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1.
Long-term impact of community psychiatric care on quality of life amongst people living with schizophrenia : a systematic review
Jožica Černe Kolarič, Anja Plemenitaš Ilješ, Darja Kraner, Vida Gönc, Mateja Lorber, Nataša Mlinar Reljić, Zvonka Fekonja, Sergej Kmetec, 2024, pregledni znanstveni članek

Opis: The review examines the long-term impact of community psychiatric care on improving the quality of life of people with schizophrenia. It addresses the global burden of this disorder and the need for effective community-based care strategies. A systematic literature search was conducted in databases such as CINAHL, Medline, Web of Science, Sage and ScienceDirect, with the search lasting until March 2024 and following the PRISMA guidelines. The inclusion criteria targeted studies that addressed the long-term effects of community mental health care for people aged 18 years and older with schizophrenia and included both quantitative and qualitative research designs. Studies unrelated to the research question or with significant methodological flaws were excluded. The risk of bias was assessed using GRADE and GRADECERqual, in addition to critical appraisal using the Joanna Briggs Institute (JBI) checklists. Independent screening and data extraction was performed, with results summarised by thematic analysis. In total, 11 studies met the inclusion criteria and included cross-sectional, cohort, qualitative and randomised controlled trial designs. The results showed that community psychiatric care significantly improves the quality of life, well-being and social integration of people with schizophrenia. Effective interventions identified include psychoeducation, cognitive behavioural therapy, social skills training and individualised care plans. However, challenges such as limited resources, labour shortages and social stigma, particularly in low-income neighbourhoods, were also identified. This study highlights the importance of continuous, personalised, multidisciplinary community-based care for sustainable mental health outcomes. Further research is recommended to investigate the long-term impact and strategies to overcome implementation challenges.
Ključne besede: schizophrenia, quality of life, community, psychiatric care, patient, systematic review
Objavljeno v DKUM: 22.11.2024; Ogledov: 0; Prenosov: 3
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2.
Multilingual framework for risk assessment and symptom tracking (MRAST)
Valentino Šafran, Simon Lin, Jama Nateqi, Alistair G. Martin, Urška Smrke, Umut Arioz, Nejc Plohl, Matej Rojc, Dina Běma, Marcela Chavez, Matej Horvat, Izidor Mlakar, 2024, izvirni znanstveni članek

Opis: The importance and value of real-world data in healthcare cannot be overstated because it offers a valuable source of insights into patient experiences. Traditional patient-reported experience and outcomes measures (PREMs/PROMs) often fall short in addressing the complexities of these experiences due to subjectivity and their inability to precisely target the questions asked. In contrast, diary recordings offer a promising solution. They can provide a comprehensive picture of psychological well-being, encompassing both psychological and physiological symptoms. This study explores how using advanced digital technologies, i.e., automatic speech recognition and natural language processing, can efficiently capture patient insights in oncology settings. We introduce the MRAST framework, a simplified way to collect, structure, and understand patient data using questionnaires and diary recordings. The framework was validated in a prospective study with 81 colorectal and 85 breast cancer survivors, of whom 37 were male and 129 were female. Overall, the patients evaluated the solution as well made; they found it easy to use and integrate into their daily routine. The majority (75.3%) of the cancer survivors participating in the study were willing to engage in health monitoring activities using digital wearable devices daily for an extended period. Throughout the study, there was a noticeable increase in the number of participants who perceived the system as having excellent usability. Despite some negative feedback, 44.44% of patients still rated the app’s usability as above satisfactory (i.e., 7.9 on 1–10 scale) and the experience with diary recording as above satisfactory (i.e., 7.0 on 1–10 scale). Overall, these findings also underscore the significance of user testing and continuous improvement in enhancing the usability and user acceptance of solutions like the MRAST framework. Overall, the automated extraction of information from diaries represents a pivotal step toward a more patient-centered approach, where healthcare decisions are based on real-world experiences and tailored to individual needs. The potential usefulness of such data is enormous, as it enables better measurement of everyday experiences and opens new avenues for patient-centered care.
Ključne besede: multilingual framework, risk assessment, symptom tracking, chronic diseases, patient-centered care, real-world data
Objavljeno v DKUM: 12.08.2024; Ogledov: 74; Prenosov: 8
.pdf Celotno besedilo (5,29 MB)

3.
Core values of family medicine in Europe : current state and challenges
Eva Arvidsson, Igor Švab, Zalika Klemenc-Ketiš, 2021, izvirni znanstveni članek

Opis: Background: Values are deeply held views that act as guiding beliefs for individuals and organizations. They state what is important in a profession. The aims of this study were to determine whether European countries have already developed (or are developing) documents on core values in family medicine; to gather the lists of core values already developed in countries; and to gather the opinions of participants on what the core family values in their countries are. Methods: This was a qualitative study. The questionnaire was distributed as an e-survey via email to present and former members of the European Society for Quality and Safety in Family Practice (EQuiP), and other family medicine experts in Europe. The questionnaire included six items concerning core values in family medicine in the respondent's country: the process of defining core values, present core values, the respondents' suggestions for core values, and current challenges of core values. Results: Core values in family medicine were defined or in a process of being defined in several European countries. The most common core values already defined were the doctor-patient relationship, continuity, comprehensiveness and holistic care, community orientation, and professionalism. Some countries expressed the need for an update of the current core values' list. Most respondents felt the core values of their discipline were challenged in today's world. The main values challenged were continuity, patient-centered care/the doctor-patient relationship and comprehensive and holistic care, but also prioritization, equity, and community orientation and cooperation. These were challenged by digital health, workload/lack of family physicians, fragmentation of care, interdisciplinary care, and societal trends and commercial interests. Conclusion: We managed to identify suggestions for core values of family medicine at the European level. There is a clear need to adopt a definition of a value and tailor the discussion and actions on the family medicine core values accordingly. There is also a need to identify the core values of family medicine in European countries. This could strengthen the profession, promote its development and research, improve education, and help European countries to advocate for the profession.
Ključne besede: value orientation, family practice, continuity of patient care, patient-centered care, Europe
Objavljeno v DKUM: 06.08.2024; Ogledov: 109; Prenosov: 9
.pdf Celotno besedilo (185,06 KB)
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4.
Safety culture and the positive association of being a primary care training practice during COVID-19 : the results of the multi-country European PRICOV-19 study
Bianca Silva, Zlata Ožvačić Adžić, Pierre Vanden Bussche, Esther Van Poel, Bohumil Seifert, Cindy Heaster, Claire Collins, Canan Tuz Yilmaz, Felicity Knights, Zalika Klemenc-Ketiš, 2022, izvirni znanstveni članek

Opis: The day-to-day work of primary care (PC) was substantially changed by the COVID-19 pandemic. Teaching practices needed to adapt both clinical work and teaching in a way that enabled the teaching process to continue, while maintaining safe and high-quality care. Our study aims to investigate the effect of being a training practice on a number of different outcomes related to the safety culture of PC practices. PRICOV-19 is a multi-country cross-sectional study that researches how PC practices were organized in 38 countries during the pandemic. Data was collected from November 2020 to December 2021. We categorized practices into training and non-training and selected outcomes relating to safety culture: safe practice management, community outreach, professional well-being and adherence to protocols. Mixed-effects regression models were built to analyze the effect of being a training practice for each of the outcomes, while controlling for relevant confounders. Of the participating practices, 2886 (56%) were non-training practices and 2272 (44%) were training practices. Being a training practice was significantly associated with a lower risk for adverse mental health events (OR: 0.83; CI: 0.70-0.99), a higher number of safety measures related to patient flow (Beta: 0.17; CI: 0.07-0.28), a higher number of safety incidents reported (RR: 1.12; CI: 1.06-1.19) and more protected time for meetings (Beta: 0.08; CI: 0.01-0.15). No significant associations were found for outreach initiatives, availability of triage information, use of a phone protocol or infection prevention measures and equipment availability. Training practices were found to have a stronger safety culture than non-training practices. These results have important policy implications, since involving more PC practices in education may be an effective way to improve quality and safety in general practice.
Ključne besede: safety culture, patient safety, quality of care, primary health care, COVID-19, medical education, vocational training, PRICOV-19, infectious disease, multi-country, general practice
Objavljeno v DKUM: 04.07.2024; Ogledov: 128; Prenosov: 17
.pdf Celotno besedilo (376,37 KB)
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5.
Kakovost oskrbe v odnosu na oceno kakovosti vodenja kronične bolezni bolnikov s koronarno boleznijo
Ksenija 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: 7
.pdf Celotno besedilo (115,26 KB)
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6.
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: 249; Prenosov: 15
.pdf Celotno besedilo (764,96 KB)
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7.
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: 577; Prenosov: 26
.pdf Celotno besedilo (126,70 KB)
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8.
Patient safety in cross-border care
Eva Turk, Stephen Leyshon, Morten Pytte, 2015, izvirni znanstveni članek

Opis: Patient safety is a right and it raises particular issues in the context of cross-border care. Patients should be able to have trust and confidence in the healthcare structure as a whole; they must be protected from the harm caused by poorly functioning health systems, medical errors and adverse events. This paper addresses the state of cross-border healthcare in the European Union, the state of patient safety, the question of quality assurance and the role of accreditation as a risk based approach.
Ključne besede: patient safety, cross-border care, accreditation, healthcare, EU
Objavljeno v DKUM: 08.10.2018; Ogledov: 1087; Prenosov: 128
.pdf Celotno besedilo (427,83 KB)
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9.
Variations in patient safety climate and perceived quality of collaboration between professions in out-of-hours care
Zalika Klemenc-Ketiš, Ellen Tveter Deilkås, Dag Hofoss, Gunnar Tschudi Bondevik, 2017, izvirni znanstveni članek

Opis: Purpose: To get an overview of health care workers perceptions of patient safety climates and the quality of collaboration in Slovenian out-of-hours health care (OOHC) between professional groups. Materials and methods: This was a cross-sectional study carried out in all (60) Slovenian OOHC clinics; 37 (61.7%) agreed to participate with 438 employees. The questionnaire consisted of the Slovenian version of the Safety Attitudes Questionnaire - Ambulatory Version (SAQ-AV). Results: The study sample consisted of 175 (70.0%) physicians, nurse practitioners, and practice nurses. Practice nurses reported the highest patient safety climate scores in all dimensions. Total mean (standard deviation) SAQ-AV score was 60.9+-15.2. Scores for quality of collaboration between different professional groups were high. The highest mean scores were reported by nurse practitioners on collaboration with practice nurses (4.4+-0.6). The lowest mean scores were reported by practice nurses on collaboration with nurse practitioners (3.8+-0.9). Conclusion: Due to large variations in Slovenian OOHC clinics with regard to how health care workers from different professional backgrounds perceive safety culture, more attention should be devoted to improving the team collaboration in OOHC. A clearer description of professional team roles should be provided.
Ključne besede: primary health care, out-of-hours medical care, patient care management
Objavljeno v DKUM: 27.11.2017; Ogledov: 1507; Prenosov: 367
.pdf Celotno besedilo (169,11 KB)
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10.
The safety attitudes questionnaire - ambulatory version : psychometric properties of the Slovenian version for the out-of-hours primary care setting
Zalika Klemenc-Ketiš, Matjaž Maletič, Vesna Stropnik, Ellen Tveter Deilkås, Dag Hofoss, Gunnar Tschudi Bondevik, 2017, izvirni znanstveni članek

Opis: Background: Several tools have been developed to measure safety attitudes of health care providers, out of which the Safety Attitudes Questionnaire (SAQ) is regarded as one of the most appropriate ones. In 2007, it was adapted to outpatient (primary health care) settings and in 2014 it was tested in out-of-hours health care settings in Norway. The purpose of this study was to translate the English version of the SAQ-Ambulatory Version (SAQ-AV) to Slovenian language; to test its reliability; and to explore its factor structure. Methods: This was a cross-sectional study that took place in Slovenian out-of-hours primary care clinics in March- May 2015 as a part of an international study entitled Patient Safety Culture in European Out-of-hours services. The questionnaire consisted of the Slovenian version of the SAQ-AV. The link to the questionnaire was emailed to health care workers in the out-of-hours clinics. A total of 438 participants were invited. We performed exploratory factor analysis. Results: Out of 438 invited participants, 250 answered the questionnaire (response rate 57.1%). Exploratory factor analysis put forward five factors: 1) Perceptions of management, 2) Job satisfaction, 3) Safety climate, 4) Teamwork climate, and 5) Communication. Cronbach's alpha of the whole SAQ-AV was 0.922. Cronbach's alpha of the five factors ranged from 0.587 to 0.791. Mean total score of the SAQ-AV was 56.6 +- 16.0 points. The factor with the highest average score was Teamwork climate and the factor with the lowest average was Job satisfaction. Conclusions: Based on the results in our study, we cannot state that the SAQ-AV is a reliable tool for measuring safety culture in the Slovenian out-of-hours care setting. Our study also showed that there might be other safety culture factors in out-of-hours care not recognised before. We therefore recommend larger studies aiming to identify an alternative factor structure.
Ključne besede: patient safety, quality assurance, health care
Objavljeno v DKUM: 28.06.2017; Ogledov: 2048; Prenosov: 185
.pdf Celotno besedilo (515,91 KB)
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