to-businesscontexts. The theoretical background of the study is in brand personality, consumer emotions, consumerbrand relationships, content marketing and B2B branding literature. The empirical research part includes a single-case study. The case company was a Swiss startup that wished to build a highquality brand for both B2C and B2B segments. The empirical data was collected in September 2014. Eight interviews were conducted; seven with target segment representatives and one with an existing customer of the case company. The empirical findings were analyzed with thematic analysis and finally a 5-stage framework was created based on the findings of the research, offering a guideline for high-quality content creation. This study finds that emotions play an important role in brand quality perceptions. Psychological processes, emotion, cognition and conation, influence the engagement process of the target segment which ultimately can lead to activation and electronic word-of-mouth. Brand quality perception is the result of the overall emotion of the brand. The overall emotion derives from brand personality, brand concept, product attributes and utilitarian benefits of the brand. The entertaining and educational functions of the audiovisual content can target and evoke these emotional processes, and result in increased quality perceptions. In the B2B context, emotions are found to play a relatively smaller role in the quality perception processes. However, the significance of emotions cannot be ignored, since they can emphasize the value for the buying organization, and build on the trust and loyalty among the potential customers. The final framework presents five stages of content creation that ultimately improve brand quality perceptions. These stages help marketers to design and implement their content and evoke positive emotions in their target segment as part of a quality-based marketing strategy. Further research is warranted to quantitatively test the generalizability of the framework. Further research is also suggested to make the framework adaptable to different stages of the brand life cycle.

Impact of Word-of-Mouth on consumer decision-making: An information processing perspective in the context of a high-involvement service

This doctoral study conducts an empirical analysis of the impact of Word-of-Mouth (WOM) on marketing-relevant outcomes such as attitudes and consumer choice, during a high-involvement and complex service decision. Due to its importance to decisionmaking, WOM has attracted interest from academia and practitioners for decades. Consumers are known to discuss products and services with one another. These discussions help consumers to form an evaluative opinion, as WOM reduces perceived risk, simplifies complexity, and increases the confidence of consumers in decisionmaking. These discussions are also highly impactful as WOM is a trustworthy source of information, since it is independent from the company or brand. In responding to the calls for more research on what happens after WOM information is received, and how it affects marketing-relevant outcomes, this dissertation extends prior WOM literature by investigating how consumers process information in a highinvolvement service domain, in particular higher-education. Further, the dissertation studies how the form of WOM influences consumer choice. The research contributes to WOM and services marketing literature by developing and empirically testing a framework for information processing and studying the long-term effects of WOM. The results of the dissertation are presented in five research publications. The publications are based on longitudinal data. The research leads to the development of a proposed theoretical framework for the processing of WOM, based on theories from social psychology. The framework is specifically focused on service decisions, as it takes into account evaluation difficulty through the complex nature of choice criteria associated with service purchase decisions. Further, other gaps in current WOM literature are taken into account by, for example, examining how the source of WOM and service values affects the processing mechanism. The research also provides implications for managers aiming to trigger favorable WOM through marketing efforts, such as advertising and testimonials. The results provide suggestions on how to design these marketing efforts by taking into account the mechanism through which information is processed, or the form of social influence.