11. Identification and ranking of core values in family medicine : a mixed methods study from UkrainePavlo Kolesnyk, Sabine Bayen, Ivanna Shushman, Andrew Kolesnyk, George Kuodza, Zalika Klemenc-Ketiš, Thomas Frese, 2021, izvirni znanstveni članek Opis: Introduction/Context: The term core value (CV) can be defined as fundamental beliefs or principles, guiding one's behavior in a social context. Though core competencies of family medicine (FM) have been clearly defined by WONCA, there has been an ongoing debate on what the CVs are for family doctors (FDs). Ukraine is a developing country in the middle of Europe with a population of 43 million inhabitants, gained independence from the Soviet Union in 1991. Ukraine is a low-income country, developing a modern European healthcare system, especially regarding FM. To implement WONCA standards, it is mandatory to assess the ongoing understanding of CVs in clinical daily practice among active FDs, working in different countries of Europe including Ukraine. Research questions: How do Ukrainian FDs (Delphi group experts) define the CVs of FM in Ukraine and how important are these CVs to a wider population of Ukrainian FDs in their everyday practice? Methods: A mixed method study was conducted in two steps during August and September 2020 in Ukraine. The first part was a qualitative Delphi round (three rounds) design among 20 Ukrainian FDs who were familiar with teaching and terms like CV. A consensus list of six CVs has emerged from the Delphi round study. The second part was a quantitative survey among Ukrainian FDs, who were not specially used to discussing CVs. The consensus list of those six CVs was then submitted to 2000 FDs (randomly selected) who were not involved in the Delphi team, to rank those values from one to nine, according to the importance from their personal point of view. Demographic characteristics have been assessed for all the participants of the Delphi round and quantitative survey. Results: Twenty FDs were involved as experts in the first Delphi round, whereas only five experts continued their participation in the second and the third rounds of the survey. The following six CVs emerged from the Delphi round: comprehensive approach, care coordination, first recourse, continuity of care, integrated approach, and patient and family centered care. The final sample consisted of 375 FDs (19% response rate). There were 323 (88.7%) female and 34 (9.3%) male FDs in the sample. The mean age of the participants was 44.6+-13.5 years. Discussion/Conclusion: Defining CVs for FM by Ukrainian FDs in a given socio-economical and historical-cultural setting is crucial to optimize primary medical care and to guarantee an appropriate and successful implementation of WONCA standards as well as CVs in different countries including those where reformation of the health system is ongoing. Ključne besede: family medicine, Ukraine, core values, delphi, mixed methods, Ukraine Objavljeno v DKUM: 27.08.2024; Ogledov: 88; Prenosov: 13 Celotno besedilo (634,64 KB) Gradivo ima več datotek! Več... |
12. Core values of family medicine in Europe : current state and challengesEva 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 Celotno besedilo (185,06 KB) Gradivo ima več datotek! Več... |
13. The moderating impact of types of caregiving on job demands, resources, and their relation to work-to-family conflict and enrichmentSara Tement, Christian Korunka, 2015, izvirni znanstveni članek Opis: This research aims to examine for whom combining work and family/caregiving may be most harmful. Employed parents, elder caregivers, and the sandwiched generation were compared with their coworkers without such responsibilities. Based on the job demandsresources model, we assumed that high job demands/low job resources would relate to work-to-family conflict (WFC) and low job demands/high job resources to work-to-family enrichment. However, this effect would depend on employees family/caregiving responsibilities. Using a large sample of Slovenian employees (N = 1,285), we found support for the moderating role of the type of caregiving responsibility between workload and WFC. In addition, the type of caregiving had a moderating effect on the relationship between coworker support and WFC. Support was also found for the differential impact of job resources on work-to-family enrichment. The results therefore indicate the relevance of types of caregiving responsibility in workfamily research and practice. Ključne besede: skrb za otroke, skrb za starejše, konflikt med delom in družino, obogatitev, delovne zahteve, delovni resursi, child care, elderly care, work-to-family conflict, enrichment, job demands, job resources Objavljeno v DKUM: 02.08.2024; Ogledov: 93; Prenosov: 2 Povezava na celotno besedilo |
14. 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... |
15. Family businesses’ succession in posttransition countries : what can be learned from the action research?Mojca Duh, Andreja Primec, 2022, izvirni znanstveni članek Opis: Succession is a very complex process and a critical phase in the life cycle of a family business. Finding a successor in ownership and management is one of the most demanding succession challenges, especially since younger generations have little interest or intention in joining their parents’ businesses. The action research was conducted to expand our understanding of owners’ attitudes and behaviors toward succession and the factors influencing successors’ intention and decision to enter the family business. The research also addresses the applicability of informal and formal family governance mechanisms in family business succession in post-transition countries. The research findings show the importance of the family dimension and emotional aspects of succession in post-transition countries. The theoretical hypotheses developed to form the basis for future confirmatory research and have implications for the key stakeholders and support infrastructure institutions involved in family business succession in post-transition countries. Ključne besede: family business, succession, affective commitment, family governance mechanism, post-transition country, action research Objavljeno v DKUM: 16.07.2024; Ogledov: 147; Prenosov: 16 Celotno besedilo (379,62 KB) Gradivo ima več datotek! Več... |
16. An innovative approach for improving information exchange between palliative care providers in Slovenian primary health : a qualitative analysis of testing a new toolErika Zelko, Jožica Ramšak-Pajk, Nevenka Krčevski-Škvarč, 2022, izvirni znanstveni članek Opis: Background: Interprofessional collaboration is an important part of palliative care. Effective communication and information exchange is essential for a high quality of care. The aim of this study was to test the effectiveness of a new tool for exchanging information between professionals in palliative care on primary healthcare level. Methods: With suggestions from the experts regarding palliative care needs in an interprofessional team from the Delphi study and community nurses from the field, we developed a paper version of the tool. The paper version was tested in a pilot phase, and subsequently, we conducted ten semi-structured interviews with the users of the new tool to test its feasibility and usability. The data were analyzed using qualitative content analysis, leading to improvement and development of the digital version of the new tool. Results: After completing the pilot phase of the research, we identified the following four categories: a systematic tool for more consistent treatment and better communication during the patient’s visit; training and empowerment; quality, safety and digitalization; these categories were later included in the final version of the digital communication tool. Conclusion: Effective palliative care requires a good exchange of information and communication between all care professionals who work with the patient. Effective communication contributes to making patients and their relatives feel safe in their home environment and allows patients to stay in their homes even as their disease progresses. The systematical new tool was assessed as useful to improve interdisciplinary cooperation and prepared in a digital version. Further research after the long-term use of the developed digital tool in everyday work might confirm its sustaining importance. Ključne besede: palliative care, family medicine, interprofessional collaboration, telemedicine Objavljeno v DKUM: 09.07.2024; Ogledov: 104; Prenosov: 12 Celotno besedilo (227,44 KB) Gradivo ima več datotek! Več... |
17. How did general practices organize care during the COVID-19 pandemic : the protocol of the cross-sectional PRICOV-19 study in 38 countriesEsther Van Poel, Piet Van den Bussche, Zalika Klemenc-Ketiš, Sara Willems, 2022, izvirni znanstveni članek Opis: Background: General practitioners (GPs) play a crucial role in the fight against the COVID-19 pandemic as the first point of contact for possibly infected patients and are responsible for short and long-term follow-up care of the majority of COVID-19 patients. Nonetheless, they experience many barriers to fulfilling this role. The PRICOV-19 study investigates how GP practices in 38 countries are organized during the COVID-19 pandemic to guarantee safe, effective, patient-centered, and equitable care. Also, the shift in roles and tasks and the wellbeing of staff members is researched. Finally, PRICOV-19 aims to study the association with practice- and health care system characteristics. It is expected that both characteristics of the GP practice and health care system features are associated with how GP practices can cope with these challenges. This paper describes the protocol of the study.
Methods: Using a cross-sectional design, data are collected through an online questionnaire sent to GP practices in 37 European countries and Israel. The questionnaire is developed in multiple phases, including a pilot study in Belgium. The final version includes 53 items divided into six sections: patient flow (including appointments, triage, and management for routine care); infection prevention; information processing; communication; collaboration and self-care; and practice and participant characteristics. In the countries where data collection is already finished, between 13 and 636 GP practices per country participated in the study. Questionnaire data are linked with OECD and HSMR data regarding national policy responses to the pandemic and analyzed using multilevel models considering the system- and practice-level.
Discussion: To the best of our knowledge, the PRICOV-19 study is the largest and most comprehensive study that examines how GP practices function during the COVID-19 pandemic. Its results can significantly contribute to better preparedness of primary health care systems across Europe for future major outbreaks of infectious diseases. Ključne besede: family medicine, primary health care, COVID-19 Objavljeno v DKUM: 05.07.2024; Ogledov: 141; Prenosov: 10 Celotno besedilo (1,31 MB) Gradivo ima več datotek! Več... |
18. Development and validation of the scale for measuring biopsychosocial approach of family physicians to their patientsIrena 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: 13 Celotno besedilo (408,05 KB) Gradivo ima več datotek! Več... |
19. The Careful Assessment tool for managing patients with medically unexplained symptoms - the experience of Slovenian family medicine trainees : a qualitative studyVojislav Ivetić, Špela Martinjak, Alem Maksuti, 2022, izvirni znanstveni članek Opis: ntroduction
Primary care physicians use various tools and methods to identify medically unexplained symptoms (MUS). The main purpose of our study is to determine the views of Slovenian family medicine trainees (FMT) about using the “Careful Assessment” tool for managing patients with MUS.
Methods
A qualitative study using open survey questions focused on the experience of family medicine trainees in managing patients with MUS. The sample consisted of surveys from 184 family medicine trainees. These trainees analysed a total of 702 patients with MUS. Manual coding was used for quantitative content analysis.
Results
In the coding process, 49 codes were developed that included broader research fields about using the “Careful Assessment” tool for managing patients with MUS. The codes were grouped into four theoretically grounded, logical categories in accordance with the elaborated theoretical concept: multi-purpose utility; improved patient management; in-depth knowledge and new skills; and patient response.
Conclusion
The study demonstrated that, in the view of Slovenian FMT, the “Careful Assessment” tool has multi-purpose utility. The study showed that FMT felt that this tool helps them in systematic patient management. Their opinion is that it helps them establish a trusting relationship with patients, which is a precondition for providing further treatment. Ključne besede: medically unexplained symptoms, Careful Assessment tool, family medicine, qualitative studies, family medicine, trainees Objavljeno v DKUM: 17.06.2024; Ogledov: 151; Prenosov: 14 Celotno besedilo (388,03 KB) Gradivo ima več datotek! Več... |
20. School belongingness and family support as predictors of school bullying perpetration and victimization in adolescents : are relations the same for students with an immigrant background?Katja Košir, Martina Zakšek, Ana Kozina, 2023, izvirni znanstveni članek Opis: The aim of the study was to examine school belongingness and family support as predictors of bullying behavior and victimization, and the moderating role of students’ gender and immigrant background in a large representative sample of Slovenian adolescents (N = 1925; 42.50% male). The results indicated that school belongingness significantly predicted both bullying and victimization. Family support did not contribute to the incremental validity beyond school belongingness in predicting victimization. Gender was found to moderate the relationship between school belongingness and both bullying outcomes. The relationship between school belongingness and victimization was stronger for students with an immigrant background. Ključne besede: bullying, victimization, school belongingness, family support, immigrant background, adolescents Objavljeno v DKUM: 31.05.2024; Ogledov: 165; Prenosov: 14 Celotno besedilo (891,51 KB) Gradivo ima več datotek! Več... |