1. Quality of life and health status in middle-aged presumed healthy Slovenian family practice attendeesMatic Tement, Polona Selič-Zupančič, 2021, original scientific article Abstract: Background: There is a gap in our knowledge of health-related quality of life (HRQoL) in a population presumed healthy, so this study aimed to assess the associations between HRQoL, demographics and clinical variables.
Methods: The participants were attendees, presumed healthy, at 40 pre-selected model family medicine practices (MFMPs), aged between 30 and 65 years and recruited during a preventive check-up in 2019. Each MFMP pragmatically invited 30 attendees to voluntarily participate. The EQ-5D questionnaire was administered as a measure of HRQoL; the independent variables were demographic characteristics, smoking, alcohol consumption, stress perception, physical activity, signs of depression, cardiovascular risk, body mass index, blood pressure values, and blood sugar and lipidogram laboratory test values. Ordinal logistic regression was used to calculate associations between self-assessed quality of life, demographics, and clinical variables, with P<0.05 set as statistically significant.
Results: Of 986 participants, 640 (64.9%) were women and 346 (35.1%) men, aged 42.7+-8.6 years. The average values for the EQ-5D-3L were 0.9+1-0.15. In the multivariate model, a positive association between adequate physical activity (p=0.003), and a negative association between higher age (p<0.001), female gender (p=0.009), signs of depression (p<0.001), stress (p=0.013), and EQ-5D score were identified.
Conclusion: Given that physical activity was shown to be positively associated with HRQoL, it is of the utmost importance for family physicians to motivate their middle-aged patients, especially women and those with signs of depression and excessive stress, to adopt a more rigorously physically active lifestyle.
Keywords: health related quality of life, health status, family practice, middle-age, physical activity, depression, stress, coping
Published in DKUM: 11.12.2024; Views: 0; Downloads: 8
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2. Core values of family medicine in Europe : current state and challengesEva Arvidsson, Igor Švab, Zalika Klemenc-Ketiš, 2021, original scientific article Abstract: Background: Values are deeply held views that act as guiding beliefs for individuals and organizations. They state what is important in a profession. The aims of this study were to determine whether European countries have already developed (or are developing) documents on core values in family medicine; to gather the lists of core values already developed in countries; and to gather the opinions of participants on what the core family values in their countries are.
Methods: This was a qualitative study. The questionnaire was distributed as an e-survey via email to present and former members of the European Society for Quality and Safety in Family Practice (EQuiP), and other family medicine experts in Europe. The questionnaire included six items concerning core values in family medicine in the respondent's country: the process of defining core values, present core values, the respondents' suggestions for core values, and current challenges of core values.
Results: Core values in family medicine were defined or in a process of being defined in several European countries. The most common core values already defined were the doctor-patient relationship, continuity, comprehensiveness and holistic care, community orientation, and professionalism. Some countries expressed the need for an update of the current core values' list. Most respondents felt the core values of their discipline were challenged in today's world. The main values challenged were continuity, patient-centered care/the doctor-patient relationship and comprehensive and holistic care, but also prioritization, equity, and community orientation and cooperation. These were challenged by digital health, workload/lack of family physicians, fragmentation of care, interdisciplinary care, and societal trends and commercial interests.
Conclusion: We managed to identify suggestions for core values of family medicine at the European level. There is a clear need to adopt a definition of a value and tailor the discussion and actions on the family medicine core values accordingly. There is also a need to identify the core values of family medicine in European countries. This could strengthen the profession, promote its development and research, improve education, and help European countries to advocate for the profession.
Keywords: value orientation, family practice, continuity of patient care, patient-centered care, Europe
Published in DKUM: 06.08.2024; Views: 109; Downloads: 12
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3. Fall risk in adult family practice non-attenders : a cross-sectional study from SloveniaNina Ružić Gorenjec, Zalika Klemenc-Ketiš, Rok Blagus, Tonka Poplas-Susič, 2023, original scientific article Abstract: Introduction: Not much is known about the fall risk among the adult population of those who rarely visit doctors. We wanted to determine the prevalence of increased fall risk in a population of family practice non-attenders and the factors associated with it.
Methods: We included participants from family medicine practices in this cross-sectional study. To be included in the study, the participants had to be adults living in the community (home-dwelling people) who had not visited their chosen family physician in the last five years (non-attenders). The identification of the eligible persons was done through a search of electronic medical records, which yield 2,025 non-attenders. Community nurses collected data in the participants’ homes. The outcome measure was increased fall risk as assessed by the Morse fall scale: increased risk (≥25) vs. no risk.
Results: The sample consisted of 1,945 patients (96.0% response rate) with a mean age of 60.4 years (range 20.5 to 99.7 years). An increased fall risk was determined in 482 or 24.8% (95% CI: [22.9, 26.8]) of the patients. The multivariate model showed a significant association of increased fall risk with higher age (p<0.001), lower systolic blood pressure (p=0.047), poor family function (p=0.016), increased risk of malnutrition (p=0.013), higher number of chronic diseases (p=0.027), higher pain intensity (p<0.001), lower self-assessment of current health (p=0.002), and higher dependence in daily activities (p<0.001).
Conclusion: Non-attenders may have an increased risk of falling which depends on their health status and age. The inclusion of community nurses in primary healthcare teams could be of use not only to identify the non-attenders’ health needs, but also to better manage their health, especially the factors that were identified to be associated with greater fall risk.
Keywords: fall risk, primary healthcare, family practice, non-attenders, cross-sectional studies
Published in DKUM: 17.07.2024; Views: 125; Downloads: 4
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4. The safety of patient management in family medicine in Slovenia during Covid-19 : a crosssectional studyMaja Cvetko Gomezelj, Špela Miroševič, Alina Verdnik Tajki, Ksenija Tušek-Bunc, Esther Van Poel, Sara Willems, Zalika Klemenc-Ketiš, 2023, original scientific article Abstract: Abstract Background During the Covid-19 pandemic, family medicine practices (FMPs) changed to improve safety against new coronavirus infections for both patients and employees. Protocols for treating patients with suspected Sars-Cov-2 infections were established to protect medical staf and other patients from being infected. However, these protocols also led to increased safety risks, such as delays in treating patients with other medical conditions. This exploratory study aimed to investigate safety risks in treating patients in FMPs during the Covid-19 pandemic and to suggest improvements to prevent Covid-19 in FMPs in Slovenia. Methods A cross-sectional study was rolled out in FMPs in Slovenia as part of the international Pricov-19 study. Data collection on safety management during the Covid-19 pandemic in FMPs in Slovenia took place from November 2020 until January 2021 using a self-administered online survey for FP working in Slovenia. A chi-square test, ANOVA, independent samples t-test or bivariate correlation test was performed to explore associations regarding the safety of patients’ management variables. Results From the 191 participating family physicians (FPs) (15.2% response rate), 54.8% reported having treated patients with fever (not Covid-19) late due to the new protocols at least once, and 54.8% reported patients with urgent conditions having been seen late at least once due to not coming. In the suburbs and rural environments FPs more often reported that at least once patient with a fever (not Covid-19) was seen late due to the protocol (p=0.017) and more often reported that at least once patient with an urgent condition was seen late due to not com‑ ing to their FP (p=0.017). The larger the practice, the more they reported that at least once a patient with fever (not Covid-19) was seen late due to the protocol (p=0.012) and the more they reported at least once a patient with an urgent condition was seen late due to not coming to their FP (p=0.012). Conclusion Covid-19 afected the safety of patient management in FMP in Slovenia. The most common prob‑ lem was foregone care. Therefor, protocols for chronic patient management in the event of epidemics need to be established.
Keywords: Covid-19, family medicine, patient safety, patient management, quality of care, PRICOV-19, primary health care, general practice, timeliness
Published in DKUM: 29.03.2024; Views: 249; Downloads: 18
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5. Defining rural, remote and isolated practices : the example of SloveniaRok Petrovčič, 2016, review article Abstract: There is no single definition of rural practice available. Definitions vary from one country to another, as countries differ in geography and have different health care systems with varying organizational specificities, even within the same country. In spite of increased urbanization and the specific health-related problems it brings with it, a large proportion of the world population still dwells in rural, remote, and isolated areas. In fact, there are many countries in the world with extensive rural areas. Rural areas are unique in organization, demographics, and infrastructure, and so are the specific health-related problems of people living in them. Healthcare in such areas is generally provided by general practitioners or by physicians specialized in family medicine. One of the basic challenges in rural health is defining which areas are rural and finding the characteristics that define “rural”. There are several criteria and combinations of criteria that can be used to define rural areas. Their use mostly depends on the purpose for which the definition is used, and can thus vary from application to application. This paper addresses issues in rural family practice and criteria that may be used to define such practices. It also presents the use of criteria for defining rural practices in a small European country, on the example of Slovenia.
Keywords: Slovenia, rural health, rural population, family practice
Published in DKUM: 07.08.2017; Views: 1267; Downloads: 198
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6. The role of the European Academy of Teachers in General Practice and Family Medicine in family medicine education in Europe : the experience of the University of MariborZalika Klemenc-Ketiš, Janko Kersnik, 2012, review article Abstract: Primary health care is important item of political agendas since Alma Ata conference in 1978. West Balkans share common history in development of primary care since 1920' when Andrija Stampar introduced social and community based primary care concepts. The first known specialist training in general practice in the world started in former Yugoslavia in the early 1960'. Since then, much has been done in the field of general practice and family medicine and this is reflected in The European Academy of Teachers in General Practice and Family Medicine (EURACT), which is a network organisation within World Organization of National Colleges, Academies and Academic Associations of General Practitioners/Family Physicians Region Europe (WONCA Europe). Its aim is to foster and maintain high standards of care in European general practice by promoting general practice as a discipline by learning and teaching. EURACT developed several documents and teachers' courses which can serve the development of family medicine curricula in new established departments of medical schools. This is also the case at Maribor Medical School, where learning outcomes and teaching methods are in concordance with EURACT teaching agenda, but also some innovative approaches are used, such as art and e-learning environment as teaching methods.
Keywords: family practice, education, Europe, Slovenia
Published in DKUM: 24.07.2017; Views: 1252; Downloads: 168
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7. Importance of international networking in academic family medicineZalika Klemenc-Ketiš, Janko Kersnik, 2014, review article Abstract: European family medicine/general practice (FM/GP) has travelled the long and successful journey of profiling the discipline and has produced valuable position papers on education and research. Nowadays, academic medicine is one of the pillars in the future development of FM/GP in Europe. A common European curriculum on undergraduate and postgraduate family medicine is needed. Also, a sound international platform of teaching institutions and/or teachers of family medicine would foster the further development of family medicine as an academic discipline. This would stimulate students and teachers to engage in international exchange to gain new knowledge and experiences, present their work and ideas abroad and prepare the conditions for further exchange of students and teachers.
Conclusion: Established departments of FM/GP, led by a teacher who is a family physician/general practitioner, at each Medical School in Europe should provide students with knowledge and skills related to the core attributes of FM/GP. International exchanges of teachers and students should foster the development of a common curriculum on FM in Europe and foster improvement in the quality of FM education.
Keywords: family practice, education, network, exchange
Published in DKUM: 24.07.2017; Views: 1685; Downloads: 376
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8. Regional coordinators : a new teaching opportunity in family medicine trainingDavorina Petek, Polona Vidič Hudobivnik, Viktorija Jančar, Bojana Petek, Zalika Klemenc-Ketiš, 2016, original scientific article Abstract: Background: A new project on education in family medicine training was implemented last year in Slovenia by establishing regional coordinators in the specialist training programme. They are responsible for conducting regular small-group meetings with family medicine trainees. This study wanted to explore the attitudes and opinions of regional coordinators and family medicine trainees concerning this new method.
Methods: This was a qualitative study based on focus groups. The participants were regional coordinators and family medicine specialist trainees. The data were analysed based on the principles of thematic content analysis with inductive technique.
Results: The study revealed five themes which were the same for the analysis of transcripts of both regional coordinators and family medicine trainees: 1) Meetings with trainees; 2) Coordination; 3) Characteristics of regional coordinators; 4) Position of regional coordinators, and 5) Evaluation of regional coordinators.
Conclusion: Participants of the study have many expectations for this new programme. They expect progress in trainees' clinical knowledge through experience-based group learning and with the help of the tutorship role of regional coordinators. The role of regional coordinators represents a new possibility for solving problems in the training programme in their coordinating role. In future, they have the potential to develop into an expert body that supervises the quality of training. A close follow-up is necessary to see if the position of regional coordinators is adequate and if they meet the expectations of the trainees as well as their own goals. Administrative and financial support for the programme is necessary. The project is important also in enabling the adaptation of the training programme's needs and the regional characteristics of medical care.
Keywords: family practice, education, mentors
Published in DKUM: 28.06.2017; Views: 1164; Downloads: 181
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9. Using movies in family medicine teaching : a reference to EURACT Educational AgendaZalika Klemenc-Ketiš, Igor Švab, 2017, original scientific article Abstract: Introduction: Cinemeducation is a teaching method where popular movies or movie clips are used. We aimed to determine whether family physicians’ competencies as listed in the Educational Agenda produced by the European Academy of Teachers in General Practice/Family Medicine (EURACT) can be found in movies, and to propose a template for teaching by these movies.
Methods: A group of family medicine teachers provided a list of movies that they would use in cinemeducation. The movies were categorised according to the key family medicine competencies, thus creating a framework of competences, covered by different movies. These key competencies are Primary care management, Personcentred care, Specific problem-solving skills, Comprehensive approach, Community orientation, and Holistic approach.
Results: The list consisted of 17 movies. Nine covered primary care management. Person-centred care was covered in 13 movies. Eight movies covered specific problem-solving skills. Comprehensive approach was covered in five movies. Five movies covered community orientation. Holistic approach was covered in five movies.
Conclusions: All key family medicine competencies listed in the Educational Agenda can be taught using movies. Our results can serve as a template for teachers on how to use any appropriate movies in family medicine education.
Keywords: family practice, medical education, narration, professional competences, movies, family medicine, education, EURACT
Published in DKUM: 06.04.2017; Views: 1471; Downloads: 172
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10. The impact of patientʼs socio-demographic characterictics, comorbidities and attitudes on flu vaccination uptake in family practice settingsAndrej Kravos, Lucija Kračun, Klara Kravos, Rade Iljaž, 2015, original scientific article Abstract: Objectives: In Slovenia, the role of family physicians in primary care and preventive procedures is very important. Influenza vaccination rates in Slovenia are low. The reasons for low vaccination rates in Slovenia were not clear. We suppose that patient’s beliefs and attitudes are important factors. We assessed patients’ opinions regarding the acceptance of flu vaccination by their family physicians and their beliefs and attitudes about flu and vaccination. The aim was to check out factors that influence the decision to take the vaccine in family physician offices.
Methods: This was a cross-sectional, multicenter, observational study in the Styria region in Slovenia. We included patients from seven family physicians during regular office visits. They filled in a questionnaire about their general demographic data and attitudes regarding influenza and vaccination. The main outcome was the decision to be vaccinated.
Results: The logistic regression model identified five predictors for influenza vaccination, namely: heart disease, previous vaccination, an agreement with the beliefs ‘the vaccination is an efficient measure to prevent influenza’, ‘after the vaccination there are usually no important side effects’ and ‘the vaccination is also recommended for a healthy adult person’. The belief that vaccinations harm the immune system is negatively associated with vaccination.
Conclusions: Patients’ beliefs are an important factor to decide for vaccination or not. Family physician teams should discuss with patients their beliefs and concerns about vaccination.
Keywords: vaccination, influenza, family practice, attitudes, chronic diseases
Published in DKUM: 05.04.2017; Views: 1296; Downloads: 138
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