0000000000314923
AUTHOR
Donata Kurpas
Experiences of family physicians after a CME ultrasound course
Background. Ultrasonography is an inexpensive, safe, noninvasive tool for obtaining diagnoses without performing further imaging tests, and for the timely referral of patients to further diagnosis or specialist care. Objectives . To determine which ultrasound tests are most often performed by family physicians, and what factors contribute to their use of ultrasound imaging. Material and methods . This survey-based study using the authors’ questionnaire was conducted in March 2016 among 81 primary care physicians who had completed weekend courses on ultrasound abdominal cavity imaging. Results . Family physicians most often took ultrasounds of the abdominal cavity (35/50; 70%) and thyroid gl…
Needs, Aggravation, and Degree of Burnout in Informal Caregivers of Patients with Chronic Cardiovascular Disease
This study aimed to answer three main questions with respect to home caregivers for people with cardiovascular disease: (1) Are the needs of home caregivers being met (and at what level)?
Understanding frailty:meanings and beliefs about screening and prevention across key stakeholder groups in Europe
Innovative methods to manage frailty are critical to managing the needs of an ageing population. Evidence suggests there are opportunities to reverse or prevent frailty through early intervention. However, little is known about older adults’, families’ and practitioners’ beliefs about the malleability of frailty. This study examined European stakeholders’ accounts of the acceptability and feasibility of frailty screening and prevention to inform future intervention development. Semi-structured focus groups and individual interviews were conducted in three European Union countries (Italy, Poland and the United Kingdom) with key stakeholders – frail and non-frail older adults, family care-giv…
The Analysis of the Relationship between the Quality of Life Level and Expectations of Patients with Cardiovascular Diseases under the Home Care of Primary Care Nurses
The World Health Organization defines quality of life as a person’s perception of his or her life situation in relation to the culture and value system in which he or she lives, in relation to and with respect to his or her functioning assumptions, expectations, and standards set by environmental conditions. Meeting the expectations of patients with CVD is one of the factors that positively influences their health status and leads to better diagnostic and treatment outcomes. The aim of this study was to answer three main questions related to patients with chronic cardiovascular disease: (1) What is their quality of life? (2) Are patients’ expectations about the quality of care p…
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Additional file 3: Table S1. Table that describes the members of the FOCUS Guideline Panel and their role in the development of the guidelines.
Frailty syndrome in community care – tips for patients and caregivers
Zespół słabości (ZS) jest dynamicznym stanem charakteryzującym się zmniejszeniem fizjologicznych rezerw organizmu, osłabieniem odporności na czynniki stresogenne oraz zaburzeniami funkcjonowania układów ciała. W ZS dochodzi do zmniejszenia masy ciała i siły mięśniowej, problemów z poruszaniem się, utrzymaniem równowagi oraz do zmniejszenia aktywności fizycznej. Wyróżniamy trzy stadia zespołu słabości: wczesny ZS (pre- -frail), zespół słabości (frail) oraz powikłania zespołu słabości. Głównym czynnikiem ryzyka wystąpienia ZS jest wiek podeszły, ale znaczenie mają również czynniki genetyczne, środowiskowe, styl życia oraz choroby współistniejące. Do rozpoznania ZS stosuje się m.in. skalę Frie…
Weekend courses on ultrasonography as a form of teaching knowledge and the skills necessary to perform ultrasounds in the family physician’s practice
Background. Growth in ultrasound use by non-radiologists has outpaced radiologist-performed ultrasound in the last decade. Poland has a well-organized system of teaching ultrasonography. Objectives. To establish whether family physicians, after completion of weekend courses on ultrasound abdominal cavity imaging, recommend this form of training. To identify main reasons for family physician to attend training in USG, their preferences regarding the form of such courses and the difficulties most often faced by family physicians when performing a USG. Material and methods. This survey-based study using the authors’ own questionnaire was conducted in March 2016 among 81 primary care physicians…
Factors Differentiating Rural and Urban Population in Determining Anxiety and Depression in Patients with Chronic Cardiovascular Disease: A Pilot Study
The aim of this cross-sectional study was to analyze selected variables differentiating rural from urban populations, as well as identify potentially increased levels of depression and anxiety in patients with chronic cardiovascular disease. The study was carried out in 193 patients. The study used the Camberwell Assessment of Need Short Appraisal Schedule (CANSAS), the Health Behavior Inventory Questionnaire (HBI), the WHOQOL-BREF Quality of Life Questionnaire, and the Hospital Anxiety and Depression Scale–Modified Version (HADS-M). Spearman’s rank correlation coefficient test and logistic regression were used for analyses. In rural patients, we observed a relationship between anxiety and …
Assessment of the health care system functioning in Poland in light of the analysis of the indicators of the hospital emergency department (ED) and primary health care (PHC) – proposals for systemic solutions
Background In the last three decades, in developed countries, the number of patients reporting to hospital emergency departments has dramatically increased. The number of visits to EDs can be an important indicator of the quality of primary health care. Objectives To analyse: 1) the frequency of admissions to EDs, 2) the type and number of medical procedures performed in EDs, and 3) the type and number of services provided by PHC in the Kedzierzyn-Kozle district. Material and methods A retrospective analysis of the statistical data regarding services provided by PHC in the Kedzierzyn-Kozle district within the National Health Fund (NHF) and data from the hospital emergency department in Kedz…
Unmet needs in emergency department patients as an important aspect of the increasing number of hospitalizations
Background. Unmet needs in the medical care of high-need patients may increase costs due to the use of emergency departments (EDs) instead of primary care. Objectives. To establish the possible correlation between the unmet needs of patients and the number of hospitalizations, and the probability of influence of the former aspect on the latter, and to analyze the level of satisfied needs of ED patients in relation to sociodemographic data. Material and methods. An original questionnaire and a modified version of the Camberwell Assessment of Need Short Appraisal Schedule (CANSAS) were used to assess the level of satisfaction of the social, medical, psychological and environmental needs of 15…
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Additional file 4. Example of the output of the voting process using the Evidence to Decision template, as received and processed by the guidelines technical team.
Understanding frailty: meanings and beliefs about screening and prevention across key stakeholder groups in Europe
ABSTRACTInnovative methods to manage frailty are critical to managing the needs of an ageing population. Evidence suggests there are opportunities to reverse or prevent frailty through early intervention. However, little is known about older adults’, families’ and practitioners’ beliefs about the malleability of frailty. This study examined European stakeholders’ accounts of the acceptability and feasibility of frailty screening and prevention to inform future intervention development. Semi-structured focus groups and individual interviews were conducted in three European Union countries (Italy, Poland and the United Kingdom) with key stakeholders – frail and non-frail older adults, family …
Indicators of an Integrated Home Care Model Shaped by the Needs of Patients Discharged from the Emergency Department
Introduction: Developing community care models aims to satisfy the needs of patients’ in-home care comprehensively. This is crucial to decrease adverse events and prevent rehospitalization. Methods: A cross-sectional study was conducted among 200 emergency department patients (EDPs) and 200 general practice patients (GPPs). The modified version of the Camberwell Assessment of Need Short Appraisal Schedule (CANSAS), the Health Behavior Inventory (HBI), the Generalized Self-Efficacy Scale (GSES), the Patient Satisfaction Questionnaire (PSQ), and the Multidimensional Health Locus of Control Scale (MHLCS) were used. Results: The study indicated the higher level of unmet needs in EDPs than in th…
Variables that Modulate Home Care Effectiveness in Patients with Chronic Cardiovascular Disease
Introduction: The growing population of patients with chronic cardiovascular disease has many complex biomedical and psychosocial needs and requires an integrated teamwork approach. There is a need to develop a model for assessing the effectiveness of home care in patients with chronic cardiovascular disease, which would take the needs of informal caregivers into account.The purpose of the study was to determine the variables affecting the level of effectiveness of home care, defined as the co-occurrence of high: quality of life (QoL), health behaviours and met needs.Subjects and method: The study involved 193 patients under the care of district nurses and 161 informal caregivers. The study…
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Additional file 1. Synthesis of quantitative evidence from the FOCUS systematic review [9], showing the effect of the interventions on frailty as an outcome, adapted from the typical GRADE Summary of Findings table structure, as offered to the guideline panellists.
Patient-centred access to health care: a framework analysis of the care interface for frail older adults
Abstract Background The objective of this study was to explore the issues surrounding access to health and social care services for frail older adults with Polish stakeholders, including healthy and frail/pre-frail older adults, health care providers, social care providers, and caregivers, in order to determine their views and perspectives on the current system and to present suggestions for the future development of a more accessible and person-centred health and social care system. Methods Focus groups were used to gather qualitative data from stakeholders. Data were analysed using framework analysis according to five dimensions of accessibility to care: approachability, acceptability, av…
A qualitative study examining everyday frailty management strategies adopted by Polish stakeholders
Abstract Background: Frailty is a multidimensional clinical state that is common in older age and can be managed through intervention. Strategies to manage frailty have not been previously explored with stakeholders in Poland. This may stem from misperceptions about the nature and malleability of frailty, which has resulted in it being viewed as a lower priority healthcare concern. Objectives: To explore stakeholders’ views to determine whether there are effective everyday strategies that they can adopt to reduce, reverse or prevent frailty. Methods: Semi-structured focus groups were conducted with five stakeholder groups (frail/pre-frail and robust older adults, health and social care prof…
The pros and cons of the implementation of a chronic care model in European rural primary care: the points of view of European rural general practitioners
Introduction: This article describes the views of European rural general practitioners regarding the strengths, weaknesses, opportunities and threats (SWOT) of the implementation of a chronic care model (CCM) in European rural primary care. Methods: This was a mixed-methods online survey. Data were collected from 227 general practitioners between May and December 2017. Categorical data were analysed using descriptive methods while free-text responses were analysed using qualitative methods. The setting was rural primary care in nine European countries (including Central and Eastern Europe). Main outcomes measures were respondents' evaluations of a chronic care model in their rural heal…
The use of technology in the context of frailty screening and management interventions: a study of stakeholders’ perspectives
Abstract Background Health and social care interventions show promise as a way of managing the progression of frailty in older adults. Information technology could improve the availability of interventions and services for older adults. The views of stakeholders on the acceptability of technological solutions for frailty screening and management have not been explored. Methods Focus groups were used to gather data from healthy and frail/pre-frail older adults, health and social care providers, and caregivers in three European countries – Italy, Poland and UK. Data were analysed using framework analysis in terms of facilitators or determinants of older adults’ adoption of technology. Results…
Variables Determining Higher Home Care Effectiveness in Patients with Chronic Cardiovascular Disease
The aim of this cross-sectional study was to analyze the variables that influence the effectiveness of home care in patients with chronic cardiovascular disease and their informal caregivers. The study was conducted in 193 patients and their 161 informal caregivers. The study used the WHOQOL-BREF Quality of Life Questionnaire, the health behavior inventory questionnaire (HBI), the Camberwell assessment of need short appraisal schedule (CANSAS) and the hospital anxiety and depression scale–modified (HADS–M) version. Spearman’s rank correlation coefficient test and logistic regression were used for analyses. Analysis of patients revealed an association between home care effe…
Somatic symptoms and level of anxiety and depression in self-referral patients at the emergency department
Background. Due to multiple morbidities, patients experience various symptoms that may be of psychogenic or somatic origin. Anxiety and depression can induce somatization and the feeling that ailments require urgent medical intervention. Aim of the study. This study aimed to: (1) identify which symptoms self-referral patients most commonly report at the emergency department (ED) and which medical diagnoses they are discharged with; and (2) determine whether the type and severity of symptoms, as well as, sociodemographic variables are related to anxiety and depression levels. Material and methods. The study included 110 patients who self-referred to the ED at the University Clinical Hospital…
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Additional file 5. Detailed justification for the judgement upon each Evidence to Decision criterion, for each guideline.
Understanding frailty:a qualitative study of European healthcare policy-makers' approaches to frailty screening and management
ObjectiveTo elicit European healthcare policy-makers’ views, understanding and attitudes about the implementation of frailty screening and management strategies and responses to stakeholders’ views.DesignThematic analysis of semistructured qualitative interviews.SettingEuropean healthcare policy departments.ParticipantsSeven European healthcare policy-makers representing the European Union (n=2), UK (n=2), Italy (n=1), Spain (n=1) and Poland (n=1). Participants were sourced through professional networks and the European Commission Authentication Service website and were required to be in an active healthcare policy or decision-making role.ResultsSeven themes were identified. Our findings re…
Interventions to prevent, delay or reverse frailty in older people: a journey towards clinical guidelines
AbstractBackgroundAge-related frailty is a multidimensional dynamic condition associated with adverse patient outcomes and high costs for health systems. Several interventions have been proposed to tackle frailty. This correspondence article describes the journey through the development of evidence- and consensus-based guidelines on interventions aimed at preventing, delaying or reversing frailty in the context of the FOCUS (Frailty Management Optimisation through EIP-AHA Commitments and Utilisation of Stakeholders Input) project (664367-FOCUS-HP-PJ-2014). The rationale, framework, processes and content of the guidelines are described.Main textThe guidelines were framed into four questions …
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Additional file 2. Narrative synthesis of the effect of interventions on secondary outcomes, as offered to the guideline panellists.