Introduction: Trust is crucial in forming a good relationship between a patient and a doctor, where both persons believe that they are benevolent, competent and willing to act in their best interest. ...This research examines factors associated with patient trust in their general practitioner (GP). Method: Every third patient at the General Practice in Pernica was asked to participate in a voluntary, anonymous survey. 464 questionnaires (92.8 % response rate) were filled in. The questionnaire consisted of patient demographic data, the Trust in Physician Scale (Cronbach α = 0.795), and the Humanistic Behaviours Questionnaire (Cronbach α = 0.965). The research sample was described with frequency and percentage distribution, average values and standard deviation. Factor analysis was implemented. Using linear regression modelling, the connection between patient demographic data, patient health status and patient’s cooperation with the GP, along with factors describing trust in physician, was analyzed. Factors of physician behaviour were included in the linear regression as independent variables. Results: Positive past experience with the GP (β = 0.20, p < 0.001), greater care and involvement in treatment (β = 0.28, p < 0.001), and greater benevolence (β = 0.32, p < 0.001) were positively correlated with the competence of the GP. A lower degree of benevolence (β = -0.28, p < 0.001) was associated with greater distrust. Discussion: Physician behavior was statistically associated with patient trust. With appropriate interventions we could improve patients’ trust in their physician and thus influence a better treatment outcome, continuity of care, better cooperation and most importantly, patient satisfaction.
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.
Background. There is now compelling evidence that screening for colorectal cancer may result in significantly reduced mortality. Screening tests for colorectal cancer are not systematically performed ...in Bulgaria.
Aim. This article explores the effect of an educational intervention on the willingness of patients to participate in the screening for colorectal cancer with the immunochemical faecal occult blood test in the home setting.
Materials and methods. A before-after design study of the effects of educational intervention comprising distribution of a brochure and one-to-one discussion with a GP. A self-administered, original questionnaire was administered before and after the intervention to 600 randomly selected patients in 40 general practices (15 patients per practice) in Plovdiv district.
Results. The intervention led to an increase with >20% of the patient’s knowledge of the importance of the test and on how to carry out the test. Statistical analysis indicated that there was an increase in knowledge after the educational intervention about the usefulness of the test (24.8% in males, 18.3% in females) and its performance (22.7% in males, 25.4% in females).
Conclusion. The educational intervention has significantly influenced the patient’s awareness about the test’s usefulness and its self-administration. It improved the awareness by providing an easy access to information, thus fostering the active involvement of the patients. A strength of the intervention was the patient-centered approach in providing additional information through one-to-one discussions, and it ensured a higher quality of the preventive screening in the general practice.
Uvod. Sedaj obstajajo prepričljivi dokazi, da presejanje za raka debelega črevesa in danke lahko bistveno zniža stopnjo smrtnosti. Presejalni testi za raka debelega črevesa in danke se v Bolgariji ne izvajajo sistematično.
Cilj. Članek raziskuje učinek izobraževalnega ukrepa na pripravljenost pacientov za presejanje za raka debelega črevesa in danke z imunokemičnim testom na domu za določanje okultne krvi v blatu.
Metode. Študija “prej in potem” učinka izobraževalnega ukrepa, ki vključuje razdeljevanje brošure in osebni pogovor s splošnim zdravnikom. Prvotni vprašalnik je bil pred in po ukrepu razdeljen 600 naključno izbranim pacientom in 40 splošnim ambulantam (15 pacientov na ambulanto) v okraju Plovdiv.
Rezultati. Ukrep je prinesel več kot 20 % povečanje zavedanja pacientov o pomenu testa in o načinu njegove izvedbe. Statistična analiza je pokazala, da po izobraževalnem ukrepu obstaja porast znanja o uporabnosti testa (24,8 % pri moških, 18,3 pri ženskah) in njegovem delovanju (22,7 % pri moških, 25,4 % pri ženskah).
Zaključek. Izobraževalni ukrep je bistveno vplival na pacientovo zavedanje o uporabnosti testa in njegovi izvedbi. Povečal je zavedanje z zagotavljanjem enostavnega dostopa do informacij in s tem spodbudil aktivno udeležbo pacientov. Ukrep je bil uspešen zaradi pristopa, usmerjenega k pacientu, pri zagotavljanju dodatnih informacij prek osebnih pogovorov in je prinesel višjo kakovost preventivnega presejanja v splošnih ambulantah.
Parenteralna uporaba zdravil za lajšanje bolečine v križu se zaradi odsotnosti dokazov o njihovi večji učinkovitosti in dodatnem tveganju za zaplete odsvetuje. Namen raziskave je bil ugotoviti, ...kolikšen delež in kateri bolniki z bolečino v križu so dobili zdravilo v injekciji.
V presečni študiji smo med 12.596 zaporednimi obiski pri 42 naključno izbranih zdravnikih družinske medicine analizirali vse obiske zaradi bolečine v križu. Na vzorcu bolnikov v starosti med 18 in 65 let smo analizirali pogostnost in dejavnike, ki vplivajo na odločitev za uporabo protibolečinskih zdravil v injekciji.
Zaradi bolečine v križu je zdravnika obiskalo 819 (6,5 %) vseh obiskovalcev ambulante, 300 (2,4 %) bolnikov z akutno in 519 (4,1 %) s kronično bolečino v križu. Injekcijo je prejelo 132 (20,7 %) obiskovalcev z bolečino v križu, starih med 18 in 65 let. Med dejavniki, ki so se v multivariatnem modelu izkazali kot pomembni pri odločitvi za injekcijo, so bili dejavniki bolnika (višja starost, nižja stopnja izobrazbe), vrsta bolečine v križu (akutna radikularna bolečina) in dejavniki zdravnika (zdravnik specialist, nižja starost). Razlike v odločitvi za injekcijo so bile med zdravniki zelo velike: 8 od 42 zdravnikov injekcije ni dalo niti enemu bolniku, medtem ko se je en zdravnik za injekcijo odločil pri 19 od 32 (59,4 %) bolnikih.
Velike razlike med zdravniki v pogostnosti odločitve za uporabo protibolečinskih zdravil v injekciji pri bolečini v križu kažejo na potrebo po usmerjeni intervenciji, katere cilj bi bil poenotiti delo zdravnikov ter povečati kakovost in varnost obravnave bolnikov.
Injections are not recommended due to the lack of evidence about their effectiveness and potential additional risks. We would like to know the proportion and characteristics of general practice attainders with low back pain who were treated with medications in injection.
In a cross-sectional study including 12,596 consecutive attainders of general practice in 42 general practices, we analysed all the contacts due to low back pain. In a sample of attainders in the age group from 18 to 65, we analysed the proportion and factors influencing a decision for treatment with medications in injection.
Low back pain was the reason for attendance in 819 (6.5%) patients; 300 (2.4%) with acute and 519 (4.1%) with chronic low back pain. 132 (20.7%) patients from 18 to 65 years were treated with medications in injection. In multivariate analysis, several factors were found to be important for the decision for injection of medications: patients’ characteristics (older age, lower level of education), type of pain (acute ishialgic pain) and physicians’ factors (specialisation in family medicine, younger age). Differences between physicians in using injections were significant: 8 out of 42 physicians did not use injections, but there was a physician who used injections in 19 out of 32 patients (59.4%).
Huge differences in the use of medications in injection in patients with low back pain indicate a necessity for intervention whose aim would be to reduce the differences between physicians and improve the quality and safety of patient care.
Rak poseže globoko v življenje obolelih in njihovih bližnjih. Paliativna oskrba pa je tista, ki zagotavlja optimalno funkcioniranje, počutje in socialno podporo bolniku in svojcem, ko ozdravitev ni ...več možna. Njena učinkovitost temelji na znanju in sodelovanju različnih strok. Poudarek je na kakovosti bolnikovega življenja. Med pokazatelji dobre kakovosti življenja je na prvem mestu malo hospitalnih dni v zadnjem obdobju življenja in paliativna oskrba na domu. Možnost in kakovost oskrbe na domu je odvisna od zdravnika družinske medicine in njegovih sodelavcev, ki pravočasno prepoznajo in učinkovito ublažijo vsak simptom in ugotovijo, ali so vse bolnikove potrebe zadovoljene. Pri tem je nenadomestljiva vloga družine. Nepogrešljive iztočnice za vse, ki so vključeni v oskrbo, so čas, sodelovanje, spoštovanje, potrpljenje, odprtost. Ob koncu paliativne oskrbe pa je pomembno, da prepoznamo tudi umiranje in spoštujemo smrt. Paliativna oskrba bo človekova pravica samo takrat, ko bo prepoznavni, sestavni del obveznega zdravstvenega varstva in ko bo vključena v obvezne izobraževalne programe zdravstvenih delavcev. Sicer pa bo ostala, kot je sedaj, odvisna od prizadevanja posameznikov in dostopna le majhnemu številu obolelih.
Trust in an individual physician and its contradictions Introduction: This article analyses the essential contradictions in the phenomenon of trust and the dilemmas this creates for empirical ...Research on health and the health care system. The trust a patient places in their physician (and--though more rarely--in the health system itself) is generally regarded as an important factor in the patient's health; hence, a crucial research problem is the question of which factors influence a patient's trust. Methods: In this article, we analyse the attitudes regarding the role of the state in health care - the analysis is based on Slovenian public opinion surveys (1995-2007). In the second part of the analysis we focus on an analysis of the influence of experience with medical institutions and medical personnel, the respondents' subjective evaluation of their own health and a group of sociodemographic factors relating to social inequality (Slovene public opinion, SPO 2001/3). Results: Similar to the results of numerous other empirical studies, our research shows that these factors only partially explain trust in an individual physician. At the same time, we find a relatively large difference between trust in an individual physician and trust in the health service. Conclusion: We explain the results by means of the contradictions and multidimensionality of the phenomenon of trust itself and the quandaries in the conceptualizations of trust. PUBLICATION ABSTRACT
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