Uvod: Telemedicinska obravnava stopa v ospredje kot strategija za obvladovanje kroničnih nenalezljivih bolezni, ki v Sloveniji povzročijo visok delež smrti. Namen raziskave je bil preučiti, kakšne ...izkušnje imajo pacienti z diagnozo kronične bolezni tako z uporabo telemedicinske opreme kot s telemedicinsko obravnavo v ambulanti družinske medicine. Metode: Julija 2020 so bile v enem od slovenskih zdravstvenih domov izvedene štiri fokusne skupine z 19 pacienti s sladkorno boleznijo tipa 2 in/ali visokim krvnim tlakom. Prepisi skupinskih pogovorov so bili analizirani po načelih induktivne tematske analize. Rezultati: S pomočjo induktivne tematske analize je bilo oblikovanih sedem tem: prednosti in slabosti telemedicinske obravnave, enostavnost uporabe telemedicinske opreme, dvosmerna komunikacija z zdravstvenim osebjem, učinki telemedicinske obravnave na zdravstveno stanje pacientov, želja po uporabi in dostopnosti telemedicinske obravnave, vpliv in opora okolja ter skrb za lastno zdravje. Teme vsebujejo 10 podtem in 29 dejavnikov. Diskusija in zaključek: Na izvajanje telemedicinskih meritev najbolj vplivajo zaznana potreba pacientov in navodila zdravstvenega osebja. Kljub pozitivni izkušnji pacientov z uporabo telemedicinske opreme je potrebna strokovna presoja primernosti tovrstne obravnave na individualni ravni, ki ne vključuje le zdravstvenega stanja pacientov, marveč tudi oceno njihovega odnosa do zdravja in digitalnih veščin.
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Osnovna zdravstvena dejavnost in z njo družinska medicina predstavljata temelj vsakega zdravstvenega sistema. V Sloveniji imamo sistem osnovne zdravstvene dejavnosti, ki je konceptualno priznan kot ...zelo dober s strani mednarodnih strokovnjakov in organizacij. Ob tem se soočamo z resnimi kritikami in težavami. Prispevek predstavlja pregled izzivov, s katerimi se sooča družinska medicina v Sloveniji zdaj. V devetih točkah so zbrani predlogi ukrepov, ki bi jih bilo potrebno izpolniti, če želimo, da se stanje na področju družinske medicine izboljša.
Type 2 diabetes (T2D) and arterial hypertension (AH) are among the greatest challenges facing health systems worldwide and require comprehensive patient-centred care. The key to successful management ...in chronic patients is self-management support, which was found to be only weakly implemented in Slovenia. The aim of the study is to develop an evidence-based model of peer support for people with T2D and AH at the primary healthcare level in Slovenia, which could represent a potential solution for upgrading integrated care for these patients.
A prospective interventional, mixed-methods pilot study will begin by recruiting approximately 40 eligible people with T2D and AH through purposive sampling. The participants will receive structured training, led by a specialist nurse, to become trained peer supporters. Each will voluntarily share their knowledge and experience at monthly group meetings with up to 10 people with T2D and AH over a three-month period in the local community. Data will be collected through interviews and focus groups and questionnaires about socio-demographic and clinical data, knowledge about T2D and AH, participants' quality of life, level of empowerment and acceptability of the intervention.
The study will provide an evidence-based model for integrating peer support into the local community. It is expected that the intervention will prove feasible and acceptable with educational, psychosocial and behavioural benefits.
Peer support through empowerment of people with T2D and AH, family members and other informal caregivers in the local community could scale-up the integrated care continuum and contribute to sustainability of the healthcare system.
Uvod: Vse pogosteje zaznavamo različne težave z načinom prehranjevanja pri otrocih. Otroci med 10. in 14. letom intenzivno rastejo in se razvijajo. Namen raziskave je bil ugotoviti vpliv izbirčnosti ...v prehrani otrok na njihovo prehranjenost v omenjeni starosti.Metode: Uporabljena je bila presečna opisna raziskava. Zajet je bil priložnostni vzorec osnovnošolcev zadnjega triletja. V raziskavi je sodelovalo 62 (49,2 %) učencev moškega in 64 (50,8 %) učencev ženskega spola zadnjega triletja ene izmed osnovnih šol v Sloveniji. Za zbiranje podatkov smo uporabili anketni vprašalnik, pridobili pa smo tudi podatke o telesni masi in višini. Uporabili smo opisno in sklepno statistiko (dvostranski test ANOVA).Rezultati: 37 (53,6 %) deklet in 28 (44,4 %) fantov je trdilo, da so izbirčni. Z dvostranskim testom ANOVA smo ugotovili, da obstaja povezava med izbirčnostjo in prehranjenostjo (p = 0,014). Pri dekletih je vidno večje odstopanje od prehranjenosti kot pri fantih.Diskusija in zaključek: Izbirčno prehranjevanje je v današnjem času zelo pogost problem, saj se je v njem prepoznala skoraj polovica vključenih učencev. Izbirčnost ima lahko negativne posledice v odrasli dobi. V starosti 10–14 let se ustvarjajo prehranjevalne navade, ki so lahko prisotne celotno življenje, zato je bistveno, da delujemo preventivno in s tem preprečimo negativne posledice. V prihodnosti bi bilo treba raziskovanje usmeriti v preventivne dejavnosti in promocijo zdravega prehranjevanja.
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The introduction of interprofessional primary care (IPC) as a model of collaborative patient care is increasingly vital in the context of complex healthcare systems and the growing needs of patients. ...Its benefits include improved patient outcomes, enhanced efficiency, and reduced costs. However, the successful implementation of IPC faces challenges due to the differences in training and backgrounds among healthcare professionals, emphasising the importance of effective teamwork and collaborative education.
Educational approaches utilising simulations have gained prominence, particularly in addressing the challenges of interprofessional primary care. Notably, simulations facilitate team learning, enhancing team management and confidence, which ultimately leads to improved performance in real-life scenarios. They also contribute to patient safety by providing comprehensive training and creating a safe environment for professionals to practice and refine their skills without risking real patient harm.
Moreover, simulations promote psychological safety, allowing healthcare workers to manage stress effectively and prepare for critical situations. Ethical considerations are met through simulation-based education, ensuring patient confidentiality, and creating a standardised and just learning environment for all students. Simulations contribute to promoting equity in medical education by providing equal access to high-quality training opportunities for all healthcare professionals.
In conclusion, successful IPC implementation requires a comprehensive approach that includes interprofessional education and the integration of simulations as an essential component of the curriculum at all levels of healthcare education. This approach fosters effective communication, teamwork, and confidence among primary care teams, ultimately leading to improved patient care and outcomes.
Patient safety is a crucial element of quality healthcare, and endeavours to enhance it are vital for attaining universal health coverage and improving patient outcomes. This study aimed to evaluate ...the perception of patient safety culture among staff at the Community Health Centre Ljubljana (CHCL).
A cross-sectional study was conducted in December 2022. All CHCL staff (N=1,564) from different professional groups were invited to participate in an anonymous electronic survey using the validated Slovenian version of the "Medical Office Survey on Patient Safety Culture" (MOSPSC). Mean percent positive scores for all items in each composite were calculated.
The final sample included 377 participants (response rate, 24.1%), most of whom were women (91.5%, N=345) with different professional profiles. The mean age of the participants was 44.5 years (SD 11.1) with a mean work experience of 20.1 years (SD 12.1). The percentage of positive overall MOSPSC composite scores was 59.6%. A strong patient safety culture perception was identified in the following dimensions: Information exchange with other settings (93.5%), Organisational learning (90.2%), List of patient safety and quality issues (88.1%), Patient care tracking/follow-up (76.2 %) and Teamwork (75.0%). Weak patient safety culture was identified in the dimensions of Work pressure and pace (10.7%), Leadership support for patient safety (27.1%), Communication openness (40.9%), Office processes and standardisation (48.2%) and Overall ratings on quality and patient safety (49.4%).
CHCL leadership should address weaknesses, redesign processes, and implement strategies to reduce patient safety incidents. Establishing a just culture that encourages employees to report errors fosters transparency and facilitates learning from errors.
Curricula are reviewed and adapted in response to a perceived need to improve interprofessional collaboration for the benefit of patient care. In 2005, the module Interprofessional Collaboration in ...Healthcare (IPCIHC) was developed by the Antwerp University Association (AUHA). The program was based upon a concept of five steps to IPCIHC. This educational module aims to help graduates obtain the competence of interprofessional collaborators in health care.
Over a span of 15 years, the IPCIHC module is evaluated annually by students and provided with feedback by the tutors and steering committee. Data up to 2014 were supplemented with data up to 2019. For the students the same evaluative one-group, post-test design was used to gather data using a structured questionnaire. The tutors' and students' feedback was thematically analyzed.
Based upon the results and the contextual changing needs, the program was adjusted. Between 2005 and 2019, a total of 8616 evaluations were received (response rate: 78%). Eighty percent of the respondents indicated through the evaluations that they were convinced of the positive effect of the IPCIHC module on their interprofessional development. Over the years, two more disciplines enrolled into this program and also education programs form the Netherlands.
After 15 years, positive outcomes are showed, and future health professionals have a better understanding of interprofessional learning. Gathering feedback and annually evaluation helped to provide a targeted interprofessional program addressing contextual changes. The challenge remains to keep on educating future healthcare providers in interprofessional collaboration in order to achieve an increase in observable interprofessional behaviour towards other professional groups.
Climate change is one of the biggest threats to public health. Sustainability is characterized by using resources wisely in a way that protects finite resources and the environment, and takes into ...account the needs of our planets’ inhabitants in the future. Sustainability in health care should be considered as a seventh domain of quality, as it can lead to improvement of patient outcomes, and more capacity for health care workers to engage in quality improvement and thereby improve the quality of care.
The carbon footprint of primary care is high, mainly due to prescribing medication, but also due to the transport of patients to hospitals and primary care services for interventions requested by family medicine. Other causes are the transport of staff and supplies, consumables and staff involved in laboratory analysis and radiation, medical and non-medical equipment, clinical and non-clinical waste, heating and cooling systems and other activities. Small adjustments in these areas could significantly decrease the carbon footprint of primary care practices. The suggested steps for primary care to achieve a more sustainable practice are fostering research, raising awareness, reducing the burden on primary care, engaging in quality improvement, and leadership and advocacy.
Each individual primary care practice has the potential to be a leader and role model for sustainable health care. With the implementation of interventions to reduce carbon footprints, primary care could set an example within the health sector and for patients. This could significantly raise the awareness of the public about the need to take actions for a greener health system.
Although the concept of integrated care for non-communicable diseases was introduced at the primary level to move from disease-centered to patient-centered care, it has only been partially ...implemented in European countries. The aim of this study was to identify and compare identified facilitators and barriers to scale-up this concept between Slovenia and Belgium.
This was a qualitative study. Fifteen focus groups and fifty-one semi-structured interviews were conducted with stakeholders at the micro, meso and macro levels. In addition, data from two previously published studies were used for the analysis. Data collection and analysis was initially conducted at country level. Finally, the data was evaluated by a cross-country team to assess similarities and differences between countries.
Four topics were identified in the study: patient-centered care, teamwork, coordination of care and task delegation. Despite the different contexts, true teamwork and patient-centered care are limited in both countries by hierarchies and a very heavily skewed medical approach. The organization of primary healthcare in Slovenia probably facilitates the coordination of care, which is not the case in Belgium. The financing and organization of primary practices in Belgium was identified as a barrier to the implementation of task delegation between health professionals.
This study allowed formulating some important concepts for future healthcare for non-communicable diseases at the level of primary healthcare. The results could provide useful insights for other countries with similar health systems.
For the purpose of celebrating the 40th anniversary of Alma Ata declaration, the WHO published a successful model of integrated patient care being performed in Slovenia. After two years, the WHO ...experts evaluated the success in practise during a visit to the Slovenian primary care environment. This report showed that Slovenia was a notable exception regarding developing effective primary care systems. The country has an impressive primary care which performs very well.