scholarly journals Criteria for diagnostics and treatment of somatic patients who use psychoactive substances in the practice of family medicine

2019 ◽  
Vol 25 (1) ◽  
pp. 15-21
Author(s):  
S. I. Tabachnikov ◽  
I. Ya. Pinchuk ◽  
Ye. M. Kharchenko ◽  
N. O. Mykhalchuk ◽  
A. M. Chepurna ◽  
...  
Keyword(s):  
Family Medicine ◽  
Medical Care ◽  
Family Doctor ◽  
Laboratory Data ◽  
Diagnostic Methods ◽  
Mental Illnesses ◽  
Psychoactive Substances ◽  
Early Diagnostics ◽  
Family Doctors ◽  
Characteristic Features

Background. The usage of psychoactive substances (PS) is one of the most urgent among other medical and social problems of nowadays. One of the aspects of menacing nature of this phenomenon is psychological and somatic consequences, so called comorbid conditions, which in the future lead to severe psychosomatic disorders, more significant in young or old age. Contemporary medical reform in Ukraine has reoriented for family doctors general medical care to somatic patients, which, in turn, requires the creation of professional scientific and practical developments to provide them with qualified assistance. Objective – to develop of the system of diagnostic and medical care for somatic patients who use PS in the practice of family medicine. Materials and methods. In accordance with the relevant methods (clinical, anamnestic, socio-demographic, psychodiagnostic, clinical-psychopathological and statistical), 220 thematic patients who applied with somatic complaints to the family doctor were examined. All these patients take different kinds of PS. Results. Characteristic features of the examined patients were such as: prevailing age group was the senior group of people (60%), the youngest was 38%; a large proportion of respondents were educated in dysfunctional families (42%); the families in which the parents use of PS, in the families in which there where systematic conflicts, material and everyday problems, burdened heredity, concomitant somatic diseases (28%), etc. Most of these surveyed began to use PS in the age of teenagers (66%), a significantly smaller number was that one who had begun to use PS in elderly age. The motivation for the usage of surfactant in the younger group was dominated by the negative impact of the micro-environment, at the elder age we diagnostic the subjective deprivation of the patients from difficult social circumstances, improvement of general mental and physical conditions. The complaints of these patients who need a help of family doctors were formed by us in the form of the main profiles of somatic pathology: cardiovascular, pulmonary-respiratory, gastro-intestinal. In the mental plan these patients had depressive, disturbing, asthenic states in different proportions. Most of them who use PS prefer tobacco and alcohol or combined forms (72%), much less patients use PS. The developed system of early diagnostics of comorbid pathology is based on a four-level clinical characteristic of psychosomatic pathology with the appropriate correlation between the type and level of PS which had been used. Conclusions. The main profiles of somatization in these cases were outlined (48% of patients have the problems with the cardiovascular system, with the digestive tract – 32%, with the pulmonary-respiratory system – 20% of patients), which were combined with mental illnesses. The system of early diagnostics of the usage of psychoactive substances by somatic patients was developed with the help of corresponding AUDIT-tests, a number of parallel psycho-diagnostic methods and laboratory data. On the basis of characteristic features of anamnesis, socio-demographic, clinical psycho-pathological and somatic data, a system of psycho-therapeutic, rehabilitation and psycho-prophylaxis assistance to the patients in the practice of family medicine was developed.

scholarly journals Psychological, clinical and instrumental-laboratory methods for the diagnosis of the usage of psychoactive substances by somatic patients in the practice of family medicine

2018 ◽  
Vol 24 (4) ◽  
pp. 229-234
Author(s):  
S. I. Tabachnikov ◽  
I. Ya. Pinchuk ◽  
Ye. M. Kharchenko ◽  
O. S. Osukhovska ◽  
О. Yu. Tabachnikov ◽  
...  
Keyword(s):  
Family Medicine ◽  
Family Doctor ◽  
Psychoactive Substances ◽  
Laboratory Methods ◽  
Family Doctors ◽  
Adult Age ◽  
Medical Reform ◽  
Wide Range

Background. The use of psychoactive substances among the population of different countries of the world, in particular in Ukraine, is one of the most significant medical and social problems of our time. The situation is even more threatening due to not only the mental and behavioral consequences of the use of surfactants, but also somatic. These comorbid disorders are severe and sometimes complete with mortality, especially in adolescence, young or adult age. In the view of modern medical reform in Ukraine, family doctors have a wide range of professional functions at the primary level of medical care, which determines the provision of qualification assistance to the contingent under review in full. Until recently, there are no scientific and practical standards on this important topic in the country. Objective – determination of criteria for psychological, clinical and instrumental and laboratory methods for diagnosing the use of surfactants in somatic patients in family medicine practice. Materials and methods. With the help of clinical-anamnestic, psychodiagnostic, clinical-psychopathological and instrumental-laboratory methods, 220 somatic patients (men – 54%, women – 46%) who use psychoactive substances visited by a family doctor were examined. The study was conducted on the basis of the Center of Primary Health Care in Kiev, during 2017-2018. Results. On the grounds of the presented diagnostics, in particular, the developed 4-step specific and quantitative use of various psychoactive substances, the ratio of the nature of psychoactive substances and their somatic consequences was found by medical evidence for the most common pathogenicity profiles: cardiovascular, gastrointestinal, and respiratory. Age, gender and follow-up indicators are presented. Conclusion. Clinical-anamnestic, socio-demographic, psychodiagnostic, clinical-psychopathological, instrumental and laboratory criteria for the characteristics of patients with comorbid pathology (use of surfactants with somatic consequences) were determined. Diagnostic psychocorrectional and preventive measures of this category of patients in the practice of family medicine are indicated.

scholarly journals New Zealand among global social media initiative leaders for primary care advocacy

2016 ◽  
Vol 8 (2) ◽  
pp. 94 ◽  
Author(s):  
Kyle Hoedebecke ◽  
Joseph Scott-Jones ◽  
Luís Pinho-Costa
Keyword(s):  
Primary Care ◽  
Social Media ◽  
New Zealand ◽  
Family Medicine ◽  
Family Doctor ◽  
Primary Care Providers ◽  
Care Providers ◽  
Family Doctors ◽  
Medicine Community ◽  
World Organisation

Abstract The international ‘#1WordforFamilyMedicine’ initiative explores the identity of General Practitioners (GPs) and Family Physicians (FPs) by allowing the international Family Medicine community to collaborate on advocating for the discipline via social media. The New Zealand version attracted 83 responses on social media. Thematic analysis was performed on the responses and a ‘word cloud’ image was created based on an image identifying the country around the world - that of the silver fern. The ‘#1WorldforFamilyMedicine’ project was promoted by WONCA (World Organisation of Family Doctors) globally to help celebrate World Family Doctor Day on 19 May 2015. To date, over 80 images have been created in 60 different countries on six continents. The images represent GPs’ love for their profession and the community they serve. We hope that this initiative will help inspire current and future Family Medicine and Primary Care providers.

Long-term cancer survivors: Satisfaction with medical care and information received during the diagnosis and treatment of cancer.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e21573-e21573
Author(s):  
Alejandro Gallego ◽  
Beatriz Martinez ◽  
Enrique Espinosa ◽  
Ismael Ghanem ◽  
Leticia Ruiz-Gimenez ◽  
...  
Keyword(s):  
Cancer Survivors ◽  
Medical Care ◽  
Family Doctor ◽  
Daily Intake ◽  
Diagnosis And Treatment ◽  
Depression Symptoms ◽  
Term Survival ◽  
Family Doctors ◽  
Adult Cancer Survivors

e21573 Background: Long-term survival rates for many types of cancer have substantially improved in past decades. A specific medical office was started up two years ago at our institution for the follow-up and comprehensive care of this population. Long-term cancer survivors were surveyed to know how they perceive medical care and information received during the diagnosis and treatment of cancer. Methods: A 54-item questionnaire was developed based on QLACS (Quality of Life in Adult Cancer Survivors). 286 patients completed the questionnaire from January 2015 to December 2016. All of them were disease-free and without any antitumour therapy for at least two years. The information was collected in a database and processed with SPSS 18. Results: Median age at the time of diagnosis was 56 years. Colorectal and breast carcinomas accounted for 54% of all cases and 61% of patients had been diagnosed in early stages of disease. Median time from cancer diagnosis to questionnaire completion was 104 months (range 29-444 months). Sixty-seven per cent of patients were satisfied with the information received by their oncologist about their cancer, although information provided about other health issues was less satisfactory. Twenty-eight per cent reported that the oncologist never made recommendations about healthy lifestyle. In fact, only 8 patients (2.8%) made dietary modifications, all regular alcohol drinkers (31.1%) maintained their daily intake and 73 patients (25.5%) gained 5 kg over their recommended weight. Anxiety/depression symptoms were reported by 30% of the best informed patients about cancer treatment and 52% of the worst informed. Only 12.4% of long-term cancer survivors of our study consulted their family doctor during the last year, while 75.4% visited their oncologist. Finally, the medical care of the oncologist was satisfactory for 235 patients (83.2%), receiving an overall score of 8.7 on a 0 to 10 scale. Conclusions: Most long-term cancer survivors feel satisfied with the medical care received, but the information provided about other health aspects should be improved. Furthermore, although they rely on their family doctors, most prefer being followed-up by their oncologist.

scholarly journals Perspectives on expert generalist practice among japanese family doctor educators: A qualitative study

BJGP Open ◽  
2021 ◽  
pp. BJGPO.2021.0011
Author(s):  
Makoto Kaneko ◽  
Ai Oishi ◽  
Noriaki Sawa ◽  
Greg Irving ◽  
Yasuki Fujinuma
Keyword(s):  
Family Medicine ◽  
Qualitative Study ◽  
Family Doctor ◽  
Structured Interview ◽  
Qualitative Description ◽  
Educational Strategies ◽  
Japanese Family ◽  
Family Doctors ◽  
Training Programmes ◽  
Generalist Practice

BackgroundExpert generalist practice (EGP) is increasingly being viewed as the defining expertise of generalist care. In Japan, several family doctors consider it important and relevant in the Japanese context. However, no study has examined Japanese family doctor educators’ perceptions of EGP.AimTo explore Japanese family doctor educators’ perceptions of EGPDesign & settingA qualitative study among family doctor educators in JapanMethodWe conducted focus group interviews using a semi-structured interview guide following a short lecture on EGP. We adopted a qualitative description method and used the framework method to conduct thematic analysis.ResultsParticipants included 17 family medicine trainers in Japan, including 11 directors and five associate directors of family medicine training programmes. The results suggested that the concept of EGP was important and applicable to primary care in Japan. Participants’ perceptions on EGP pertained to the following four areas: impact of EGP, triggers for EGP, enablers for EGP, and educational strategies for EGP.ConclusionThe concept of EGP may be useful in clinical practice in Japan, especially in complex patient care. A clearer framework for or description of EGP, and of non-traditional methods such as ascetic practice and awareness of the self, were proposed as possible educational strategies.

scholarly journals Difficulties of general practitioners in (de)prescribing benzodiazepines

2021 ◽  
Vol 31 (Supplement_2) ◽  
Author(s):  
L Veloso de Sousa ◽  
I Rosendo ◽  
L M Monteiro
Keyword(s):  
Family Medicine ◽  
Family Doctor ◽  
Added Value ◽  
Convenience Sample ◽  
Family Doctors ◽  
Digital Platforms ◽  
Doctor Patient Communication ◽  
Open Questions ◽  
Doctor Communication

Abstract Background In Portugal, the consumption of psychotropic drugs, namely benzodiazepines, is almost double the average European consumption. Most of the prescriptions for benzodiazepines (BZD) are carried out by family doctors, since they are doctors more accessible to the general population. Therefore, it is essential to assess the difficulties of family doctors in prescribing and discontinuing BZD in order to understand how to optimize the consumption of these drugs in Portugal. Methods The data were collected through a survey sent to family doctors across the country by email and other digital platforms. The participants were interns and specialists in family medicine and a convenience sample was obtained of 274 physicians. The survey, previously structured, contained three open questions and twenty-five statements to be classified using a Likert scale. For the quantitative analysis, SPSS® program was used and the qualitative analysis was performed using the MAXQDA® data analysis facilitation software. Results Difficulties related to: patient's beliefs/attitudes and doctor-patient communication, means and strategies of prescription and discontinuation, dependence and tolerance, unwanted effects of BZDs, need for BZD and lack of alternatives/resources, doctor-doctor communication and role of the family doctor were identified. Conclusions The qualitative approach used in this study was essential, since the theme of the study is not widely explored in Portugal. An added value of the study is the inclusion of interns in General and Family Medicine. Studies are suggested that deepen these topics and allow the development of appropriate strategies to optimize the process of BZD (de)prescription.

scholarly journals Integration of obstetrics and gynecology services into primary health care

2021 ◽  
Vol 4 ◽  
pp. 40-47
Author(s):  
N.Ya. Zhilka ◽  
G.O. Slabky ◽  
O.S. Shcherbinska
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Family Medicine ◽  
Family Doctor ◽  
Stage Iv ◽  
Medical Department ◽  
Ministry Of Health ◽  
Family Doctors ◽  
Primary Health ◽  
Gynecological Care

In the historical dimension in Ukraine, family medicine (SM) was founded as a pilot project in the Lviv region in 1987. In 1992, after the successful introduction of the elements of the SM, a decision was made to reorganize the district service in the SM. This process was designed for several years and its implementation was planned in 5 stages: Stage I - UT (local therapist) perform the functions of doctors whose specialization is as close as possible to therapy; Stage II - UT replace doctors of narrower specialties; Stage III - UT provide not only primary health care (PTD), but also monitor patients with chronic diseases; Stage IV - UT provide obstetric and gynecological care, and pregnant women seek help from a family doctor; Stage V - complete retraining of UT, who must become qualified general practitioners - family medicine (GP-SM).The introduction of obstetric and gynecological services in the medical department was planned at stage IV, this process was long-awaited and provided, first of all, the training of family doctors in obstetric and gynecological technologies and skills. And only in 2002, the sectoral Order of the Ministry of Health of Ukraine No. 503 of 28.12.2002 «On the improvement of outpatient obstetric and gynecological care in Ukraine» for the first time defined the features of the functions of a family doctor to provide obstetric and gynecological care, and the Order of the Ministry of Health of Ukraine dated 15.07.2011 No. 417 “On the organization of outpatient obstetric and gynecological care in Ukraine”, the functions of the GP-SM on obstetric and gynecological care were expanded.However, taking into account the results of the analysis, the integration of obstetric and gynecological services at the PHC level is extremely imperfect, which makes it inaccessible to the population, ineffective in the preventive direction, unattainable for organizing the treatment process in cases of gynecological diseases. In addition, there are legal conflicts between the sectoral order on PMP No. 504 «On the approval of the procedure for the provision of primary health care», which does not define examination and instrumental obstetric and gynecological technologies for GP-SM, and the designated clinical protocols approved by orders of the Ministry of Health of Ukraine which do not contribute to the integration of obstetric and gynecological services at the PHC level.

scholarly journals Family Medicine as a Model of Primary Health Services Delivery: A Pilot Study in Almaty, Kazakhstan

2015 ◽  
Vol 4 (1) ◽  
Author(s):  
Dilara Orynbassarova
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Pilot Study ◽  
Family Medicine ◽  
Rural Areas ◽  
Family Doctor ◽  
Family Doctors ◽  
Primary Health ◽  
Access To Primary Care

Introduction. Advanced models of delivering primary health care are being implemented in various countries of the world. This is especially true for countries undergoing a healthcare transition in Central Asia, such as Kazakhstan, which obtained independence from Soviet Union in 1991. The Kazakhstan National Program of Health Reform, implemented between 2005-2010, aimed to create an effective system of primary care. One of the key directions of healthcare reform implemented in Kazakhstan included the development of family medicine, which has become cutting-edge agenda for Kazakhstan Health Ministry over the past 10 years. While many papers have been published about the importance of family medicine and primary healthcare models, few have focused on analyzing family medicine effectiveness in Kazakhstan and its impact on access to family doctor services and patient satisfaction. The key aims of this pilot investigation were 1) to assess the model’s impact on access to primary care and patients’ satisfaction, and 2) to explore the model’s effectiveness in some Central Asian and transitional countries in the literature. Methods. This pilot study was based on semi-structured interviews and questionnaires about the perception and impact of the primary care model to 86 respondents aged 19-51 (54% females, 46% males). The majority of respondents were Almaty city residents (71%), while the rest were Almaty Province rural residents (22%) and residents of other Kazakhstan regions (7%).Results. Respondents from rural areas associated general practitioners, or family doctors, with community clinics (also referred to as feldsher posts). Even though urban area respondents use family doctor services, they were more likely to get those services in private rather than public clinics. Rural residents appear to have better access to primary care providers than urban residents participating in our study. Also, respondents from rural areas were more satisfied with services provided by family doctors than respondents from urban areas.Conclusions. This pilot study helped to improve our understanding of primary health care reforms implemented in Kazakhstan, a topic that is not traditionally covered in international literature. This pilot study suggests that primary care is more effectively implemented in rural areas of Kazakhstan (Almaty Province); however, future full-scale research in this area is needed to fully understand the complexity of primary healthcare access in Kazakhstan.

RETROSPECTIVE ANALYSIS OF THE MEDICAL DOCUMENTATION OF PATIENTS WHO APPLIED TO THE AMBULATORY OF GENERAL PRACTICE - FAMILY MEDICINE

2019 ◽  
Vol 72 (5) ◽  
pp. 938-941
Author(s):  
Оlexander Ye. Kononov ◽  
Liliana V. Klymenko ◽  
Ganna V. Batsiura ◽  
Larysa F. Matiukha ◽  
Olha V. Protsiuk ◽  
...  
Keyword(s):  
Family Medicine ◽  
Middle Ages ◽  
Risk Groups ◽  
Medical Documentation ◽  
Aged Patients ◽  
Family Doctors ◽  
Functional Changes ◽  
Medicine Clinic ◽  
Leading Role ◽  
The Family

Introduction: In today’s realities of health care reform in Ukraine family doctors play a leading role. The aim of our work was to analyze the medical cards of patients who applied for medical care to the family medicine clinic. Materials and methods: It was analyzed outpatient medical cards of 87 patients who applied to the family medicine clinic in the Khotov village, Kyiv region. The study included people aged 18 to 60 years, which corresponded to the groups of young and middle ages according to the WHO classification. Review: Our findings indicate the prevalence of functional changes among young people: somatoform dysfunction of the autonomic nervous system - 9 (37,5%) and the development of organic manifestations at middle-aged patients: arterial hypertension - 32 (62,7%) and coronary artery disease - 17 (33,3%). Conclusions: This study is important for determining the risk groups, early diagnosis and prevention of diseases.

scholarly journals Patients’ Perspectives about Lifestyle Behaviors and Health in the Context of Family Medicine: A Cross-Sectional Study in Portugal

2021 ◽  
Vol 18 (6) ◽  
pp. 2981
Author(s):  
Rosália Páscoa ◽  
Andreia Teixeira ◽  
Micaela Gregório ◽  
Rosa Carvalho ◽  
Carlos Martins
Keyword(s):  
Family Medicine ◽  
Family Doctor ◽  
Cross Sectional Study ◽  
Demographic Variables ◽  
Future Research ◽  
Lifestyle Behaviors ◽  
Sectional Study ◽  
Self Assessment ◽  
Cross Sectional ◽  
The Family

Lifestyle interventions are recognized as essential in the prevention and treatment of non-communicable diseases. Previous studies have shown that Portuguese patients tend to give more importance to diagnostic and laboratory tests than to lifestyle measures, and seem unaware that behavioral risks are the main modifiable risk factors. The study aimed to analyze patients’ perspectives about lifestyle behaviors and health in the context of family medicine in Portugal. A population-based cross-sectional study was carried out in Portugal (the mainland). A total of 900 Portuguese patients aged ≥20 years, representative of the population, were surveyed using face-to-face questionnaires. Participants were selected by the random route method. Descriptive statistics and non-parametric tests were performed to evaluate differences between the personal beliefs and the personal behavior self-assessment, as well as between the level of importance given to the family doctor to address health behaviors and the reported approach implemented by the family doctor, and its association with bio-demographic variables. The results indicate that the vast majority of this Portuguese cohort has informed beliefs regarding lifestyle behaviors, tends to overestimate their own behavior self-assessment, and strongly agrees that it is important that their family doctor asks/advises on these lifestyle behaviors, although the proportion of those who totally agree that their family doctor usually does this is significantly lower. Differences concerning bio-demographic variables were found. Future research directions should focus on the politics, economics, and policy aspects that may have an impact in this area. It will also be important to understand more broadly the relationships between lifestyle behaviors and clinical, physical, and sociodemographic variables.

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