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Assessment of attitudes of family physicians and patients towards treatment of chronic noncommon diseases

dc.contributor.advisorVasiljević, Nađa
dc.contributor.otherJanković, Janko
dc.contributor.otherKalimanovska-Oštrić, Dimitra
dc.contributor.otherĐorđević-Nikić, Marina
dc.creatorPilipović-Broćeta, Nataša
dc.date.accessioned2019-12-24T16:07:26Z
dc.date.available2019-12-24T16:07:26Z
dc.date.available2020-07-03T08:52:12Z
dc.date.issued2019-07-10
dc.identifier.urihttp://eteze.bg.ac.rs/application/showtheses?thesesId=6959
dc.identifier.urihttps://nardus.mpn.gov.rs/handle/123456789/11625
dc.identifier.urihttps://fedorabg.bg.ac.rs/fedora/get/o:20387/bdef:Content/download
dc.identifier.urihttp://vbs.rs/scripts/cobiss?command=DISPLAY&base=70036&RID=51640847
dc.description.abstractHronične bolesti su u stalnom porastu i značajno utiču na kvalitet života pojedinca, porodice, zajednice i društva u celini. Tretman hroničnih nezaraznih bolesti se najvećim delom sprovodi na nivou primarne zdravstvene zaštite u okviru timova porodične medicine, koji predstavljaju prvu tačku kontakta građana sa zdravstvenim sistemom. Savremeni model zdravstvene zaštite pacijenata sa hroničnim bolestima obuhvata 6 ključnih elemenata sistema zdravstvene zaštite: organizaciju zdravstvene zaštite, dizajniranje sistema pružanja usluga, zdravstveni informacioni sistem, odlučivanje zasnovano na dokazima, jačanje pacijentove uloge u tretmanu i resurse u zajednici. Istraživanje je provedeno sa ciljem da se ispitaju stavovi i saglasnost stavova porodičnih doktora i pacijenata o načinima lečenja hroničnih bolesti i usklađenosti sa savremenim modelom; proceni sprovođenje preporuka za lečenje navedenih bolesti u kliničkim vodičima za hipertenziju, dijabetes melitus i hroničnu opstruktivnu bolest pluća uvidom u medicinsku dokumentaciju i njenom analizom, kao i da se predlože mere za unapređenje zdravstvenih usluga pruženih pacijentima sa hroničnim bolestima. Istraživanje je provedeno kao studija preseka u dva doma zdravlja Prijedor i Bijeljina, a uzorak je činilo 1697 ispitanika. Instrumenti istraživanja su bili PACIC (Patient Assessment of Chronic Illness Care) upitnik za procenu stavova pacijenata o lečenju hronične bolesti i ACIC (Assessment of Chronic Illness Care) upitnik za procenu stavova doktora o lečenju hroničnih bolesti. Porodični doktori su popunili formular o pacijentima, uključujući sociodemografske podatke, podatke o životnom stilu pacijenata, o broju pregleda kod porodičnog doktora i specijalista na sekundarnom nivou zdravstvene zaštite, o broju hospitalizacija, pacijentovu procenu vlastitog zdravlja, podatke o bolestima srca i krvnih sudova, dijabetes melitusu i moždanom udaru kod roditelja, braće, sestara; podatke na osnovu fizikalnog/kliničkog pregleda pacijenta iz medicinske dokumentacije, koja će posvedočiti da je pregled izvršen i da su evidentirani neophodni biomarkeri, kontrolisani kao što je navedeno u kliničkom vodiču za odgovarajuće hronične bolesti. Podaci su analizirani metodama deskriptivne statistike i bivarijantnim i multivarijantnim regresionim metodama. Srednja ocjena ukupnog PACIC upitnika ove studije u vrednosti od 4.0766 ukazuje da je zdravstvena zaštita, u proseku, “većinu vremena” pružena u skladu sa savremenim modelom. Srednja ocena prema oblastima je bila najviša u oblasti Rešavanje zdravstvenog problema/savetovanje, a najniža u oblasti Kontrolni pregledi/koordinacija...sr
dc.description.abstractChronic non-communicable diseases are constantly increasing and influencing quality of life of each person, family and community. The treatment of most common chronic conditions has been performed mainly at the primary health care level within family medicine teams. The Chronic Care Model is a modern approach in chronic disease management and focuses on improving and optimizing six key elements of the health care system: health care organization, delivery system design, clinical information systems, decision-support, self-management support and community resource. The objectives of this study were as follows: to assess attitudes of family physicians and patients towards chronic disease care implementation of the Chronic Care Model; to assess the implementation of chronic disease clinical guidelines for hypertension, diabetes mellitus and chronic obstructive pulmonary disease at primary health care level using patient medical records; propose measures for improving of chronic disease care. This is a cross-sectional study implemented in two randomly selected primary health care (PHC) centers in Bijeljina and Prijedor and the study sample consisted of 1697 patients. Patient Assessment of Chronic Illness Care (PACIC) and Assessment of Chronic Illness Care (ACIC) version 3.5 have been tools in the study. Family physicians filled the form on following patient characteristics from the medical documentations: socio-demographic variables; life habits; the number of visits to family physicians and secondary health care level specialists, the number of hospitalizations; self-perception of health status; family history of cardiovascular diseases, diabetes mellitus, stroke; physical examination recorded in medical documentation as well as results of diagnostic procedures in accordance with clinical guidelines. Data were analyzed by methods of descriptive and bivariate and multiple regressions. The mean PACIC score of 4.0766 obtained in this study indicates that, on average, Chronic Care Model-concordant care occurred “most of the time”. Subscale “Problem solving/Contextual” had the highest score while subscale “Follow up/Coordination” had the lowest score. There was significant association between socio-demographic characteristics, life habits and patient health status with PACIC scores. Family physicians in this study stated that chronic illness care was good supported. Delivery System Design was best scored and Community Linkage and Integration of components had the lowest average scores...en
dc.formatapplication/pdf
dc.languagesr
dc.publisherУниверзитет у Београду, Медицински факултетsr
dc.rightsopenAccessen
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/4.0/
dc.sourceУниверзитет у Београдуsr
dc.subjectsavremeni model lečenja hroničnih bolestisr
dc.subjectthe Chronic Care Modelen
dc.subjecthypertensionen
dc.subjectdiabetes mellitusen
dc.subjectCOPDen
dc.subjectPACICen
dc.subjectACICen
dc.subjectthe Republic of Srpskaen
dc.subjecthipertenzijasr
dc.subjectdijabetes melitussr
dc.subjectHOBPsr
dc.subjectPACICsr
dc.subjectACICsr
dc.subjectRepublika Srpskasr
dc.titleIspitivanje saglasnosti stavova doktora porodične medicine i pacijenata o lečenju hroničnih nezaraznih bolestisr
dc.title.alternativeAssessment of attitudes of family physicians and patients towards treatment of chronic noncommon diseasesen
dc.typedoctoralThesisen
dc.rights.licenseBY-NC-ND
dc.identifier.fulltexthttps://nardus.mpn.gov.rs/bitstream/id/10498/Disertacija.pdf
dc.identifier.fulltexthttps://nardus.mpn.gov.rs/bitstream/id/10499/IzvestajKomisije21181.pdf
dc.identifier.fulltexthttp://nardus.mpn.gov.rs/bitstream/id/10498/Disertacija.pdf
dc.identifier.fulltexthttp://nardus.mpn.gov.rs/bitstream/id/10499/IzvestajKomisije21181.pdf
dc.identifier.rcubhttps://hdl.handle.net/21.15107/rcub_nardus_11625


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