Managing risk factors for cardiovascular diseases in a reference family medicine clinic

Authors

  • Alenka Terbovc Zdravstveni dom Kranj
  • Boštjan Gomišček University of Wollongong in Dubai, Faculty of Business, Block 15, Knowledge ark, PO Box 20183, Dubai, UAE

DOI:

https://doi.org/10.14528/snr.2017.51.1.100

Keywords:

registered nurse, quality, quality indicators

Abstract

Introduction: The model of reference family medicine clinics is introducing changes to the treatment of patients at the primary health level. The purpose of the study was to explore the risk factors that contribute to reducing the occurrence of cardiovascular disease using non-pharmacological approaches in patients who are treated in a reference medicine family clinic. Methods: A retrograde survey was carried out on the data of the patients, who were treated in reference clinics for cardiovascular risk. The random study sample covered 128 patients, who passed the screening tests and control measurements in a reference medicine family clinic in the period from 1 May to 25 August 2014. Data were analysed using descriptive statistics and chi-square test. Results: Screening tests revealed a higher share of patients with acceptable measured parameters for blood pressure (41.6 %), cholesterol (45.5 %) and blood sugar (53.3 %) while the percentage of smokers decreased by 4 %. High cardiovascular risk (20−40 %) has reduced to 28.0 %, whereas extremely high cardiovascular risk decreased to 6.6 %. After the treatment in the clinic, the percentage of people performing physical activity 2-4 times per week increased to 54.3 % while 19.4 % of respondents reported physical activity 5 times per week. Statistically significant differences were demonstrated for blood pressure (χ2 = 8.780, p = 0.003) and cholesterol (χ2 =4.781, p = 0.029). Discussion and conclusions: Patients have significantly improved risk factors due to quality treatment that is enabled by the model of reference medicine clinics and the essential role of registered nurses in this model.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

Author Biographies

Alenka Terbovc, Zdravstveni dom Kranj

Alenka Terbovc, dipl.m.s., mag.zdr.-soc.manag.

Boštjan Gomišček, University of Wollongong in Dubai, Faculty of Business, Block 15, Knowledge ark, PO Box 20183, Dubai, UAE

prof. dr. Boštjan Gomišček, univ. dipl. inz. el.

References

Allen, J.K., Dernnison-Himmelfarb, C.R., Szanton, S.L., Bone, L., Hill, M.N., Levine, D.M., et al., 2011. Community outreach and cardiovascular health (COACH). Tril: a randomized, controlled trial of nurse practitioner/comunity health worker cardiovascular disease risk reduction in urban comunity health centers. Circulation: Cardiovascular Quality and Outcomes, 4(6), pp. 595– 602.https://doi.org/10.1161/CIRCOUTCOMES.111.961573 PMid:21953407; PMCid:PMC3218795

Bizjak, T., 2013. Stroškovna učinkovitost prenosa aktivnosti na medicinske sestre v ambulanti družinske medicine: magistrska naloga. Izola: Univerza na Primorskem, Fakulteta za vede o zdravju, pp. 36–37.

Cipot Prinčič, J., 2005. Odpravimo dejavnike tveganja za bolezni srca in ožilja. Ljubljana: Novartis, pp. 9–13.

Clark, C.E., Smith, L.F., Taylor, R.S. & Campbell, J.L., 2010. Nurse led interventions to improve control of blood pressure in people with hypertension: systematic review and meta-analysis. British Medical Journal, 341, p. c3995. https://doi.org/10.1136/bmj.c3995 PMid:20732968; PMCid:PMC2926309

Collins, S., 2005. Explanations in consultations: the combined effectiveness of doctors andnurses communication with patients. Medical Education, 39(8), pp. 785–796. https://doi.org/10.1111/j.1365-2929.2005.02222.x PMid:16048621

Delamaire, M. & Lafortune, G., 2010. Nurses in advanced roles: a description and evaluation of experiences in 12 developed countries. Pariz: Organisation for Economic Co-operation and Development, pp. 29–35.

Govc Eržen, J., 2004. Zdravstveno vzgojne delavnice 2002/2003. In: Z. Fras, ed. Slovenski forum za preventivo bolezni srca in ožilja 2004: zbornik prispevkov, Ljubljana, 27. marca 2004. Ljubljana: Združenje kardiolgov Slovenije, pp. 54–57.

Harbman, P., 2014. The development and testing of a nurse practitioner secondary prevention intervention for patients after a acute myocardial infarction: a prospective cohort study. International of Nursing Studies, 51(12), pp. 1542–1556. https://doi.org/10.1016/j.ijnurstu.2014.04.004 PMid:24836930

Horrocks, S., Anderson, E. & Salisbury, C., 2002. Systematic review of wheter nurse practitioners working in primary care can provide equal care to doctors. British Medical Journal, 324(7341), pp. 819–823. https://doi.org/10.1136/bmj.324.7341.819 PMid:11934775; PMCid:PMC100791

Issakidu, K., 2013. Vodenje bolnika z astmo v ambulanti družinske medicine: specialistična naloga. Ljubljana: Univerza v Ljubljani, Medicinska fakulteta, Katedra za družinsko medicino, p. 46.

Kodeks etike v zdravstveni negi in oskrbi Slovenije in Kodeks etike za babice Slovenije, 2014. Ljubljana: Zbornica zdravstvene in babiške nege Slovenije – Zveza strokovnih društev medicinskih sester, babic in zdravstvenih tehnikov Slovenije.

Kotseva, K., Wood, D., De Backer, G., De Bacquer, D., Pyörälä, K. & Kell, U., 2007. Cardiovascular prevention guidelines in daily practice: a comparision of EUROSPIRE I, II and III surveys in eight European countries. Lancet, 373(9667), pp. 929–940. https://doi.org/10.1016/SO140-6736(09)60330-5 PMid:19286092

Ministrstvo za zdravje Republike Slovenije, 2011. Projekt: Referenčna ambulanta. Projektna pisarna. Poročanje o kazalnikih v referenčnih ambulantah za leto 2011. Ministrstvo za zdravje. Nadgradnja zdravstvenega sistema do leta 2020. Available at: http://www.vlada.si/fileadmin/dokumenti/si/projekti/2011/zdravstvena/NADGRADNJA_ZDRAVSTVENEGA_SISTEMA_DO_LETA_2020_pdf_160211.pdf [12. 9. 2013].

Paniagua, H., 2011. Advanced nurse practitioners and GPs: what is the difference? Practice nursing, 22(7), pp. 386–388. Available at: http://www.magonlinelibrary.com/doi/abs/10.12968/pnur.2011.22.7.383 [17. 11. 2016]

Pečelin, S. & Sočan, M., 2015. Referenčne ambulante: izkušnje diplomiranih medicinskih sester. Obzornik zdravstvene nege, 50(2), pp. 157–162. Available at: http://www.obzornikzdravstvenenege.si/2016.50.2.157[17. 11. 2016].

Petek Šter, M. & Šter, B., 2014. Pomen izobraževanja diplomiranih medicinskih sester v referenčnih ambulantah: primer arterijske hipertenzije. Obzornik zdravstvene nege, 49(1), pp. 52–59. Available at: http://www.obzornikzdravstvenenege.si/2015.49.1.52[17. 11. 2016].

Redsell, A.S. & Cheater F.M., 2008. Nurse's roles in primary care: developments and future prospects. Quality in Primary care, 16(2), pp. 69–71. Available at: http://primarycare.imedpub.com/nurses-roles-in-primarycaredevelopments-and-future-prospects.pdf [17. 11. 2016]. PMid:1870008

Referenčne ambulante družinske medicine, 2012. Projekt ministrstva za zdravje. Available at: http://www.referencna-ambulanta.si/ [2. 10. 2013].

Richardson, G.C., Derouin, A.L., Vorderstrasse, A.A., Hipkens, J., & Thompson, J.A., 2014. Nurse practitioner management of tipe 2 diabetes. The Permanente Journal, 18(2), pp. e134–e140. https://doi.org/10.7812/TPP/13-108 PMid:24867560; PMCid:PMC4022572

Shum, C., Humphreys, A., Wheeler, D., Cochrane, M.A., Skoda, S., & Clement, S., 2000. Nurse management of patients with minor illnesses in general practice: multicentre, randomised controlled trial. British Medical Journal, 320(7241), pp. 1038–1043. https://doi.org/10.1136/bmj.320.7241.1038 PMid:10764365; PMCid:PMC27346

Šic, A., 2009. Sodobno življenje in nevarnosti za srce in ožilje: diplomsko delo. Maribor: Univerza v Mariboru, Fakulteta za zdravstvene vede, pp. 23–28.

Štemberger Kolnik, T. & Klemenc, D., 2010. Stroka zdravstvene nege ob Mednarodnem dnevu medicinskih sester zagotavlja varnost in uvaja novosti. In: T. Štemberger Kolnik, & S. Majcen Dvoršak, eds. Medicinske sestre zagotavljamo varnost in uvajamo novosti pri obravnavi pacientov s kroničnimi obolenji. 12. simpozij zdravstvene in babiške nege Slovenije; 2010, maj 5–6, Portorož. Ljubljana: Zbornica zdravstvene in babiške nege Slovenije – Zveza strokovnih društev medicinskih sester, zdravstvenih tehnikov in babic; Koper: Društvo medicinskih sester, zdravstvenih tehnikov in babic, pp. 5–6.

Venning, P., Durie, A., Roland, M., Robets, C., & Leese, B., 2000. Randomised controlled trial comparing coast effectiveness of general practitioners and nurse practitioners in primary care. British Medical Journal, 320(7241), pp. 1048–1053. https://doi.org/10.1136/bmj.320.7241.1048 PMid:10764367; PMCid:PMC27348

World Medical Association, 2013. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. Journal of the American Medical Association, 310(20), pp. 2191–2194. Avaliable at: http://www.wma.net/en/20activities/10ethics/10helsinki/DoH-Oct2013-JAMA.pdf [1.9.2016].

World Health Organization, 2008. The World Health Report – primary Health Care (Now More Than Ever) Available at: http://www.who.int/whr/2008/en/index.html [10. 5. 2015].

Published

2017-03-15

How to Cite

Terbovc, A., & Gomišček, B. (2017). Managing risk factors for cardiovascular diseases in a reference family medicine clinic. Slovenian Nursing Review, 51(1), 34–41. https://doi.org/10.14528/snr.2017.51.1.100

Issue

Section

Original scientific article