1. Kakovost oskrbe v odnosu na oceno kakovosti vodenja kronične bolezni bolnikov s koronarno boleznijoKsenija Tušek-Bunc, Marija Petek Šter, Davorina Petek, 2018, izvirni znanstveni članek Opis: Purpose: Patient-centered assessment of chronic illness care is replacing the assessment of satisfaction, which does not cover all dimensions of care. Pa- tient assessments reflect both the qual- ity of chronic illness care and provide feedback to healthcare workers about their work. The study aim was to inves- tigate the patient-centered assessment of coronary heart disease (CHD) pa- tients and its correlation with the care that was delivered. Methods: This cross-sectional study evaluated data obtained from the patient medical records and surveyed patients using the Patient Assessment of Chronic Illness Care (PACIC) ques- tionnaire. A descriptive analysis of the overall and domain-specific responses to the PACIC questionnaire was con- ducted and the association of the results with delivery of care data in the patient records was determined by Pearson's correlation coefficient. Results: The study sample included 768 of 1080 CHD patients (71,1%) at 36 family medicine practices who com- pleted the PACIC questionnaire. The mean age of the re- spondents was 68.3 +- 10.7 years and the overall PACIC score was 3.3 +- 0.9. The highest PACIC scores were deliv- ery system design (3.7), patient activation (3.7), and prob- lem solving (3.6). Follow-up received the lowest score (2.8). Quality of delivered care and PACIC scores were correlated (r = 0.10, p = 0.009). Conclusions: CHD patients highly rated all aspects of chronic care included in the PACIC questionnaire. They were least satisfied with the follow-up and coordination as- pects of chronic care. The process indicators of care were positively correlate with patient assessment of care. Ključne besede: coronary heart disease patients, patient's assessment of chronic illness care, quality of care Objavljeno v DKUM: 05.04.2024; Ogledov: 199; Prenosov: 9
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2. Comorbidities and characteristics of coronary heart disease patients: their impact on health-related quality of lifeKsenija Tušek-Bunc, Davorina Petek, 2016, izvirni znanstveni članek Opis: Background: Patients with coronary heart disease (CHD) commonly present with more than one comorbid condition, contributing to poorer health-related quality of life (HRQoL). The aim of our study was to identify the associations between HRQoL and patient characteristics, vascular comorbidities and anxiety/depression disorders.
Methods: This observational study was conducted in 36 family medicine practices selected by random stratified sampling from all regions of Slovenia. HRQoL was assessed using the European Quality of Life - 5 Dimensions (EQ-5D) questionnaire and EQ Visual Analogue Scale (EQ-VAS). The associations between HRQoL and patient characteristics stratified by demographics, vascular comorbidities, health services used, their assessment of chronic illness care, and anxiety/depression disorders were identified by ordinal logistic regression and linear regression models.
Results: The final sample included 423 CHD patients with a mean age of 68.0 ± SD 10.8 years; 35.2% were female. Mean EQ-VAS score was 58.6 ± SD 19.9 (median: 60 with interquartile range of 45–75), and mean EQ-5D index was 0.60 ± SD 0.19 (median: 0.56 with interquartile range of 0.41–0.76). The statistically significant predictors of a lower EQ-VAS score were higher family physician visit frequency, heart failure (HF) and anxiety/depression disorders (R² 0.240; F = 17.368; p < 0.001). The statistically significant predictor of better HRQoL, according to EQ-5D was higher patient education, whereas higher family physician visit frequency, HF and peripheral artery disease (PAD) were predictors of poorer HRQoL (Nagelkerke R 2 = 0.298; χ 2 = 148.151; p < 0.001).
Conclusions: Results of our study reveal that comorbid conditions (HF and PAD), family physician visit frequency and years in education are significant predictors of HRQoL in Slovenian CHD patients. Ključne besede: coronary heart disease patient, health-related quality of life, vascular comorbidities, anxiety/depression disorders Objavljeno v DKUM: 29.06.2017; Ogledov: 1747; Prenosov: 429
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3. Regional coordinators : a new teaching opportunity in family medicine trainingDavorina Petek, Polona Vidič Hudobivnik, Viktorija Jančar, Bojana Petek, Zalika Klemenc-Ketiš, 2016, izvirni znanstveni članek Opis: 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. Ključne besede: family practice, education, mentors Objavljeno v DKUM: 28.06.2017; Ogledov: 1164; Prenosov: 181
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4. Kazalniki kakovosti preventive srčno-žilnih bolezni v ambulanti družinske medicineDavorina Petek, Stephen Campbell, Maša Serec, Janko Kersnik, 2012, pregledni znanstveni članek Opis: Namen: Nacionalna validacija kazalnikov kakovosti v preventivi bolezni srca in ožilja v primarnem zdravstvu v Sloveniji in primerjava z mednarodno validiranimi kazalniki.
Metode: V okviru mednarodne raziskave Epa cardio je bil razvit seznam kazalnikov kakovosti, ki so izvirali iz strokovnih smernic, priporo- čil in dobre klinične prakse. V vsaki sodelujoči državi so bili predlagani kazalniki predstavljeni skupini nacionalnih ekspertov, ki so jih glede na razumljivost, veljavnost in izvedljivost ocenili v dveh krogih s pomočjo metodologije Delphi. V Sloveniji je sodelovalo 14 ekspertov–zdravnikov družinske medicine s posebnim zanimanjem za bolezni srca in ožilja.
Rezultati: Največ validiranih kazalnikov je pripadalo skupini zdravstvene oskrbe bolnikov z boleznijo srca in ožilja. Manjše število kazalnikov je bilo validiranih s področja primarne preventive, večinoma glede zapisa in nasveta v zvezi z življenjskim slogom. Zelo malo je bilo validiranih kazalnikov izida (vrednost dejavnikov tveganja). Noben kazalnik o vključenosti bolnika ali o novejših dejavnikih tveganja, npr. socioekonomske okoliščine, ni bil validiran.
Zaključki: Slovenija je validirala več kazalnikov kot mednarodna skupina, posebej s področja primarne preventive. Eksperti niso dosegli konsenza glede kazalnikov bolnikove perspektive kljub paradigmi družinske medicine, da je bolnik v središču oskrbe. Validirane kazalnike je potrebno pred uporabo za sistematično sledenje kakovosti preizkusiti v praksi. Ključne besede: kazalniki kakovosti, zdravstvena oskrba, bolezni srca in ožilja, preventiva Objavljeno v DKUM: 28.03.2017; Ogledov: 1728; Prenosov: 211
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