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Title:The effect of an educational intervention in family phisicians on self-rated quality of life in patients with medically unexplained symptoms
Authors:Ivetić, Vojislav (Author)
Pašić, Klemen (Author)
Selič, Polona (Author)
Files:.pdf Zdravstveno_varstvo_2017_Ivetic,_Pasic,_Selic_The_effect_of_an_educational_intervention_in_family_phisicians_on_self-rated_quality_of_li.pdf (955,23 KB)
 
URL http://www.degruyter.com/view/j/sjph.2017.56.issue-2/sjph-2017-0012/sjph-2017-0012.xml
 
Language:English
Work type:Scientific work (r2)
Typology:1.01 - Original Scientific Article
Organization:MF - Faculty of Medicine
Abstract: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.
Keywords:medically unexplained symptoms, family medicine, educational intervention, quality of life, treatment satisfaction, family physician-patient relationship
Year of publishing:2017
Number of pages:str. 91-98
Numbering:št. 2, Letn. 56
ISSN:0351-0026
UDC:614
ISSN on article:0351-0026
COBISS_ID:3764709 Link is opened in a new window
DOI:10.1515/sjph-2017-0012 Link is opened in a new window
NUK URN:URN:SI:UM:DK:R8JJNY0P
License:CC BY-NC-ND 4.0
This work is available under this license: Creative Commons Attribution Non-Commercial No Derivatives 4.0 International
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Record is a part of a journal

Title:Zdravstveno varstvo
Shortened title:Zdr. varst.
Publisher:De Gruyter Open
ISSN:0351-0026
COBISS.SI-ID:3287810 New window

Document is financed by a project

Funder:ARRS - Agencija za raziskovalno dejavnost Republike Slovenije (ARRS)
Project no.:P3-0339
Name:Raziskave na področju javnega zdravja

Secondary language

Language:Slovenian
Title:Vpliv edukativne intervencije zdravnikov na samooceno kakovosti življenja, zadovoljstva z obravnavo in partnerskega odnosa z zdravnikom družinske medicine pri bolnikih z medicinsko nepojasnjenimi stanji
Abstract:Uvod: V družinski medicini so medicinsko nepojasnjena stanja (MNS) pogosta, vendar slabo opredeljena klinična entiteta; od 2,5 do 25% bolnikov, ki obiskujejo zdravnika, se pritožuje zaradi telesnih simptomov, za katere ni mogoče odkriti patofiziološkega vzroka. Namen študije je bil odkriti dejavnike, povezane s samooceno kakovosti življenja pri bolnikih z MNS v povezavi z edukativno intervencijo (EI), ki so ji bili podvrženi zdravniki. Metode:K sodelovanju v multicentrični vzdolžni intervencijski raziskavi, ki je potekala od leta 2012 do leta 2014, je bilo povabljenih 90 zdravnikov družinske medicine, v sodelovanje jih je privolilo 63 (70% ali 7,5% vseh timov družinske medicine v Sloveniji). Po koncu prve faze je bila polovica zdravnikov (32 od 63) povabljena na dvodnevno usposabljanje s področja prepoznavanja in obravnave bolnikov z MNS. Bolniki so pred EI in po njej izpolnjevali vprašalnike o kakovosti življenja, depresiji, anksioznosti, stresu in somatizaciji, hipohondriji, zadovoljstvu in o partnerskem odnosu z zdravnikom. Rezultati: Zdravniki so s sistematičnim vzorčenjem povabili k sodelovanju 1410 bolnikov, v sodelovanje je privolilo 826 (58,58%) bolnikov, od tega 422 z izpolnjenimi kriteriji za MNS: (1) starost (18 do 80 let), (2) zdravnikov sum in (3) izpolnjeni točkovni in klinični kriteriji za MNS (prisotnost simptoma vsaj tri mesece, klinično pomembne težave pri bolniku, nezmožnost razlage simptoma s katerokoli znano telesno boleznijo). Povprečna starost bolnikov je bila 50,35 leta ± 11,49 leta, izstopale so ženske (64,9 %) in osebe z osnovnošolsko (23,7%) in srednješolsko izobrazbo (29,1%). Brezposelnih je bilo 28,9% bolnikov. Bolniki z MNS so po intervenciji izkazovali v povprecju nižjo (skupno) oceno težav in višjo kakovost življenja ter boljše mnenje o partnerskem odnosu z zdravnikom (p<0,05), ne pa razlik v (skupni) oceni zadovoljstva z obravnavo pred intervencijo in po njej (p=0,423). Značilne razlike v simptomih pri bolnikih z MNS pred intervencijo in po njej smo potrdili v primeru stresa, somatizacije in hipohondrije (p<0,05). Zaključki: Edukacija zdravnikov je pri bolnikih z MNS izboljšala samooceno težav z zdravjem in kakovosti življenja, vplivala je na znižanje stopnje simptomov stresa, somatizacije in znižala stopnjo hipohondrije ter izboljšala mnenje bolnikov o partnerskem odnosu z zdravnikom. Do sedaj v Sloveniji MNS kot ena od specifičnih vsebin dela v družinski medicini niso bila dovolj raziskana, tudi pristopi k obravnavi bolnikov z MNS še niso bile oblikovani. Zdravnike bi kazalo opremiti z znanji, veščinami in orodji za zmanjševanje hipohondrije in somatizacije pri bolnikih z MNS, saj bi na ta način tudi izboljšali samooceno zdravja bolnikov.
Keywords:medicinsko nepojasnjena stanja, družinska medicina, edukacijska intervencija, kakovost življenja, zadovoljstvo bolnikov, odnos med družinskim zdravnikom in bolnikom


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