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Patients' genetic data protection in Polish law and EU law
Kinga Michałowska, Karol Magoń, 2018, original scientific article

Abstract: The article entitled "Patients' genetic data protection in Polish law and EU law - selected issues" presents issues related to the protection of patients' rights and focuses on the legal basis for genetic testing and genetic data protection. Based on a comparison of regulations of international law and regulations on genetic tests introduced in foreign legal systems, the text analyzes the assumptions for the draft of the Polish act on genetic tests performed for health purposes. It presents the patient's consent to testing, the scope of information provided to the patient, the right to disclose research results to related persons and the protection of genetic data. In reference to the regulations set out in other acts, it was noted that they do not guarantee the protection of information obtained as a result of research. Due to the particular nature of genetic data, they require increased protection, which can be guaranteed through implementation of the Act on Genetic Research. In the final part, authors presented the most important achievements of the judicature of European Court of Human Rights in the field of genetic data protection.
Keywords: genetic research, genetic data, protection of genetic data, patient's rights, medical documentation
Published: 09.10.2018; Views: 560; Downloads: 49
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Selected legal problems of EEG biofeedback therapy under the Polish law
Aleksandra Nowak-Gruca, 2018, original scientific article

Abstract: The use of EEG biofeedback for therapeutic or healing purposes has its justification in modern research and recently one can notice the increasing popularity of this method. Possible threats which may be associated with improper training and EEG biofeedback therapy may result from error in the diagnosis or incorrect selection of the training protocol. The effectiveness of therapy depends largely on the efforts of the patient himself, however, the range of waves will be amplified or suppressed by diagnosticians and therapists. If during an EEG biofeedback, the correct neuronal signal is amplified or suppressed, this can have adverse effects. In Poland, there are no legal regulations regarding the acquisition of qualifications for conducting neurotherapy. Likewise, there are no indications as to which institutions have the right to assign appropriate powers to use this type of apparatus. The lack of legal regulations means that now everyone can practice neurotherapy. The article presents selected legal problems related to conducting EEG biofeedback therapy under law, especially under Polish regulations, including the problem of the responsibility of the therapist or trainer.
Keywords: EEG biofeedback, EEG applications, neurotheraphy, neurotherapist, legal liability, medical device, medical profession, patient's consent to treatment
Published: 09.10.2018; Views: 557; Downloads: 113
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The legal nature of doctor patient relationship in Turkish medical law
Yener Ünver, 2016, original scientific article

Abstract: The article discusses the relationship between the physician and the patient through different branches of Turkish Law. The author explains the legal theory of physician (as self-employed as well as employed in hospital) – patient relationship in the limits of legislation and court practices, and gives special emphasis on contemporary open questions in Turkish Law. Special intentions is given also to criminal law, duty to inform, liability and consent. The author presents contemporary constitutional and supreme court decision relating to the Casarean, plastic surgery, burden of proof, compensations ...
Keywords: patient, physician, discrimination, criminal law, Turkish law
Published: 08.10.2018; Views: 374; Downloads: 60
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Patient safety in cross-border care
Eva Turk, Stephen Leyshon, Morten Pytte, 2015, original scientific article

Abstract: Patient safety is a right and it raises particular issues in the context of cross-border care. Patients should be able to have trust and confidence in the healthcare structure as a whole; they must be protected from the harm caused by poorly functioning health systems, medical errors and adverse events. This paper addresses the state of cross-border healthcare in the European Union, the state of patient safety, the question of quality assurance and the role of accreditation as a risk based approach.
Keywords: patient safety, cross-border care, accreditation, healthcare, EU
Published: 08.10.2018; Views: 341; Downloads: 50
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Variations in patient safety climate and perceived quality of collaboration between professions in out-of-hours care
Zalika Klemenc-Ketiš, Ellen Tveter Deilkås, Dag Hofoss, Gunnar Tschudi Bondevik, 2017, original scientific article

Abstract: Purpose: To get an overview of health care workers perceptions of patient safety climates and the quality of collaboration in Slovenian out-of-hours health care (OOHC) between professional groups. Materials and methods: This was a cross-sectional study carried out in all (60) Slovenian OOHC clinics; 37 (61.7%) agreed to participate with 438 employees. The questionnaire consisted of the Slovenian version of the Safety Attitudes Questionnaire - Ambulatory Version (SAQ-AV). Results: The study sample consisted of 175 (70.0%) physicians, nurse practitioners, and practice nurses. Practice nurses reported the highest patient safety climate scores in all dimensions. Total mean (standard deviation) SAQ-AV score was 60.9+-15.2. Scores for quality of collaboration between different professional groups were high. The highest mean scores were reported by nurse practitioners on collaboration with practice nurses (4.4+-0.6). The lowest mean scores were reported by practice nurses on collaboration with nurse practitioners (3.8+-0.9). Conclusion: Due to large variations in Slovenian OOHC clinics with regard to how health care workers from different professional backgrounds perceive safety culture, more attention should be devoted to improving the team collaboration in OOHC. A clearer description of professional team roles should be provided.
Keywords: primary health care, out-of-hours medical care, patient care management
Published: 27.11.2017; Views: 642; Downloads: 264
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The concept of Watson's carative factors in nursing and their (dis)harmony with patient satisfaction
Majda Pajnkihar, Gregor Štiglic, Dominika Vrbnjak, 2017, original scientific article

Abstract: Background: Constant reviews of the caring behavior of nurses and patient satisfaction help to improve the quality of nursing. The aim of our research was to explore relationships between the level of nursing education, the perception of nurses and nursing assistants of Watson's carative factors, and patient satisfaction. Methods: A questionnaire survey using a convenience sample of 1,098 members of nursing teams and a purposive sample of 1,123 patients in four health care institutions in Slovenia was conducted in August 2012. A demographic questionnaire and the Caring Nurse-Patient Interactions Scale (nurse version) were delivered to the nurses. A Hospital Consumer Assessment of Health Plans Survey was delivered to discharged patients. Data were analyzed using descriptive and inferential statistics. Results: Carative factor sensibility was related to the level of nursing education. Patients were satisfied with the care received from nurses, nursing assistants and hospitals, although we found differences between the perceptions of nurses and nursing assistants of carative factors and patient satisfaction. By comparing only the perceptions of nurses and nursing assistants of carative factors in health care institutions, differences were found for seven out of ten carative factors. Discussion: We did not find major significant differences between carative factors and level of nurse education, except in one carative factor. Differences in perceptions of carative factors between health care institutions are probably the result of different institutional factors. The results can be of great benefit to nurse administrators and educators, indicating the factors that must be taken into account for enhancing patient satisfaction. Emphasis on caring theories should be placed in nursing education and their application in nursing practice.
Keywords: caring, patient satisfaction, cross-sectional studies
Published: 02.08.2017; Views: 1436; Downloads: 307
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An approach to consider the arterial residual stresses in modelling of a patient-specific artery
Janez Urevc, Miroslav Halilovič, Milan Brumen, Boris Štok, 2016, original scientific article

Abstract: In this work, the residual stress state of a human common carotid artery is predicted using the so-called thermomecha- nical analogy approach. The purpose of the approach is to enable consistent mapping of residual stresses and the respec- tive configuration from a circular arterial segment to a patient-specific arterial geometry. This is achieved by applying proper volumetric dilatations to the actual arterial stress-free in vivo geometry, which makes use of the analogy that states that the bending stresses can be obtained on an equivalent manner by applying proper thermal dilatations. The common carotid artery data are obtained in vivo from a healthy 28-year-old man using non-invasive methods. The pre- dicted residual stresses of the common carotid artery are in good quantitative agreement with the data from prior work in this field. The approach is validated by predicting the common carotid artery zero-stress state configuration, where a sector-like (cut-open) state is obtained. With this approach, it is thus possible to predict the residual stresses as well as the configuration of patient-specific arterial geometry without the need to model its cut-open zero-stress configuration.
Keywords: patient-specific artery, common carotid artery, residual stresses, arterial zero-stress state, thermomechanics, finite element method
Published: 12.07.2017; Views: 651; Downloads: 276
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Comorbidities and characteristics of coronary heart disease patients: their impact on health-related quality of life
Ksenija Tušek-Bunc, Davorina Petek, 2016, original scientific article

Abstract: Background: Patients with coronary heart disease (CHD) commonly present with more than one comorbid condition, contributing to poorer health-related quality of life (HRQoL). The aim of our study was to identify the associations between HRQoL and patient characteristics, vascular comorbidities and anxiety/depression disorders. Methods: This observational study was conducted in 36 family medicine practices selected by random stratified sampling from all regions of Slovenia. HRQoL was assessed using the European Quality of Life - 5 Dimensions (EQ-5D) questionnaire and EQ Visual Analogue Scale (EQ-VAS). The associations between HRQoL and patient characteristics stratified by demographics, vascular comorbidities, health services used, their assessment of chronic illness care, and anxiety/depression disorders were identified by ordinal logistic regression and linear regression models. Results: The final sample included 423 CHD patients with a mean age of 68.0 ± SD 10.8 years; 35.2% were female. Mean EQ-VAS score was 58.6 ± SD 19.9 (median: 60 with interquartile range of 45–75), and mean EQ-5D index was 0.60 ± SD 0.19 (median: 0.56 with interquartile range of 0.41–0.76). The statistically significant predictors of a lower EQ-VAS score were higher family physician visit frequency, heart failure (HF) and anxiety/depression disorders (R² 0.240; F = 17.368; p < 0.001). The statistically significant predictor of better HRQoL, according to EQ-5D was higher patient education, whereas higher family physician visit frequency, HF and peripheral artery disease (PAD) were predictors of poorer HRQoL (Nagelkerke R 2 = 0.298; χ 2 = 148.151; p < 0.001). Conclusions: Results of our study reveal that comorbid conditions (HF and PAD), family physician visit frequency and years in education are significant predictors of HRQoL in Slovenian CHD patients.
Keywords: coronary heart disease patient, health-related quality of life, vascular comorbidities, anxiety/depression disorders
Published: 29.06.2017; Views: 701; Downloads: 342
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The safety attitudes questionnaire - ambulatory version
Zalika Klemenc-Ketiš, Matjaž Maletič, Vesna Stropnik, Ellen Tveter Deilkås, Dag Hofoss, Gunnar Tschudi Bondevik, 2017, original scientific article

Abstract: Background: Several tools have been developed to measure safety attitudes of health care providers, out of which the Safety Attitudes Questionnaire (SAQ) is regarded as one of the most appropriate ones. In 2007, it was adapted to outpatient (primary health care) settings and in 2014 it was tested in out-of-hours health care settings in Norway. The purpose of this study was to translate the English version of the SAQ-Ambulatory Version (SAQ-AV) to Slovenian language; to test its reliability; and to explore its factor structure. Methods: This was a cross-sectional study that took place in Slovenian out-of-hours primary care clinics in March- May 2015 as a part of an international study entitled Patient Safety Culture in European Out-of-hours services. The questionnaire consisted of the Slovenian version of the SAQ-AV. The link to the questionnaire was emailed to health care workers in the out-of-hours clinics. A total of 438 participants were invited. We performed exploratory factor analysis. Results: Out of 438 invited participants, 250 answered the questionnaire (response rate 57.1%). Exploratory factor analysis put forward five factors: 1) Perceptions of management, 2) Job satisfaction, 3) Safety climate, 4) Teamwork climate, and 5) Communication. Cronbach's alpha of the whole SAQ-AV was 0.922. Cronbach's alpha of the five factors ranged from 0.587 to 0.791. Mean total score of the SAQ-AV was 56.6 +- 16.0 points. The factor with the highest average score was Teamwork climate and the factor with the lowest average was Job satisfaction. Conclusions: Based on the results in our study, we cannot state that the SAQ-AV is a reliable tool for measuring safety culture in the Slovenian out-of-hours care setting. Our study also showed that there might be other safety culture factors in out-of-hours care not recognised before. We therefore recommend larger studies aiming to identify an alternative factor structure.
Keywords: patient safety, quality assurance, health care
Published: 28.06.2017; Views: 772; Downloads: 102
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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, original scientific article

Abstract: 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.
Keywords: patient, experience, family physician, state-employed, concessionaire
Published: 10.05.2017; Views: 669; Downloads: 270
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