There is evidence that the prevalence of common mental disorders varies across Europe.
To compare prevalence of common mental disorders in general practice attendees in six European countries.
...Unselected attendees to general practices in the UK, Spain, Portugal, Slovenia, Estonia and The Netherlands were assessed for major depression, panic syndrome and other anxiety syndrome. Prevalence of DSM-IV major depression, other anxiety syndrome and panic syndrome was compared between the UK and other countries after taking account of differences in demographic factors and practice consultation rates.
Prevalence was estimated in 2,344 men and 4,865 women. The highest prevalence for all disorders occurred in the UK and Spain, and lowest in Slovenia and The Netherlands. Men aged 30-50 and women aged 18-30 had the highest prevalence of major depression; men aged 40-60 had the highest prevalence of anxiety, and men and women aged 40-50 had the highest prevalence of panic syndrome. Demographic factors accounted for the variance between the UK and Spain but otherwise had little impact on the significance of observed country differences.
These results add to the evidence for real differences between European countries in prevalence of psychological disorders and show that the burden of care on general practitioners varies markedly between countries.
Similar to other countries, Departments of Family Medicine in the former Yugoslavia had to transition from face-to-face to distance education during COVID-19.
To elucidate obstacles and facilitators ...of the transition from face-to-face to distance education.
A cross-sectional, multicentre, qualitative study design was used to analyse nine open-ended questions from an online survey using inductive thematic analysis. The questionnaire was distributed to 21 medical schools, inviting them to involve at least two teachers/students/trainees. Data were collected between December 2021 and March 2022.
In 17 medical schools, 23 students, 54 trainees and 40 teachers participated. The following themes were identified: facilitators and barriers of transition, innovations for enhancing distance education, convenience of distance education, classical teaching for better communication, the future of distance education, reaching learning outcomes and experience of online assessment. Innovations referred mainly to new online technologies for interactive education and communication. Distance education allowed for greater flexibility in scheduling and self-directed learning; however, participants felt that classical education allowed better communication and practical learning. Teachers believed knowledge-related learning outcomes could be achieved through distance education but not teaching clinical skills. Participants anticipated a future where a combination of teaching methods is used.
The transition to distance education was made possible thanks to its flexible scheduling, innovative tools and possibility of self-directed learning. However, face-to-face education was considered preferable for fostering interpersonal relations and teaching clinical skills. Educators should strive to strike a balance between innovative approaches and the preservation of personal experiences.
The countries of the former Yugoslavia have health and education systems with the same tradition but these have changed over the years. Little is known about how family medicine teaching transitioned ...from face-to-face to distance education during the COVID-19 pandemic.
to investigate student/teacher experience in transitioning from face-to-face to distance education.
A cross-sectional, online survey was conducted among 21 medical schools of the former Yugoslavia between December 2021 and March 2022. Under/postgraduate teachers and students who taught/studied family medicine during the academic year 2020/2021 were invited to participate. Of 31 questions for students and 35 for teachers, all but nine open questions were analysed using descriptive statistics.
Seventeen of 21 medical schools contributed data involving 117 participants representing all countries of the former Yugoslavia. At the beginning of the pandemic, 30%, 26% and 15% of teachers, students and trainees, respectively, received formal preparation in distance education. Of these, 92% of teachers and 58% of students/trainees felt they were not adequately prepared. Synchronous teaching was the main method used, with a third using hybrid methods. All participants were least confident about online assessment. More than 75% of respondents agreed that lectures could be kept online, not patient consultations or practical skills' classes.
Teachers used various old and new methods to provide learning opportunities despite COVID-19 constraints. Effective technology-based strategies are essential to ensure assessment integrity and enhance the learning environment.
BackgroundDepression, anxiety and physical function may be bi-directionally related. We aim to estimate the strength of the longitudinal associations between depression, anxiety and physical ...function.MethodsProspective cohort study of general practice attendees across Europe (N=4757) assessed at baseline, 6, 12 and 24 months. Main outcome measures were Diagnostic and Statistical Manual of Mental Disorders-IV major depression, Patient Health Questionnaire anxiety and Short Form 12 physical function. Complete-case analyses using random coefficient models and logistic regression models were performed.ResultsThose with depression (β=−1.90, 95% CI −3.42 to −0.39), anxiety (β=−4.12, 95% CI −5.39 to −2.86) or depression and anxiety (β=−5.74, 95% CI −7.38 to −4.10) had lower levels of physical function at baseline and over time compared with no diagnosis after adjustment for potential confounders. Physical function increased over time, but the rate of increase was not different between the groups. When compared with depression, those with anxiety (β=−2.22, 95% CI −4.08 to −0.36) or depression and anxiety (β=−3.83, 95% CI −5.95 to −1.71) had significantly lower levels of physical function at baseline. Lower levels of physical function at baseline were associated with onset of depression (OR 1.83, 95% CI 1.08 to 3.10) but even stronger with anxiety (OR 2.79, 95% CI 1.52 to 5.12) or depression and anxiety (OR 5.05, 95% CI 2.55 to 9.99) during 24 months compared with no dysfunction, after adjustment for potential confounders.ConclusionIt is essential to prevent lower levels of physical function as this is likely to lead to onset of depression and anxiety over time.
Croatia and Slovenia were the transit countries on the Balkan route for migrants and refugees from Middle East countries in 2015 and 2016. They had to optimize health care delivery in the special ...circumstances in refugee camps and transit centres. Little is known about health care provision in border camps where a large number of migrants stay for only couple of hours. Previous studies emphasize that language barriers and cultural differences play a central part in the relationship between health workers and migrants inside the transit zone. The aim of the study was to identify specific characteristics of health care provision experienced by primary healthcare providers in order to prepare solutions on how to organise health care in refugee settings.
Twelve thematic interviews were conducted in the middle of the most intense migration movements to the North-West Europe between November and December 2015 with health workers from Croatia and Slovenia. Interview transcripts were read, coded, reviewed, and labelled. We used qualitative content analysis.
Four themes about the health service provision for refugees at Schengen border were identified. The circumstance when mutual understanding is poor and the consultation not successful, cultural differences represent a central barrier. Participants highlighted that the importance of respecting human dignity is crucial for the provision of basic medical care for migrants in transit.
Successful overcoming language barriers, respecting cultural differences, humanity, susceptibility to social deprivation and traumatic experiences are the key factors important for organisation of health care in transit centers and camps. This article gives some useful tips for healthcare workers and policy makers who are participating in health services provision for migrants and other refugees. Health workers should be prepared to work in special working conditions with a lack of resources. Their work would require timely planning and reflection on the organization of more transit camps.
Ethical Committee of the Republic of Slovenia approved the study as a project number 112/02/16.
Renaissance is the term used for the societal movement that marked the end of the Middle Ages. With the development of science came the rediscovery of the works and values of ancient scholars. This ...brought enormous development in all areas of society, including education. Man became the measure of all things, humanism became important again, and there was a blossoming of science and art.
The ‘renaissance of family medicine’ took place approximately 50 years ago as a response to over-technical (even inhumane) medicine. Family medicine focused on the patient and was, as such, rediscovered and developed as a scientific discipline.
In 2022 Wonca Europe launched a new document that set out the core values of family medicine, initiating a discussion about the ‘new’ renaissance of family medicine. The idea implies that, due to the changes brought about by rapid technical advances and recent global events, family medicine will develop further. However, the really intriguing question is whether these rapid and dramatic changes will actually result in a new renaissance of family medicine or whether they will result in its decline.
Background: Most patients that commit suicide consult their GPs before their death. This topic is often surrounded by secrecy and associated with guilt and shame. There is a lack of knowledge about ...support for GPs after patient suicide.
Objectives: To identify the widest range of Slovenian GPs' problems and needs in connection with patient suicide, and, based on the findings of the study, to prepare ways to assist GPs after patient suicide.
Methods: Semi-structured interviews were held with GPs that had experienced a patient's suicide during their professional career until saturation was reached. The interview guide was piloted. Twenty-two in-depth interviews were carried out between April 2012 and February 2013. Transcripts were coded and thematically analysed using qualitative content analysis.
Results: Participating GPs suggested possible forms of support, most frequently individual consultation with a psychologist or a psychiatrist, in person, by phone, or via e-mail. Balint groups, group consultations and various workshops on suicide or depression would be a preferable form of support. Some GPs perceived critical incident review as an attempt to blame them, whereas others saw it as an opportunity for support. A group of peers that could discuss professional dilemmas in which more experienced GPs would help younger GPs would be helpful.
Conclusion: Slovenian GPs did not have any formal support system at the time of the research, but they would appreciate such a possibility.
AimWe sought to examine strength of primary care service delivery as measured by selected process indicators by general practitioners from 31 European countries plus Australia, Canada, and New ...Zealand. We explored the relation between strength of service delivery and healthcare expenditures.
The strength of a country's primary care is determined by the degree of development of a combination of core primary care dimensions in the context of its healthcare system. This study analyses the strength of service delivery in primary care as measured through process indicators in 31 European countries plus Australia, New Zealand, and Canada.
A comparative cross-sectional study design was applied using the QUALICOPC GP database. Data on the strength of primary healthcare were collected using a standardized GP questionnaire, which included 60 questions divided into 10 dimensions related to process, structure, and outcomes. A total of 6734 general practitioners participated. Data on healthcare expenditure were obtained from World Bank statistics. We conducted a correlation analysis to analyse the relationship between strength and healthcare expenditures.FindingsOur findings show that the strength of service delivery parameters is less than optimal in some countries, and there are substantial variations among countries. Continuity and comprehensiveness of care are significantly positively related to national healthcare expenditures; however, coordination of care is not.
Factors associated with depression are usually identified from cross-sectional studies.
We explore the relative roles of onset and recovery in determining these associations.
Hazard ratios for onset ...and recovery were estimated for 39 risk factors from a cohort study of 10,045 general practice attendees whose depression status was assessed at baseline, 6 and 12 months.
Risk factors have a stronger relative effect on the rate of onset than recovery. The strongest risk factors for both onset and maintenance of depression tend to be time-dependent. With the exception of female gender the strength of a risk factor's effect on onset is highly predictive of its impact on recovery.
Preventive measures will achieve a greater reduction in the prevalence of depression than measures designed to eliminate risk factors post onset. The strength of time-dependent risk factors suggests that it is more productive to focus on proximal rather than distal factors.
We live in an age of information revolution, where trends in informing physicians and the lay public bring new challenges that must be faced by healthcare professionals. Predatory journals and fake ...conferences are common. Social media is full of false information, which results in serious public health damage. Therefore, it is important that health professionals communicate properly with the public and patients and that they address the education of both the public and other health professionals.
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