Search

The introduction of interprofessional primary care (IPC) as a model of collaborative patient care is increasingly vital in the context of complex healthcare systems and the growing needs of patients. Its benefits include improved patient outcomes, enhanced efficiency, and reduced costs. However, the successful implementation of IPC faces challenges due to the differences in training and backgrounds among healthcare professionals, emphasising the importance of effective teamwork and collaborative education.

The COVID-19 pandemic has led to a surge in scientific publications, some of which have bypassed the usual peer-review processes, leading to an increase in unsupported claims being referenced. Therefore, the need for references in scientific articles is increasingly being questioned. The practice of relying solely on quantitative measures, such as impact factor, is also considered inadequate by many experts. This can lead to researchers choosing research ideas that are likely to generate favourable metrics instead of interesting and important topics. Evaluating the quality and scientific value of articles requires a rethinking of current approaches, with a move away from purely quantitative methods.

Climate change is one of the biggest threats to public health. Sustainability is characterized by using resources wisely in a way that protects finite resources and the environment, and takes into account the needs of our planets’ inhabitants in the future. Sustainability in health care should be considered as a seventh domain of quality, as it can lead to improvement of patient outcomes, and more capacity for health care workers to engage in quality improvement and thereby improve the quality of care.

For the purpose of celebrating the 40th anniversary of Alma Ata declaration, the WHO published a successful model of integrated patient care being performed in Slovenia. After two years, the WHO experts evaluated the success in practise during a visit to the Slovenian primary care environment. This report showed that Slovenia was a notable exception regarding developing effective primary care systems. The country has an impressive primary care which performs very well.

The easy access to data from electronic patient records has made using this type of data in pay-for-performance systems increasingly common. General practitioners (GPs) throughout Europe oppose this for several reasons. Not all data can be used to derive good quality indicators and quality indicators can’t reflect the broad scope of primary care. Qualities like person-centred care and continuity are particularly difficult to measure. The indicators urge doctors and nurses to spend too much time on the registration and administration of required data. However, quality indicators can be very useful as starting points for discussions about quality in primary care, with the purpose being to initiate, stimulate and support local improvement work. This led to The European Society for Quality and Patient Safety in General Practice (EQuiP) feeling the urge to clarify the different aspects of quality indicators by updating their statement on measuring quality in Primary Care. The statement has been endorsed by the Wonca Europe Council in 2018.

The aim of our systematic review was to analyse the published literature on the psychosocial dimension of care in family medicine and its relationship with quality of care. We wanted to find out whether there is any evidence on the psychosocial approach in (family) medicine. The recommended bio-psycho-social approach, besides the biomedical model of illness, takes into account several co-influencing psychological, sociological and existential factors. An online search of nine different databases used Boolean operators and the following selection criteria: the paper contained information on the holistic approach, quality indicators, family medicine, patient-centred care and/or the bio-psycho-social model of treatment. We retrieved 743 papers, of which 36 fulfilled our inclusion criteria. Including the psychosocial dimension in patient management has been found to be useful in the prevention and treatment of physical and psychiatric illness, resulting in improved social functioning and patient satisfaction, reduced health care disparities, and reduced annual medical care charges. The themes of patient-centred, behavioural or psychosocial medicine were quite well presented in several papers. We could not find any conclusive evidence of the impact of a holistic biopsycho-social-approach. Weak and variable definitions of psychosocial dimensions, a low number of welldesigned intervention studies, and low numbers of included patients limited our conclusions.

Background. Hazardous and harmful alcohol drinking is an important health, social and economic issue in Slovenia amongst all age groups. While drinking in Slovenia has been well researched amongst elementary and high school students, there is a lack of research on drinking amongst university students.

Objectives To determine the views of Slovenian family physicians on medically unexplained symptoms (MUS) and learn more about potential types of treatment for such patients.Methods Five focus groups, comprising 24 family medicine physicians (FMPs) from two Slovenian University centres, were convened. Conversations were led towards the research objectives by professionally trained researchers and followed a preliminarily established protocol. Qualitative content analysis of audio and transcripts of the discussions was performed using ATLAS.ti software to establish categories (‘codes’) relevant to issues regarding MUS.Results Slovenian FMPs emphasized the importance of good communication and trust between physicians and patients with MUS. Systemic barriers to effective management of MUS arising from the Slovenian health system were highlighted. FMPs stressed the need for more education in the recognition and treatment of MUS in primary care. From the discussions, 64 codes comprising broader research fields of MUS were developed, then grouped into a further eight categories: communication; doctor–patient relationship; causes of MUS; patient characteristics; physician characteristics; courses of action so far; positive relationship with patients; proposals for treatment.Conclusions The results are valuable in terms of investigating the treatment of patients with MUS in Slovenia, thereby opening new avenues of research on the subject of MUS.

Disability in patients with chronic non-specific low back pain: validation of the Slovene version of the Oswestry Disability IndexAim:To validate the Slovene version of the Oswestry Disability Index.Method:A case series study of 129 adult patients with non-specific chronic low back pain attending a 10-day physical therapy programme. Visual Analog Pain Scale (VAS), Euroqol questionnaire (EQq), and Oswestry Disability Index (ODI) were used at the beginning and at the end of the physical therapy programme.Results:Cronbach's a of the Slovene ODI was 0.876 at the beginning of the physical therapy programme and 0.901 at the end of the programme. All items of the questionnaire loaded on the same factor. A significant positive correlation existed between the Slovene ODI and VAS, EQ-5D and EQ-VAS at the beginning of the physical therapy programme (r=0.630, p<0.001; r=0.657, p<0.001; r=-0.510, p<0.001, respectively), as well as at the end of the programme (r=0.491, p<0.001; r=0.725, p<0.001; r=-0.648, p<0.001, respectively). The difference between ODI scores obtained at the first and at the second interview was 2.7 ± 5.2 (p<0.001), and the difference between ODI disability scores was 5.4 ± 10.5 (p<0.001). The effect size of the Slovene ODI questionnaire was 0.30.Conclusions:The Slovene ODI questionnaire is a reliable and valid instrument for assessing outcomes of physical therapy in patients with chronic non-specific low back pain.

Ocena Pogostosti Kroničnih Bolezni Med Polnoletnimi Prebivalci SlovenijeIzhodišča:Raziskava, ki jo predstavljamo v prispevku, je del raziskovalne naloge »Razširjenost samozdravljenja v slovenski populaciji«. Prikazati želimo razširjenost kroničnih bolezni v Sloveniji ter značilnosti posameznikov z obravnavanimi boleznimi. Posebno pozornost namenjamo prevalenci kroničnih bolezni v populaciji ter njihovi pojavnosti glede na starost, izobrazbo in zaposlitveni status.Metode:Raziskava je presečna in temelji na anonimnem vprašalniku, ki smo ga aprila 2009 poslali na dom 1.000 iz telefonskega imenika naključno izbranim polnoletnim prebivalcem Republike Slovenije. Podatke smo statistično analizirali z metodo hi-kvadrat in s t-testom glede na naravo spremenljivk ter opravili multivariatno analizo.Rezultati:V analizo smo vključili 41,0% vsebinsko pravilno izpolnjenih anket. Ugotovili smo, da je imelo v letu 2008 zdravstvene težave kar 70,5 % anketiranih oseb. Anketirani s kroničnimi boleznimi so bili v povprečju 15 let starejši od anketiranih brez kroničnih težav. Najvišjo povprečno starost smo ugotovili pri anketiranih osebah s sladkorno boleznijo (66,7±11,4), pri bolnikih z rakom (65,1±18,7) in pri bolnikih z revmatskimi boleznimi (64,5±14,6). Bolezni, kot so zvišan krvni tlak, revmatske bolezni, kožne bolezni in sladkorna bolezen, so pogostejše pri anketiranih osebah z nižjo stopnjo izobrazbe. Prav tako je prevalenca vseh bolezni višja pri skupini upokojenih kot pri ostalih anketiranih.Zaključki:Raziskava je pokazala, da je prevalenca kroničnih bolezni v Sloveniji visoka. Znatno višja je pri ljudeh z nižjim socialno-ekonomskim statusom ter pri upokojenih, zato svetujemo, da v prihodnje posebno pozornost namenimo predvsem odkrivanju in obravnavanju kroničnih bolezni pri omenjenih skupinah slovenskega prebivalstva.