Zmanjševanje dejavnikov tveganja za nastanek srčnožilnih bolezni pri pacientih, vodenih v referenčni ambulanti družinske medicine - vloga diplomirane medicinske sestre

Background: Model of reference family medicine clinic reveals changes in treating patients on primary health level. The consequence is reduction or elimination of risk factors for the occurrence of cardiovascular diseases. Team consists of a doctor, a nurse and a graduate nurse, who significantly improves the quality of controling patients with risk factors by knowledge, proficiency and individual approach. The purpose of master\u27s degree: The purpose of the master\u27s degree thesis is to explore the risk factors for the occurrence of cardiovascular diseases among groups of patients, who are treated in the reference medicine family clinic and general clinic. Research methodology: There was a cross-sectional method of data gathering used in this study. Primary data were collected from the prescribed forms, that are filled in when testing for cardiovascular risk, and are statistically analysed by SPSS program. The following statistical methods were used to examine the data: regression analysis, ANOVA, hi-square and t-test. The theoretical part consists of analysing the literature. The literature has been reviewed on the basis of scientific and technical literature. Results: When doing control measurements patients had settled blood pressure in 41,6 %, settled cholesterol in 45,5 % and settled blood sugar in 53,3 %. All three measurements were higher than in screening tests. There were 23,7 % smokers, which is less than in screening tests. High cardiovascular risk (20 to 40 %) has reduced to a 28,0 %, whereas extremely high cardiovascular risk to a 6,6 %. Physical activity 2-4 times per week was stated in 54,3 %, physical activity 5 times per week was stated in 19,4 %, which is higher than in screening test. The results of the control measurements show statistically significant improvements in following factors (x^2=8,780; p=o,oo3) and cholesterol (x^2=4,781; p=0,029) in patients, studied in the family medicine clinic, whereas blood sugar was no longer statistically significant. When controlling physical activity the result was opposite - subjects treated in reference family medicine clinic stated statistically significant difference (x^2=15,304; p=0,002). Gender comparison in the family medicine clinic once again showed (x^2=19,243; p\u3c0,001). When studying women, the high cardiovascular risk reduced to a 18,8 % (-6,2 % based on a screening test), and extremely high cardiovascular risk to a 0,0 % (-3,1 % based on a screening test). When studying men, the measurements have reduced to a 26,6 % and 10,9 % (-15,6 % and -4,7 % based on a screening test). Conclusion: Patients, studied in the family medicine clinic, have essentially improved risk factors due to quality treatment, that is enabled by the model of reference family medicine clinic, and graduate nurse\u27s essential role in this model

Health behavior and health-related quality of life in patients with a high risk of cardiovascular disease

Health-related quality of life (HRQoL) is measuring a patient’s experience of his health status and represents an outcome of medical interventions. Existing data proves that a healthy lifestyle is positively associated with HRQoL in all age groups. Patients with a high risk for cardiovascular disease typically led an unhealthy lifestyle combined with risk diseases. We aimed to analyse these characteristics and their reflection in HRQoL

European general practitioners’/family physicians’ attitudes towards person-centered care and factors that influence its implementation in everyday practice : preliminary results

Background: Person-centered care (PCC) is widely acknowledged as a core value in family medicine and has been associated with many positive outcomes of care. There has been no comparison of GPs attitudes towards person-centeredness across European countries. Research questions: To investigate GPs/FPs attitudes towards person-centeredness. To understand GPs/FPs facilitators and barriers related to practicing PCC. To document obstacles to practicing PCC in practice. Method: A cross-sectional questionnaire-based study across 22 European countries (finished in one country, in 10 countries ongoing, in 11 countries finishing the preparatory phase). In each country, the population of GPs/FPs will be reached through the official mailing list of the national medical associations. The study instrument consists of four parts: General information about the doctor and the doctor's office, Perceived Stress Scale (PSS), Patient Practitioner Orientation Scale (PPOS) and Facilitators and barriers to PCC in everyday practice. The Ethics Committee, School of Medicine, University of Zagreb approved the project. The study will be carried out in close collaboration with the European Association for Quality and Patient Safety in Primary Care (EQuiP) and the European General Practice Research Network (EGPRN). The study will be coordinated by the Department of Family Medicine, School of Medicine University of Zagreb (Croatia). The project is supported by the EGPRN Grant. Results: GPs/FPs attitudes towards person-centeredness will be described and investigated in correlation to sociodemographic data and work stress in each participating European country. GPs/FPs facilitators and barriers to practicing PCC in everyday practice will be analysed. Data will be analysed using software package STATISTICA 7.1 (StatSoft Inc, Tulsa, OK, USA), and P < .05 will be considered statistically significant. Conclusions: Regardless of the specific context of care that is highly dependent on the patient, physician and healthcare system characteristics, PCC represents a core value of family medicine that should be implemented in GPs/FPs everyday work across Europe