51. Importance of international networking in academic family medicineZalika Klemenc-Ketiš, Janko Kersnik, 2014, pregledni znanstveni članek Opis: European family medicine/general practice (FM/GP) has travelled the long and successful journey of profiling the discipline and has produced valuable position papers on education and research. Nowadays, academic medicine is one of the pillars in the future development of FM/GP in Europe. A common European curriculum on undergraduate and postgraduate family medicine is needed. Also, a sound international platform of teaching institutions and/or teachers of family medicine would foster the further development of family medicine as an academic discipline. This would stimulate students and teachers to engage in international exchange to gain new knowledge and experiences, present their work and ideas abroad and prepare the conditions for further exchange of students and teachers.
Conclusion: Established departments of FM/GP, led by a teacher who is a family physician/general practitioner, at each Medical School in Europe should provide students with knowledge and skills related to the core attributes of FM/GP. International exchanges of teachers and students should foster the development of a common curriculum on FM in Europe and foster improvement in the quality of FM education. Ključne besede: family practice, education, network, exchange Objavljeno v DKUM: 24.07.2017; Ogledov: 1685; Prenosov: 377
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52. Regional coordinators : a new teaching opportunity in family medicine trainingDavorina Petek, Polona Vidič Hudobivnik, Viktorija Jančar, Bojana Petek, Zalika Klemenc-Ketiš, 2016, izvirni znanstveni članek Opis: Background: A new project on education in family medicine training was implemented last year in Slovenia by establishing regional coordinators in the specialist training programme. They are responsible for conducting regular small-group meetings with family medicine trainees. This study wanted to explore the attitudes and opinions of regional coordinators and family medicine trainees concerning this new method.
Methods: This was a qualitative study based on focus groups. The participants were regional coordinators and family medicine specialist trainees. The data were analysed based on the principles of thematic content analysis with inductive technique.
Results: The study revealed five themes which were the same for the analysis of transcripts of both regional coordinators and family medicine trainees: 1) Meetings with trainees; 2) Coordination; 3) Characteristics of regional coordinators; 4) Position of regional coordinators, and 5) Evaluation of regional coordinators.
Conclusion: Participants of the study have many expectations for this new programme. They expect progress in trainees' clinical knowledge through experience-based group learning and with the help of the tutorship role of regional coordinators. The role of regional coordinators represents a new possibility for solving problems in the training programme in their coordinating role. In future, they have the potential to develop into an expert body that supervises the quality of training. A close follow-up is necessary to see if the position of regional coordinators is adequate and if they meet the expectations of the trainees as well as their own goals. Administrative and financial support for the programme is necessary. The project is important also in enabling the adaptation of the training programme's needs and the regional characteristics of medical care. Ključne besede: family practice, education, mentors Objavljeno v DKUM: 28.06.2017; Ogledov: 1164; Prenosov: 190
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53. Which positive factors determine the GP satisfaction in clinical practice? : a systematic literature reviewBernard Le Floch, Hilde Bastiaens, Jean-Yves Le Reste, Heidrun Lingner, Robert Hoffman, Sĺawomir Czachowski, Radost Spiridonova Assenova, Tuomas Koskela, Zalika Klemenc-Ketiš, P. Nabbe, A. Sowinska, T. Montier, Lieve Peremans, 2016, pregledni znanstveni članek Opis: Background: Looking at what makes General Practitioners (GPs) happy in their profession, may be important in increasing the GP workforce in the future. The European General Practice Research Network (EGPRN) created a research team (eight national groups) in order to clarify the factors involved in GP job satisfaction throughout Europe. The first step of this study was a literature review to explore how the satisfaction of GPs had been studied before. The research question was "Which factors are related to GP satisfaction in Clinical Practice?"
Methods: Systematic literature review according to the PRISMA statement. The databases searched were Pubmed, Embase and Cochrane. All articles were identified, screened and included by two separate research teams, according to inclusion or exclusion criteria. Then, a qualitative appraisal was undertaken. Next, a thematic analysis process was undertaken to capture any issue relevant to the research question.
Results: The number of records screened was 458. One hundred four were eligible. Finally, 17 articles were included. The data revealed 13 subthemes, which were grouped into three major themes for GP satisfaction. First there were general profession-related themes, applicable to many professions. A second group of issues related specifically to a GP setting. Finally, a third group was related to professional life and personal issues.
Conclusions: A number of factors leading to GP job satisfaction, exist in literature They should be used by policy makers within Europe to increase the GP workforce. The research team needs to undertake qualitative studies to confirm or enhance those results. Ključne besede: family medicine, primary health care, career Objavljeno v DKUM: 28.06.2017; Ogledov: 1157; Prenosov: 172
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54. Process quality indicators in family medicine : results of an international comparisonDanica Rotar-Pavlič, Maja Sever, Zalika Klemenc-Ketiš, Igor Švab, 2015, izvirni znanstveni članek Opis: Background: The aim of our study was to describe variability in process quality in family medicine among 31 European countries plus Australia, New Zealand, and Canada. The quality of family medicine was measured in terms of continuity, coordination, community orientation, and comprehensiveness of care.
Methods: The QUALICOPC study (Quality and Costs of Primary Care in Europe) was carried out among family physicians in 31 European countries (the EU 27 except for France, plus Macedonia, Iceland, Norway, Switzerland, and Turkey) and three non-European countries (Australia, Canada, and New Zealand). We used random sampling when national registers of practitioners were available. Regional registers or lists of facilities were used for some countries. A standardized questionnaire was distributed to the physicians, resulting in a sample of 6734 participants. Data collection took place between October 2011 and December 2013. Based on completed questionnaires, a three-dimensional framework was established to measure continuity, coordination, community orientation, and comprehensiveness of care. Multilevel linear regression analysis was performed to evaluate the variation of quality attributable to the family physician level and the country level.
Results: None of the 34 countries in this study consistently scored the best or worst in all categories. Continuity of care was perceived by family physicians as the most important dimension of quality. Some components of comprehensiveness of care, including medical technical procedures, preventive care and health care promotion, varied substantially between countries. Coordination of care was identified as the weakest part of quality. We found that physician-level characteristics contributed to the majority of variation.
Conclusions: A comparison of process quality indicators in family medicine revealed similarities and differences within and between countries. The researchers found that the major proportion of variation can be explained by physicians' characteristics. Ključne besede: family physician, process quality, comparison Objavljeno v DKUM: 28.06.2017; Ogledov: 6811; Prenosov: 351
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55. Family history as a predictor for disease risk in healthy individuals : a cross-sectional study in SloveniaZalika Klemenc-Ketiš, Borut Peterlin, 2013, izvirni znanstveni članek 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: 218
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56. Usefulness of the patient information leaflet (PIL) and information on medicines from professionals : a patient's viewTonka Poplas-Susič, Zalika Klemenc-Ketiš, Janko Kersnik, 2014, izvirni znanstveni članek Opis: Background: The Patient information leaflet (PIL) is an important source of information for every patient. Little is known about whether patients read the PIL and whether it contains useful information. Other sources of drug-related information are professionals (a family practitioner, a pharmacist and a nurse). Informing patients on drugs improves their compliance. The aim of the study was to identify the usefulness of PIL from the perspective of the patient, to assess professionals as a source of drug-related information and to suggest changes that can improve informing and therefore patients' compliances.
Methods: Four focus group interviews were conducted across different primary health care centres in the North East of Slovenia. Focus groups were composed of randomly selected patients (in total 20) who were willing to express their views on PILs, on other drug information sources and on possible improvements. A qualitative analysis of the data was based of the transcription of the audiotapes.
Results: Patients read the PILs selectively. They were most interested in side effects, contraindications and the purpose of the prescribed drug. Participants reported that the language in PILs is too scientific. In the case they do not understand PILs or they recognise some of the side effects, a majority of participants decide to contact a family physician first, and less frequently a pharmacist or a nurse. A family physician is considered to be the most trustworthy source of information and patients think that pharmacists could play a more active role in patients% education.
Conclusion: Current PILs offer enough partial information to patients but need some improvements in terms of better legibility and access to the most crucial information. PIL does not enable a comprehensive information with respect to patient%s health status. Most reliable source of information is considered to be a family practitioner. Pharmacists could play a more active role in the education of patients. Ključne besede: PIL, focus groups, medicines, family practitioner Objavljeno v DKUM: 10.05.2017; Ogledov: 1635; Prenosov: 92
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57. Do the experiences of patients of state-employed family physicians and concessionaires in Slovenia differ?Danica Rotar-Pavlič, Maja Sever, Zalika Klemenc-Ketiš, Igor Švab, Janko Kersnik, Wienke Boerma, 2015, izvirni znanstveni članek 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: 400
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58. Using movies in family medicine teaching : a reference to EURACT Educational AgendaZalika Klemenc-Ketiš, Igor Švab, 2017, izvirni znanstveni članek Opis: Introduction: Cinemeducation is a teaching method where popular movies or movie clips are used. We aimed to determine whether family physicians’ competencies as listed in the Educational Agenda produced by the European Academy of Teachers in General Practice/Family Medicine (EURACT) can be found in movies, and to propose a template for teaching by these movies.
Methods: A group of family medicine teachers provided a list of movies that they would use in cinemeducation. The movies were categorised according to the key family medicine competencies, thus creating a framework of competences, covered by different movies. These key competencies are Primary care management, Personcentred care, Specific problem-solving skills, Comprehensive approach, Community orientation, and Holistic approach.
Results: The list consisted of 17 movies. Nine covered primary care management. Person-centred care was covered in 13 movies. Eight movies covered specific problem-solving skills. Comprehensive approach was covered in five movies. Five movies covered community orientation. Holistic approach was covered in five movies.
Conclusions: All key family medicine competencies listed in the Educational Agenda can be taught using movies. Our results can serve as a template for teachers on how to use any appropriate movies in family medicine education. Ključne besede: family practice, medical education, narration, professional competences, movies, family medicine, education, EURACT Objavljeno v DKUM: 06.04.2017; Ogledov: 1471; Prenosov: 183
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59. The effect of an educational intervention in family phisicians on self-rated quality of life in patients with medically unexplained symptomsVojislav Ivetić, Klemen Pašić, Polona Selič-Zupančič, 2017, izvirni znanstveni članek 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: 408
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60. The impact of patientʼs socio-demographic characterictics, comorbidities and attitudes on flu vaccination uptake in family practice settingsAndrej Kravos, Lucija Kračun, Klara Kravos, Rade Iljaž, 2015, izvirni znanstveni članek Opis: Objectives: In Slovenia, the role of family physicians in primary care and preventive procedures is very important. Influenza vaccination rates in Slovenia are low. The reasons for low vaccination rates in Slovenia were not clear. We suppose that patient’s beliefs and attitudes are important factors. We assessed patients’ opinions regarding the acceptance of flu vaccination by their family physicians and their beliefs and attitudes about flu and vaccination. The aim was to check out factors that influence the decision to take the vaccine in family physician offices.
Methods: This was a cross-sectional, multicenter, observational study in the Styria region in Slovenia. We included patients from seven family physicians during regular office visits. They filled in a questionnaire about their general demographic data and attitudes regarding influenza and vaccination. The main outcome was the decision to be vaccinated.
Results: The logistic regression model identified five predictors for influenza vaccination, namely: heart disease, previous vaccination, an agreement with the beliefs ‘the vaccination is an efficient measure to prevent influenza’, ‘after the vaccination there are usually no important side effects’ and ‘the vaccination is also recommended for a healthy adult person’. The belief that vaccinations harm the immune system is negatively associated with vaccination.
Conclusions: Patients’ beliefs are an important factor to decide for vaccination or not. Family physician teams should discuss with patients their beliefs and concerns about vaccination. Ključne besede: vaccination, influenza, family practice, attitudes, chronic diseases Objavljeno v DKUM: 05.04.2017; Ogledov: 1296; Prenosov: 141
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