scholarly journals Motives for requesting an electrocardiogram in primary health care

2015 ◽  
Vol 20 (5) ◽  
pp. 1549-1554 ◽  
Author(s):  
Paulo Santos ◽  
Carlos Martins ◽  
Luísa Sá ◽  
Alberto Hespanhol ◽  
Luciana Couto

The management of requests for diagnostic exams presents its own inherent characteristics in primary health care and reflects the specific nature of the physician-patient relationship. The scope of the study was to identify the reasons for requesting an electrocardiogram (ECG) in primary health care. A cross-sectional study was conducted in an urban region in Portugal, establishing the motives to ask for an ECG consecutively over two years, starting on 01/03/2007 using data retrieved from structured forms filled out by the physician at the moment of requesting the exam. A total of 870 ECGs of 817 patients were included. Symptoms manifested during the patient visit justified 48.5% of the ECGs, and follow-up of cardiovascular risk factors motivated 25.2%. A global health examination accounted for 22.8% of the requests. Multivariate analysis showed that the presence of symptoms (p < 0.001), presence of any cardiovascular risk factor (p = 0.002), hypertension (p < 0.001), diabetes (p = 0.002), and urgency (p < 0.001) were the main factors associated with the requests. The requests for electrocardiograms are predominantly for clinical reasons as a result of patients symptoms. The integration of expectations and beliefs of the patients is present in the decision-making process.

2019 ◽  
Vol 4 (5) ◽  

Background: Cardiovascular disease (CVD) is common in the general population, affecting many of adults above 40 years of age. It is a multi-factorial disease. Some risk factors; such as family history, gender, ethnicity and age cannot be changed. Other risk factors are modifiable including high blood pressure, high cholesterol and diabetes. Patients will not necessarily develop cardiovascular disease if they have a risk factor. But the more risk factors they have the greater the likelihood that they will, unless protective measures and actions are taken to modify their risk factors and work to prevent them compromising their heart health. Objectives: The objectives of this study were: to evaluate the adherence of major primary health care centers to the WHO-PEN Protocol 1, Package of essential noncommunicable (PEN) disease interventions for primary health care, recommendations;and to provide more accurate estimate of cardiovascular risk using hypertension, type 2 diabetes mellitus and tobacco use as entry points. Methods: A cross-sectional study involving 200 patients who were already diagnosed with NCDs was conducted atprimary health care centers. Data was collected retrospectively using a self-designed questionnaire based on the WHO- PEN checklist. Patients’ files were selected randomly. Results: Based on the analysis of whole cohort (200 cases). The prevalence of type 2 diabetes was 39% and hypertension was 28.5%, whereas 32.5% had both. There were only 17 smokers among patients representing 8.5% of the sample. Using WHO/ISH, WHO/International Society of Hypertension, Risk prediction charts; half of patients were in the tenyear cardiovascular risk category of less than 10%. On the other hand, 5% had a ten-year cardiovascular risk over 40%.49% of patients had a first-degree family history of heart disease? All patients were counseled on diet, exercise and smoking cessation. Conclusion: These results demonstrate high adherence to the WHO-PEN protocol in these two centers reflecting a high quality of care and follow-up. Furthermore, the medical records were fully filled with adequate information for each item. However, there were some deficiencies in the risk estimation, which should be documented for better counseling for patients with high risk.


2020 ◽  
Vol 12 (2) ◽  
pp. 191
Author(s):  
Gita Purnamasari ◽  
Misnaniarti Misnaniarti

A doctor’s job satisfaction is important because it will improve the quality of health services. This study aimed to determine the relationship between intensity training and doctors satisfaction. This research was a cross-sectional study using data from Risnakes 2017. The sample was 5,140 doctors primary health care with civil servant status in Indonesia that was randomly selected. The data were analyzed using the Spearman correlation. This study showed that mean job satisfaction was 70.07 and intensity of the training was 3.98. There is a positive correlation between the training intensityand the doctor's job satisfaction of primary health care in Indonesia (p-value <0.000 and r = 0.063). More doctor's training will improve the ability of doctors to care for the patient's clinical according to the standards of competence.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Juan-José Zamora-Sánchez ◽  
Edurne Zabaleta-del-Olmo ◽  
Vicente Gea-Caballero ◽  
Iván Julián-Rochina ◽  
Gemma Pérez-Tortajada ◽  
...  

Abstract Background The Frail-VIG frailty index has been developed recently. It is an instrument with a multidimensional approach and a pragmatic purpose that allows rapid and efficient assessment of the degree of frailty in the context of clinical practice. Our aim was to investigate the convergent and discriminative validity of the Frail-VIG frailty index with regard to EQ-5D-3L value. Methods We carried out a cross-sectional study in two Primary Health Care (PHC) centres of the Catalan Institute of Health (Institut Català de la Salut), Barcelona (Spain) from February 2017 to January 2019. Participants in the study were all people included under a home care programme during the study period. No exclusion criteria were applied. We used the EQ-5D-3L to measure Health-Related Quality of Life (HRQoL) and the Frail-VIG index to measure frailty. Trained PHC nurses administered both instruments during face-to-face assessments in a participant’s home during usual care. The relationships between both instruments were examined using Pearson’s correlation coefficient and multiple linear regression analyses. Results Four hundred and twelve participants were included in this study. Frail-VIG score and EQ-5D-3L value were negatively correlated (r = − 0.510; P < 0.001). Non-frail people reported a substantially better HRQoL than people with moderate and severe frailty. EQ-5D-3L value declined significantly as the Frail-VIG index score increased. Conclusions Frail-VIG index demonstrated a convergent validity with the EQ-5D-3L value. Its discriminative validity was optimal, as their scores showed an excellent capacity to differentiate between people with better and worse HRQoL. These findings provide additional pieces of evidence for construct validity of the Frail-VIG index.


2015 ◽  
Vol 38 (5) ◽  
pp. 343-356
Author(s):  
Ana Maseda ◽  
José Carlos Millán-Calenti ◽  
Julia Carpente ◽  
José Luis Rodríguez-Villamil ◽  
Carmen de Labra

2014 ◽  
Vol 22 (6) ◽  
pp. 1048-1055 ◽  
Author(s):  
Ana Carine Arruda Rolim ◽  
Gracyelle Alves Remigio Moreira ◽  
Sarah Maria Mendes Gondim ◽  
Soraya da Silva Paz ◽  
Luiza Jane Eyre de Souza Vieira

OBJECTIVE: to analyze the factors associated with the underreporting on the part of nurses within Primary Health Care of abuse against children and adolescents.METHOD: cross-sectional study with 616 nurses. A questionnaire addressed socio-demographic data, profession, instrumentation and knowledge on the topic, identification and reporting of abuse cases. Bivariate and multivariate logistic regression was used.RESULTS: female nurses, aged between 21 and 32 years old, not married, with five or more years since graduation, with graduate studies, and working for five or more years in PHC predominated. The final regression model showed that factors such as working for five or more years, having a reporting form within the PHC unit, and believing that reporting within Primary Health Care is an advantage, facilitate reporting.CONCLUSION: the study's results may, in addition to sensitizing nurses, support management professionals in establishing strategies intended to produce compliance with reporting as a legal device that ensures the rights of children and adolescents.


Author(s):  
Olumuyiwa A. Olowe ◽  
Andrew J. Ross

Background: Despite hypertension being a common condition among patients attending primary health care (PHC) clinics, blood pressure (BP) control is often poor. Greater insight into patient-related factors that influence the control of hypertension will assist in the development of an intervention to address the issues identified.Aim: The aim of the study was to assess patient-related variables associated with hypertension control among patients attending a peri-urban PHC clinic.Setting: The setting for this study was a peri-urban PHC clinic in KwaZulu-Natal.Method: This was an observational, descriptive and cross-sectional study with 348 patients selected over a 1-month period. A validated questionnaire was used to collect data on patients’ hypertension knowledge and self-reported adherence, and BP recordings from their medical record were recorded to ascertain control.Results: Of the 348 participants, only 49% had good BP control and 44% (152/348) had concurrent diabetes mellitus. The majority of patients had moderate levels of knowledge on hypertension and exhibited moderate adherence. There was a significant relationship between knowledge and reported adherence, between reported adherence and control, but not between reported knowledge and control.Conclusion: Despite over 90% of the study population having moderate knowledge, and 62% with moderate reported adherence, BP was well controlled in only less than 50% of the study population. These findings suggest a need to emphasise adherence and explore new ways of approaching adherence.


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