Zdravstveno Varstvo最新文献

Objectives: Patient falls deteriorate patients' functional condition and quality of life, and increase their treatment costs. E-learning is considered an effective way to gain knowledge and competencies for quality and safety in nursing practice. The aim of the study is to evaluate the effectiveness of an e-learning course for nurses in preventing in-patient falls.

Methods: The research design was mixed. In the first phase of the study, a five-year retrospective analysis of 2,280 in-patient falls was performed. Based on the analysis of risk factors for patient falls and group interviews with clinic managers an e-learning course was designed and completed by 250 nurses from five surgical and internal departments. The course's effectiveness was evaluated based on the incidence of patient falls and the consequences of the falls before and after e-learning.

Results: At surgical departments, there was a statistically significant decrease in patient fall indices after the implementation of the e-learning course (from 4.4 to 2.6 falls per 1,000 patients; p=0.022). On the contrary, in internal departments, this index increased in the monitored period (from 19.0 to 26.9 falls per 1,000 patients; p=0.001). In all departments, there was a decrease in the incidence of patient injuries caused by falls after the implementation of the e-learning course; in internal medicine, this decrease was statistically significant (from 54.5% to 33.3%; p=0.014).

Conclusions: The study confirmed that e-learning forms of education for healthcare professionals have a positive effect in preventing patient falls.

Introduction: 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.

Methods: 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.

Results: 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.

Conclusion: 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.

Introduction: Objectives were to estimate the lifetime prevalence of self-reported sexually transmitted infections (STIs) and describe STIs healthcare.

Methods: Data was collected in the period 2016-2017 from a probability sample of the general population, 18-49 years old, at respondents' homes by a combination of face-to-face interviews and self-administration of more sensitive questions. Statistical methods for complex survey data were used to account for stratification, clustered sampling, and weighting.

Results: Approximately every tenth sexually experienced individual reported to have had genitourinary symptoms suggestive of STIs, but only a minority of them reported to have had those respective STIs diagnosed. The proportion of sexually experienced individuals that reported to have ever been diagnosed with an STI (excluding trichomoniasis, pubic lice for men and women, and pelvic inflammatory disease, vaginal thrush, bacterial vaginosis for women) was 2.4% for men and 6.7% for women (p<0.001). Independent risk factors associated with self-reported STIs in women included at least 10 lifetime sexual partners and having been forced into sex. The majority of the last STI episodes in women were treated by gynaecologists accessible at the primary healthcare level and in men by a dermatovenerologist, after referral by a general practitioner. Approximately half of STI patients were counselled for safer sex and majority reported to have notified their sexual contacts.

Conclusions: Our estimates for lifetime prevalence of self-reported STIs in a probability sample of Slovenian sexually experienced men and women, 18-49 years old, indicate a substantial national burden of STIs. The results will inform national STI prevention and control policies and strategies.

Introduction: Teachers in Slovenia have been noticing the increased consumption of energy drinks among pupils. Therefore, the purpose of this study was to investigate habits that contribute to the frequency of energy drink consumption.

Method: 36 teens participated in the study: elementary school pupils (6th and 8th grades), general upper secondary school pupils, and secondary technical school pupils (1st and 3rd year). In the course of the study 6 group interviews were held to help investigate young people's habits and their reasons for energy drink purchase and consumption. Moreover, we investigated the influence of age on the consumption and knowledge about energy drink ingredients, as well as their influence on the body.

Results: Interview analysis showed that energy drink consumers are predominantly secondary school pupils. Their choice most frequently depends on the price, their taste, or the brand. What influences elementary school pupils' purchasing decisions are price, packaging, and advertisements, while secondary school pupils choose their drinks according to the lack of energy and how tired they feel. The predominant factors preventing energy drink consumption are health problems among family members and friends. Secondary school pupils know more about energy drink ingredients than elementary school pupils.

Conclusion: On the basis of these findings, we will design a survey questionnaire for Slovenian teenagers and teachers, didactic material, and suggestions for improving educational programmes.

Aim: With the aim of improving personalized treatment of patients on chemotherapy, the objective of the study was to assess the degree of association between selected Quality of life (QoL) indicators and both clinical and imaging cardiac status indicators when detecting deterioration in QoL of these patients.

Methods: In a cohort clinical study in Hamburg, from August 2017 through October 2020, 59 cancer patients, aged 18-80 years, were evaluated before chemotherapy, and at several follow-ups, using EQ-5D and SF-36 QoL questionnaires, fast strain-encoded (fast-SENC) cardiac magnetic resonance (CMR), conventional CMR, and echocardiography, and further received a clinical and biomarker examination. Data was analyzed using survival analyses. A decline of more than 5% in each observed QoL metric value was defined as the observed event. Patient were separated into groups according to the presentation of cardiotoxicity as per its clinical definition, the establishment of the indication for cardioprotective therapy initiation, and by a worsening in the value of each observed imaging metric by more than 5% in the previous follow-up compared to the corresponding pre-chemotherapy baseline value.

Results: Among clinical cardiac status indicators, the indication for cardioprotective therapy showed statistically good association with QoL scores (EQ-5D p=0.028; SF-36 physical component p=0.016; SF-36 mental component p=0.012). In terms of imaging metrics, the MyoHealth segmental myocardial strain score was the only one demonstrating consistently good QoL score association (EQ-5D p=0.005; SF-36 physical component p=0.056; SF-36 mental component p=0.002).

Conclusions: Established fast-SENC CMR scores are capable of highlighting patients with reduced QoL, who require more frequent/optimal management.

This editorial describes how research in primary health care can be used to influence policy. It draws on previous literature to give an example from the UK of how research in one part of primary care, the health-visiting service, has endeavoured to use evidence to influence policy and practice. The editorial considers frameworks for policy implementation such as Bardach's eight phase approach and concepts that can inform policy implementation such as Lipsky's Street-Level Bureaucrat approach.

Background: Slovenia is an aging society. Social security expenditures for the elderly are rising steadily, and the majority of Slovenians are firmly convinced that the state must provide elder care. This situation means that informal caregivers face many challenges and problems in their altruistic mission.

Objectives: To explore the experiences and feelings of informal caregivers and to provide an understanding of how informal caregivers support the elderly and what challenges and difficulties they face in Slovenian society.

Methods: The study is based on qualitative semi-structured interviews with 10 caregivers. In addition to descriptive statistics, we conducted a qualitative study using the qualitative content analysis method.

Results: We identified four themes among health caregivers' experiences with challenges and problems in providing long-term health care for the elderly. Caregivers pointed out that they are mostly left to themselves and their altruistic mission of giving informal long-term care to their elderly relatives and friends. Systemic regulation of the national public health care system is the source of many problems.

Conclusion: Other social systems determine and limit the position of informal caregivers in Slovenia. This qualitative study should be understood as useful stepping-stone to future research and real improvement in this area.

Introduction: 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.

Methods: 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.

Results: 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.

Conclusion: 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.

Introduction: Although the concept of integrated care for non-communicable diseases was introduced at the primary level to move from disease-centered to patient-centered care, it has only been partially implemented in European countries. The aim of this study was to identify and compare identified facilitators and barriers to scale-up this concept between Slovenia and Belgium.

Methods: This was a qualitative study. Fifteen focus groups and fifty-one semi-structured interviews were conducted with stakeholders at the micro, meso and macro levels. In addition, data from two previously published studies were used for the analysis. Data collection and analysis was initially conducted at country level. Finally, the data was evaluated by a cross-country team to assess similarities and differences between countries.

Results: Four topics were identified in the study: patient-centered care, teamwork, coordination of care and task delegation. Despite the different contexts, true teamwork and patient-centered care are limited in both countries by hierarchies and a very heavily skewed medical approach. The organization of primary healthcare in Slovenia probably facilitates the coordination of care, which is not the case in Belgium. The financing and organization of primary practices in Belgium was identified as a barrier to the implementation of task delegation between health professionals.

Conclusions: This study allowed formulating some important concepts for future healthcare for non-communicable diseases at the level of primary healthcare. The results could provide useful insights for other countries with similar health systems.

Background: Curricula are reviewed and adapted in response to a perceived need to improve interprofessional collaboration for the benefit of patient care. In 2005, the module Interprofessional Collaboration in Healthcare (IPCIHC) was developed by the Antwerp University Association (AUHA). The program was based upon a concept of five steps to IPCIHC. This educational module aims to help graduates obtain the competence of interprofessional collaborators in health care.

Methods: Over a span of 15 years, the IPCIHC module is evaluated annually by students and provided with feedback by the tutors and steering committee. Data up to 2014 were supplemented with data up to 2019. For the students the same evaluative one-group, post-test design was used to gather data using a structured questionnaire. The tutors' and students' feedback was thematically analyzed.

Results: Based upon the results and the contextual changing needs, the program was adjusted. Between 2005 and 2019, a total of 8616 evaluations were received (response rate: 78%). Eighty percent of the respondents indicated through the evaluations that they were convinced of the positive effect of the IPCIHC module on their interprofessional development. Over the years, two more disciplines enrolled into this program and also education programs form the Netherlands.

Conclusions: After 15 years, positive outcomes are showed, and future health professionals have a better understanding of interprofessional learning. Gathering feedback and annually evaluation helped to provide a targeted interprofessional program addressing contextual changes. The challenge remains to keep on educating future healthcare providers in interprofessional collaboration in order to achieve an increase in observable interprofessional behaviour towards other professional groups.