Læknablaðið : fylgirit - 05.01.2015, Blaðsíða 10

X V I I V Í S I N D A R Á Ð S T E F N A H Í
F Y L G I R I T 8 2
10 LÆKNAblaðið/Fylgirit 82 2015/101
E 4 Heilsueflandi heimsóknir til 80 ára einstaklinga á þjónustusvæði
heilsugæslustöðvarinnar á Selfossi
Steinunn Birna Svavarsdóttir1, Árún K. Sigurðardóttir2, Sólveig Ása Árnadóttir3
1Heilsugæslustöðinni á Selfossi, 2Heilbrigðisvísindasviði Háskólans á Akureyri, 3námsbraut í
sjúkraþjálfun, læknadeild Háskóla Íslands
steinunn@hsu.is
Inngangur: Stjórnvöld horfa í vaxandi mæli til heilsueflandi heimsókna
til að ýta undir heilbrigða öldrun og að viðhalda sjálfstæði aldraðra á
eigin heimili. Lítið hefur þó borið á rannsóknum á þessari þjónustu.
Tilgangurinn var að rannsaka einkenni og afdrif tveggja hópa aldraðra
einstaklinga sem ýmist þáðu eða afþökkuðu heilsueflandi heimsókn.
Efniviður og aðferðir: Megindleg samanburðarferilrannsókn var notuð
til að rýna í fyrirliggjandi gögn í Sögukerfinu. Gögnin byggðu á upp-
lýsingum um 148 áttræða einstaklinga sem fengu boð um eina heilsu-
eflandi heimsókn frá heilsugæslustöðinni á Selfossi á árunum 2005-2010.
Niðurstöður: Alls þáðu 100 (68%) heilsueflandi heimsókn (51 karl og 49
konur) en 48 (32%) afþökkuðu (17 karlar og 31 kona). Við upphaf rann-
sóknartímabilsins reyndist marktækur munur á svefnlyfjanotkun eftir
hópum (p=0,011). Þeir sem þáðu heimsókn notuðu frekar svefnlyf (44%)
en þeir sem afþökkuðu (21%). Þrátt fyrir fáa þátttakendur, eina heilsu-
eflandi heimsókn og stutta eftirfylgd voru marktæk tengsl á milli þess
að hafa þegið heimsóknina og að vera á lífi einu (p=0,014) og tveimur
(p=0,006) árum eftir hana. Meðal þess sem einkenndi hópinn sem þáði
heilsueflandi heimsókn var að konur bjuggu frekar einar en karlar,
rúmlega helmingur hópsins stundaði enga reglulega hreyfingu og 71%
var yfir kjörþyngd. Gagnagöt (missing data) í gagnagrunni takmörkuðu
möguleika á úrvinnslu.
Ályktanir: Til að meta þörf fyrir forvarnir og heilsueflingu, sem og
árangur heilsueflandi heimsókna, er brýnt að bæta skráningu og efla
notkun staðlaðra matskvarða. Rannsaka þarf orsök þess hvað fær fólk
til að þiggja heilsueflandi heimsókn og þróa þarf þetta þjónustuúrræði
áfram. Æskilegt er að samræma heilsueflandi heimsóknir á landsvísu
þannig að safna megi gögnum og nýta til að meta langtímaárangur fyrir
stærri hópa eldra fólks.
E 5 Guidelines and tests for antenatal care in normal pregnancies:
Evaluation of clinical guidelines in Europe
Helga Gottfreðsdóttir1,2, Lucy Frith3, Katrien Beekman4, Annette Bernloehr5
1Department of Midwifery, Faculty of Nursing, University of Iceland, 2Landspítala, 3The
University of Liverpool, Department of Health Services Research, 4 Vrije Universiteit Brussel,
Department of Nursing and Midwifery, 5Midwifery Research and Education Unit Department
of Obstetrics, Gynaecology and Reproductive Medicine, Hannover Medical School
helgagot@hi.is
Introduction: Clinical guidelines for low risk pregnancies have been
developed and implemented in many European countries. The aim is to
provide an overview of excisting antenatal care guidelines (ANC) on a
national basis for healthy women in Europe.
Methods and data: A questionnaire was developed and pretested in
18 countries with help from experts in maternity care in each country.
The content of the guidelines was explored with emphasis on 5 specific
components; fetal screening, blood pressure measurement, ultrasound
scans, blood samples and number of visits.
Results: 12/18 countries have ANC implemented on a national basis,
but two countries have regional guidelines, as such 14 questionnaires
were analyzed. 11/12 ANC incorporated description of Down syndrome
screening, where 9/12 emphasized first trimester screening. The total
number of blood samples advised in normal pregnancy varied from 2 to
8, and advised number of visits were reccomended 5-15 for a primigra-
vida and 4-15 for multipara.
Conclusions: There are indications of a wide rangeof content in ANC in
Europe. If ANC are meant to change clinical practice, they must be app-
ropriately developed, disseminated, and implemented. Data has been
collected from 30 countries which are being analyzed.
E 6 Associations between meal frequency and glycemic properties
of maternal diet and preterm delivery
Linda Englund-Ögge1, Bryndís Eva Birgisdóttir2,3, Anne Lise Brantsæter2, Verena
Sengpiel1, Margareta Haugen2, Ronny Myhre4, Helle Margrete Meltzer2, Bo
Jacobsson1, 4
1Department of Obstetrics and Gynecology, Institute of Clinical Sciences, The Sahlgrenska
Academy, Sahlgrenska University Hospital, 2Department of Exposure and Risk Assessment,
Division of Environmental Medicine, Norwegian Institute of Public Health, 3Unit for Nutrition
Research, Landspítali University Hospital and University of Iceland, 4Department of Genes and
Environment, Division of Epidemiology, Norwegian Institute of Public Health
beb@hi.is
Introduction: The objective of this study was to examine associations
between meal frequency and glycemic properties of maternal diet and
preterm delivery.
Methods and data: A nation wide prospective cohort study including
66,000 singleton pregnancies from the Norwegian Mother and Child
cohort study. Information about mothers’ meal frequency and maternal
diet was obtained from a validated self-reported food frequency ques-
tionnaire answered in mid-pregnancy. Information on gestational age at
delivery was obtained from the Medical Birth Registry of Norway and
preterm delivery was defined as birth before 37 weeks of gestation.
Results: After adjustments there was a trend towards lower risk
for preterm delivery when following a “main meal pattern”, which
included eating breakfast, lunch and dinner regularly, p = 0.025. After
additional adjustments for meal frequency and dietary fiber none of the
glycemicproperty measures was significantly associated with overall
risk of preterm delivery. However, glycemic load was associated with
late preterm delivery in the whole group, with a hazard ratio for the
highest vs lowest quartile of 1.25 (95% CI 1.00 to 1.56). A high intake of
dietary fibers was associated with a significantly reduced risk of preterm
delivery in younger women (age <= 35 years) with hazard ratio for the
highest vs lowest quartile of 0.85 (95% CI 0.73 to 0.98).
Conclusions: Thesignificant associationof meal frequency and various
measures of glycemic properties with different subgroups of thestudy
populationand for different subgroups of preterm deliveryindicate the
importance of maternal diet for infant health and needs further inve-
stigation to be fully understood.
E 7 Útkoma heimafæðinga og sjúkrahúsfæðinga á Íslandi 2005-
2009: Afturskyggn ferilrannsókn
Berglind Hálfdánsdóttir1, Alexander Kr. Smárason2,3, Ólöf Ásta Ólafsdóttir1,
Ingegerd Hildingsson4,5,6, Herdís Sveinsdóttir1,7
1Hjúkrunarfræðideild Háskóla Íslands, 2heilbrigðisvísindasviði Háskólans á Akureyri,
3fæðinga- og kvensjúkdómalækningum, Sjúkrahúsinu á Akureyri, 4Department of Nursing,
Mid Sweden University, 5Department of Women’s and Children’s Health, Karolinska Institutet,
6Department of Women’s and Children’s Health, Uppsala University, 7skurðlækningasviði
Landspítala
beh6@hi.is
Inngangur: Tíðni heimafæðinga á Íslandi var 2,2% árið 2012. Tíðnin
er sú hæsta á Norðurlöndunum og hefur aukist hratt á síðustu árum í
kjölfar sögulegrar lægðar í lok síðustu aldar. Útkoma heimafæðinga á