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.
V članku se osredotočamo na izkušnjo doživljanja kronične bolezni in soočanja z njo. Zanimalo nas je, kako se oblikujejo bolnikove strategije soočanja z boleznijo in od katerih dejavnikov je ...odvisen stil prilagajanja bolezni. Opiramo se na rezultate kvantitativne in kvalitativne raziskave bolnikov s kronično revmatično boleznijo. Rezultati raziskave kaežjo, da obstajata različni skupini bolnikov, ki se razlikujeta po stopnji udeležbe v socialnem svetu, po načinu reševanja težav in po prilagoditvi življenjskega stila na bolezen. Naklo- njenost družbenega okolja in empatičen odnos z bližnjimi bistveno pripomorejo k uspešni prilagoditvi bolnika na bolezen.
Uvod. V Sloveniji ima zdravnik družinske medicine pomembno vlogo pri izvajanju preventive. Delež cepljenih proti gripi je v Sloveniji nizek. Razlogi za to niso povsem jasni. Preučevali smo mnenje ...bolnikov glede cepljenja proti gripi pri njihovem družinskem zdravniku ter njihova stališča in prepričanja o gripi in cepljenju. Cilj naloge je bil odkriti dejavnike, ki vplivajo na odločitev o cepljenju v ambulanti družinske medicine.
Objectives. In Slovenia, the role of family physicians in primary care and preventive procedures is very important. Influenza vaccination rates in Slovenia are low. The reasons for low vaccination ...rates in Slovenia were not clear. We suppose that patient’s beliefs and attitudes are important factors. We assessed patients’ opinions regarding the acceptance of flu vaccination by their family physicians and their beliefs and attitudes about flu and vaccination. The aim was to check out factors that influence the decision to take the vaccine in family physician offices.
Methods. This was a cross-sectional, multicenter, observational study in the Styria region in Slovenia. We included patients from seven family physicians during regular office visits. They filled in a questionnaire about their general demographic data and attitudes regarding influenza and vaccination. The main outcome was the decision to be vaccinated.
Results. The logistic regression model identified five predictors for influenza vaccination, namely: heart disease, previous vaccination, an agreement with the beliefs ‘the vaccination is an efficient measure to prevent influenza’, ‘after the vaccination there are usually no important side effects’ and ‘the vaccination is also recommended for a healthy adult person’. The belief that vaccinations harm the immune system is negatively associated with vaccination.
Conclusions. Patients’ beliefs are an important factor to decide for vaccination or not. Family physician teams should discuss with patients their beliefs and concerns about vaccination.
Uvod. V Sloveniji ima zdravnik družinske medicine pomembno vlogo pri izvajanju preventive. Delež cepljenih proti gripi je v Sloveniji nizek. Razlogi za to niso povsem jasni. Preučevali smo mnenje bolnikov glede cepljenja proti gripi pri njihovem družinskem zdravniku ter njihova stališča in prepričanja o gripi in cepljenju. Cilj naloge je bil odkriti dejavnike, ki vplivajo na odločitev o cepljenju v ambulanti družinske medicine.
Metode. Raziskava je bila presečna multicentrična opazovalna. Vključili smo bolnike iz 7 ambulant družinske medicine na Štajerskem v Sloveniji. Vzorec je zajemal bolnike, ki so prišli v ambulanto. Izpolnili so vprašalnik z demografskimi podatki ter stališči o gripi in cepljenju. Glavni opazovani dogodek je bil odločitev za cepljenje.
Rezultati. V logističnem regresijskem modelu so bili najpomembnejši napovedni dejavniki odločitve za cepljenje srčna bolezen, cepljenje v preteklosti, strinjanje, da je cepljenje najbolj učinkovit ukrep proti gripi, strinjanje, da cepljenje običajno nima pomembnih stranskih učinkov, in strinjanje, da je cepljenje priporočljivo tudi za odraslo zdravo osebo. Prepričanje, da cepljenje škodi imunskemu sistemu, je negativni napovedni dejavnik odločitve za cepljenje.
Zaključki. Stališča bolnikov so pomemben dejavnik pri odločitvi za cepljenje. V ambulantah družinske medicine bi se morali z bolniki več pogovarjati o njihovih stališčih in pomislekih o cepljenju.
Objectives. Health-related quality of life (HRQoL) measures a patient’s subjective experience of his or her health status. We aimed to show how the presence of chronic diseases and satisfaction with ...family physicians (FPs) were associated with the HRQoL of a Roma population.
Methods. A cross-sectional study was carried out in May 2011 on a representative sample of 650 Roma living in Prekmurje, Slovenia. The EQ-5D questionnaire was used for measuring the HRQoL of the Roma. Demographical data, 12 groups of diseases diagnosed in the last 12 months and satisfaction with FPs were included in the questionnaire.
Results. The response rate was 88.3% (574), of which 56.4% were female, and the average age of the participants had a mean value of 40.2±12.7 years. The presence of cardiovascular problems with risk factors for them or presence of musculoskeletal disorders were strongly associated with the presence of pain (Cramer’s V = 0.40 and 0.46 respectively).There was a strong association between the presence of mental disorders and anxiety and depression (Cramer´s V = 0.58). The average satisfaction with the family physician was 3.9 (mean±1.10) on a five-point Likert scale. There was no significant association between HRQoL and satisfaction with the family physician.
Conclusions. Roma with chronic mental health problems had the lowest HRQoL in the Roma population. More attention should be paid to this subgroup of Roma in family medicine, and interventions should be provided. High satisfaction with their FPs is not associated with the observed quality of life variables
Uvod. Z zdravjem povezana kakovost življenja (HRQoL) je odraz pacientove subjektivne ocene lastnega zdravstvenega stanja. V naši raziskavi smo skušali ugotoviti, kakšen je vpliv nekaterih kroničnih bolezni in zadovoljstva z izbranim zdravnikom na HRQoL med romskim prebivalstvom.
Metode. Maja 2011 smo izvedli presečno raziskavo v reprezentativnem vzorcu 650 pomurskih Romov. HRQoL smo merili z vprašalnikom EQ-5D; vključili smo še demografske podatke, zadovoljstvo z izbranim družinskim zdravnikom in 12 bolezenskih stanj, ki so bila diagnosticirana v zadnjih 12 mesecih.
Rezultati. Odzivnost je bila 88,3-odstotna (574), 56,4 % je bilo žensk in povprečna starost sodelujočih je bila 40,2 +/- 12,7 leta. Nizek HRQoL v skupini s srčno-žilnimi boleznimi z dejavniki tveganja zanje in kostnomišičnimi boleznimi je bil močno povezan s prisotnostjo bolečine (Cramer z V = 0,40 in 0,46). V skupini z duševnimi težavami pa je bila močna povezava nizkega HRQoL s prisotnimi znaki anksioznosti in depresije (Cramer z V = 0,58). Povprečno zadovoljstvo z zdravnikom družinske medicine je bilo 3,9 (mediana +/- 1,10) na pettočkovni Likertovi lestvici. Ni bilo statistične povezave med HRQoL in zadovoljstvom z zdravnikom družinske medicine.
Zaključki. Romi s prisotnostjo duševnih težav imajo najnižji HRQoL v romskem prebivalstvu. Več pozornosti bi v družinski medicini morali posvetiti tej podskupini Romov. Zadovoljstvo z zdravnikom družinske medicine ni povezano z opazovanimi spremenljivkami kakovosti življenja
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