1. Process evaluation of the scale-up of integrated diabetes and hypertension care in Belgium, Cambodia and Slovenia (the SCUBY Project) : a study protocolMonika Martens, Edwin Wouters, Josefien Van Olmen, Zalika Klemenc-Ketiš, Srean Chhim, Savina Chham, Verle Buffel, Katrien Danhieux, Nataša Stojnić, Črt Zavrnik, Tonka Poplas-Susič, Win Van Damme, Por Ir, Roy Remmen, Grace Marie V Ku, Kerstin Klipstein-Grobusch, Daniel Boateng, 2022, izvirni znanstveni članek Opis: Introduction Integrated care interventions for type 2 diabetes (T2D) and hypertension (HT) are effective, yet challenges exist with regard to their implementation and scale-up. The ‘SCale-Up diaBetes and hYpertension care’ (SCUBY) Project aims to facilitate the scale-up of integrated care for T2D and HT through the co-creation and implementation of contextualised scale-up roadmaps in Belgium, Cambodia and Slovenia. We hereby describe the plan for the process and scale-up evaluation of the SCUBY Project. The specific goals of the process and scale-up evaluation are to (1) analyse how, and to what extent, the roadmap has been implemented, (2) assess how the differing contexts can influence the implementation process of the scale-up strategies and (3) assess the progress of the scale-up.
Methods and analysis A comprehensive framework was developed to include process and scale-up evaluation embedded in implementation science theory. Key implementation outcomes include acceptability, feasibility, relevance, adaptation, adoption and cost of roadmap activities. A diverse range of predominantly qualitative tools—including a policy dialogue reporting form, a stakeholder follow-up interview and survey, project diaries and policy mapping—were developed to assess how stakeholders perceive the scale-up implementation process and adaptations to the roadmap. The role of context is considered relevant, and barriers and facilitators to scale-up will be continuously assessed.
Ethics and dissemination Ethical approval has been obtained from the Institutional Review Board (ref. 1323/19) at the Institute of Tropical Medicine (Antwerp, Belgium). The SCUBY Project presents a comprehensive framework to guide the process and scale-up evaluation of complex interventions in different health systems. We describe how implementation outcomes, mechanisms of impact and scale-up outcomes can be a basis to monitor adaptations through a co-creation process and to guide other scale-up interventions making use of knowledge translation and co-creation activities.
Ključne besede: diabetes and hypertension care, Belgium, Cambodia, Slovenia
Objavljeno v DKUM: 27.06.2024; Ogledov: 120; Prenosov: 3
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2. Perceptions of the primary health care team about the implementation of integrated care of patients with type 2 diabetes and hypertension in Slovenia : qualitative studyNataša 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: 236; Prenosov: 7
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3. Artificial intelligence based prediction of diabetic foot risk in patients with diabetes : a literature reviewLucija Gosak, Adrijana Svenšek, Mateja Lorber, Gregor Štiglic, 2023, pregledni znanstveni članek Opis: Diabetic foot is a prevalent chronic complication of diabetes and increases the risk of lower limb amputation, leading to both an economic and a major societal problem. By detecting the risk of developing diabetic foot sufficiently early, it can be prevented or at least postponed. Using artificial intelligence, delayed diagnosis can be prevented, leading to more intensive preventive treatment of patients. Based on a systematic literature review, we analyzed 14 articles that included the use of artificial intelligence to predict the risk of developing diabetic foot. The articles were highly heterogeneous in terms of data use and showed varying degrees of sensitivity, specificity, and accuracy. The most used machine learning techniques were support vector machine (SVM) (n = 6) and K-Nearest Neighbor (KNN) (n = 5). Future research is recommended on larger samples of participants using different techniques to determine the most effective one.
Ključne besede: artificial intelligence, machine learning, thermography, diabetic foot prediction, diabetes, diabetes care, diabetic foot, literature review
Objavljeno v DKUM: 27.11.2023; Ogledov: 374; Prenosov: 16
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