Healthcare systems collect little information about the experiences and outcomes of care from the perspectives of patients. Patient Reported Indicator Surveys (PaRIS) is an OECD initiative to measure ...the outcomes and experiences of people living with chronic conditions, who are managed in primary care.
To evaluate the feasibility of the methodology employed in the Field Trial of the PaRIS survey in Slovenia and propose adjustments to enhance sampling in the Main Survey.
In 2022, we conducted a cross-sectional observational study in 50 family medicine practices in Slovenia with a target of recruiting 70 patients per practice. We used the Slovenian version of the PaRIS questionnaires, and evaluated sampling and data collection.
The sample contained 21 providers (42.0% response rate) and 454 patients (50.7% response rate). The provider sample did not differ from the population characteristics, while the patient sample differed significantly from the patient population. All providers completed the survey online, in 20.9±11.1 minutes and had 1.5±1.5 restarts. Most patients (74.9%) completed the survey online and needed 36.0±22.6 minutes, and the mean number of restarts was 1.4±2.2.
Based on the results, we recommend conducting a methodology test for quality assessment studies before initiating the main survey. Legal issues should be addressed and considered early when developing the methodology. It is also necessary to be aware of the feasibility of the study in practice, to avoid a low participation rate.
Institucionalna igra moči Sedmak, Mateja; Medarić, Zorana
Javnost (Ljubljana, Slovenia),
12/10/2018, 2018-12-10, Letnik:
25, Številka:
sup1
Journal Article
Recenzirano
Prispevek obravnava izkušnjo nasilja migrantk v okviru zdravstvenega sistema, natančneje na področju spolnega in reproduktivnega zdravja. Osredotoča se na institucionalno nasilje v obliki ...diskriminatornih praks, omejitev v dostopu do pravic, kršenja pravic, zlorabe moči zdravstvenega osebja in drugo. Rezultati kvalitativne študije, izvedene med zdravstvenim osebjem in migrantkami na območju treh obalnih občin, izpostavijo obstoj diskriminacije, nesprejemanje drugačnih kulturnih praks ravnanja in omejitve v dostopu do ustrezne zdravstvene obravnave. Pri tem so ključni komunikacijski izzivi, ki izvirajo iz nepoznavanja slovenskega jezika, (posledično) slaba informiranost migrantk ter otežen dostop do (ustreznih) zdravstvenih storitev. Problematično je tudi pomanjkanje medkulturnih kompetenc zdravstvenega osebja in primanjkljaj sistemskih rešitev na področju spolnega in reproduktivnega zdravja, ki bi naslavljale migrantke.
U radu se iznose socijalnomedicinski aspekti analize zagrebačke stambene bijede između dva rata na temelju sačuvane zbirke fotografija iz ostavštine Vladimira Ćepulića (1891. – 1964.), jednog od ...predsjednika Hrvatskoga liječničkog zbora (1935. – 1945.). Navedena zbirka koja sadržava 13 fotografija danas se nalazi u Hrvatskome muzeju medicine i farmacije Hrvatske akademije znanosti i umjetnosti, a poslužila je kao polazište u razmatranju pojavnosti socijalne fotografije na području Hrvatske, ali i socijalne medicine / patologije, s osobitim naglaskom na tuberkulozu početkom 20. stoljeća. Istaknuta je njezina rana pojavnost kao dosad nezapaženi segment socijalne fotografije u Hrvatskoj te njezina muzeološka vrijednost kao akvizicije prvog Muzeja za povijest zdravstva koji je osnovan 1944. u Zagrebu pri Hrvatskome liječničkom zboru.
SAŽETAK
Rad donosi analizu okolnosti pojave prvih eugeničkih rasprava na području Hrvatske od kraja devetnaestog stoljeća do 1918. godine. Na temelju uvida u radove objavljene u Liječničkom vjesniku ...pokazalo se da se eugenička razmatranja najčešće pojavljuju u liječničkim raspravama o tzv. socijalnim bolestima (tuberkuloza, sifilis, alkoholizam), a u kontekstu tada aktualnih javnozdravstvenih politika. Hrvatski su liječnici, slijedeći Lamarckovu pretpostavku o nasljeđivanju stečenih svojstava, vjerovali da se poboljšanjem socijalno-higijenskih uvjeta i edukacijom, ali i prisilnim mjerama poput zabrane braka može utjecati na zdravlje nasljednog materijala te time spriječiti degeneracija naroda. Njihova su polazišta individualnog karaktera i nisu dovela do utemeljenja eugeničkih društava ili razrađenih eugeničkih programa, no utjecala su na ranu institucionalizaciju hrvatske medicine. Eugeničke koncepcije koje inzistiraju na nacionalnom prosperitetu putem biološkog osnaženja nadovezivale su se na južnoslavenski politički projekt te retorički, simbolički i ideološki oponirale Habsburškoj monarhiji.
The plague epidemics that ravaged the Habsburg Monarchy from 1677 to 1716 strongly influenced the development of health institutions and the organization of a public health system. Primarily, there ...was a need to employ a larger number of educated medical doctors and to establish institutions that would deal with health and epidemiological issues, especially during the epidemics. In 1710, Emperor Joseph I established the Court Sanitary Commission (Sanitäts-Hofkommission), which would soon become the central public health institution in the Habsburg Monarchy. Research of historical documents has shown that two other institutions were especially important for the Croatian-Slavonian lands during the epidemic of 1708-1716: the Court War Council in Vienna, and from 1710 the Hauptdeputation in Contagionssachen in Graz. It is evident from the mentioned documents that the Deputation, as the main (Haupt-) Inner Austrian anti-epidemic institution, also coordinated the anti-epidemic activities in Banal Croatia and the Varaždin Generalate. The plague epidemic in the Habsburg Monarchy from 1708 to 1716 is very important in this sense, because the experience and structure of the anti-epidemic system built at that time were the basis for the establishment of a later permanent system of Sanitary Commissions and Sanitary Cordon, which began in the 1730s and was fully formed with the enactment of the General Health Act (Generale Normativum in Re Sanitatis) in 1770. These experiences proved to be especially useful for Banal Croatia, which was not affected by the plague epidemic of 1708-1716 due to the anti-epidemic measures.
Pandemija COVID-19 otvorila je neka nova pitanja u pružanju zdravstvene zaštite na koja je nužno odgovoriti u suočavanju s ovom pandemijom. Kako se pandemija COVID-19 javila u razdoblju poštivanja ...„ljudskih prava“, u ovom članku uspoređujemo odredbe koje se tiču zaštite zdravlja te ograničavanje prava dviju ranjivih kategorija, osoba s duševnim smetnjama i osoba za koje postoji sumnja da boluju ili boluju od zaraznih bolesti, budući da se radi o kategorijama osoba čija sloboda može biti ograničena bez njihove volje u određenim slučajevima. Članak ukazuje na nedorečenosti Zakona o zaštiti pučanstva od zaraznih bolesti vezano uz (sudsku) kontrolu izrečenih sigurnosnih mjera, poglavito u usporedbi sa Zakonom o zaštiti osoba s duševnim smetnjama. U zaključku navodimo možebitna rješenja uočenih nedorečenosti. Autori analiziraju pravnu zaštitu navedenih kategorija osoba u odnosu na ostvarivanje njihovog prava na zdravlje i u kontekstu čl. 16 Ustava RH koji omogućuje ograničavanje prava i sloboda da bi se zaštitila sloboda i prava drugih ljudi, pravni poredak, javni moral i zdravlje, što mora biti razmjerno naravi potrebe za ograničavanjem.
Zgodnja diagnostika, nove terapevtske možnosti in uspešnejše zdravljenje raka so pripomogli tudi k temu, da se lahko večji delež bolnikov po zdravljenju raka vsaj deloma, če ne v celoti, vrne na ...delo. Za izvajalce zdravstvene oskrbe pomeni vrnitev na delo uspešen zaključek rehabilitacije, za bolnike in njihove bližnje pa boljšo kakovost življenja. Avtorica članka na primeru začasne nezmožnosti za delo bolnice z rakom dojke predstavlja vračanje na delo po procesu zdravljenja in rehabilitacije. V zaključku razmišlja o tem, kaj je pomembno za terapevta in bolnika po zdravljenju raka.
Lung cancer is the leading cause of cancer death, with wide variations in national survival rates. This study compares primary care system factors and primary care practitioners' (PCPs') clinical ...decision-making for a vignette of a patient that could have lung cancer in five Balkan region countries (Slovenia, Croatia, Bulgaria, Greece, Romania).
PCPs participated in an online questionnaire that asked for demographic data, practice characteristics, and information on health system factors. Participants were also asked to make clinical decisions in a vignette of a patient with possible lung cancer.
The survey was completed by 475 PCPs. There were significant national differences in PCPs' direct access to investigations, particularly to advanced imaging. PCPs from Bulgaria, Greece, and Romania were more likely to organise relevant investigations. The highest specialist referral rates were in Bulgaria and Romania. PCPs in Bulgaria were less likely to have access to clinical guidelines, and PCPs from Slovenia and Croatia were more likely to have access to a cancer fast-track specialist appointment system. The PCPs' country had a significant effect on their likelihood of investigating or referring the patient.
There are large differences between Balkan region countries in PCPs' levels of direct access to investigations. When faced with a vignette of a patient with the possibility of having lung cancer, their investigation and referral rates vary considerably. To reduce diagnostic delay in lung cancer, direct PCP access to advanced imaging, availability of relevant clinical guidelines, and fast-track referral systems are needed.
In this article, the author examines the appearance of plague epidemics in the Dalmatian commune of Šibenik in the late medieval period, from the Black Death in 1348 until the end of the fifteenth ...century. The analysis is based on the research of data from Šibenik’s statutory law – statutory decrees and later added novels (reformationes) – of the diplomatic relations and commissions between the Venetian central authorities and the commune of Šibenik, and of various communal published and unpublished sources. Yet, the most valuable data are the communal notary records, primarily last wills and inventories of goods, which enable the punctual examination of places where the plague epidemics raged in certain periods (villages, city, islands in the district). Last wills and inventories of goods are extremely valuable in establishing the beginning and ending of plague epidemics because they contain data on the dates of recording the wills, the death of testators, and the composing of inventories. These sources also allow us to examine the duration of plague epidemics. Thus, we know that some plague epidemics in the commune of Šibenik lasted for several months while others raged for one or even two years. The research has shown that the outbreaks of plague epidemics occurred much more frequently than has been hitherto assumed, either in the city of Šibenik or in the villages of its densely populated district. In any case, the research has shown that plague epidemic in the fifteenth-century commune of Šibenik appeared much more frequent than it has been considered until now. The author also discusses the health protection measures undertaken by the central Venetian and communal Šibenik authorities to prevent the spreading of plague epidemics, particularly within the city walls. The sources, especially last wills and inventories of goods, but also some other types of notary deeds, statutory law and its novels, as well as the ducales issued by the central Venetian government and decrees issued by the communal authorities, clearly show that the commune of Šibenik implemented the same healthy, medical, and hygiene measures available at the time as other European urban-rural societies. Deceased persons, as well as members of their nuclear families, were immediately put into isolation outside the city walls and situated in empty houses in the surrounding villages. The communal authorities, patricians, rich merchants, and members of clergy likewise found refugee in villages within the communal district or in their houses and palaces on communal islands.
Tijekom istraživanja povijesti zdravstva grada Bjelovara pronađeni su podatci o šesnaest liječnika Židova koji su radili u Bjelovaru tijekom 19. i 20. stoljeća. Neki od njih čitav su radni vijek ...proveli u Bjelovaru (primjerice dr. Herman Fischer, dr. Dragutin Ländler, dr. Bela Milhofer), dok su neki radili kraće ili dulje vrijeme kao privatni, bolnički, kotarski ili vojni liječnici prema tadašnjem ustrojstvu zdravstvene skrbi i nastavili karijere diljem svijeta. Medicinski i povijesni izvori govore o njihovu djelovanju i trajnoj ostavštini za bjelovarsko zdravstvo i kulturu, što se inače rijetko spominje u postojećoj literaturi.