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1.
Perceptions of the primary health care team about the implementation of integrated care of patients with type 2 diabetes and hypertension in Slovenia : qualitative study
Nataša Stojnić, Zalika Klemenc-Ketiš, Majda Mori-Lukančič, Črt Zavrnik, Tonka Poplas-Susič, 2023, original scientific article

Abstract: Background Integrated care involves good coordination, networking, and communication within health care services and externally between providers and patients or informal caregivers. It affects the quality of services, is more cost-effective, and contributes to greater satisfaction among individuals and providers of integrated care. In our study, we examined the implementation and understanding of integrated care from the perspective of providers - the health care team - and gained insights into the current situation. Methods Eight focus groups were conducted with health care teams, involving a total of 48 health care professionals, including family physicians, registered nurses, practice nurses, community nurses, and registered nurses working in a health education center. Prior to conducting the focus groups, a thematic guide was developed based on the literature and contextual knowledge with the main themes of the integrated care package. The analysis was conducted using the NVivo program. Results We identified 12 main themes with 49 subthemes. Health care professionals highlighted good accessibility and the method of diagnostic screening integrated with preventive examinations as positive aspects of the current system of integrated care in Slovenia. They mentioned the good cooperation within the team, with the involvement of registered nurses and community nurses being a particular advantage. Complaints were made about the high workload and the lack of workforce. They feel that patients do not take the disease seriously enough and that patients as teachers could be useful. Conclusion Primary care teams described the importance of implementing integrated care for diabetes and hypertension patients at four levels: Patient, community, care providers, and state. Primary care teams also recognized the importance of including more professionals from different health care settings on their team.
Keywords: integrated health care system, type-2-diabetes, Hypertension, Health care team, interdisciplinary primary care, qualitative research
Published in DKUM: 19.04.2024; Views: 151; Downloads: 5
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2.
The safety of patient management in family medicine in Slovenia during Covid-19 : a crosssectional study
Maja Cvetko Gomezelj, Špela Miroševič, Alina Verdnik Tajki, Ksenija Tušek-Bunc, Esther Van Poel, Sara Willems, Zalika Klemenc-Ketiš, 2023, original scientific article

Abstract: Abstract Background During the Covid-19 pandemic, family medicine practices (FMPs) changed to improve safety against new coronavirus infections for both patients and employees. Protocols for treating patients with suspected Sars-Cov-2 infections were established to protect medical staf and other patients from being infected. However, these protocols also led to increased safety risks, such as delays in treating patients with other medical conditions. This exploratory study aimed to investigate safety risks in treating patients in FMPs during the Covid-19 pandemic and to suggest improvements to prevent Covid-19 in FMPs in Slovenia. Methods A cross-sectional study was rolled out in FMPs in Slovenia as part of the international Pricov-19 study. Data collection on safety management during the Covid-19 pandemic in FMPs in Slovenia took place from November 2020 until January 2021 using a self-administered online survey for FP working in Slovenia. A chi-square test, ANOVA, independent samples t-test or bivariate correlation test was performed to explore associations regarding the safety of patients’ management variables. Results From the 191 participating family physicians (FPs) (15.2% response rate), 54.8% reported having treated patients with fever (not Covid-19) late due to the new protocols at least once, and 54.8% reported patients with urgent conditions having been seen late at least once due to not coming. In the suburbs and rural environments FPs more often reported that at least once patient with a fever (not Covid-19) was seen late due to the protocol (p=0.017) and more often reported that at least once patient with an urgent condition was seen late due to not com‑ ing to their FP (p=0.017). The larger the practice, the more they reported that at least once a patient with fever (not Covid-19) was seen late due to the protocol (p=0.012) and the more they reported at least once a patient with an urgent condition was seen late due to not coming to their FP (p=0.012). Conclusion Covid-19 afected the safety of patient management in FMP in Slovenia. The most common prob‑ lem was foregone care. Therefor, protocols for chronic patient management in the event of epidemics need to be established.
Keywords: Covid-19, family medicine, patient safety, patient management, quality of care, PRICOV-19, primary health care, general practice, timeliness
Published in DKUM: 29.03.2024; Views: 156; Downloads: 10
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3.
The psychometric properties of the Slovenian version of the medical office survey on patient safety culture
Zalika Klemenc-Ketiš, Irena Makivić, Tonka Poplas-Susič, 2020, original scientific article

Keywords: patient safety, primary care, validation studies
Published in DKUM: 23.01.2023; Views: 500; Downloads: 13
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4.
Community health nursing in Slovenia and Croatia - selected legal aspects
Suzana Kraljić, Blanka Kačer, 2020, original scientific article

Abstract: This article is dedicated to community health nursing which today constitutes the indispensable cornerstone of Slovenian and Croatian primary health-care. Authors also stress that community health nursing is recognized of crucial importance for public health and various vulnerable groups (e.g., children, elderly, ...) in many other European as well as non-European states. In Chapter 2, the authors represent basic historical milestones in both countries, Slovenia and Croatia, which have common historical roots. In Chapters 3 and 4, the central part of the article, authors analyze the current legal regulation related to community health nursing and thereby give special attention to differences in both national legal regulations. The major difference is given in concessions. Namely in Slovenia, community health nursing can be performed also based on a granted concession, but not in Croatia. In Chapter 5, some legal views on the role of community health nursing in local communities are emphasized (e.g., domestic violence). The last chapter is dedicated to the summarization of the authors' conclusions, in which they especially stress that the community health nursing in both countries today represents an important key factor for ensuring the constitutional right to health-care.
Keywords: community health nurse, primary care, aging population, concession, legal regulation
Published in DKUM: 15.01.2021; Views: 948; Downloads: 54
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5.
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 in DKUM: 27.11.2017; Views: 1454; Downloads: 360
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6.
Patient safety culture in Slovenian out-of-hours primary care clinics
Zalika Klemenc-Ketiš, Ellen Tveter Deilkås, Dag Hofoss, Gunnar Tschudi Bondevik, 2017, original scientific article

Abstract: Introduction: Patient safety culture is a concept which describes how leader and staff interaction, attitudes, routines and practices protect patients from adverse events in healthcare. We aimed to investigate patient safety culture in Slovenian out-of-hours health care (OOHC) clinics, and determine the possible factors that might be associated with it. Methods: This was a cross-sectional study, which took place in Slovenian OOHC, as part of the international study entitled Patient Safety Culture in European Out-of-Hours Services (SAFE-EUR-OOH). All the OOHC clinics in Slovenia (N=60) were invited to participate, and 37 agreed to do so; 438 employees from these clinics were invited to participate. We used the Slovenian version of the Safety Attitudes Questionnaire % an ambulatory version (SAQAV) to measure the climate of safety. Results: Out of 438 invited participants, 250 answered the questionnaire (57.1% response rate). The mean overall score % standard deviation of the SAQ was 56.6%16.0 points, of Perceptions of Management 53.6%19.6 points, of Job Satisfaction 48.5%18.3 points, of Safety Climate 59.1%22.1 points, of Teamwork Climate 72.7%16.6, and of Communication 51.5%23.4 points. Employees working in the Ravne na Koroškem region, employees with variable work shifts, and those with full-time jobs scored significantly higher on the SAQ-A V. Conclusion: The safety culture in Slovenian OOHC clinics needs improvement. The variations in the safety culture factor scores in Slovenian OOHC clinics point to the need to eliminate variations and improve working conditions in Slovenian OOHC clinics.
Keywords: safety culture, out-of-hours medical care, primary health care, Slovenia
Published in DKUM: 03.11.2017; Views: 1368; Downloads: 414
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7.
Which positive factors determine the GP satisfaction in clinical practice? : a systematic literature review
Bernard Le Floch, Hilde Bastiaens, Jean-Yves Le Reste, H. Lingner, Robert Hoffman, Sĺawomir Czachowski, Radost Spiridonova Assenova, Tuomas Koskela, Zalika Klemenc-Ketiš, P. Nabbe, A. Sowinska, T. Montier, Lieve Peremans, 2016, review article

Abstract: 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.
Keywords: family medicine, primary health care, career
Published in DKUM: 28.06.2017; Views: 1035; Downloads: 155
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8.
Correlates of depression in the slovenian working population
Zalika Klemenc-Ketiš, Borut Peterlin, 2013, original scientific article

Abstract: This multicentre, cross-sectional observational study aimed to determine the prevalence of depression among the working population of Slovenia and identify factors correlating with higher prevalence of depression. It was conducted in three occupational medicine practices within major Slovenian primary health care centres. The study population consisted of 1,474 respondents [73.7 % of the invited participants, 889 (60.3 %) men and 585 (39.7 %) women with mean age of (40.5±9.8) years] who visited these practices for their regular check-ups from November 2010 to June 2012 and were asked to fill in a self-developed questionnaire and score depression on the Zung’s self-rating depression scale. According to the rating, 50 (3.4 %) respondents suffered from depression. In the multivariate analysis, depression correlated with the following independent variables: self-perceived exposure to chronic stress, positive family history of depression, and primary school education.
Keywords: mental diseases, primary health care, cross-sectional study, demographic data, family history
Published in DKUM: 30.03.2017; Views: 1358; Downloads: 342
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