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1.
An approach to consider the arterial residual stresses in modelling of a patient-specific artery
Janez Urevc, Miroslav Halilovič, Milan Brumen, Boris Štok, 2016, izvirni znanstveni članek

Opis: 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.
Ključne besede: patient-specific artery, common carotid artery, residual stresses, arterial zero-stress state, thermomechanics, finite element method
Objavljeno: 12.07.2017; Ogledov: 343; Prenosov: 137
.pdf Celotno besedilo (3,97 MB)
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2.
PRIMERJAVA MED KONVENCIONALNO PARENTERALNO ANALGEZIJO IN "PATIENT CONTROLLED" ANALGEZIJO
Darko Kokot, 2015, diplomsko delo

Opis: Akutna pooperativna bolečina po operativnem posegu lahko prizadene vsakega pacienta in vpliva na njegovo fizično, psihično in duševno stanje. Učinkovitost lajšanja bolečine je odvisna od pacienta samega, zdravnika in medicinske sestre. Danes obstajajo številni pristopi k zdravljenju bolečine vendar niti ena metoda ni popolna. V diplomskem delu smo opisali in primerjali dve metodi, ki veljata za zelo učinkoviti v procesu lajšanja bolečine V slovenskem prostoru je se še vedno najbolj uporabljena konvencionalna parenteralna analgezija, v tujini pa se je pokazala kot učinkovitejša in bolj razširjena metoda analgezije, pri kateri pacient aktivno sodeluje pri lajšanju bolečine »patient controlled analgezija« (PCA). Namen diplomske naloge je predstaviti, opisati in primerjati ti dve metodi, in ugotoviti katera je najučinkovitejša, ima manj slabosti in stranskih učinkov. V diplomskem delu smo opisali in definirali kaj je bolečina, mehanizme bolečine, akutno pooperativno bolečino, konvencionalno parenteralno analgezijo in »patient controlled analgezijo«, se poglobili in raziskali njihove prednosti in slabosti ter jih primerjali. Ugotovili smo, da se je v številnih raziskavah »patient controlled analgezija« pokazala kot metoda, ki ima več prednosti od konvencionalne parenteralne analgezije.
Ključne besede: Bolečina, pooperativna bolečina, zdravljenje bolečine, konvecionalna analgezija, »patient controlled« analgezija.
Objavljeno: 22.10.2015; Ogledov: 595; Prenosov: 107
.pdf Celotno besedilo (555,48 KB)

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Quality of life and patient satisfaction with family practice care in a roma population with chronic conditions in northeast Slovenia
Erika Zelko, Igor Švab, Danica Rotar-Pavlič, 2015, izvirni znanstveni članek

Opis: Objectives: Health-related quality of life (HRQoL) measures a patient's subjective experience of his or her health status. We aimed to show how the presence of chronic diseases and satisfaction with family physicians (FPs) were associated with the HRQoL of a Roma population. Methods: A cross-sectional study was carried out in May 2011 on a representative sample of 650 Roma living in Prekmurje, Slovenia. The EQ-5D questionnaire was used for measuring the HRQoL of the Roma. Demographical data, 12 groups of diseases diagnosed in the last 12 months and satisfaction with FPs were included in the questionnaire. Results: The response rate was 88.3% (574), of which 56.4% were female, and the average age of the participants had a mean value of 40.2+-12.7 years. The presence of cardiovascular problems with risk factors for them or presence of musculoskeletal disorders were strongly associated with the presence of pain (Cramer's V = 0.40 and 0.46 respectively). There was a strong association between the presence of mental disorders and anxiety and depression (Cramer's V = 0.58). The average satisfaction with the family physician was 3.9 (mean+-1.10) on a five-point Likert scale. There was no significant association between HRQoL and satisfaction with the family physician. Conclusions: Roma with chronic mental health problems had the lowest HRQoL in the Roma population. More attention should be paid to this subgroup of Roma in family medicine, and interventions should be provided. High satisfaction with their FPs is not associated with the observed quality of life variables.
Ključne besede: quality of life, Roma, patient satisfaction
Objavljeno: 05.04.2017; Ogledov: 350; Prenosov: 45
.pdf Celotno besedilo (232,60 KB)
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5.
The effect of an educational intervention in family phisicians on self-rated quality of life in patients with medically unexplained symptoms
Vojislav Ivetić, Klemen Pašić, Polona Selič, 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: 06.04.2017; Ogledov: 650; Prenosov: 166
.pdf Celotno besedilo (955,23 KB)
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6.
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: 10.05.2017; Ogledov: 404; Prenosov: 164
.pdf Celotno besedilo (105,74 KB)
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7.
Comorbidities and characteristics of coronary heart disease patients: their impact on health-related quality of life
Ksenija Tušek-Bunc, Davorina Petek, 2016, izvirni znanstveni članek

Opis: 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.
Ključne besede: coronary heart disease patient, health-related quality of life, vascular comorbidities, anxiety/depression disorders
Objavljeno: 29.06.2017; Ogledov: 370; Prenosov: 184
.pdf Celotno besedilo (407,23 KB)
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8.
The safety attitudes questionnaire - ambulatory version
Zalika Klemenc-Ketiš, Matjaž Maletič, Vesna Stropnik, Ellen Tveter Deilkås, Dag Hofoss, Gunnar Tschudi Bondevik, 2017, izvirni znanstveni članek

Opis: 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.
Ključne besede: patient safety, quality assurance, health care
Objavljeno: 28.06.2017; Ogledov: 467; Prenosov: 61
.pdf Celotno besedilo (515,91 KB)
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9.
The concept of Watson's carative factors in nursing and their (dis)harmony with patient satisfaction
Majda Pajnkihar, Gregor Štiglic, Dominika Vrbnjak, 2017, izvirni znanstveni članek

Opis: 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.
Ključne besede: caring, patient satisfaction, cross-sectional studies
Objavljeno: 02.08.2017; Ogledov: 820; Prenosov: 179
.pdf Celotno besedilo (250,38 KB)
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10.
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, izvirni znanstveni članek

Opis: 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.
Ključne besede: primary health care, out-of-hours medical care, patient care management
Objavljeno: 27.11.2017; Ogledov: 370; Prenosov: 157
.pdf Celotno besedilo (169,11 KB)
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