1. Factors that determine dependence in daily activities : a cross-sectional study of family practice non-attenders from SloveniaTonka Poplas-Susič, Zalika Klemenc-Ketiš, Rok Blagus, Nina Ružić Gorenjec, 2021, izvirni znanstveni članek Opis: Background: Independence in daily activities is defined as the ability to perform functions related to daily living, i.e. the capacity of living independently in the community with little or no help from others.
Objective: We focused on non-attenders as a subgroup of patients whose health status is not well known to family practice teams. Our goal was to estimate the prevalence of dependence and its severity level in the daily activities of patients, and to determine the factors that are associated with the occurrence of dependence.
Design: Cross-sectional observational study.
Settings and participants: Data was obtained in family medicine settings. Participants in the study were adults living in the community (aged 18 or over) who had not visited their chosen family physician in the last 5 years (non-attenders) and who were able to participate in the study. Through the electronic system, we identified 2,025 non-attenders. Community nurses collected data in the participants' homes. The outcome measure was dependence in daily activities, assessed through eight items: personal hygiene; eating and drinking; mobility; dressing and undressing; urination and defecation; continence; avoiding hazards in the environment; and communication.
Results: The final sample consisted of 1,999 patients (98.7% response rate). The mean age was 59.9 (range 20 to 99). Dependence in daily activities was determined in 466 or 23.3% (95% CI: [21.5, 25.2]) of the patients. Older patients (over 60 years), with at least one chronic disease, increased risk of falling, moderate feelings of loneliness and a lower self-assessment of health were statistically significantly more likely to be dependent in their daily activities, according to our multivariate model.
Conclusions: A considerable proportion of family practice non-attenders were found to be dependent in daily activities, though at a low level. We identified several factors associated with this dependence. This could help to identify people at risk of being dependent in daily activities in the general adult population, and enable specific interventions that would improve their health status. Ključne besede: family medicine, ability to perform functions, daily activities Objavljeno v DKUM: 17.10.2024; Ogledov: 0; Prenosov: 1 Celotno besedilo (910,89 KB) Gradivo ima več datotek! Več... |
2. Implementation of integrated primary care for patients with diabetes and hypertension : a case from SloveniaZalika Klemenc-Ketiš, Nataša Stojnić, Črt Zavrnik, Nina Ružić Gorenjec, Katrien Danhieux, Majda Mori-Lukančič, Tonka Poplas-Susič, 2021, izvirni znanstveni članek Opis: Introduction: Research on models of integrated health care for hypertension and diabetes is one of the priority issues in the world. There is a lack of knowledge about how integrated care is implemented in practice. Our study assessed its implementation in six areas: identification of patients, treatment, health education, self-management support, structured collaboration and organisation of care. Methods: This was a mixed methods study based on a triangulation method using quantitative and qualitative data. It took place in different types of primary health care organisations, in one urban and two rural regions of Slovenia. The main instrument for data collection was the Integrated Care Package (ICP) Grid, assessed through four methods: 1) a document analysis (of a current health policy and available protocols; 2) observation of the infrastructure of health centres, organisation of work, patient flow, interaction of patients with health professionals; 3) interview with key informants and 4) review of medical documentation of selected patients. Results: The implementation of the integrated care in Slovenia was assessed with the overall ICP score of 3.7 points (out of 5 possible points). The element Identification was almost fully implemented, while the element Self-management support was weakly implemented. Discussion: The implementation of the integrated care of patients with diabetes and/ or hypertension in Slovenian primary health care organisations achieved high levels of implementation. However, some week points were identified. Conclusion: Integrated care of the chronic patients in Slovenia is already provided at high levels, but the area of self-management support could be improved. Ključne besede: delivery of health care, integrated, primary care, self-care Objavljeno v DKUM: 27.08.2024; Ogledov: 105; Prenosov: 5 Celotno besedilo (1018,36 KB) Gradivo ima več datotek! Več... |
3. Fall risk in adult family practice non-attenders : a cross-sectional study from SloveniaNina Ružić Gorenjec, Zalika Klemenc-Ketiš, Rok Blagus, Tonka Poplas-Susič, 2023, izvirni znanstveni članek 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 Celotno besedilo (570,04 KB) Gradivo ima več datotek! Več... |