Clinical dietitians play a crucial role in the nutritional support of patients at risk of malnutrition in primary care settings. The study aimed to evaluate the effect of an individualized ...nutritional intervention on clinically relevant outcomes for patients with chronic disease at nutritional risk.
A longitudinal evaluation study was conducted in two Slovenian primary health centres. We used pre-test and post-test design. Patients with chronic disease were screened using the Malnutrition Universal Screening Tool and additional risk factors (≥70 years and BMI <22 kg/m
; lower food intake in the last five days). Patients at nutritional risk were referred to a clinical dietitian for individual nutritional intervention. The effect of the nutritional intervention was assessed six months after the patients' first visit with a clinical dietitian.
The sample included 94 patients. Nutritional risk was reduced significantly in high-risk and moderate-risk patients. In a subgroup of patients with a MUST score ≥1 (77 patients), body weight, BMI, Fat-Free Mass Index (FFMI), energy intake, and protein intake increased significantly (p<0.001). At the same time, the phase angle significantly increased (p<0.001), but there were no statistically significant changes in the improvement of grip strength. In a subgroup of patients with MUST score 0 (17 patients), we observed an increase in their median daily energy intake (p<0.001) and median protein intake (p=0.003).
Nutritional intervention delivered by a clinical dietitian improved patients' nutritional intake and nutritional and functional status.
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.
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.
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.
Namen raziskave je bil določiti prevalence depresije med delovno aktivno populacijo in odkriti morebitne dejavnike, povezane z večjo prevalence depresije. Izvedli smo multicentrično presečno opazovalno raziskavo v ambulantah medicine dela, prometa in športa v treh večjih zdravstvenih domovih v Sloveniji. Opazovana populacija je bila sestavljena iz zaporednih obiskov delavcev, ki so prišli na redni preventivni pregled od novembra 2010 do junija 2012. Podatke smo zbirali s pomočjo vprašalnika, depresijo pa smo ugotavljali na podlagi Zungovega vprašalnika. V vzorcu je bilo 1.474 (73,7 %) posameznikov, od katerih je bilo 889 (60,3 %) moških. Povprečna starost vzorca je bila (40,5±9,8) let. V vzorcu je bilo 590 (3,4 %) posameznikov z depresijo. V multivariatni analizi so bile naslednje spremenljivke neodvisno povezane s prisotnostjo depresije: izpostavljenost stresu, pozitivna družinska anamneza depresije in osnovnošolska izobrazba.
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