In order to achieve a high standard in training programmes for future family medicine specialists, it is essential to have good tutors with well-organised family medicine practices. Proper working ...conditions for young doctors are essential for their satisfaction and future professional development. The aim of our study was to check the current working conditions of family medicine trainees in the practical modular part of the training programme in Slovenia, and to determine their satisfaction with working conditions.
A cross-sectional study was conducted. The data was collected through a questionnaire distributed to 105 family medicine trainees undergoing the practical modular part of their training programme.
The study showed that the following 7 out of 25 organisational and labour law factors are significantly associated with a trainee's general satisfaction with working conditions: the location where work with patients takes place, the privacy of the premises, the accessibility of the main tutor, a constant patient population, suitable places for rest, paid out-of-hours substitutions, and appropriate pay grade.
The results we obtained can be used to address certain aspects of trainees' working conditions in Slovenia that need improvement. By determining which working conditions significantly affect a trainee's satisfaction, we have the opportunity to modify these conditions and thereby improve the training programme. This could result in a less stressful and more efficient residency programme.
Primary care physicians use various tools and methods to identify medically unexplained symptoms (MUS). The main purpose of our study is to determine the views of Slovenian family medicine trainees ...(FMT) about using the "Careful Assessment" tool for managing patients with MUS.
A qualitative study using open survey questions focused on the experience of family medicine trainees in managing patients with MUS. The sample consisted of surveys from 184 family medicine trainees. These trainees analysed a total of 702 patients with MUS. Manual coding was used for quantitative content analysis.
In the coding process, 49 codes were developed that included broader research fields about using the "Careful Assessment" tool for managing patients with MUS. The codes were grouped into four theoretically grounded, logical categories in accordance with the elaborated theoretical concept: multi-purpose utility; improved patient management; in-depth knowledge and new skills; and patient response.
The study demonstrated that, in the view of Slovenian FMT, the "Careful Assessment" tool has multi-purpose utility. The study showed that FMT felt that this tool helps them in systematic patient management. Their opinion is that it helps them establish a trusting relationship with patients, which is a precondition for providing further treatment.
Patient safety is one of the key aspects of healthcare quality and a serious global public health concern. Patient safety culture is a part of the patient safety concept. In Slovenia, primary care is ...easily accessible, and for medical care, it serves as a gatekeeper to hospital care. For several years, the quality and safety at the primary healthcare level have been the focus of several studies. The present study aimed to assess patient safety culture among all employees of the Community Health Centre Ljubljana.
We conducted a cross-sectional study in 2017 using the Slovene version of "Medical Office Survey on Patient Safety Culture" from the Agency for Healthcare Research and Quality. Mean percent positive scores on all items in each composite were calculated according to a user guide.
The final sample contained 1021 participants (67.8% response rate), of which 909 (89.0%) were women. The mean age of the sample was 43.0±11.0 years. The dimensions most highly rated by the respondents were: teamwork and patient care tracking/follow-up. The lowest scores came from leadership support for patients' safety and work pressure and pace.
Patient safety culture in the Community Health Centre Ljubljana is high, but there are certain areas of patient safety that need to be evaluated further and improved. Our study revealed differences between professions, indicating that a customized approach per profession group might contribute to the successful implementation of safety strategies. Patient safety culture should be studied at national levels.
There is a gap in our knowledge of health-related quality of life (HRQoL) in a population presumed healthy, so this study aimed to assess the associations between HRQoL, demographics and clinical ...variables.
The participants were attendees, presumed healthy, at 40 pre-selected model family medicine practices (MFMPs), aged between 30 and 65 years and recruited during a preventive check-up in 2019. Each MFMP pragmatically invited 30 attendees to voluntarily participate. The EQ-5D questionnaire was administered as a measure of HRQoL; the independent variables were demographic characteristics, smoking, alcohol consumption, stress perception, physical activity, signs of depression, cardiovascular risk, body mass index, blood pressure values, and blood sugar and lipidogram laboratory test values. Ordinal logistic regression was used to calculate associations between self-assessed quality of life, demographics, and clinical variables, with P<0.05 set as statistically significant.
Of 986 participants, 640 (64.9%) were women and 346 (35.1%) men, aged 42.7±8.6 years. The average values for the EQ-5D-3L were 0.91±0.15. In the multivariate model, a positive association between adequate physical activity (p=0.003), and a negative association between higher age (p<0.001), female gender (p=0.009), signs of depression (p<0.001), stress (p=0.013), and EQ-5D score were identified.
Given that physical activity was shown to be positively associated with HRQoL, it is of the utmost importance for family physicians to motivate their middle-aged patients, especially women and those with signs of depression and excessive stress, to adopt a more rigorously physically active lifestyle.
The Safety Attitudes Questionnaire (SAQ) is among the most frequently cited tools for measuring safety culture in healthcare settings. Its ambulatory version was used in this study. The aim was to ...assess safety culture in out-of-hours (OOH) family medicine service and its variation across job positions, regions, and respondents' demographic characteristic.
A cross-sectional observational study was carried out targeting 358 health professionals working in the 29 largest Croatian healthcare centres providing out-of-hours family medicine service. The response rate was 51.7% (185 questionnaires). The questionnaire comprised 62 Likert items with 5 responses (fully disagree to fully agree). Scores of negatively worded items were reversed before analysis. Scores on the total scale and subscales were calculated as additive scores. The study included demographic data on gender, age, working experience, and job position. Repeated measurement analysis of variance was used to assess variation of Safety Attitudes Questionnaire - Ambulatory Version (SAQ-AV) sub-scales.
Nurses assessed safety culture higher than did physicians and residents. Teamwork climate had higher scores than Ambulatory process of care and Organizational climate. Stress recognition and Perceptions of workload had the lowest overall scores. Variation across gender, age, working experience, and region was not statistically significant.
SAQ-AV can be used to identify areas for improvement in patient safety at OOH GPs. There is a need to improve staffing and support for OOH GP residents. Further research is needed in order to gain better understanding of factors influencing observed variations among job positions.
Family history (FH) is an important part of the patients' medical history during preventive management at model family medicine practices (MFMP). It currently includes a one (or two) generational ...inquiry, predominately in terms of cardiovascular diseases, arterial hypertension, and diabetes, but not of other diseases with a probable genetic aetiology. Beside family history, no application-based algorithm is available to determine the risk level for specific chronic diseases in Slovenia.
A web application-based algorithm aimed at determining the risk level for selected monogenic and polygenic diseases will be developed. The data will be collected in MFMP; approximately 40 overall with a sample including healthy preventive examination attendees (approximately 1,000). Demographic data, a three-generational FH, a medical history of acquired and congenital risk factors for the selected diseases, and other important clinical factors will be documented.
The results will be validated by a clinical genetic approach based on family pedigrees and the next-generation genetic sequencing method. After the risk of genetic diseases in the Slovenian population has been determined, clinical pathways for acting according to the assessed risk level will be prepared.
By means of a public health tool providing an assessment of family predisposition, a contribution to the effective identification of people at increased risk of the selected monogenic and polygenic diseases is expected, lessening a significant public health burden.
Study aimed to assess the burnout prevalence and level of empathic attitude in family medicine doctors (FMDs) and its associations with demographic factors, working conditions and physician health, ...using the Jefferson Scale of Empathy - Health Professional version (JSE-HP).
Slovenian FMDs (n=316, response rate 56%) completed an online socio-demographic questionnaire, with questions on working conditions, physician health, and the Slovenian versions of the Maslach Burnout Inventory (MBI) and the JSE-HP. Univariate and multivariate analyses were used, applying linear regression to calculate associations between demographic variables, factors of empathy and burnout dimensions, P<0.05 was set as a limit of statistical significance.
Of the 316 participants, aged 40±10.2 years, 57 (18%) were men. The FMDs achieved mean scores on the JSE-HP (JSE
of 112.8±10.2 and on the MBI 27.8±11.6 for EE, 10.8±5.5 for D and 33.5±6.0 for PA. High burnout was reported in one dimension by 24.8% of participants, in two by 17.2%, and by 6% in all three dimensions. Multivariate analysis revealed a higher EE and D and lower PA in specialists as opposed to trainees. Higher EE was also identified in older physicians having longer work experience, working in a rural setting, dealing with more than 40 patients/day and having a chronic illness. The latter was also associated with higher JSE
. JSE
was negatively associated with D, while PA was positively associated with JSE
and Perspective Taking.
The incidence of burnout warns both physicians and decision-makers against too heavy workload, especially in older professionals.
Telemonitoring and web-based interventions are increasingly used in primary-care practices in many countries for more effective management of patients with diabetes mellitus (DM). A new approach in ...treating patients with diabetes mellitus in family practices, based on ICT use and nurse practitioners, has been introduced and evaluated in this study.
Fifteen Slovene family practices enrolled 120 DM patients treated only with a diet regime and/or tablets into the study. 58 of them were included into the interventional group, and the other 62 DM patients into the control group, within one-year-long interventional, randomised controlled trial. Patients in the control group had conventional care for DM according to Slovenian professional guidelines, while the patients in the interventional group were using also the eDiabetes application. Patients were randomised through a balanced randomisation process.
Significant reductions of glycated haemoglobin (HbA1c) values were found after 6 and 12 months among patients using this eDiabetes application (p<0.05). Among these patients, a significant correlation was also found between self-monitored blood pressure and the final HbA1c values. Diabetic patients' involvement in web-based intervention had only transient impact on their functional health status.
This eDiabetes application was confirmed to be an innovative approach for better self-management of DM type 2 patients not using insulin. Both a significant reduction of HbA1c values and a significant correlation between the average self-measured blood pressure and the final HbA1c values in the interventional group were found. Nurse practitioners - as diabetes care coordinators - could contribute to better adherence in diabetes e-care.
Uvod: Diplomirane medicinske sestre se za delo v referenčnih ambulantah dodatno izobražujejo. Namen raziskave je bil preveriti potrebo in oceniti uspešnost izobraževanja za diplomirane medicinske ...sestre v referenčnih ambulantah za področje arterijske hipertenzije. Metode: Vključene so bile diplomirane medicinske sestre (n = 143), ki so obiskovale petintrideseturno urno izobraževanje o arterijski hipertenziji v času od januarja 2012 do marca 2013. Ugotavljali smo spremembo v znanju o vodenju bolnika z arterijsko hipertenzijo, zadovoljstvo udeležencev s celotnim modulom in posameznimi vsebinami modulov ter izbranimi učnimi metodami. Uporabili smo kvantitativno (deskriptivna statistika, parni t-test, enovzorčni t-test) in kvalitativno analizo podatkov. Rezultati: Z vstopnim testom so bile prepoznane velike razlike v znanju udeležencev (zbrali so med 15,0 % in 100,0 % točk). Z izobraževanjem se je njihovo znanje pomembno izboljšalo (vstopni test 56,6 % vs. končni test 89,1 %, p < 0,001). Zadovoljstvo s celotnim modulom in posameznimi deli modula je bilo visoko: povprečna vrednost za celoten modul na lestvici od 5 do 10 je znašala 8,6 (s = 1,3). Metode poučevanja so bile ocenjene kot ustrezne: povprečna vrednost na lestvici od 1 do 5 je bila 4,6 (s = 0,6). Udeleženci so najbolj pohvalili uporabnost in kakovost predavanj, dostopnost predavateljev in povezovanje teorije s prakso preko prikazov praktičnih primerov. Diskusija in zaključek: Ugotovitve naše raziskave podpirajo potrebo po dodatnem izobraževanju diplomiranih medicinskih sester v referenčnih ambulantah s področja arterijske hipertenzije.
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