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The effectiveness of active prophylactic screening analysis at family medicine clinic
No full textThe aim is to assess the effectiveness of active prophylactic screening analysis by identifying risk factors at the family medicine clinic of Lithuanian University of Health Sciences. Tasks: 1. To assess the prevalence of risk factors in the analysed population by the means of active prophylactic screening analysis. 2. To compare the prevalence of risk factors determined during the period of 2 years before the commencement of active prophylactic program and during the period when the program was in operation. 3. To assess the factors that influence patients’ motivation to participate in the active prophylactic program. 4. To assess the literacy of patients’ regarding the importance of analysed risk factors (BMI, physical activity) for health. Methodology. A quantitative research was carried out in the years 2016 – 2017 at the Family medicine clinic of Lithuanian University of Health Sciences. A permit to carry out the research was granted by the Centre of Bioethics of Lithuanian University of Health Sciences. Analysed population – patients from 18 years old who have participated in the program of active prophylactic screening. The method – search of assessment of risk factors in patient medical records for the period of 2 years before the commencement of prophylactic program and patient telephone survey. 147 patient medical records were analysed. 121 person agreed to participate in the study (response rate 82,3 %). A questionnaire prepared by the author including investigative questions about knowledge, opinion, and previous experience of respondents was used for the survey. Results. 32 percent of males and 68 percent of females participated in the survey, median age of investigated persons was 59,3 (±16) years. After assessment of physical activity of investigated persons it was established that 25,2 percent were physically active, 39,5 percent were insufficiently physically active and 35,4 percent were physically inactive. 3,4 percent of investigated persons had insufficient body mass, 27,2 percent had normal body mass, 32,7 percent were overweight, and 36,7 percent were obese. During the two years before the commencement of active prophylactic screening 25,9 percent of investigated persons had their physical activity assessed, 29,9 percent had their BMI assessed, 20 percent of which was carried out under the Heart and cardiovascular disease prevention program. 52,9 percent of the respondents were advised to participate in the program by health professionals, and 47,1 percent of investigated persons participated on their own initiative. 80,2 percent of investigated persons evaluated the program from 2 to 10 points, median 8, average 8,23, standard deviation 1,526, the rest of the respondents refused to provide assessments. It was established that the program received more positive evaluations from male persons, rural dwellers, working persons, health professionals and the persons who participated on their own initiative. When literacy on the subject was investigated, it was established that 71,1 percent of investigated persons did not know how to calculate BMI, and 81,8 percent knew about the influence of physical activity on health. It was established that women, persons of 18-64 years of age, persons having higher than primary education, working persons, persons having insufficient or normal body mass, and health professionals had better knowledge of the influence of physical activity on health. When investigated persons were assessed based on their physical activity, it was established that their knowledge of the influence of physical activity on health and their actual physical activity did not correspond. Conclusions: 1. Having assessed risk factors within the scope of prophylactic program and having determined their prevalence during the program it was established that more than a half of investigated persons were insufficiently physically active or physically inactive, had increased BMI, increased arterial blood pressure, deteriorated vision, and consumed alcohol. Every fifth investigated person had impaired hearing, every fourth was a smoker. 2. The screening rates for investigated characteristics before the introduction of active prophylactic program were low, it was established that the major part of screened characteristics was assessed during other prophylactic programs. 3. The major part of investigated persons check their health when health professional informs them about the importance of prophylactic health checks and their availability. Male persons, city dwellers, working persons, health professionals and persons who check their health on their own initiative gave more positive evaluations of the program. 4. Investigated persons have more knowledge about the influence of physical activity on health than about the calculation of BMI. Female persons, persons of younger age, persons having higher education, working persons, persons having sufficient physical activity and lower or normal BMI have higher literacy level on the investigated issues. Recommendation: Having assessed risk factors within the scope of prophylactic program and having determined their prevalence, target risk groups may be identified and necessary care may be planned to achieve better health status of a person
The Problem of Lower Back Pain in the Practice of a Family Doctor.
No full textThe Aim: To review the articles that analyze the problem of lower back pain which occur in a family doctor practice and to summarize the results of treatment effectiveness. Objectives: (1) To find out the prevalence of lower back pain in Europe and Lithuania; (2) To find out the methods of treatment of non-specific lower back pain; (3) To analyze the effectiveness of non-specific lower back pain treatment methods which is presented in articles. Method - systematic literature analysis. A computer bibliographic database of scientific works - PubMed - was used to search the scientific literature, using the selected keywords during the search. Scientific articles not older than 5 years (from March 1, 2015 to March 1, 2020) were analyzed. Results: Of the 146 articles found, only 6 articles remained after applying the inclusion and exclusion criteria. All selected studies are experimental in patients with chronic nonspecific lower back pain. In 1 study, additional cognitive behavioral therapy was used, 1 - an attempt to establish a closer relationship with the patient, 1 - chiropractic therapy, 3 - improvement of proprioreception and other exercises to help control movement. Conclusions: 1. Lower back pain in Europe and Lithuania accounts for about 80-95% of back pain. About 90% of people, though, have experienced back pain in their lifetime. About 2% of back pain consists of specific spinal pathology (usually tumor process, vertebral fracture), about 10-15% consists of pain associated with root syndrome (root pain, radiculopathy, spinal stenosis). Remaining pain - about 85% - Nonspecific lower back pain. 2. NANDS treatment is complex. It consists of (1) medical treatment - NSAIDs, acetaminophen, muscle relaxants or opioid analgesics, (2) non-medical treatment - physiotherapy, acupuncture, chiropractic manipulations, yoga, meditation, etc. (3) invasive treatment - steroid injections into epidural, intranasal injection or even radiofrequency ablation (RDA), (4) surgical treatment - such as discectomy, disc arthroplasty, spondyliosis. 3. After analyzing the articles, it can be concluded that physical activity is the most effective in the treatment of non-specific lower back pain, regardless of its nature, as there were no statistically significant differences in selected articles between study groups and controls (comparing different physical activities). Cognitive behavioral therapy in the treatment of chronic lower back pain was statistically significant
Diabetic patients’ health care and disease control: family physician’s role and needs
No full textDiabetes mellitus (DM) is one of today's most relevant public health problems. If the health care of patients with DM is not ensured, health of patients with this disease as well as their quality of life and working capacity suffer. Family physician performs long-term disease care of patients with DM; they are responsible for disease control, for treatment and patient education. It is the first research performed in Lithuania. The study objective was to evaluate the Lithuanian diabetic patients’ health care, their disease control and the family physicians’ services, their needs. We found that DM care and disease control in Lithuania is complicated, glycemic control is not good enough, rate of complications is large, type 2 DM treatment not always correspond to patient's state of health, disease care carried out in compliance with methodological recommendations. The evaluation of the family physicians’ opinions was showed that to achieve better DM care, they need the specialized training, community nurses’ involvement and establishment of diabetes training schools The analysis was showed that general physicians know quite well the responsibilities of community nurse, endocrinologist, nurse-diabetologist, psychologist, diabetic patients' association in DM care. The more than half of family physicians weren’t assigned for theirs responsibilities the consultation about non-medical treatment, psychological problems and motivating patients to participate in disease management
Parental attitudes towards children's vaccination
No full textEma Burbaitė PARENTAL ATTITUDES TOWARDS CHILDREN‘S VACCINATION Objecive. To asses parental attitudes about children‘s vaccination and the most common causes of vaccine refusal. Goals. To asses and compare attitudes toward children‘s vaccination of those parents, who vaccinate their child with those – who are not. To identify the most common causes of vaccine refusal. To asses parental information and knowledge about children‘s vaccination. Methods. In this study anonymous survey was conducted in August 2016 among parents of 0 – 18 – year – old children who were seen in the Hospital of Lithuaninan university of health sciences Kaunas Clincs. Of 445 contacted parents, 410 agreed to participate (92,13 % acceptance rate). 398 of 410 filled forms were includet into data analysis. Statistic data analysis was made by using SPSS 19.0. Chi – square (χ2) test was used for comparison of qualitative variable. The difference was significant when p<0,05. Results. 310 (77,89 %) of respondents agreed that vaccination is more beneficial than harmful. Majority (95,73 %) of parents agreed that vaccination is essential, and 359 (90,20 %) believed that vaccination always warrant protection of diseases. More than a half (58,04 %) of parents agreed that vaccines for children‘s immunization are safe. 23 (5,78 proc.) of respondents stated refusal of one or more vaccines for their children. Almost all parents (95,65%) of those, who refused to vaccine their children did it because of possibility of vaccines adverse events. Parents who believed in vaccines safety and those who have a lower than a higher education are more likely to vaccinate their children with free off charge vaccines. Parents who have higher education and those who get more than 1000 euros per month are more likely to vaccinate their children with self – paid vaccines. Only 125 (31,41 %) of respondents know that all vaccine preventable diseses are dangerous. The main source of information on vaccination is a general physician (85,68 %). One third (31,66%) of respondents indicated insufficient knowledge on children‘s vaccination. Conclusions. Most of respondents can be characterized as having a positive opinion about vaccination, however 31,66 % of respondents indicated insufficient knowledge on this issue. The main reason of vaccines refusal is possibility of vaccines adverse events
Patients suffering from cardiovascular diseases sleep quality and sleep quality affecting factors
No full textAim and objectives. To examine sleep quality and duration of LUHS Kaunas Clinics Family Medicine Clinic patients suffering from cardiovascular diseases and to evaluate their relationship with sociodemographic characteristics and body mass index. Methods. Anonymous survey questionnaire of patients suffering from cardiovascular diseases. The statistical analysis of the collected and systematized data was done using the IBM SPSS Statistics program package, version 21.0. Statistical significance (p) has been chosen as α=0,05, the results were considered statistically significant when p ≤ α. Study participants. Adult patients registered in Lithuanian University of Health Sciences Kaunas Clinics Family Medicine Clinic diagnosed with one or more cardiovascular disease diagnosis. Results. 69,1 proc. of patients with cardiovascular diseases assess the quality of their sleep as poor and only 30,9 proc. of the patients think that their quality of sleep is good. Women evaluate their sleep quality as poor statistically significantly more often than men, p=0,026. The subjective sleep quality and sleep duration are statistically significantly related, p=1,27×10-10, and a shorter duration of sleep leads to a reduction in the quality of sleep, p=2,17×10-20. There was observed statistically significant link between sleep quality and age, p=0,036, older patients think their sleep quality is worse more often than younger patients. Between BMI and the quality of sleep there is no statistically significant difference, p=0,186 or statistically significant correlation, p=0,596. Conclusions. The most part (69,1 proc.) of patients with cardiovascular diseases evaluate their sleep quality as poor. Women and older patients evaluate their sleep quality as poor statistically significantly more often than men and younger patients. Shorter duration of sleep leads to a reduction in the quality of sleep. The size of the BMI does not affect the quality of sleep. Recommendations. In old age, especially for women increases the risk of poor sleep quality. Interpreting sleep disorders medical history and treatment of patients with sleep disorders, it is especially important to pay attention to the duration of sleep, because the duration of sleep significantly affects persons sleep quality
Benzodiazepine prescribing in general practice
No full textMaster Theses of U. Snieganaite “Benzodiazepine prescribing in general practice”, supervisor Prof. L. Valius; Lithuanian University of Health Sciences, Academy of Medicine, Faculty of Medicine, Family Medicine Clinic – Kaunas. The aim of the research: To analyse benzodiazepine prescribing tendencies in General Practice in Family Medicine Department of Lithuanian University of Health Sciences. The objectives of the research: 1.To identify benzodiazepine prescribing indications 2. To assess the knowledge of patients regarding benzodiazepines. 3. To associate demographic factors and consumption tendencies with long-term benzodiazepine use. Methodology: anonymous survey questionnaire of patients with history of benzodiazepine consumption. The statistical analysis of the collected data was done using the SPSS program package, version 20.0. Participants: patients with history of benzodiazepine consumption in Lithuanian University of Health Sciences Hospital Kaunas Clinics Family Medicine Department. Results: The most common indications for benzodiazepine use are insomnia (75,5 %) and anxiety (40,8 %). 18,4 % of all patients asked prescription for benzodiazepine themselves. Insomnia is related to lack of alternative treatment offering, p=0,002. Alternative treatment is more often offered to younger people, p=0,019. If a psychiatrist initiates treatment with benodiazepines, consumption often lasts more than 3 months of every day use, p=0,016. Increase of a dose (p=0,036) and diminished effectiveness of benzodiazepines (p=0,035) are related to long-term (>3 months of everyday use) benzodiazepine consumption. Encouragement made by General practitioner to reduce or completely discontinue benzodiazepine consumption is related to patients‘ attempts to do so, p3 months everyday tend to think that benzodiazepines are entirely safe for long-term use, p=0,03. Conclusions: patients expect general practitioners to prescribe benzodiazepines. The most common indications for benzodiazepine use are insomnia and anxiety. Long-term treatment with benzodieazepines is related to psychiatrist as a first prescribing physician. There is a relation between long-term use and development of tolerance and dependence. Patients especially elderly do not have enough knowledge about benzodiazepines. Recommendations: patients should get more information about benzodiazepines from their general practitioners, general practitioners should encourage to reduce or discontinue benzodiazepine consumption and suggest non-medical treatment options for insomnia more often
Hepatitis B vaccination among students and residents of LUHS
No full textAistė Mikalauskaitė. Hepatitis B vaccination among students and residents of LUHS. Aim: To determine the reasons why students and residents of LUHS refused or failed to complete the hepatitis B vaccination. Goals: 1.To determine and compare how students and residents of LUHS who are unvaccinated and failed to complete vaccination course assess benefits of hepatitis B vaccination. 2. To determine the reasons why students and residents do not vaccinate or fail to complete hepatitis B vaccination course. 3. To compare the knowledge among students and residents of LUHS who are not vaccinated and failed to complete the vaccination course. Methods: Qualitative research method was chosen for a study. Students and residents of LUHS who refused to get a free vaccination and failed to complete vaccination course participated in a study. 172 questionnaires was sent electronically, 157 was fully completed. The collected data was processed and analyzed with SPSS 20.0. Qualitative evidence of the independence of the hypothesis was tested using chi-square (χ2) criteria and 95% confidence interval. Results were considered statistically significant if the error probability (p) of less than 0.05. Research results: 172 questionnaires was sent electronically, 157 was fully completed. Questionnaire response rate: 93% of students and residents who refused to vaccinate and 87% who failed to complete the hepatitis B course. 73% of respondents lack of data on vaccination programs. Partially vaccinated students and residents statistically significantly (p<0.05) assessed benefits of hepatitis B vaccination more positively than students and residents who refused to get a vaccination. 61% of participants refused to vaccinate because of belief that they do not become infected by hepatitis B. 67% of partially vaccinated persons did not have time to complete free vaccination program, 57 % – noted an unfavorable vaccination place, 41% – an improper time. 75 % of participants who refused vaccination and 86 % who failed to complete vaccination knowledge of hepatitis B was evaluated as a very good. Research conclusions: 1. Partially vaccinated students and residents of LUHS assessed benefits of hepatitis B vaccination more positively than students and residents who refused to get a vaccination.2. The main reason why students and residents of LUHS refused to vaccinate is their prevailing opinion that they will not be infected by hepatitis B. Other reasons why students and residents failed to complete the course are that they did not have time to vaccinate during the program and an unfavorable vaccination place. 3. Knowledge of hepatitis B was evaluated as a very good for more than three quarters of students and residents of LUH
The outlook of LUHS students and residents towards the organization of primary health care
No full textThe aim of the study. The aim is to evaluate the attitude of LUHS students and residents towards the organization of primary health care. Objectives. 1. Identify and evaluate LUHS students and residents knowledge of primary health care. 2. Identify and evaluate the attitude of LUHS students and residents outlook on the organization of primary health care. 3. Identify existing problems in organizing primary health care. 4. Find out the view of LUHS students and residents on information technology in health care. Methods. An electronic questionnaire for LUHS students and residents was conducted. Statistical data analysis was performed using the standard statistical package IBM SPSS Statistics 23.0. The selected level of statistical reliability p <0.05. Participants. The electronic questionnaire provided was answered voluntarily, answers included were from V-VI course medical students and resident doctors. In total, 104 respondents responded to the survey. Research results and conclusion. The opinion of LUHS students and residents about the Lithuanian health care system was mostly average (33.9 % and 35.6 %, respectively) or poor (40.7 % and 28.9 %, respectively). Respondents have identified Primary ambulatory health care as one of the most important link in the healthcare system. All residents and most of the students knew that family physicians are paid for the patients who are assigned, but not everyone knew that the salary components of the primary level included other types of payment. The most change demanding areas of the Lithuanian health care system were the issue specialists payment (97.8 % of residents and 93.2 % of students) and the calculation for doctors needed (88.9 % and 81.4 %, respectively). The majority of respondents that answered the survey tried to use the electronical medical information system and pointed out the need to improve the system. 49.2 % of students and 91.1 % of residents reported slow performance as a major shortcoming in the electronical medical information system, also 86.7 % of the residents and 54.2 % of the students indicated poor work of the electronical information system (p <0.05). Conclusion. 1. The majority of the LUHS students and LUHS KK residents know the most important primary health care functions and organizational aspects, residents have a better understanding of the system than students. However, there are misconceptions among both students and residents. 2. The majority of respondents are critical of the primary health care system and its organization. 3. Both medical students and residents refer to the same problems in the organization of primary health care, especially the calculation of physicians needed and the payment of specialists. It is important to note that all respondents indicate that there are problems. 4. The majority of respondents believe that information technologies are important in the health care system. The ESPBI system has been evaluated favorably, but with shortcomings
Uptake of influenza vaccination and awareness among medical and public health students of LUHS
No full textAim: To evaluate uptake and awareness of influenza vaccination among LUHS medical and public health students. Objectives: 1. To evaluate awareness of influenza vaccination among LUHS medical and public health students. 2. To describe behavior regarding influenza vaccination and its uptake among LUHS medical and public health students. 3. To evaluate LUHS medical and public health students' awareness of influenza vaccine and related behavioral links. Methods: A method of quantitative research was chosen for study. LUHS medical and public health students were surveyed with anonymous online questionnaire. Statistical analysis was performed using SPSS 23.0 program. Statistical association between the outcome variable and categorical predictor variables was assessed using Pearson chi-square test. Logistic regression analysis was undertaken to identify significant, independent predictors of the main outcome variable. Differences are statistically significant when p <0.05. Results: Assessing the awareness of respondents, correct answers about the influenza and influenza vaccine averaged 70, 93% ± 1.35. Medical students' awareness was better than public health students’. 22% of all respondents were vaccinated against influenza. 9.9% of the respondents were vaccinated for this flu season. Most common causes of influenza vaccine uptake was desire to protect themselves and to protect their relatives and friends. Most common barrier of influenza vaccination uptake was lack of time and doubts regarding vaccine effectiveness. Each percentage of correct answers regarding awareness of influenza and influenza vaccine increased vaccination probability by 1.017, which was statistically significant. Conclusions:. Medical students' awareness of influenza vaccine was higher than that of public health students. The knowledge of senior students on this subject is also better than that of younger students. The study found that medical and public health students irregularly vaccinated against influenza. Of the one fifth of the vaccinated respondents, less than half were vaccinated with this season’s vaccine. Medical students tend to recommend influenza vaccine more than public health students. The analysis of a series of factors possibly influencing medical and public health students uptake of influenza vaccine, found that the main factor was awareness
Influence of active invitation for vaccinating against the flu in 65 years or older people
No full textAim of study: To assess the influence of an active invitation and other causes that are important to decide about getting vaccinated against flu for 65 years or older people Objectives: 1. To assess the influence of active invitation getting vaccinated against the flu in 65 years or older people. 2. To assess the importance of letter – invitation informing about the vaccination against the flu. 3. To find out about the reasons why 65 years or older people decide to get vaccinated against the flu. Methods: Quantative research type was chosen for study. 65 years or older patients of Family Medicine Clinic participated in the study. They all get 3000 letters with invitations to be vaccinated. Then they came to the clinic they get a questionnaire. 182 people came to the clinic to be vaccinated and 158 of them completed the questionnaire. Statistical analysis was performed using SPSS 20.0. P < 0.05 was regarded as statistically significant. Results: 182 of 3000 people came to the clinic to be vaccinated against flu (response to the invitations is 6,067%). The results showed that 72,8 % of people know that they belong to risk group of flu and they could get a free vaccine, but 27,8% of people heard this information for the first time from the letter - invitation. 79,7% of people decided to be vaccinated after the invitation. 56,3% of people get vaccinated for the first time. Statistically significant more were those people who received the invitation and been vaccinated for the first time, compared with those who vaccinate annually. Moreover, there was statistically more people who decided to get vaccinated because the invitation, but they will not get vaccinated if they have to pay for the flu vaccine. Study conclusions: 1. Active invitation is not very important before making the decision about getting vaccinated against flu. 2. A letter – invitation is an important way of information, because about one third of 65 years or older people learned about free flu vaccine and more than a half of people get vaccinated for the first time. 3. To avoid the flu, to infect the family members and free flu vaccine are the most important reasons why 65 years or older people get vaccinated. 4. The most reliable information about vaccines 65 years and older patients receive from their family doctor
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