International journal of family medicine最新文献_第10页

Chronic Condition Clusters and Polypharmacy among Adults. 成人慢性疾病群集与多重用药。

International journal of family medicine Pub Date : 2012-01-01 Epub Date: 2012-08-01 DOI: 10.1155/2012/193168

Ami Vyas, Xiaoyun Pan, Usha Sambamoorthi

{"title":"Chronic Condition Clusters and Polypharmacy among Adults.","authors":"Ami Vyas, Xiaoyun Pan, Usha Sambamoorthi","doi":"10.1155/2012/193168","DOIUrl":"https://doi.org/10.1155/2012/193168","url":null,"abstract":"Objective. The primary objective of the study was to estimate the rates of polypharmacy among individuals with multimorbidity defined as chronic condition clusters and examine their associations with polypharmacy. Methods. Cross-sectional analysis of 10,528 individuals of age above 21, with at least one physical condition in cardiometabolic (diabetes or heart disease or hypertension), musculoskeletal (arthritis or osteoporosis), and respiratory (chronic obstructive pulmonary disease (COPD) or asthma) clusters from the 2009 Medical Expenditure Panel Survey. Chi-square tests and logistic regressions were performed to analyze the association between polypharmacy and multimorbidity. Results. Polypharmacy rates varied from a low of 7.2% among those with respiratory cluster to a high of 64.1% among those with all three disease clusters. Among those with two or more disease clusters, the rates varied from 28.3% for musculoskeletal and respiratory clusters to 41.8% for those with cardiometabolic and respiratory clusters. Individual with cardiometabolic conditions alone or in combination with other disease clusters were more likely to have polypharmacy. Compared to those with musculoskeletal and respiratory conditions, those with cardiometabolic and respiratory conditions had 1.68 times higher likelihood of polypharmacy. Conclusions. Rates of polypharmacy differed by specific disease clusters. Individuals with cardiometabolic condition were particularly at high risk of polypharmacy, suggesting greater surveillance for adverse drug interaction in this group.","PeriodicalId":89569,"journal":{"name":"International journal of family medicine","volume":"2012 ","pages":"193168"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2012/193168","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30840376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 68

Individual Development of Professionalism in Educational Peer Group Supervision: A Multiple Case Study of GPs. 教育同伴团体监督中专业精神的个体发展:以全科医生为例。

International journal of family medicine Pub Date : 2012-01-01 Epub Date: 2012-05-27 DOI: 10.1155/2012/792018

Bibi Hølge-Hazelton, Charlotte Tulinius

{"title":"Individual Development of Professionalism in Educational Peer Group Supervision: A Multiple Case Study of GPs.","authors":"Bibi Hølge-Hazelton, Charlotte Tulinius","doi":"10.1155/2012/792018","DOIUrl":"https://doi.org/10.1155/2012/792018","url":null,"abstract":"Background. Research has shown that peer-group supervision can strengthen GPs' professionalism, but little is known about the individual learning processes. To establish professionalism beyond professional behaviour, identity and idealism need to be included. The inner attitudinal values of professionalism within the individual are, however, difficult to assess. Aim. On the basis of a multiple case study, this paper describes the process of professional learning and challenges for individual GPs, as they take part in supervision groups focusing on children cases. Methods and Results. By using a two-dimensional theoretical model, it is shown that all GPs developed their professional behaviour, and many of them strengthened their professional identity in this domain towards a changed professionalism. Most participants emphasized the positive experience of sharing worries with families indicating care and interest. Some participants learning processes were very linear/convergent; others were complex/divergent—starting out with a relatively simple objective, realizing how multifaceted the issue was after the first year leading to a final development of new perspectives or action possibilities. Conclusion. The composition of supervision groups, as well as the professional background of the supervisor, may play a significant role in the development of professional behaviour and professionalism.","PeriodicalId":89569,"journal":{"name":"International journal of family medicine","volume":"2012 ","pages":"792018"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2012/792018","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30687449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

Care-Seeking Pattern among Persons with Depression and Anxiety: A Population-Based Study in Sweden. 抑郁症和焦虑症患者的求医模式:瑞典一项基于人群的研究

International journal of family medicine Pub Date : 2012-01-01 Epub Date: 2012-05-10 DOI: 10.1155/2012/895425

Anna Wallerblad, Jette Möller, Yvonne Forsell

{"title":"Care-Seeking Pattern among Persons with Depression and Anxiety: A Population-Based Study in Sweden.","authors":"Anna Wallerblad, Jette Möller, Yvonne Forsell","doi":"10.1155/2012/895425","DOIUrl":"https://doi.org/10.1155/2012/895425","url":null,"abstract":"Background. In primary care, a vast majority of patients affected with depression and anxiety present with somatic symptoms. Detection rate of psychiatric symptoms is low, and knowledge of factors influencing care seeking in persons affected by depressive and anxiety disorders on a population level is limited. Objective. This study aims to describe if persons, affected by depression and anxiety disorders, seek care and which type of care they seek as well as factors associated with care seeking. Method. Data derives from a longitudinal population-based study of mental health conducted in the Stockholm County in 1998-2010 and the present study includes 8387 subjects. Definitions of anxiety and depressive disorders were made according to DSM-IV criteria, including research criteria, using validated diagnostic scales. 2026 persons (24%) fulfilled the criteria for any depressive or anxiety disorder. Results. Forty-seven percent of those affected by depression and/or anxiety had been seeking care for psychological symptoms within the last year. A major finding was that seeking care for psychological symptoms was associated with having treatment for somatic problems. Conclusions. As a general practitioner, it is of great importance to increase awareness of mild mental illness, especially among groups that might be less expected to be affected.","PeriodicalId":89569,"journal":{"name":"International journal of family medicine","volume":"2012 ","pages":"895425"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2012/895425","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30659679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 38

Undetected common mental disorders in long-term sickness absence. 长期疾病缺席中未被发现的常见精神障碍。

International journal of family medicine Pub Date : 2012-01-01 Epub Date: 2012-05-14 DOI: 10.1155/2012/474989

Hans Joergen Soegaard

{"title":"Undetected common mental disorders in long-term sickness absence.","authors":"Hans Joergen Soegaard","doi":"10.1155/2012/474989","DOIUrl":"https://doi.org/10.1155/2012/474989","url":null,"abstract":"Background. Undetected Common Mental Disorders (CMDs) amongst people on sick leave complicate rehabilitation and return to work because appropriate treatments are not initiated. Aims. The aim of this study is to estimate (1) the frequencies of CMD, (2) the predictors of undetected CMD, and (3) the rate of return to work among sick listed individuals without a psychiatric disorder, who are registered on long-term sickness absence (LSA). Methods. A total of 2,414 incident individuals on LSA with a response rate of 46.4%, were identified for a two-phase study. The subsample of this study involved individuals registered on LSA who were sick-listed without a psychiatric sick leave diagnosis. In this respect, Phase 1 included 831 individuals, who were screened for mental disorders. In Phase 2, following the screening of Phase 1, 227 individuals were thoroughly examined by a psychiatrist applying Present State Examination. The analyses of the study were carried out based on the 227 individuals from Phase 2 and, subsequently, weighted to be representative of the 831 individuals in Phase 1. Results. The frequencies of undetected mental disorders among all sick-listed individuals were for any psychiatric diagnosis 21%, depression 14%, anxiety 4%, and somatoform disorder 6%. Conclusions. Undetected CMD may delay the initiation of appropriate treatment and complicate the rehabilitation and return to work.","PeriodicalId":89569,"journal":{"name":"International journal of family medicine","volume":"2012 ","pages":"474989"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2012/474989","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30667495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 21

Prevalent obstacles and predictors for people living with type 2 diabetes. 2型糖尿病患者的常见障碍和预测因素。

International journal of family medicine Pub Date : 2012-01-01 Epub Date: 2012-12-02 DOI: 10.1155/2012/842912

L Pilv, A Rätsep, M Oona, R Kalda

{"title":"Prevalent obstacles and predictors for people living with type 2 diabetes.","authors":"L Pilv, A Rätsep, M Oona, R Kalda","doi":"10.1155/2012/842912","DOIUrl":"https://doi.org/10.1155/2012/842912","url":null,"abstract":"Background. Type 2 diabetes (T2DM) is a chronic, progressive disease with serious micro- and macrovascular complications. A person affected by T2DM should learn to accept the new restricted lifestyle. Aims. The aim of the study was to identify the prevalence of obstacles in coping with daily life for people with T2DM and the magnitude of the relationships of the obstacles with various patient characteristics. Methods. Participants were recruited from randomly selected GPs' lists in Estonia. Respondents completed the Estonian version of the Diabetes Obstacles Questionnaire (DOQ). The statements were assessed on a 5-point scale. Biomedical and clinical variables were measured. The central tendency statistics and skewness and kurtosis for all statements were computed to find out those that reflect obstacles. Then obstacles of the DOQ were stratified. Multinomial logistic regression (MLR) was computed to estimate the influences of descriptive variables on the statements. Results and Conclusions. Altogether, 138 diabetic patients were enrolled in the study. Fourteen statements were identified as obstacles. Variables such as age, type of diabetes treatment, and BMI had significant effects on five of them. Younger age, BMI, and insulin nonuse were revealed as the strongest predictive characteristics for perceiving obstacles more often in coping with daily life.","PeriodicalId":89569,"journal":{"name":"International journal of family medicine","volume":"2012 ","pages":"842912"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2012/842912","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31133595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 9

Effects of self-empowered teams on rates of adverse drug events in primary care. 自我授权团队对初级保健中药物不良事件发生率的影响。

International journal of family medicine Pub Date : 2012-01-01 Epub Date: 2012-02-16 DOI: 10.1155/2012/374639

Ranjit Singh, Diana Anderson, Elizabeth McLean-Plunkett, Angela Wisniewski, Renee Kee, Kelvin Gold, Chet Fox, Gurdev Singh

{"title":"Effects of self-empowered teams on rates of adverse drug events in primary care.","authors":"Ranjit Singh, Diana Anderson, Elizabeth McLean-Plunkett, Angela Wisniewski, Renee Kee, Kelvin Gold, Chet Fox, Gurdev Singh","doi":"10.1155/2012/374639","DOIUrl":"https://doi.org/10.1155/2012/374639","url":null,"abstract":"Background. Most safety issues in primary care arise from adverse drug events. Team Resource Management intervention was developed to identify systemic safety issues to design and implement interventions to address prioritized issues. Objectives. Evaluate impact of intervention on rates of events and preventable events in a vulnerable population. Design. Cluster randomized trial. 12 practices randomly assigned to either: (1) Intervention; (2) Intervention with Practice Enhancement Assistants; (3) No intervention. The intervention took 12 months. Main Outcome Measure. Rate and severity of events and preventable events measured using a Trigger Tool chart review method for the 12-month periods before and after the start of the intervention. Results. In the ''intervention with Assistants\" group there was a statistically significant decrease in the overall rate of events and in the rate of moderate/severe events. Analysis of Variance with study arm and time as the factors and moderate/severe events as the outcome showed a significant interaction between arm and time supporting the notion that the ''Intervention with Assistants\" practices had a greater reduction in moderate/severe preventable events. Conclusions. The intervention had a significant effect on medication safety as estimated using a trigger tool. Further exploration of role of Assistants and trigger tool is warranted.","PeriodicalId":89569,"journal":{"name":"International journal of family medicine","volume":" ","pages":"374639"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2012/374639","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40169113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 12

The danish model for improvement of diabetes care in general practice: impact of automated collection and feedback of patient data. 改善糖尿病护理的丹麦模式:患者数据自动收集和反馈的影响。

International journal of family medicine Pub Date : 2012-01-01 Epub Date: 2012-07-24 DOI: 10.1155/2012/208123

Henrik Schroll, René Depont Christensen, Janus Laust Thomsen, Morten Andersen, Søren Friborg, Jens Søndergaard

{"title":"The danish model for improvement of diabetes care in general practice: impact of automated collection and feedback of patient data.","authors":"Henrik Schroll, René Depont Christensen, Janus Laust Thomsen, Morten Andersen, Søren Friborg, Jens Søndergaard","doi":"10.1155/2012/208123","DOIUrl":"https://doi.org/10.1155/2012/208123","url":null,"abstract":"Background. Sentinel Data Capture is an IT program designed to collect data automatically from GPs' electronic health record system. Data include ICPC diagnoses, National Health Service disbursement codes, laboratory analysis, and prescribed drugs. Quality feedback reports are generated individually for each practice on the basis of the accumulated data and are available online only for the specific practice. Objective. To describe the development of the quality of care concerning drug prescriptions for diabetes patients listed with GPs using the Data Capture module. Methods. In a cohort study, among 8320 registered patients with diabetes, we analyzed the change in the proportion of medication for uncontrolled cases of diabetes. Results. From 2009 to 2010, there was an absolute risk reduction of 1.35% (0.89-1.81: P < 0.001) in proportion of persons not in antidiabetic medication despite an HbA1c above 7.0. Similarly, there was a 4.51% (3.42-5.61: P < 0.001) absolute risk reduction in patients not in antihypertensive treatment despite systolic blood pressure above 130 mm Hg and 4.73% (3.56-5.90: P < 0.001) absolute risk reduction in patients with total cholesterol level above 4.5 mmol/L and not receiving lipid-lowering treatment. Conclusions. Structured collection of electronic data from general practice and feedback with reports on quality of care for diabetes patient seems to give a significant reduction in proportion of patients with no medical treatment over one year for participating GPs. Due to lack of a control group, we are, however, not able to say if the drop in the proportion of uncontrolled cases is a result of participation in collection of electronic data and feedback alone.","PeriodicalId":89569,"journal":{"name":"International journal of family medicine","volume":"2012 ","pages":"208123"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2012/208123","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30830067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 33

The role of health literacy and social networks in arthritis patients' health information-seeking behavior: a qualitative study. 健康素养和社会网络在关节炎患者健康信息寻求行为中的作用:一项定性研究。

International journal of family medicine Pub Date : 2012-01-01 Epub Date: 2012-09-10 DOI: 10.1155/2012/397039

Janette Ellis, Judy Mullan, Anthony Worsley, Nagesh Pai

{"title":"The role of health literacy and social networks in arthritis patients' health information-seeking behavior: a qualitative study.","authors":"Janette Ellis, Judy Mullan, Anthony Worsley, Nagesh Pai","doi":"10.1155/2012/397039","DOIUrl":"https://doi.org/10.1155/2012/397039","url":null,"abstract":"Background. Patients engage in health information-seeking behaviour to maintain their wellbeing and to manage chronic diseases such as arthritis. Health literacy allows patients to understand available treatments and to critically appraise information they obtain from a wide range of sources. Aims. To explore how arthritis patients' health literacy affects engagement in arthritis-focused health information-seeking behaviour and the selection of sources of health information available through their informal social network. Methods. An exploratory, qualitative study consisting of one-on-one semi-structured interviews. Twenty participants with arthritis were recruited from community organizations. The interviews were designed to elicit participants' understanding about their arthritis and arthritis medication and to determine how the participants' health literacy informed selection of where they found information about their arthritis and pain medication. Results. Participants with low health literacy were less likely to be engaged with health information-seeking behaviour. Participants with intermediate health literacy were more likely to source arthritis-focused health information from newspapers, television, and within their informal social network. Those with high health literacy sourced information from the internet and specialist health sources and were providers of information within their informal social network. Conclusion. Health professionals need to be aware that levels of engagement in health information-seeking behaviour and sources of arthritis-focused health information may be related to their patients' health literacy.","PeriodicalId":89569,"journal":{"name":"International journal of family medicine","volume":"2012 ","pages":"397039"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2012/397039","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30921947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 67

Continuing care for mentally stable psychiatric patients in primary care: patients' preferences and views. 初级保健中精神稳定型精神病患者的持续护理:患者的偏好和观点。

International journal of family medicine Pub Date : 2012-01-01 Epub Date: 2012-07-11 DOI: 10.1155/2012/575381

Vincent I O Agyapong

{"title":"Continuing care for mentally stable psychiatric patients in primary care: patients' preferences and views.","authors":"Vincent I O Agyapong","doi":"10.1155/2012/575381","DOIUrl":"https://doi.org/10.1155/2012/575381","url":null,"abstract":"Objective. To investigate the preferences of psychiatric patients regarding attendance for their continuing mental health care once stable from a primary care setting as opposed to a specialized psychiatric service setting. Methods. 150 consecutive psychiatric patients attending outpatient review in a community mental health centre in Dublin were approached and asked to complete a semistructured questionnaire designed to assess the objectives of the study. Results. 145 patients completed the questionnaire giving a response rate of 97%. Ninety-eight patients (68%) preferred attending a specialized psychiatry service even when stabilised on their treatment. The common reason given by patients in this category was fear of substandard quality of psychiatric care from their general practitioners (GPs) (67 patients, 68.4%). Twenty-nine patients (20%) preferred to attend their GP for continuing mental health care. The reasons given by these patients included confidence in GPs, providing same level of care as psychiatrist for mental illness (18 patients or 62%), and the advantage of managing both mental and physical health by GPs (13 patients, 45%). Conclusion. Most patients who attend specialised psychiatric services preferred to continue attending specialized psychiatric services even if they become mentally stable than primary care, with most reasons revolving around fears of inadequate psychiatric care from GPs.","PeriodicalId":89569,"journal":{"name":"International journal of family medicine","volume":"2012 ","pages":"575381"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2012/575381","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30798060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 3

A Survey of Primary Care Offices: Triage of Poisoning Calls without a Poison Control Center. 初级保健办公室的调查:没有中毒控制中心的中毒电话分类。

International journal of family medicine Pub Date : 2012-01-01 Epub Date: 2012-07-01 DOI: 10.1155/2012/417823

Travis Austin, Daniel E Brooks, Sharyn Welch, Frank Lovecchio

引用次数: 8