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Perceptions of the primary health care team about the implementation of integrated care of patients with type 2 diabetes and hypertension in Slovenia : qualitative study
Nataša Stojnić, Zalika Klemenc-Ketiš, Majda Mori-Lukančič, Črt Zavrnik, Tonka Poplas-Susič, 2023, izvirni znanstveni članek

Opis: Background Integrated care involves good coordination, networking, and communication within health care services and externally between providers and patients or informal caregivers. It affects the quality of services, is more cost-effective, and contributes to greater satisfaction among individuals and providers of integrated care. In our study, we examined the implementation and understanding of integrated care from the perspective of providers - the health care team - and gained insights into the current situation. Methods Eight focus groups were conducted with health care teams, involving a total of 48 health care professionals, including family physicians, registered nurses, practice nurses, community nurses, and registered nurses working in a health education center. Prior to conducting the focus groups, a thematic guide was developed based on the literature and contextual knowledge with the main themes of the integrated care package. The analysis was conducted using the NVivo program. Results We identified 12 main themes with 49 subthemes. Health care professionals highlighted good accessibility and the method of diagnostic screening integrated with preventive examinations as positive aspects of the current system of integrated care in Slovenia. They mentioned the good cooperation within the team, with the involvement of registered nurses and community nurses being a particular advantage. Complaints were made about the high workload and the lack of workforce. They feel that patients do not take the disease seriously enough and that patients as teachers could be useful. Conclusion Primary care teams described the importance of implementing integrated care for diabetes and hypertension patients at four levels: Patient, community, care providers, and state. Primary care teams also recognized the importance of including more professionals from different health care settings on their team.
Ključne besede: integrated health care system, type-2-diabetes, Hypertension, Health care team, interdisciplinary primary care, qualitative research
Objavljeno v DKUM: 19.04.2024; Ogledov: 94; Prenosov: 4
.pdf Celotno besedilo (1007,00 KB)
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Pogostnost etičnih dilem med zdravniki družinske medicine v Sloveniji
Zalika Klemenc-Ketiš, Janko Kersnik, 2009, izvirni znanstveni članek

Opis: Purpose: To de termine the per~ ceived prevalence of ethical dilem~ mas in family practice.Methods: Selfadministered ques~ tionnaire sent to a random sample of 259 Slovenian family physicians.The main outcome measure was the percentage of doctors reporting the frequency of ethical dilemmas on a 5 ~point scale.Results: Ethical dilemmas were common ( mean score standard de~viation, 36.2 12.5, out of a maxi~ mum of 100). The most common dilemmas involved decision~making regarding use of limited resources (23.9%), patient attempts to abuse the health care service (20.4%) and interfacing with the rest of the health care system (20.4%). Dealing with patients suspected of being physically abused, sexually abused, or involved in other violent acts was the least common ethical dilemma 0.1 %), followed by issues involving breaking bad news 0.1 %) and special situations regarding adolescents (0.7%).Older physicians and those with more experience reported ethical dilemmas less commonly (32.3 11.9 vs.40.1 11.9, P < 0.001; 32.4 11.8 vs. 39.5 12.2, P = O. OO 1 , respectively) . Specialists in family medicine and family medicine residents reported ethical dilemmas more commonly than general practitioners without specialist training (37.0 12.6 vs. 30.7 1O.8, P = 0.05 and 39.5 12.5 vs. 30.7 1O.8, P = 0.04, respectively).Conclusions: Ethical issues are common in Slovenian family practice and are most of ten reported byresidents in specialist training. This supports the need to continue and even improve specialist training in recognizing and comprehending ethical dilemmas.
Ključne besede: bioetika, pogostnost, družinska medicina, odnos med zdravnikom in bolnikom, presečna študija
Objavljeno v DKUM: 19.04.2024; Ogledov: 53; Prenosov: 0
.pdf Celotno besedilo (505,58 KB)
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The safety of patient management in family medicine in Slovenia during Covid-19 : a crosssectional study
Maja Cvetko Gomezelj, Špela Miroševič, Alina Verdnik Tajki, Ksenija Tušek-Bunc, Esther Van Poel, Sara Willems, Zalika Klemenc-Ketiš, 2023, izvirni znanstveni članek

Opis: 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.
Ključne besede: Covid-19, family medicine, patient safety, patient management, quality of care, PRICOV-19, primary health care, general practice, timeliness
Objavljeno v DKUM: 29.03.2024; Ogledov: 108; Prenosov: 6
.pdf Celotno besedilo (764,96 KB)
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The impact of psychological interventions with elements of mindfulness on burnout and well-being in healthcare professionals : a systematic review
Polona Selič-Zupančič, Zalika Klemenc-Ketiš, Sara Onuk Tement, 2023, pregledni znanstveni članek

Opis: Background Healthcare professionals are highly likely to experience various causes of work-related stress, which often leads to burnout. This became even more obvious during the Covid-19 pandemic. This systematic review aimed to analyze articles where psychological interventions with elements of mindfulness (PIM) were used to support healthcare professionals to foster well-being and reduce burnout levels. Compared to other recently published reviews, it is unique, due to its focus on a wide group of healthcare professionals, a broader selection of psychological interventions, and the evaluation of any sustained effects. Methods Systematic searches were carried out in February 2021 with different combinations of Boolean operators within six electronic databases: PubMed, EBSCOhost, MEDLINE, PsycArticles, Cochrane Library, JSTOR and Cobiss. We included articles that had been published in the last ten years (2011 to 2021) and which reported on original research focused on evaluating the influence of PIM on healthcare professionals. MERSQI was used to assess the quality of the included studies. Results Of 1315 identified studies, 15 were included in this systematic review. Regardless of the specific type, duration and setting (individual vs group) of PIM applied, the results demonstrated a positive impact on well-being and burnout in participating healthcare professionals. The most studied interventions involved MBSR (mindfulness-based stress reduction) and other mindfulness training programmes, in online as well as in-person versions. Conclusion Given the new reality with the presence of the SARS-Cov-2 virus, it is of the utmost importance to offer feasible, effective interventions for burnout reduction to vulnerable groups of healthcare professionals. By focusing on their needs, several key aspects of burnout and mindfulness could be efficiently improved; this review demonstrates that short, online interventions could be as effective as longer, in-person ones.
Ključne besede: mindfulness, burnout, perceived stress, well-being, Covid-19, MBSR
Objavljeno v DKUM: 26.03.2024; Ogledov: 106; Prenosov: 3
.pdf Celotno besedilo (1,14 MB)
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Family history tools for primary care : a systematic review
Špela Miroševič, Zalika Klemenc-Ketiš, Borut Peterlin, 2022, pregledni znanstveni članek

Opis: Background: Many medical family history (FH) tools are available for various settings. Although FH tools can be a powerful health screening tool in primary care (PC), they are currently underused. Objectives: This review explores the FH tools currently available for PC and evaluates their clinical performance. Methods: Five databases were systematically searched until May 2021. Identified tools were evaluated on the following criteria: time-to-complete, integration with electronic health record (EMR) systems, patient administration, risk-assessment ability, evidence-based management recommendations, analytical and clinical validity and clinical utility. Results: We identified 26 PC FH tools. Analytical and clinical validity was poorly reported and agreement between FH and gold standard was commonly inadequately reported and assessed. Sensitivity was acceptable; specificity was found in half of the reviewed tools to be poor. Most reviewed tools showed a capacity to successfully identify individuals with increased risk of disease (6.2-84.6% of high and/or moderate or increased risk individuals). Conclusion: Despite the potential of FH tools to improve risk stratification of patients in PC, clinical performance of current tools remains limited as well as their integration in EMR systems. Twenty-one FH tools are designed to be self-administered by patients.
Ključne besede: genetics, family medicine, meta-analyses
Objavljeno v DKUM: 17.07.2023; Ogledov: 279; Prenosov: 7
.pdf Celotno besedilo (1,51 MB)
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Ukrepanje zdravnikov družinske medicine v primeru lastne bolezni
Luka Vučkič, Laura Volk, 2022, končno poročilo o rezultatih raziskav

Ključne besede: samozdravljenje zdravnikov, zdravniki družinske medicine, ukrepanje v primeru bolezni
Objavljeno v DKUM: 27.01.2023; Ogledov: 579; Prenosov: 14
.pdf Celotno besedilo (1,03 MB)

The psychometric properties of the Slovenian version of the medical office survey on patient safety culture
Zalika Klemenc-Ketiš, Irena Makivić, Tonka Poplas-Susič, 2020, izvirni znanstveni članek

Ključne besede: patient safety, primary care, validation studies
Objavljeno v DKUM: 23.01.2023; Ogledov: 456; Prenosov: 9
.pdf Celotno besedilo (126,70 KB)
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Znanje in veščine prve pomoči študentov Medicinske fakultete v Mariboru tekom študija
Kaja Čeh, Ludvik Drobne, Ana Špehonja, 2019, končno poročilo o rezultatih raziskav

Ključne besede: prva pomoč, znanje, veščine, študenti, temeljni postopki oživljanja
Objavljeno v DKUM: 30.11.2020; Ogledov: 1164; Prenosov: 67
.pdf Celotno besedilo (1,03 MB)

Obravnava bolnikov s pogostimi stanji v družinski medicini
Aljaž Brlek, Ernestina Bedek, 2018, končno poročilo o rezultatih raziskav

Ključne besede: pljučnica, motnje začetka in vzdrževanja spanja, sinuzitis, bolečina v križu
Objavljeno v DKUM: 25.03.2019; Ogledov: 1770; Prenosov: 130
.pdf Celotno besedilo (1,29 MB)

KOPB pri kadilcih v referenčnih ambulantah družinske medicine : prepoznava in obravnava
Anja Stopar, 2017, končno poročilo o rezultatih raziskav

Ključne besede: KOPB, kajenje, referenčne ambulante
Objavljeno v DKUM: 23.07.2018; Ogledov: 1704; Prenosov: 198
.pdf Celotno besedilo (772,12 KB)

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