Iskanje po katalogu digitalne knjižnice

Opis: Background Family history can be used as a genetic risk predictor for common non-communicable diseases. The aim of this study was to determine the prevalence of healthy individuals at risk of developing these diseases, based on their self-reported family history.Methods and Findings This was a cross-sectional observational study. Data were collected in the three largest occupational practices in primary health care centres in Slovenia, a Central European country. The study population consisted of consecutive individuals who came to occupational practices for their regular preventive check-up from November 2010 to June 2012. We included 1,696 individuals. Data were collected by a self-developed questionnaire. The main outcome was the number of participants at a moderate or high risk for the development of cardiovascular diseases, diabetes, and cancer.The final sample consisted of 1,340 respondents. Moderate or high risk for the development of cardiovascular diseases was present in 280 (20.9%) participants, for the development of diabetes in 154 (11.5%) participants and for cancer in 163 (12.1%) participants. Conclusions In this study, we found a significant proportion of healthy individuals with an increased genetic risk for common non-communicable diseases; consequently further genetic and clinical evaluation and preventive measures should be offered.
Ključne besede: family history, predictor for disease risk, sectional study in Slovenia
Objavljeno v DKUM: 19.06.2017; Ogledov: 1195; Prenosov: 173
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Opis: Background: Family practice healthcare in Slovenia is provided by state-employed family physicians as well as concessionaires. However, both work under a contract with the National Health Insurance Institute. This study focuses on comparing patients’ experiences with Slovenian concessionaires and state-employed physicians. Methods: We performed analyses using survey data from a cross-sectional study on patient experiences, which took place from September 2011 to April 2012 as a part of the international QUALICOPC study. The Slovenian branch of this study included 1,962 patients visiting family practices. Patients were classified into two groups with respect to the registered status of their family physician. They completed the questionnaires immediately aſter visiting their family physicians. Data used in the analyses included 76 variables: 18 socio-economic and 58 variables linked to the patient’s experience. Results: The analyses showed few differences between concessionaires and state-employed family physicians. In comparison with patients of state-employed family physicians, patients of concessionaires were less likely to make an appointment for a visit (19.8 % vs. 29.2 %), were generally more frequent visitors (43.7 % vs. 50.7 %), and more oſten felt that opening hours were too restricted (25.7 % vs. 31.9 %). Patients of concessionaires believed more oſten that in general, doctors can be trusted (40.1 % vs.47.1 %). A smaller percentage of patients of concessionaires felt that their physician had the capacity to deal with personal problems as well as to provide medical care (61.9 % vs. 54.7 %). Conclusions: There are few differences in patients’ experiences of state-employed family physicians and concessionaires. Slovenian patients have a generally positive experience with family practice services regardless of the family physicians’ status. Plans for organizational change of the health sector should include patients’ perceptions of services.
Ključne besede: patient, experience, family physician, state-employed, concessionaire
Objavljeno v DKUM: 10.05.2017; Ogledov: 1352; Prenosov: 354
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Opis: Introduction: Medically unexplained symptoms (MUS) are very common in family medicine, despite being a poorly-defined clinical entity. This study aimed to evaluate the effect of an educational intervention (EI) on self-rated quality of life, treatment satisfaction, and the family physician-patient relationship in patients with MUS. Methods: In a multi-centre longitudinal intervention study, which was performed between 2012 and 2014, patients were asked to rate their quality of life, assess their depression, anxiety, stress and somatisation, complete the Hypochondriasis Index, the Medical Interview Satisfaction Scale and the Patient Enablement Instrument for assessing the physician-patient relationship, before and after the EI. Results: The mean values before and after the intervention showed that after the EI, patients with MUS gave a lower (total) mean rating of their health issues and a higher rating of their quality of life, and they also had a more positive opinion of their relationship with the physician (p<0.05). However, there were no differences in the (total) rating of treatment satisfaction before and after the EI (p=0.423). Significant differences in the symptoms in patients with MUS before and after the intervention were confirmed for stress, somatisation and hypochondriasis (p<0.05). Conclusions: It could be beneficial to equip family physicians with the knowledge, skills and tools to reduce hypochondriasis and somatisation in MUS patients, which would improve patients’ self-rated health status.
Ključne besede: medically unexplained symptoms, family medicine, educational intervention, quality of life, treatment satisfaction, family physician-patient relationship
Objavljeno v DKUM: 06.04.2017; Ogledov: 1886; Prenosov: 404
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Opis: Aim: To perform a cross-cultural adaptation of the Quality Improvement Competency Self Assessment (QICS) questionnaire for family physicians into the Slovenian language and to validate it in a representative sample of Slovenian FPs. Methods: This cross-sectional observational postal survey was conducted in a random sample of 398 Slovenian FPs. We used the QICS questionnaire that was developed on the basis of the new Quality Improvement Competency Framework for family medicine. The QICS questionnaire consists of 37 items included in six domains. The questions can be answered on a five-point Likert scale. The validity of the translation was provided by the backward translation from Slovenian to the English language and by the reference group consisting of experienced FPs in the consensus process. The reliability of the questionnaire was assessed by Cronbach’s alpha coefficient and Spearman rho to determine the test-retest reliability (the questionnaire was sent to the physicians in the sample twice in a period of two weeks). Results: The final sample consisted of 100 (25.1%) family physicians, out of which 71 (71.0%) were women. Mean age of the sample was 43.3 ± 9.6 years. Mean score of the QICS questionnaire was 127.0 ± 30.1 points (first round) and 127.8 ± 30.6 points (second round). Cronbach’s alpha scores were 0.984 (first round) and 0.988 (second round). Spearman’s rho for the summary score of the whole scale was 0.829 with p < 0.001. Conclusion: The Slovenian version of the QICS questionnaire proved to be a valid and reliable tool for selfassessment of quality improvement competencies by FPs in terms of continuous professional development.
Ključne besede: clinical competence, family medicine, self-assessment, quality improvement
Objavljeno v DKUM: 05.04.2017; Ogledov: 1702; Prenosov: 182
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Opis: The aim of this study was to find out how Slovenian family physicians (FPs) would manage a hypothetical clinical case, to explore their views about possible ethical dilemmas associated with this clinical case and to determine possible associations with demographic and other characteristics of FPs. This was an observational cross-sectional postal study in the Slovenian FPs’ surgeries. The study population consisted of the whole population of Slovenian FPs (n = 950). The main outcome measures were the percentages of the answers of FPs on different questions about the clinical case on the management of patient and his relative with hereditary cardiomyopathy. There were 271 FPs who answered the questionnaire (response rate was 27.1%). A sample included 66 (24.4%) men and the mean age of all respondents was 45.5 ± 10.6 years. When dealing with the clinical case, most FPs expressed willingness to take the patient’s family history. Only 34.2% FPs did not believe that ordering genetic tests was part of their job. Additionally, only 50.0% of them felt competent to interpret the genetic risk, 25.0% of them would give information about genetic testing and only 6.0% would interpret the results of the genetic testing. Family physicians in Slovenia were willing to include genetic tasks into routine management of their patients, but they do not feel competent enough to interpret the genetic risks and the results of genetic testing. However, an important part of FPs would not refer patients at risk to genetic counseling. The inclusion of genetic topics to family medicine specialization curriculum is needed.
Ključne besede: case management, family medicine, genetics
Objavljeno v DKUM: 30.03.2017; Ogledov: 1972; Prenosov: 193
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