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Factors associated with health-related quality of life among university students
Zalika Klemenc-Ketiš, Janko Kersnik, Ksenija Eder, Dušan Colarič, 2011, izvirni znanstveni članek

Opis: Introduction: University students are subjected to different kinds of stressors, i.e.academic pressures, social issues and financial problems. This can affect their academic achievements and quality of life. Objective: The aim of this study was to determine the health-related quality of life of university students, and how it is affected by the presence of chronic diseases, mental disorders comorbidity, and patterns of medical services' use. Methods: This web-based study included a sample of 1,410 Slovenian university students. We used a self-administered questionnaire, containing a sheet with demographic data, Zung's self-assessment inventories about anxiety and depression, and EQ-5D questionnaire. The main outcome measures were scores on EQ-5D part and VAS part of the EQ-5D questionnaire. Results: Independent factors associated with the health-related quality of life of university students, were the presence of chronic pain, the presence of depression and anxiety, need for urgent medical help and at least one visit to a clinical specialist in the past year. The independent factors associated with the health status of university students were the presence of chronic diseases, chronic pain, depression and anxiety, a visit to a clinical specialist, a need for urgent medical help and a visit to an emergency unit in the past year. Conclusion: Health-related quality of life of university students can be seriously affected by the presence of mental disorders and chronic pain. Appropriate health-related measures should be adopted to achieve early recognition of worse health-related quality of life, the presence of mental disorders and other chronic conditions, and to enable their effective treatment.
Ključne besede: quality of life, students, chronic disease, pain, depression, anxiety
Objavljeno: 04.08.2017; Ogledov: 575; Prenosov: 337
.pdf Celotno besedilo (192,97 KB)
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Deficiency areas in decision making in undergraduate medical students
Zalika Klemenc-Ketiš, Janko Kersnik, 2014, izvirni znanstveni članek

Opis: Background: In family medicine, decisions can be difficult due to the early presentation of often poorly developed symptoms or the presentation of undifferentiated conditions that require competencies unique to family medicine, such as; primary care management, specific problem-solving skills, and a comprehensive and holistic approach to be taught to medical students. Purpose: The aim of this study was to assess the decision-making process covering all theoretical aspects of family practice consultation and to recognize possible areas of deficiency in undergraduate medical students. Materials and methods: This was a cross-sectional, observational study performed at the Medical School of the University of Maribor in Slovenia. The study population consisted of 159 fourth-year medical students attending a family medicine class. The main outcome measure was the scores of the students' written reports on solving the virtual clinical case. An assessment tool consisted of ten items that could be graded on a 5-point Likert scale. Results: The final sample consisted of 147 (92.5%) student reports. There were 95 (64.6%) female students in the sample. The mean total score on the assessment scale was 35.1+-7.0 points of a maximum 50 points. Students scored higher in the initial assessment items and lower in the patient education/involvement items. Female students scored significantly higher in terms of total assessment score and in terms of initial assessment and patient education/involvement. Conclusion: Undergraduate medical education should devote more time to teaching a comprehensive approach to consultation, especially modification of the health behavior of patients and opportunistic health promotion to patients. Possible sex differences in students' performance should be further evaluated.
Ključne besede: assessment, family medicine, undergraduate medical education, decision making
Objavljeno: 03.08.2017; Ogledov: 526; Prenosov: 298
.pdf Celotno besedilo (240,92 KB)
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The role of the European Academy of Teachers in General Practice and Family Medicine in family medicine education in Europe
Zalika Klemenc-Ketiš, Janko Kersnik, 2012, pregledni znanstveni članek

Opis: 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.
Ključne besede: family practice, education, Europe, Slovenia
Objavljeno: 24.07.2017; Ogledov: 580; Prenosov: 73
.pdf Celotno besedilo (83,80 KB)
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Importance of international networking in academic family medicine
Zalika Klemenc-Ketiš, Janko Kersnik, 2014, pregledni znanstveni članek

Opis: 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.
Ključne besede: family practice, education, network, exchange
Objavljeno: 24.07.2017; Ogledov: 522; Prenosov: 287
.pdf Celotno besedilo (71,97 KB)
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Factors impacting on the activation and approach times of helicopter emergency medical services in four Alpine countries
Iztok Tomazin, Miljana Vegnuti, John Ellerton, Oliver Reisten, Guenther Sumann, Janko Kersnik, 2012, izvirni znanstveni članek

Opis: Background: The outcome of severely injured or ill patients can be time dependent. Short activation and approach times for emergency medical service (EMS) units are widely recognized to be important quality indicators. The use of a helicopter emergency medical service (HEMS) can significantly shorten rescue missions especially in mountainous areas. We aimed to analyze the HEMS characteristics that influence the activation and approach times. Methods: In a multi-centre retrospective study, we analyzed 6121 rescue missions from nineHEMS bases situated in mountainous regions of four European countries. Results: We found large differences in mean activation and approach times among HEMS bases. The shortest mean activation time was 2.9 minutes; the longest 17.0 minutes. The shortest mean approach time was 10.4 minutes; the longest 45.0 minutes. Short times are linked (p < 0.001) to the following conditions: helicopter operator is not state owned; HEMS is integrated in EMS; all crew members are at the same location; doctors come from state or private health institutions; organization performing HEMS is privately owned; helicopters are only for HEMS; operation area is around 10.000 km2; HEMS activation is by a dispatching centre of regional government who is in charge of making decisions; there is only one intermediator in the emergency call; helicopter is equipped with hoist or fixed line; HEMS has more than one base with helicopters, and one team per base; closest neighboring base is 90 km away; HEMS is about 20 years old and has more than 650 missions per year; and modern helicopters are used. Conclusions: An improvement in HEMS activation and approach times is possible. We found 17 factors associated with shorter times.
Ključne besede: emergency medical services, air ambulances, emergency helicopters, quality of health care, activation and approach time
Objavljeno: 29.06.2017; Ogledov: 826; Prenosov: 243
.pdf Celotno besedilo (1,22 MB)
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The effect of carbon dioxide on near-death experiences in out-of-hospital cardiac arrest survivors: a prospective observational study
Zalika Klemenc-Ketiš, Janko Kersnik, Štefek Grmec, 2010, izvirni znanstveni članek

Opis: Introduction: Near-death experiences (NDEs) are reported by 11-23% of cardiac arrest survivors. Several theories concerning the mechanisms of NDEs exist - including physical, psychological, and transcendental reasons - but so far none of these has satisfactorily explained this phenomenon. In this study, we investigated the effect of partial pressures of O2 and CO2, and serum levels of Na and K on the occurrence of NDEs in out-of-hospital cardiac arrest survivors. Methods: A prospective observational study was conducted in the three largest hospitals in Slovenia. Fifty-two consecutive patients (median age 53.1 years, 42 males) after out-of-hospital cardiac arrest were included. The presence of NDEs was assessed with a self-administered Greyson's NDE scale. The initial partial pressure of end-tidal CO2, the arterial blood partial pressures of O2 and CO2 and the levels of Na and K in venous blood were analysed and studied. Univariate analyses and multiple regression models were used. Results: NDEs were reported by 11 (21.2%) of the patients. Patients with higher initial partial pressures of end-tidal CO2 had significantly more NDEs (P < 0.01). Patients with higher arterial blood partial pressures of CO2 had significantly more NDEs (P = 0.041). Scores on a NDE scale were positively correlated with partial pressures of CO2 (P = 0.017) and with serum levels of potassium (P = 0.026). The logistic regression model for the presence of NDEs (P = 0.002) explained 46% of the variance and revealed higher partial pressures of CO2 to be an independent predictor of NDEs. The linear regression model for a higher score on the NDE scale (P = 0.001) explained 34% of the variance and revealed higher partial pressures of CO2, higher serum levels of K, and previous NDEs as independent predictors of the NDE score. Conclusions: Higher concentrations of CO2 proved significant, and higher serum levels of K might be important in the provoking of NDEs. Since these associations have not been reported before, our study adds novel information to the field of NDEs phenomena.
Ključne besede: near-death experience, cardiac arrest, survivors
Objavljeno: 29.06.2017; Ogledov: 602; Prenosov: 304
.pdf Celotno besedilo (301,05 KB)
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Using movies to teach professionalism to medical students
Zalika Klemenc-Ketiš, Janko Kersnik, 2011, izvirni znanstveni članek

Opis: Background: Professionalism topics are usually not covered as a separate lesson within formal curriculum, but in subtler and less officially recognizededucational activities, which makes them difficult to teach and assess. Interactive methods (e.g. movies) could be efficient teaching methods but are rarely studied. The aims of this study were: 1) to test the relevance and usefulness of movies in teaching professionalism to fourth year medical students and, 2) to assess the impact of this teaching method on students' attitudes towards some professionalism topics. Method: This was an education study with qualitative data analysis in a group of eleven fourth year medical students from the Medical School of University Maribor who attended an elective four month course on professionalism. There were 8 (66.7%) female students in the group. The mean age of the students was 21.9 +/- 0.9 years. The authors used students' written reports and oral presentations as the basisfor qualitative analysis using thematic codes. Results: Students recognised the following dimensions in the movie: communication, empathy, doctors' personal interests and palliative care. It also made them think abouttheir attitudes towards their own life, death and dying. Conclusion: The controlled environment of movies successfully enables students to explore their values, beliefs, and attitudes towards features of professionalism without feeling that their personal integrity had been threatened. Interactiveteaching methods could become an indispensible aid in teaching professionalism to new generations.
Ključne besede: teaching methods, movies, medical students
Objavljeno: 28.06.2017; Ogledov: 869; Prenosov: 328
.pdf Celotno besedilo (246,35 KB)
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Usefulness of the patient information leaflet (PIL) and information on medicines from professionals
Tonka Poplas-Susič, Zalika Klemenc-Ketiš, Janko Kersnik, 2014, izvirni znanstveni članek

Opis: Background: The Patient information leaflet (PIL) is an important source of information for every patient. Little is known about whether patients read the PIL and whether it contains useful information. Other sources of drug-related information are professionals (a family practitioner, a pharmacist and a nurse). Informing patients on drugs improves their compliance. The aim of the study was to identify the usefulness of PIL from the perspective of the patient, to assess professionals as a source of drug-related information and to suggest changes that can improve informing and therefore patients' compliances. Methods: Four focus group interviews were conducted across different primary health care centres in the North East of Slovenia. Focus groups were composed of randomly selected patients (in total 20) who were willing to express their views on PILs, on other drug information sources and on possible improvements. A qualitative analysis of the data was based of the transcription of the audiotapes. Results: Patients read the PILs selectively. They were most interested in side effects, contraindications and the purpose of the prescribed drug. Participants reported that the language in PILs is too scientific. In the case they do not understand PILs or they recognise some of the side effects, a majority of participants decide to contact a family physician first, and less frequently a pharmacist or a nurse. A family physician is considered to be the most trustworthy source of information and patients think that pharmacists could play a more active role in patients% education. Conclusion: Current PILs offer enough partial information to patients but need some improvements in terms of better legibility and access to the most crucial information. PIL does not enable a comprehensive information with respect to patient%s health status. Most reliable source of information is considered to be a family practitioner. Pharmacists could play a more active role in the education of patients.
Ključne besede: PIL, focus groups, medicines, family practitioner
Objavljeno: 10.05.2017; Ogledov: 807; Prenosov: 48
.pdf Celotno besedilo (91,61 KB)
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Do the experiences of patients of state-employed family physicians and concessionaires in Slovenia differ?
Danica Rotar-Pavlič, Maja Sever, Zalika Klemenc-Ketiš, Igor Švab, Janko Kersnik, Wienke Boerma, 2015, izvirni znanstveni članek

Opis: Background: Family practice healthcare in Slovenia is provided by state-employed family physicians as well as concessionaires. However, both work under a contract with the National Health Insurance Institute. This study focuses on comparing patients’ experiences with Slovenian concessionaires and state-employed physicians. Methods: We performed analyses using survey data from a cross-sectional study on patient experiences, which took place from September 2011 to April 2012 as a part of the international QUALICOPC study. The Slovenian branch of this study included 1,962 patients visiting family practices. Patients were classified into two groups with respect to the registered status of their family physician. They completed the questionnaires immediately aſter visiting their family physicians. Data used in the analyses included 76 variables: 18 socio-economic and 58 variables linked to the patient’s experience. Results: The analyses showed few differences between concessionaires and state-employed family physicians. In comparison with patients of state-employed family physicians, patients of concessionaires were less likely to make an appointment for a visit (19.8 % vs. 29.2 %), were generally more frequent visitors (43.7 % vs. 50.7 %), and more oſten felt that opening hours were too restricted (25.7 % vs. 31.9 %). Patients of concessionaires believed more oſten that in general, doctors can be trusted (40.1 % vs.47.1 %). A smaller percentage of patients of concessionaires felt that their physician had the capacity to deal with personal problems as well as to provide medical care (61.9 % vs. 54.7 %). Conclusions: There are few differences in patients’ experiences of state-employed family physicians and concessionaires. Slovenian patients have a generally positive experience with family practice services regardless of the family physicians’ status. Plans for organizational change of the health sector should include patients’ perceptions of services.
Ključne besede: patient, experience, family physician, state-employed, concessionaire
Objavljeno: 10.05.2017; Ogledov: 690; Prenosov: 275
.pdf Celotno besedilo (105,74 KB)
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The role of the psychosocial dimension in the improvement of quality of care
Irena Makivić, Janko Kersnik, Zalika Klemenc-Ketiš, 2016, pregledni znanstveni članek

Opis: The aim of our systematic review was to analyse the published literature on the psychosocial dimension of care in family medicine and its relationship with quality of care. We wanted to find out whether there is any evidence on the psychosocial approach in (family) medicine. The recommended bio-psycho-social approach, besides the biomedical model of illness, takes into account several co-influencing psychological, sociological and existential factors. An online search of nine different databases used Boolean operators and the following selection criteria: the paper contained information on the holistic approach, quality indicators, family medicine, patient-centred care and/or the bio-psycho-social model of treatment. We retrieved 743 papers, of which 36 fulfilled our inclusion criteria. Including the psychosocial dimension in patient management has been found to be useful in the prevention and treatment of physical and psychiatric illness, resulting in improved social functioning and patient satisfaction, reduced health care disparities, and reduced annual medical care charges. The themes of patient-centred, behavioural or psychosocial medicine were quite well presented in several papers. We could not find any conclusive evidence of the impact of a holistic biopsycho-social-approach. Weak and variable definitions of psychosocial dimensions, a low number of welldesigned intervention studies, and low numbers of included patients limited our conclusions.
Ključne besede: general practice, social problems, psychosocial care, quality of health care, reviews
Objavljeno: 05.04.2017; Ogledov: 492; Prenosov: 96
.pdf Celotno besedilo (744,29 KB)
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