Iskanje po katalogu digitalne knjižnice

Opis: Introduction: Although the concept of integrated care for non-communicable diseases was introduced at the primary level to move from disease-centered to patient-centered care, it has only been partially implemented in European countries. The aim of this study was to identify and compare identified facilitators and barriers to scale-up this concept between Slovenia and Belgium. Methods: This was a qualitative study. Fifteen focus groups and fifty-one semi-structured interviews were conducted with stakeholders at the micro, meso and macro levels. In addition, data from two previously published studies were used for the analysis. Data collection and analysis was initially conducted at country level. Finally, the data was evaluated by a cross-country team to assess similarities and differences between countries. Results: Four topics were identified in the study: patient-centered care, teamwork, coordination of care and task delegation. Despite the different contexts, true teamwork and patient-centered care are limited in both countries by hierarchies and a very heavily skewed medical approach. The organization of primary healthcare in Slovenia probably facilitates the coordination of care, which is not the case in Belgium. The financing and organization of primary practices in Belgium was identified as a barrier to the implementation of task delegation between health professionals. Conclusions: This study allowed formulating some important concepts for future healthcare for non-communicable diseases at the level of primary healthcare. The results could provide useful insights for other countries with similar health systems.
Ključne besede: scale-up, noncommunicable diseases, patientcentered care, primary healthcare, integrated healthcare
Objavljeno v DKUM: 22.10.2024; Ogledov: 0; Prenosov: 3
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Opis: Introduction: Patient safety is one of the key aspects of healthcare quality and a serious global public health concern. Patient safety culture is a part of the patient safety concept. In Slovenia, primary care is easily accessible, and for medical care, it serves as a gatekeeper to hospital care. For several years, the quality and safety at the primary healthcare level have been the focus of several studies. The present study aimed to assess patient safety culture among all employees of the Community Health Centre Ljubljana. Methods: We conducted a cross-sectional study in 2017 using the Slovene version of “Medical Office Survey on Patient Safety Culture” from the Agency for Healthcare Research and Quality. Mean percent positive scores on all items in each composite were calculated according to a user guide. Results: The final sample contained 1021 participants (67.8% response rate), of which 909 (89.0%) were women. The mean age of the sample was 43.0±11.0 years. The dimensions most highly rated by the respondents were: teamwork and patient care tracking/follow-up. The lowest scores came from leadership support for patients’ safety and work pressure and pace. Conclusion: Patient safety culture in the Community Health Centre Ljubljana is high, but there are certain areas of patient safety that need to be evaluated further and improved. Our study revealed differences between professions, indicating that a customized approach per profession group might contribute to the successful implementation of safety strategies. Patient safety culture should be studied at national levels.
Ključne besede: patient safety, safety culture, family medicine, primary healthcare, Slovenia
Objavljeno v DKUM: 18.10.2024; Ogledov: 0; Prenosov: 1
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Opis: Introduction: The development of a family history (FH) questionnaire (FHQ) provides an insight into a patient's familiarity of a trait and helps to identify individuals at increased risk of disease. A critical aspect of developing a new tool is exploring users' experience. Objective: The objective of this study was to examine users' experience, obstacles and challenges, and their views and concerns in the applicability of a new tool for determining genetic risk in Slovenia's primary care. Methods: We used a qualitative approach. The participants completed a risk assessment software questionnaire that calculates users' likelihood of developing familial diseases. Audio-taped semi-structured telephone interviews were conducted to evaluate their experience. There were 21 participants, and analyses using the constant comparative method were employed. Results: We identified 3 main themes: obstacles/key issues, suggestions for improvements, and coping. The participants were poorly satisfied with the clarity of instructions, technical usability problems, and issues with the entry of relatives' data. They expressed satisfaction with some of the characteristics of the FHQ (e.g., straightforward and friendly format, easy entry, and comprehension). They suggested simpler language, that the disease risk should be targeted toward the disease, that the FHQ should include patient-specific recommendations, and that it should be part of the electronic medical records. When discussing what would they do with the results of the FHQ, the participants used different coping strategies: active (e.g., seeking information) or passive (e.g., avoidance). Discussion/conclusion: User experience was shown to be a synthesis of obstacles, overcoming them with suggestions for improvements, and exploration of various coping mechanisms that may emerge from dealing with the stressor of "being at risk."
Ključne besede: primary healthcare, family history, qualitative methodology
Objavljeno v DKUM: 01.10.2024; Ogledov: 0; Prenosov: 2
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Opis: A digital twin is a virtual model to reflect a physical object and helps it by making proper decisions. The decision-making process is based on the same input data that the simulated physical object has access to. Due to exploiting artificial intelligence, the decision-making process of the digital twin is more sophisticated than that of the physical object. In this study, the digital twin is applied to the sports training domain, where it addresses those questions that have arisen during the implementation of interval cycling training sessions. Thus, the digital twin runs on a mobile device (i.e., the Raspberry Pi platform), with which a cycle is equipped and demonstrates user-friendliness, robustness, reliability, and accuracy. The interval training sessions are transferred to the mobile device in the form of the domain-specific language EasyTrain, ensuring higher expressive power and ease of use. During the implementation, the digital twin advises the athlete with predicted information obtained by a sophisticated prediction model via a screen. The results of a huge experimental work showed that the difference in the average efficiency of the interval training implementation between the two cyclists that performed the experiments is prominent, as the efficiency of the professional training surpassed 90%, while the amateur training efficiency barely achieved 70%.
Ključne besede: digital twin, interval sports training, healthcare, domain-specific language, cycling
Objavljeno v DKUM: 23.08.2024; Ogledov: 119; Prenosov: 13
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Opis: 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.
Ključne besede: fall risk, primary healthcare, family practice, non-attenders, cross-sectional studies
Objavljeno v DKUM: 17.07.2024; Ogledov: 125; Prenosov: 4
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