Reflection is a form of enquiry, the purpose of which includes the following: to query take-for-granted assumptions; to look for answers to puzzles or questions that are from real-world observations, dilemmas, and critical incidents; and, eventually, to transform these into action so that professional expertise develops. 1 It is a fundamental skill of health-care professionals and plays an important role in ensuring the qualityofcare in health-care practice. Its advantages have been verified in numerous studies, ranging from enabling nurses
did not fully cover regular laboratory testing according to the guidelines, and the education of patients was not available within the primary practice team. According to this, only a smaller part of diabetes patients, those with simple oral treatment and no complications, were not referred to the diabetologist. The qualityofcare for patients with DM2 managed at the primary level was not followed.
The quality of diabetes care in model practices is evaluated by the quality indicators based on diabetes guidelines (12) . Accordingly, HbA1c, laboratory tests (serum
Breast Cancer among Urban Nigerian Women: Appraising Presentation and the Quality of Care
Introduction: Late presentation is the hallmark of breast cancer among Nigerians. Awareness of the disease is low and care of this condition has not received adequate attention from Government. Health education to improve awareness was intensified in the last 2 decades. This study aims to assess the current state of care and presentation of breast cancer in Lagos, Nigeria.
Patients and Methods: A prospective study of 350 breast cancer patients seen over a period of four years at a General Surgical unit out-patient clinic of LASUTH was carried out. Data on patient characteristics, presentation, diagnosis and treatment were obtained and analyzed.
Results: Average duration of symptoms was 46.48 weeks. One fifth presented within 3 months while 17% presented after 1 year. Lumps were self-detected in 96% and 287 (82%) presented with advanced disease (stages III & IV). Two hundred and thirty seven patients (67%) received treatment and 175 (74%) among them had mastectomy. None had breast conservation surgery. One hundred and fourteen patients (48%) absconded and did complete treatment.
Conclusion: The trend of late presentation has not changed with current efforts to improve breast cancer awareness. Quality of care for our breast cancer patients is not satisfactory and needs improvement.
Irena Makivić, † Janko Kersnik and Zalika Klemenc-Ketiš
normal life events and trigger unwarranted illness behaviour in patients ( 6 ). A combination of bio-psycho-social approachesaddresses the complexity of the presentation of illness in modern family practice( 7 ). A view of the human body that goes beyond the reductionist tendencies of naturalistic and social constructionist perspectives sees the body as an unfinished, biological and social phenomenon ( 8 ).
Qualityofcare encompasses patients (the adequate identification of vulnerable/eligible patients), doctors, and resources ( 9 ). There have been different
Medical care in disabled sports is crucial both as prophylaxis and as ongoing medical intervention. The aim of this paper was to present changes in the quality of medical care over the consecutive Paralympic Games (PG). The study encompassed 31 paralympians: Turin (11), Vancouver (12), and Sochi (8) competing in cross-country skiing, alpine skiing, biathlon and snowboarding. The first, questionnaire-based, part of the study was conducted in Poland before the PG. The athletes assessed the quality of care provided by physicians, physiologists, dieticians, and physiotherapists, as well as their cooperation with the massage therapist and the psychologist. The other part of the study concerned the athletes’ health before leaving for the PG, as well as their diseases and injuries during the PG. The quality of medical care was poor before the 2006 PG, but satisfactory before the subsequent PG. Only few athletes made use of psychological support, assessing it as poor before the 2006 PG and satisfactory before the 2010 and 2014 PG. The athletes’ health condition was good during all PG. The health status of cross-country skiers was confirmed by a medical fitness certificate before all PG, while that of alpine skiers only before the 2014 PG. There were no serious diseases; training injuries precluded two athletes from participation. The quality of medical care before the PG was poor, however, became satisfactory during the actual PG. The resulting ad hoc pattern deviates from the accepted standards in medical care in disabled sports.
veselības nozarē [European Union Structural Funds in Health Care]. Available from: http://esfondi.vm.gov.lv/lat/2014__2020gads/ (accessed 12.12.2018).
Awara, M., Fasey, C. (2008). Patients’ satisfaction and qualityofcare in psychiatric out-patient settings. J. Mental Health , 17 (3), 327–335.
Barbato, A., Bajoni, A., Rapisarda, F., D'Anza, V., De Luca, L. F., Inglese, C., Iapichino, S., Mauriello, F., D'Avanzo, B. (2014). Quality assessment of mental health care by people with severe mental disorders: A participatory research project. Commun. Mental
physicians’ accuracy in recording with qualityofcare in cardiovascular medicine. Eur J Cardiovasc Prev Rehabil 2009; 16: 722-728.
12. Bulc M, Fras Z, Zaletel-Kragelj L. Twelve-year blood pressure dynamics in adults in Ljubljana area, Slovenia: contribution of WHO Countrywide Integrated Noncommunicable Diseases Intervention Program. Croat Med J 2006; 47: 469-477.
13. Zaletel-Kragelj L, Erzen I, Fras Z. Interregional differences in health in Slovenia. II. Estimated prevalence of selected behavioral risk factors for cardiovascular and related
Zlata Ožvačić Adžić, Milica Katić, Josipa Kern, Jean Karl Soler, Venija Cerovečki and Ozren Polašek
Campbell SM, Roland MO, Buetow SA. Defining qualityofcare. Soc Sci Med 2000;51:1611-25. doi: 10.1016/S0277-9536(00)00057-5
16 Howie JGR, Heaney DJ, Maxwell M. Quality, core values and the general practice consultation: issues of definition, measurment and delivery. Fam Pract 2004;21:458-68. doi: 10.1093/fampra/cmh419
17 Orton P, Orton C, Pereira Gray D. Depersonalised doctors: a cross sectional study of 564 doctors, 760 consultations and 1876 patient reports in UK general practice. BMJ Open 2012;2:e000274. doi: 10.1136/bmjopen-2011
Marek Kos, Agnieszka Dziewa, Bartłomiej Drop, Marzena Furtak-Niczyporuk and Ewa Warchoł-Sławińska
Introduction. Measuring the patient satisfaction with the hospital stay, as well as the knowledge of their requirements are very important in the management of health institutions. A good example of the recognition of patients’ expectations is studying the level of satisfaction with specially prepared questionnaires.
Aim. The aim of the study was to investigate the relationship between the patients’ place of residence and their satisfaction with the medical care they received when treated in local hospitals
Material and methods. Patient satisfaction survey was carried out in the Independent Public Health Care Centre in Kraśnik in two subsequent years: at the turn of 2011/2012 and in February 2013. The survey consisted of patients hospitalized in the surgical wards of the hospital. A testing tool for this survey was a self-designed questionnaire entitles “Patient satisfaction survey” specifically developed by nursing managers and approved by the management of the hospital.
Results. Patients of the District Hospital in Kraśnik gave their complex assessment of satisfaction with the benefits provided by the health care facility, taking into account not only the quality of strictly medical services, but the entire infrastructure of the hospital, including ancillary services. The obtained results gave a positive assessment of the analyzed branches. No statistically significant differences between the assessments of rural and urban inhabitants were found. The results allow knowledge of the strengths and weaknesses of medical care in the wards.
Conclusions. Residents of rural areas, who are slightly better than those who live in cities, assess the work of local hospital surgical wards. You can clearly see it by assessing the quality of nurses’ and doctors’ work and the assessment of nutrition and the appearance of patient rooms. Systematic research, measurement and evaluation of patient satisfaction with hospital care can be the basis for the improvement and ensure an appropriate level of quality
Background: Sparse information exists regarding the progress of the chronic care model (CCM) implementation for type 2 diabetes, at system-wide level for developing countries including Thailand.
Objective: We assessed the extent to which type 2 diabetes patients in Bangkok, Thailand report having received CCM-based services by using the Patient Assessment of Chronic Illness Care (PACIC).
Methods: One thousand type 2 diabetes patients from 64 healthcare facilities throughout Bangkok were randomly selected, data about the extent they have received CCM-based services, their dietary, physical activity, medication-taking behaviors, body mass index (BMI), and blood sugar control status were collected by a set of structured questionnaires and medical record abstraction.
Results: PACIC and self-management scores for patients receiving care from public hospitals and health centers were significantly higher than those from private hospitals. Being the primary care unit (PCU)-where the CCM implementation has been enforced since 2008 was significantly associated with higher PACIC scores for public hospitals. This was not the case for private hospitals. PCU status was significantly associated with better selfmanagement scores for patients in both public and private hospitals. However, variations in PACIC and selfmanagement scores did not reflect to BMI or glycemic control outcomes of the patients.
Conclusion: There is encouraging evidence of progress of CCM implementation for type 2 diabetes patients in Bangkok, Thailand. This had also resulted in improved self-management, but not physiological or metabolic outcomes.