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1.
Dojemanje oskrbe, osredotočene na pacienta, v treh klinikah za zdravljenje neplodnosti : vpliv zdravljenja v domačem okolju ali tujini in povračila stroškov
Veljko Vlaisavljević, Borut Kovačič, 2024, izvirni znanstveni članek

Opis: Namen te študije je bil oceniti izkušnje bolnikov z oskrbo, osredotočeno na bolnika (PCC), na treh klinikah za zdravljenje neplodnosti glede na kritje stroškov zdravljenja in kraj, kjer so bili zdravljeni.
Ključne besede: assisted reproductive therapy, cross-border patients, patient treatment experience, patient centeredness, quality of care
Objavljeno v DKUM: 07.01.2025; Ogledov: 0; Prenosov: 15
.pdf Celotno besedilo (247,78 KB)
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2.
Mistreatment by patients : an analysis of the patient-related social stressors among Slovenian healthcare workers
Tatjana Kozjek, Vanja Erčulj, 2021, izvirni znanstveni članek

Opis: Introduction: Healthcare workers (HCWs) are often exposed to mistreatment by patients, which has negative effects on both staff and institutions. To take appropriate action to help HCWs in this context, patient-related social stressors (PSS) should be explored. The purpose of the research was to identify the most pronounced patient behaviour contributing to the social stress (SS) of HCWs, and compare PSS between different HCWs and different types of healthcare institutions. Methods: 750 HCWs from Slovenian public health centres and hospitals participated in the online survey. Although the non-probability sampling was used, the sample was representative according to gender and HCW type (doctors, nurses and other HCWs). Results: The results show that the most pronounced patient behaviour contributing to the SS of HCWs are attitudes and behaviour of patients that are challenging in terms of what is - from the HCWs' point of view - considered as acceptable and reasonable (disproportionate patient expectations), and unpleasant, humourless, and hostile patients. HCWs in primary institutions meet less verbally aggressive and unpleasant patients than in tertiary ones. Although among all HCWs less educated ones are more exposed to inappropriate behaviour, doctors are those HCWs who experience more inappropriate behaviour. Conclusion: Managers should enable HCWs to get comprehensive patient service training, oriented towards improving relationship management and patient-HCW relationships.
Ključne besede: healthcare workers, mistreatment, patients, social stressors
Objavljeno v DKUM: 04.09.2024; Ogledov: 59; Prenosov: 3
.pdf Celotno besedilo (409,95 KB)
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3.
Clinical pharmacist interventions in ambulatory psychogeriatric patients with excessive polypharmacy
Matej Štuhec, Kaja Zorjan, 2022, izvirni znanstveni članek

Opis: Psychogeriatric primary care patients are frequently treated with excessive polypharmacy (≥ 10 medications), leading to complications and increased costs. Such cases are rarely included in treatment guidelines and randomized controlled trials. This paper evaluates the impact of clinical pharmacist medication reviews on the quality of pharmacotherapy in primary care psychogeriatric patients with excessive polypharmacy. The retrospective observational multicentric pre-post study included patients (aged 65 or above) treated with at least one psychotropic and ten or more medications. Clinical pharmacists' recommendations were retrieved from medication review forms for the period 2012-2014. The study outcome measures were the number of medications, potentially inappropriate medications in the elderly (PIMs), potential drug-drug interactions which should be avoided (pXDDIs), and adherence to treatment guidelines. The study included 246 patients receiving 3294 medications, of which 14.6% were psychotropics. The clinical pharmacists proposed 374 interventions in psychopharmacotherapy. The general practitioners accepted 45.2% of them (169). Accepting clinical pharmacist recommendations reduced the total number of medications by 7.5% from 13.4 to 12.4 per patient (p < 0.05), the total number of prescribed PIMs by 21.8% from 312 to 244 (p < 0.05), the number of pXDDIs by 54.9% from 71 to 31 (p < 0.05) and also improved treatment guidelines adherence for antidepressants and antipsychotics (p < 0.05). Clinical pharmacist interventions significantly improved the quality of psychopharmacotherapy by reducing the total number of medications, PIMs, and pXDDIs. Accepting clinical pharmacist interventions led to better treatment guidelines adherence.
Ključne besede: polypharmacy, elderly patients, clinical pharmacist, medications, drug-drug interactions, psychopharmacotherapy
Objavljeno v DKUM: 05.07.2024; Ogledov: 101; Prenosov: 9
.pdf Celotno besedilo (1,14 MB)
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4.
Development and validation of the scale for measuring biopsychosocial approach of family physicians to their patients
Irena Makivić, Zalika Klemenc-Ketiš, 2022, izvirni znanstveni članek

Opis: Objective While other models focus more on disease and pathophysiology, the biopsychosocial approach emphasises the importance of human health and disease in their fullest contexts. If we are to gain an insight into physical and psychological health needs, and address them quickly and adequately, it is important that we recognise them already at the family practice stage. An approach that assesses needs at patient level could also be seen as patient-centred care, which is one of the key elements of high-quality care. To the best of our knowledge, no scale for measuring the biopsychosocial approach of family physicians has yet been developed. Design The aim of this study was to develop and validate a scale that measures the biopsychosocial approach of family physicians to their patients through the Delphi and validation process. Setting The scale was developed through the Delphi study and validated by means of significant statistical methods. Pearson’s correlation coefficient, Cronbach’s alpha, the intracorrelation coefficient, the Spearman-Brown coefficient and exploratory factor analysis were applied. Participants Five family physicians took part in a brainstorming process and 24 family medicine experts took part in the Delphi study. For the first part of the validation process, there were 31 family medicine trainees in the first group and 32 in the second group. For the last part of the validation process, 164 family physicians completed the scale. Result Through the Delphi study, 39 final items covering three areas within the biopsychosocial approach were identified. Construct validity was high, with positive linear correlation and good face validity. The intraclass correlation coefficient for test–retest reliability was 0.862. The Spearman-Brown coefficient was the highest (0.931) on an even and odd division. Factor rotation showed that three factors on 35 items explained 39.5% of variances. The final internal consistency on 35 items was 0.911. Conclusion The developed scale measures the biopsychosocial dimension of family physicians’ work with high Cronbach’s alpha measures and good validity.
Ključne besede: scale for measuring biopsychosocial approach, family physicians, patients, development, validation
Objavljeno v DKUM: 26.06.2024; Ogledov: 147; Prenosov: 14
.pdf Celotno besedilo (408,05 KB)
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5.
Self-management of chronic diseases : a concept analysis
Lucija Gosak, Dominika Vrbnjak, Majda Pajnkihar, 2022, pregledni znanstveni članek

Opis: Introduction. Due to coronavirus disease 2019, which affected the provision of nursing care to chronic patients, the self-management of patients has increased through the use of modern technology. To support the self-management of chronic patients, it is essential to analyze and clarify the concept of self-management before using it in practice. Methods. A literature search was performed in the Web of Science, PubMed, CINAHL, ScienceDirect, Sage Journals, MEDLINE, Cochrane Library databases, in addition to Google Scholar and COBISS using the keywords “concept,” “self-care,” “chronic disease,” and “nurse.” Qualitative, quantitative, and mixed methods research, books, and abstracts, related to the selected concept in English were included in the review. Studies were ranked according to the hierarchy of evidence. Concept analysis by Cutcliffe and McKenna was used. Results. Of the 2974 identified studies, 31 were included in the analysis. Seven attributes were identified: assessment of physical and emotional signs and symptoms, response to changes, consultation with the health care provider, communication, goals, attention to treatment effectiveness, and awareness of the situation. The antecedents are learning, motivation, habits, cultural and religious values, self-efficacy, literacy. The consequences concept includes improving individuals’ clinical outcomes and quality of life and reducing public health costs. Conclusions. As nursing care focuses more and more on self-management of the disease and not just on treatment, patients are increasingly using different techniques to manage their disease. By incorporating the concept of self-management of chronic disease into modern technology, we can contribute to patient care.
Ključne besede: chronic patients, health care, self-care, self-management
Objavljeno v DKUM: 13.06.2024; Ogledov: 149; Prenosov: 34
.pdf Celotno besedilo (215,81 KB)
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6.
Using structural equation modeling to explore patients’ and healthcare professionals’ expectations and attitudes towards socially assistive humanoid robots in nursing and care routine
Izidor Mlakar, Urška Smrke, Vojko Flis, Nina Kobilica, Samo Horvat, Bojan Ilijevec, Bojan Musil, Nejc Plohl, 2023, izvirni znanstveni članek

Opis: Healthcare systems around the world are currently witnessing various challenges, including population aging and workforce shortages. As a result, the existing, overworked staff are struggling to meet the ever-increasing demands and provide the desired quality of care. One of the promising technological solutions that could complement the human workforce and alleviate some of their workload, are socially assistive humanoid robots. However, despite their potential, the implementation of socially assistive humanoid robots is often challenging due to low acceptance among key stakeholders, namely, patients and healthcare professionals. Hence, the present study first investigated the extent to which these stakeholders accept the use of socially assistive humanoid robots in nursing and care routine, and second, explored the characteristics that contribute to higher/lower acceptance within these groups, with a particular emphasis on demographic variables, technology expectations, ethical acceptability, and negative attitudes. In study 1, conducted on a sample of 490 healthcare professionals, the results of structural equation modeling showed that acceptance is driven primarily by aspects of ethical acceptability, although education and technology expectations also exert an indirect effect. In study 2, conducted on a sample of 371 patients, expectations regarding capabilities and attitudes towards the social influence of robots emerged as important predictors of acceptance. Moreover, although acceptance rates differed between tasks, both studies show a relatively high acceptance of socially assistive humanoid robots. Despite certain limitations, the study findings provide essential knowledge that enhances our understanding of stakeholders’ perceptions and acceptance of socially assistive humanoid robots in hospital environments, and may guide their deployment.
Ključne besede: socially assistive humanoid robots, attitudes, expectations, patients, healthcare professionals
Objavljeno v DKUM: 12.06.2024; Ogledov: 166; Prenosov: 14
.pdf Celotno besedilo (1,74 MB)
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7.
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: 8
.pdf Celotno besedilo (115,26 KB)
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8.
Factors associated with gastrointestinal dysmotility in critically ill patients
Nemanja Petrović, Miodrag Žunić, Ana Pejčić, Miloš Milosavljević, Slobodan Janković, 2023, izvirni znanstveni članek

Opis: Critical illness may disrupt nutritional, protective, immune, and endocrine functions of the gastrointestinal tract, leading to a state of gastrointestinal dysmotility. We aimed to identify factors associated with the occurrence of gastrointestinal dysmotility in critically ill patients. A cross-sectional retrospective study was conducted, using patient files as a source of data. The study included 185 critically ill patients treated in the intensive care unit of the University Clinical Center, Kragujevac, Serbia, from January 1, 2016, to January 1, 2022. Significant risk factors associated with some form of gastrointestinal dysmotility were acute kidney injury (with paralytic ileus, nausea, vomiting, and constipation), recent abdominal surgery (with ileus, nausea, vomiting, and constipation), mechanical ventilation (with ileus, and nausea), age (with ileus and constipation), and use of certain medication such as opioids (with ileus, gastro-esophageal reflux, nausea, vomiting, and constipation), antidepressants (with ileus, nausea, and vomiting), and antidiabetics (with ileus). On the other hand, Charlson comorbidity index had divergent effects, depending on the form of gastrointestinal dysmotility: it increased the risk of gastro-esophageal reflux but protected against ileus, nausea, and vomiting. In clonclusion, recognition of factors associated with gastrointestinal dysmotility should initiate preventative measures and, thus, accelerate the recovery of critically ill.
Ključne besede: gastrointestinal dysmotility, critically ill patients, risk factors, intensive care unit
Objavljeno v DKUM: 04.04.2024; Ogledov: 188; Prenosov: 11
.pdf Celotno besedilo (372,51 KB)
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9.
Components of a model of person-centredness in palliative care among patients with non-communicable diseases in slovenian hospitals
Sergej Kmetec, 2023, doktorska disertacija

Opis: Introduction: Palliative care aims to provide an early person-centred approach to patients with non-communicable disease(s) by monitoring distressing symptoms, providing support at all four domains of health, supporting their care partners, and enhancing the quality of patients and their care partners' lives. A problem lies in the late introduction of person-centred palliative care in acute care and the emergence of barriers to providing such care. Therefore, the present doctoral thesis explores the perceptions of person-centred palliative care of healthcare professionals and patients with non-communicable disease(s). Based on the results of both data analyses, we identified the key components of a model to provide person-centred palliative care for patients and their care partners. Methods: A two-phase sequential explanatory design was used, which involved collecting data in consecutive phases between August 2020 and July 2021. The study's first phase involved health professionals and patients from eight institutions, and the second phase involved health professionals, patients and care partners. Data from the first part of the study were gathered using validated questionnaires, and inferential and descriptive statistics were used to analyse the results. Semi-structured interviews were used in the second phase to collect data, then thematically analysed. We have merged the outcomes of the quantitative and qualitative stages utilising the pillar integration approach in order to interpret them in a more thorough and comprehensive manner. Results: Through the data integration process, we identify four key components to providing person-centred palliative care in patients with non-communicable disease(s). These components are: (1) Healthcare professionals' prerequisites and traits; (2) Person-centred palliative care environment; (3) Person-centred palliative process; and (4) Person-centred palliative care outcome. A Healthcare professional's prerequisites and traits can be said to contain three aspects: (1) Attitudes, (2) Commitment to the work and (3) Values and beliefs. When these three aspects are considered, a person-centred palliative care environment can be created. Here it is important to consider four aspects: (1) Transdisciplinary approach; (2) Patient empowerment; (3) Partner engagement; and (4) Institution/policy climate. A person-centred palliative process that allows the patient to maintain their quality of life and dignity includes the following aspects: (1) Person-centred approach; (2) Establishing an advance care plan; (3) Early integration of person-centred palliative care, and (4) Enlightenment and raising awareness. Person-centred palliative care outcomes can be (1) Positive experiences and (2) Negative experiences. Discussion and conclusion: Person-centred palliative care is essential in treating patients with non-communicable diseases. For that reason, it is pivotal to follow the four key components of how to provide person-centred palliative care, comprising: (1) Healthcare professionals' prerequisites and traits, (2) The person-centred palliative environment, (3) The person-centred palliative process and (4) The person-centred palliative outcomes. These four key components provide healthcare professionals and transdisciplinary palliative teams with the steps for providing person-centred palliative care to the patient and support to the care partners. The term ‘patient’ is herein used to denote patients with one or more non-communicable disease(s).
Ključne besede: person-centred care, palliative care, patients, care partners, healthcare professionals', mixed-method, sequential explanatory design
Objavljeno v DKUM: 10.11.2023; Ogledov: 702; Prenosov: 239
.pdf Celotno besedilo (5,55 MB)

10.
Endometrial cancer in young woman
Alenka Repše-Fokter, 2020, drugi znanstveni članki

Ključne besede: Pap smear, atypical endometrial cells, young patients
Objavljeno v DKUM: 23.01.2023; Ogledov: 660; Prenosov: 16
.pdf Celotno besedilo (138,57 KB)
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