Eeva-eerika Helminen | University of Eastern Finland (original) (raw)

Papers by Eeva-eerika Helminen

JMIR. Journal of medical internet research/Journal of medical internet research, Nov 11, 2023

Background: Mental disorders posit a major public health problem in most western countries. The d... more Background: Mental disorders posit a major public health problem in most western countries. The demand for services for common mental health disorders has been on the rise despite the widespread accessibility of medication. Especially the supply and demand for evidence-based psychotherapy do not align. Large-scale increase of modern psychotherapy is difficult with current methods of training which are often expensive, time consuming and dependent on a small number of top-level professionals as trainers. E-learning have been proposed to enhance psychotherapy training accessibility, quality, and scalability. Objective: This systematic review aims to provide an overview of the current evidence regarding e-learning in psychotherapy training. In particular, the review examines the usability, acceptability and learning outcomes associated with e-learning. Learning outcomes are assessed in different modalities including trainee experiences, knowledge acquisition, skill acquisition and application of trained content in daily practice. Furthermore, the equivalence of online training and conventional training methods is evaluated. Methods: Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, a search from Ovid Medline, PsycINFO, and SCOPUS databases between 2008 and June 2022. Inclusion criteria required studies to describe e-learning systems for psychotherapy training and assess acceptability, feasibility, or learning outcomes. The risk of bias was evaluated for both randomized and non-randomized studies. Learning outcomes were categorized using the Kirkpatrick model. Effect sizes comparing e-learning and traditional methods were calculated. Results: The search yielded 3380 publications, of which 34 fulfilled the inclusion criteria. Positive learning outcomes are generally associated with various e-learning programs in psychotherapy training including trainee satisfaction, knowledge, and skill acquisition, and in application of trained content in clinical practice. Learning outcomes are generally comparable between elearning and conventional training methods. The current literature displays a high level of heterogeneity in e-learning solutions and assessment methods. Conclusions: E-learning seems to have good potential to enhance psychotherapy training by increasing access, scalability, and cost-effectiveness while maintaining quality in terms of learning outcomes. Results are congruent with findings related to elearning in health education in general where e-learning as a pedagogy is linked to an opportunity to carry out learner-centric practices. Recommendations for conducting psychotherapy training programs in hybrid settings supported by active learning practices are presented. However, due to the heterogeneity and limitations in the existing literature, more research is warranted to further replicate the results and establish international standards for e-learning and assessment in psychotherapy training. Research is especially needed on optimal ways to combine e-learning and conventional training methods in blended learning settings.

Clinical Rehabilitation, Nov 20, 2014

To assess the effectiveness of a six week cognitive-behavioural group intervention in patients wi... more To assess the effectiveness of a six week cognitive-behavioural group intervention in patients with knee osteoarthritis pain. Single-blinded randomized controlled trial. Primary care providers in a medium-sized city in Finland. A total of 111 participants aged from 35 to 75 with clinical symptoms and radiographic grading (Kellgren-Lawrence 2-4) of knee osteoarthritis were included. In the intervention group, 55 participants attended a cognitive-behavioural training programme for pain management with six weekly group sessions supervised by a psychologist and a physiotherapist. Concurrently, they and the 56 participants of the control group continued in ordinary GP care that was not altered by the study. The primary outcome on three-month and 12-month follow-up was the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis index pain subscale. Secondary outcome measures included self-reports of pain and physical function, health-related quality of life, and a comprehensive set of psychological questionnaires. Mixed model results showed no significant differences between the intervention and control group for any measures of pain or function. A significant difference between the groups was found in the Pain Self-Efficacy Questionnaire (Pr = 0.022) in favour of the control group, and in the RAND-36 emotional well-being subscale in favour of the intervention group (Pr = 0.038). Conventional group comparisons of mean follow-up values showed no significant differences in any of the outcome variables. This trial could not confirm the hypothesized advantage of a cognitive-behavioural training programme over ordinary GP care in knee osteoarthritis pain patients. Current Controlled Trials ISRCTN64794760.

Itä-Suomen yliopisto, Sep 15, 2015

Clinical rehabilitation, Jan 20, 2014

To assess the effectiveness of a six week cognitive-behavioural group intervention in patients wi... more To assess the effectiveness of a six week cognitive-behavioural group intervention in patients with knee osteoarthritis pain. Single-blinded randomized controlled trial. Primary care providers in a medium-sized city in Finland. A total of 111 participants aged from 35 to 75 with clinical symptoms and radiographic grading (Kellgren-Lawrence 2-4) of knee osteoarthritis were included. In the intervention group, 55 participants attended a cognitive-behavioural training programme for pain management with six weekly group sessions supervised by a psychologist and a physiotherapist. Concurrently, they and the 56 participants of the control group continued in ordinary GP care that was not altered by the study. The primary outcome on three-month and 12-month follow-up was the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis index pain subscale. Secondary outcome measures included self-reports of pain and physical function, health-related quality of life, and a comprehensive s...

Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases, 2014

Knee osteoarthritis (OA) is the most common type of arthritis and imposes a heavy burden on indiv... more Knee osteoarthritis (OA) is the most common type of arthritis and imposes a heavy burden on individual welfare among elderly people. There is preliminary evidence that psychological factors play a role in functional ability and pain in knee OA patients, particularly with respect to the surgery outcome. Less is known about psychological factors among community-dwelling patients with knee OA. We aimed to determine which psychological factors are associated with pain and functional ability among community-dwelling knee OA patients using a comprehensive set of psychological questionnaires. In the cross-sectional baseline setting of a prospective, randomized controlled intervention study, 111 patients aged from 35 to 75 years with clinical symptoms and radiographic grading of knee OA were included. They completed a comprehensive set of psychological questionnaires, including measures of resources and coping, fear and catastrophizing, and distress. In cross-sectional comparisons, pain sel...

Clinical Rehabilitation

Objective: To identify predictors of long-term pain and disability in knee osteoarthritis. Design... more Objective: To identify predictors of long-term pain and disability in knee osteoarthritis. Design: A longitudinal cohort study of five years. Setting: Primary care providers. Subjects: In all, 108 patients (mean age = 63.6 years, standard deviation (SD) = 7.2 years) with knee pain (⩾40 mm on a 100 mm visual analogue scale in the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index pain scale) and radiographic grading (Kellgren–Lawrence: 2–4) of knee osteoarthritis who participated in a randomized controlled trial. Main measures: Disease-specific pain and functioning were assessed using the corresponding WOMAC subscales. Generic functioning was assessed by the RAND-36 subscales for function and physical and mental component summary scores. Possible baseline predictors for these outcomes were (1) demographic and disease-related variables and (2) psychological variables of mood (anxiety, depression), pain-related cognitions (pain self-efficacy, pain catastrophizing, k...

Clinical Rehabilitation, 2016

Objective: To identify predictors of pain and disability in knee osteoarthritis. Design: A one-ye... more Objective: To identify predictors of pain and disability in knee osteoarthritis. Design: A one-year prospective analysis of determinants of pain and functioning in knee osteoarthritis. Study setting: Primary care providers in a medium-sized city. Patients: A total of 111 patients aged from 35 to 75 with clinical symptoms and radiographic grading (Kellgren-Lawrence 2–4) of knee osteoarthritis who participated in a randomized controlled trial. Main measures: The outcome measures were self-reported pain and function, which were recorded at 0, 3 and 12 months. Disease-specific pain and functioning were assessed using the pain and function subscales of the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index. Generic physical and mental functioning were assessed using the RAND-36 subscales for function, and physical and mental component summary scores. Possible baseline predictors for these outcomes were 1) demographic, socioeconomic and disease-related variables, and 2...

Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases, 2014

Knee osteoarthritis (OA) is the most common type of arthritis and imposes a heavy burden on indiv... more Knee osteoarthritis (OA) is the most common type of arthritis and imposes a heavy burden on individual welfare among elderly people. There is preliminary evidence that psychological factors play a role in functional ability and pain in knee OA patients, particularly with respect to the surgery outcome. Less is known about psychological factors among community-dwelling patients with knee OA. We aimed to determine which psychological factors are associated with pain and functional ability among community-dwelling knee OA patients using a comprehensive set of psychological questionnaires. In the cross-sectional baseline setting of a prospective, randomized controlled intervention study, 111 patients aged from 35 to 75 years with clinical symptoms and radiographic grading of knee OA were included. They completed a comprehensive set of psychological questionnaires, including measures of resources and coping, fear and catastrophizing, and distress. In cross-sectional comparisons, pain sel...

BMC Musculoskeletal Disorders, 2013

Background: Knee osteoarthritis is the most common type of arthritis, with pain being its most co... more Background: Knee osteoarthritis is the most common type of arthritis, with pain being its most common symptom. Little is known about the psychological aspects of knee osteoarthritis pain. There is an emerging consensus among osteoarthritis specialists about the importance of addressing not only biological but also psychosocial factors in the assessment and treatment of osteoarthritis. As few studies have evaluated the effect of psychological interventions on knee osteoarthritis pain, good quality randomized controlled trials are needed to determine their effectiveness. Methods/Design: We intend to conduct a 6-week single-blinded randomized controlled trial with a 12-month follow-up. Altogether, 108 patients aged from 35 to 75 years with clinical symptoms and radiographic grading (KL 2-4) of knee osteoarthritis will be included. The clinical inclusion criteria are pain within the last year in or around the knee occurring on most days for at least one month, and knee pain of ≥40 mm on a 100-mm visual analogue scale in the WOMAC pain subscale for one week prior to study entry. Patients with any severe psychiatric disorder, other back or lower limb pain symptoms more aggravating than knee pain, or previous or planned lower extremity joint surgery will be excluded. The patients will be randomly assigned to a combined GP care and cognitive-behavioral intervention group (n = 54) or to a GP care control group (n = 54). The cognitive-behavioral intervention will consist of 6 weekly group sessions supervised by a psychologist and a physiotherapist experienced in the treatment of pain. The main goals of the intervention are to reduce maladaptive pain coping and to increase the self-management of pain and disability. The follow-up-points will be arranged at 3 and 12 months. The primary outcome measure will be the WOMAC pain subscale. Secondary outcome measures will include self-reports of pain and physical function, a health related quality of life questionnaire, and various psychological questionnaires. Personnel responsible of the data analysis will be blinded. Discussion: This study addresses the current topic of non-pharmacological conservative treatment of knee OA-related pain. We anticipate that these results will provide important new insights to the current care recommendations. Trial registration: Current Controlled Trials ISRCTN64794760

BMC Family Practice, 2009

Background: Metabolic syndrome (MetS) is a major public health challenge. General practitioners (... more Background: Metabolic syndrome (MetS) is a major public health challenge. General practitioners (GPs) could play a key role in its recognition. However, it often remains undiagnosed in primary care. This study assesses how well GPs and patients recognise MetS among patients with coronary heart disease or at least one of its risk factors.

Clinical rehabilitation, Jan 20, 2014

To assess the effectiveness of a six week cognitive-behavioural group intervention in patients wi... more To assess the effectiveness of a six week cognitive-behavioural group intervention in patients with knee osteoarthritis pain. Single-blinded randomized controlled trial. Primary care providers in a medium-sized city in Finland. A total of 111 participants aged from 35 to 75 with clinical symptoms and radiographic grading (Kellgren-Lawrence 2-4) of knee osteoarthritis were included. In the intervention group, 55 participants attended a cognitive-behavioural training programme for pain management with six weekly group sessions supervised by a psychologist and a physiotherapist. Concurrently, they and the 56 participants of the control group continued in ordinary GP care that was not altered by the study. The primary outcome on three-month and 12-month follow-up was the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis index pain subscale. Secondary outcome measures included self-reports of pain and physical function, health-related quality of life, and a comprehensive s...

JMIR. Journal of medical internet research/Journal of medical internet research, Nov 11, 2023

Background: Mental disorders posit a major public health problem in most western countries. The d... more Background: Mental disorders posit a major public health problem in most western countries. The demand for services for common mental health disorders has been on the rise despite the widespread accessibility of medication. Especially the supply and demand for evidence-based psychotherapy do not align. Large-scale increase of modern psychotherapy is difficult with current methods of training which are often expensive, time consuming and dependent on a small number of top-level professionals as trainers. E-learning have been proposed to enhance psychotherapy training accessibility, quality, and scalability. Objective: This systematic review aims to provide an overview of the current evidence regarding e-learning in psychotherapy training. In particular, the review examines the usability, acceptability and learning outcomes associated with e-learning. Learning outcomes are assessed in different modalities including trainee experiences, knowledge acquisition, skill acquisition and application of trained content in daily practice. Furthermore, the equivalence of online training and conventional training methods is evaluated. Methods: Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, a search from Ovid Medline, PsycINFO, and SCOPUS databases between 2008 and June 2022. Inclusion criteria required studies to describe e-learning systems for psychotherapy training and assess acceptability, feasibility, or learning outcomes. The risk of bias was evaluated for both randomized and non-randomized studies. Learning outcomes were categorized using the Kirkpatrick model. Effect sizes comparing e-learning and traditional methods were calculated. Results: The search yielded 3380 publications, of which 34 fulfilled the inclusion criteria. Positive learning outcomes are generally associated with various e-learning programs in psychotherapy training including trainee satisfaction, knowledge, and skill acquisition, and in application of trained content in clinical practice. Learning outcomes are generally comparable between elearning and conventional training methods. The current literature displays a high level of heterogeneity in e-learning solutions and assessment methods. Conclusions: E-learning seems to have good potential to enhance psychotherapy training by increasing access, scalability, and cost-effectiveness while maintaining quality in terms of learning outcomes. Results are congruent with findings related to elearning in health education in general where e-learning as a pedagogy is linked to an opportunity to carry out learner-centric practices. Recommendations for conducting psychotherapy training programs in hybrid settings supported by active learning practices are presented. However, due to the heterogeneity and limitations in the existing literature, more research is warranted to further replicate the results and establish international standards for e-learning and assessment in psychotherapy training. Research is especially needed on optimal ways to combine e-learning and conventional training methods in blended learning settings.

Clinical Rehabilitation, Nov 20, 2014

To assess the effectiveness of a six week cognitive-behavioural group intervention in patients wi... more To assess the effectiveness of a six week cognitive-behavioural group intervention in patients with knee osteoarthritis pain. Single-blinded randomized controlled trial. Primary care providers in a medium-sized city in Finland. A total of 111 participants aged from 35 to 75 with clinical symptoms and radiographic grading (Kellgren-Lawrence 2-4) of knee osteoarthritis were included. In the intervention group, 55 participants attended a cognitive-behavioural training programme for pain management with six weekly group sessions supervised by a psychologist and a physiotherapist. Concurrently, they and the 56 participants of the control group continued in ordinary GP care that was not altered by the study. The primary outcome on three-month and 12-month follow-up was the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis index pain subscale. Secondary outcome measures included self-reports of pain and physical function, health-related quality of life, and a comprehensive set of psychological questionnaires. Mixed model results showed no significant differences between the intervention and control group for any measures of pain or function. A significant difference between the groups was found in the Pain Self-Efficacy Questionnaire (Pr = 0.022) in favour of the control group, and in the RAND-36 emotional well-being subscale in favour of the intervention group (Pr = 0.038). Conventional group comparisons of mean follow-up values showed no significant differences in any of the outcome variables. This trial could not confirm the hypothesized advantage of a cognitive-behavioural training programme over ordinary GP care in knee osteoarthritis pain patients. Current Controlled Trials ISRCTN64794760.

Itä-Suomen yliopisto, Sep 15, 2015

Clinical rehabilitation, Jan 20, 2014

To assess the effectiveness of a six week cognitive-behavioural group intervention in patients wi... more To assess the effectiveness of a six week cognitive-behavioural group intervention in patients with knee osteoarthritis pain. Single-blinded randomized controlled trial. Primary care providers in a medium-sized city in Finland. A total of 111 participants aged from 35 to 75 with clinical symptoms and radiographic grading (Kellgren-Lawrence 2-4) of knee osteoarthritis were included. In the intervention group, 55 participants attended a cognitive-behavioural training programme for pain management with six weekly group sessions supervised by a psychologist and a physiotherapist. Concurrently, they and the 56 participants of the control group continued in ordinary GP care that was not altered by the study. The primary outcome on three-month and 12-month follow-up was the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis index pain subscale. Secondary outcome measures included self-reports of pain and physical function, health-related quality of life, and a comprehensive s...

Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases, 2014

Knee osteoarthritis (OA) is the most common type of arthritis and imposes a heavy burden on indiv... more Knee osteoarthritis (OA) is the most common type of arthritis and imposes a heavy burden on individual welfare among elderly people. There is preliminary evidence that psychological factors play a role in functional ability and pain in knee OA patients, particularly with respect to the surgery outcome. Less is known about psychological factors among community-dwelling patients with knee OA. We aimed to determine which psychological factors are associated with pain and functional ability among community-dwelling knee OA patients using a comprehensive set of psychological questionnaires. In the cross-sectional baseline setting of a prospective, randomized controlled intervention study, 111 patients aged from 35 to 75 years with clinical symptoms and radiographic grading of knee OA were included. They completed a comprehensive set of psychological questionnaires, including measures of resources and coping, fear and catastrophizing, and distress. In cross-sectional comparisons, pain sel...

Clinical Rehabilitation

Objective: To identify predictors of long-term pain and disability in knee osteoarthritis. Design... more Objective: To identify predictors of long-term pain and disability in knee osteoarthritis. Design: A longitudinal cohort study of five years. Setting: Primary care providers. Subjects: In all, 108 patients (mean age = 63.6 years, standard deviation (SD) = 7.2 years) with knee pain (⩾40 mm on a 100 mm visual analogue scale in the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index pain scale) and radiographic grading (Kellgren–Lawrence: 2–4) of knee osteoarthritis who participated in a randomized controlled trial. Main measures: Disease-specific pain and functioning were assessed using the corresponding WOMAC subscales. Generic functioning was assessed by the RAND-36 subscales for function and physical and mental component summary scores. Possible baseline predictors for these outcomes were (1) demographic and disease-related variables and (2) psychological variables of mood (anxiety, depression), pain-related cognitions (pain self-efficacy, pain catastrophizing, k...

Clinical Rehabilitation, 2016

Objective: To identify predictors of pain and disability in knee osteoarthritis. Design: A one-ye... more Objective: To identify predictors of pain and disability in knee osteoarthritis. Design: A one-year prospective analysis of determinants of pain and functioning in knee osteoarthritis. Study setting: Primary care providers in a medium-sized city. Patients: A total of 111 patients aged from 35 to 75 with clinical symptoms and radiographic grading (Kellgren-Lawrence 2–4) of knee osteoarthritis who participated in a randomized controlled trial. Main measures: The outcome measures were self-reported pain and function, which were recorded at 0, 3 and 12 months. Disease-specific pain and functioning were assessed using the pain and function subscales of the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index. Generic physical and mental functioning were assessed using the RAND-36 subscales for function, and physical and mental component summary scores. Possible baseline predictors for these outcomes were 1) demographic, socioeconomic and disease-related variables, and 2...

Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases, 2014

Knee osteoarthritis (OA) is the most common type of arthritis and imposes a heavy burden on indiv... more Knee osteoarthritis (OA) is the most common type of arthritis and imposes a heavy burden on individual welfare among elderly people. There is preliminary evidence that psychological factors play a role in functional ability and pain in knee OA patients, particularly with respect to the surgery outcome. Less is known about psychological factors among community-dwelling patients with knee OA. We aimed to determine which psychological factors are associated with pain and functional ability among community-dwelling knee OA patients using a comprehensive set of psychological questionnaires. In the cross-sectional baseline setting of a prospective, randomized controlled intervention study, 111 patients aged from 35 to 75 years with clinical symptoms and radiographic grading of knee OA were included. They completed a comprehensive set of psychological questionnaires, including measures of resources and coping, fear and catastrophizing, and distress. In cross-sectional comparisons, pain sel...

BMC Musculoskeletal Disorders, 2013

Background: Knee osteoarthritis is the most common type of arthritis, with pain being its most co... more Background: Knee osteoarthritis is the most common type of arthritis, with pain being its most common symptom. Little is known about the psychological aspects of knee osteoarthritis pain. There is an emerging consensus among osteoarthritis specialists about the importance of addressing not only biological but also psychosocial factors in the assessment and treatment of osteoarthritis. As few studies have evaluated the effect of psychological interventions on knee osteoarthritis pain, good quality randomized controlled trials are needed to determine their effectiveness. Methods/Design: We intend to conduct a 6-week single-blinded randomized controlled trial with a 12-month follow-up. Altogether, 108 patients aged from 35 to 75 years with clinical symptoms and radiographic grading (KL 2-4) of knee osteoarthritis will be included. The clinical inclusion criteria are pain within the last year in or around the knee occurring on most days for at least one month, and knee pain of ≥40 mm on a 100-mm visual analogue scale in the WOMAC pain subscale for one week prior to study entry. Patients with any severe psychiatric disorder, other back or lower limb pain symptoms more aggravating than knee pain, or previous or planned lower extremity joint surgery will be excluded. The patients will be randomly assigned to a combined GP care and cognitive-behavioral intervention group (n = 54) or to a GP care control group (n = 54). The cognitive-behavioral intervention will consist of 6 weekly group sessions supervised by a psychologist and a physiotherapist experienced in the treatment of pain. The main goals of the intervention are to reduce maladaptive pain coping and to increase the self-management of pain and disability. The follow-up-points will be arranged at 3 and 12 months. The primary outcome measure will be the WOMAC pain subscale. Secondary outcome measures will include self-reports of pain and physical function, a health related quality of life questionnaire, and various psychological questionnaires. Personnel responsible of the data analysis will be blinded. Discussion: This study addresses the current topic of non-pharmacological conservative treatment of knee OA-related pain. We anticipate that these results will provide important new insights to the current care recommendations. Trial registration: Current Controlled Trials ISRCTN64794760

BMC Family Practice, 2009

Background: Metabolic syndrome (MetS) is a major public health challenge. General practitioners (... more Background: Metabolic syndrome (MetS) is a major public health challenge. General practitioners (GPs) could play a key role in its recognition. However, it often remains undiagnosed in primary care. This study assesses how well GPs and patients recognise MetS among patients with coronary heart disease or at least one of its risk factors.

Clinical rehabilitation, Jan 20, 2014

To assess the effectiveness of a six week cognitive-behavioural group intervention in patients wi... more To assess the effectiveness of a six week cognitive-behavioural group intervention in patients with knee osteoarthritis pain. Single-blinded randomized controlled trial. Primary care providers in a medium-sized city in Finland. A total of 111 participants aged from 35 to 75 with clinical symptoms and radiographic grading (Kellgren-Lawrence 2-4) of knee osteoarthritis were included. In the intervention group, 55 participants attended a cognitive-behavioural training programme for pain management with six weekly group sessions supervised by a psychologist and a physiotherapist. Concurrently, they and the 56 participants of the control group continued in ordinary GP care that was not altered by the study. The primary outcome on three-month and 12-month follow-up was the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis index pain subscale. Secondary outcome measures included self-reports of pain and physical function, health-related quality of life, and a comprehensive s...