scholarly journals Patient satisfaction with doctor-patient interaction and its association with modifiable cardiovascular risk factors among moderately-high risk patients in primary healthcare

PeerJ ◽  
2017 ◽  
Vol 5 ◽  
pp. e2983 ◽  
Author(s):  
Mohd Noor Norhayati ◽  
Abd Aziz Masseni ◽  
Ishak Azlina

BackgroundThe outcomes of the physician-patient discussion intervene in the satisfaction of cardiovascular disease risk patients. Adherence to treatment, provision of continuous care, clinical management of the illness and patients’ adjustment are influenced by satisfaction with physician-patient interaction. This study aims to determine the patient satisfaction with doctor-patient interaction and over six months after following prevention counselling, its associations with modifiable cardiovascular risk factors amongst moderately-high risk patients in a primary healthcare clinic in Kelantan, Malaysia.MethodsA prospective survey was conducted amongst patients with moderately-high cardiovascular risk. A total of 104 moderately-high risk patients were recruited and underwent structured prevention counselling based on the World Health Organization guideline, and their satisfaction with the doctor-patient interaction was assessed using ‘Skala Kepuasan Interaksi Perubatan-11,’ the Malay version of the Medical Interview Satisfaction Scale-21. Systolic blood pressure, total cholesterol and high-density lipoprotein cholesterol were measured at baseline and at a follow-up visit at six months. Descriptive analysis, pairedttest and linear regression analyses were performed.ResultsA total of 102 patients responded, giving a response rate of 98.1%. At baseline, 76.5% of the respondents were satisfied with the relation with their doctor, with the favourable domain of distress relief (85.3%) and rapport/confidence (91.2%). The unfavourable domain was interaction outcome, with satisfaction in only 67.6% of the respondents. Between the two visits, changes had occurred in total cholesterol (P = 0.022) and in systolic blood pressure (P < 0.001). Six months after the initial visits, no relationship existed between patient satisfaction scores and changes in modifiable cardiovascular risks.DiscussionThe ‘Skala Kepuasan Interaksi Perubatan-11’ which represents a component of the interpersonal doctor-patient relationship can be used to assess improvements of the medical skills and in medical training to enhance the quality of therapeutic communication.

2014 ◽  
pp. 254-261 ◽  
Author(s):  
Katarzyna Mizia-Stec ◽  
Joanna Wieczorek ◽  
Michał Orszulak ◽  
Magdalena Mizia ◽  
Klaudia Gieszczyk-Strózik ◽  
...  

2012 ◽  
Vol 65 (6) ◽  
pp. 615-620 ◽  
Author(s):  
Raul Zamora-Ros ◽  
Mireia Urpi-Sarda ◽  
Rosa M. Lamuela-Raventós ◽  
Miguel Ángel Martínez-González ◽  
Jordi Salas-Salvadó ◽  
...  

2020 ◽  
Author(s):  
Xintong Jiang ◽  
Xun Wang ◽  
Mengxi Yang ◽  
Li Sun ◽  
Jiangli Jin ◽  
...  

Abstract Background A comprehensive assessment of cardiovascular disease (CVD) risk factors is the foundation of CVD prevention and treatment. This study assessed the awareness of CVD risk factors and treatment among Chinese medical students. Methods This cross-sectional study enrolled 48 3 rd year medical students who had finished preclinical course of medicine and 61 4 th year medical students who had finished their rotation in Internal Medicine’s Ambulatory Medicine clerkship from Peking University. The knowledge of CVD risk factors and therapeutic strategy was assessed by a self-administered questionnaire. Results Only about 50% of the 4 th year students knew the target value of low-density lipoprotein cholesterol for diabetic patients and blood pressure for high-risk patients, while the proportions in 3 rd year students were 20.8% and 29.2%, respectively. Although more than 90% students would prescribe cholesterol-lowering therapy to high-risk patients, few students knew the therapy of hypertriglyceridemia (2.1% and 27.9% of 3 rd and 4 th year students, respectively, p =0.001) or combined dyslipidemia. The awareness of their own lipid profile or blood glucose level was not as good as their blood pressure. Conclusions There is an urgent need to improve the knowledge of CVD risk factors and the details of therapeutic strategies among Chinese medical students.


2013 ◽  
Vol 52 (4) ◽  
pp. 263-274 ◽  
Author(s):  
Davorina Petek ◽  
Janko Kersnik

Izvleček Izhodišča: Bolezni srca in ožilja (BSO) predstavljajo vodilni vzrok smrti v večini evropskih držav, njihovo preprečevanje pa predstavlja pomembno nalogo osnovnega zdravstvenega varstva. Ocena dejavnikov tveganja in usmerjene preventivne aktivnosti so posebej pomembne pri visokoogroženih bolnikih. Pomembno je poznati tudi dejavnike, ki vplivajo na uspešnost preventive teh bolezni. Metode: V presečno raziskavo je bilo z naključnim stratificiranim vzorčenjem vključenih 36 slovenskih ambulant. Vsaka ambulanta je iz registra visokoogroženih vključila 30 bolnikov, ki so izpolnili vprašalnik o življenjskem slogu, kakovosti življenja, samooceni zdravja in o uporabi zdravstvenih storitev. Vir podatkov o dejavnikih tveganja BSO so bile kartoteke bolnikov, z vprašalnikom o ambulanti pa so bila pridobljena vprašanja o obremenjenosti, projektih kakovosti, izobraževanju, informacijski tehnologiji, o preventivnih aktivnostih. Rezultati: Sodelovalo je 871 bolnikov iz 36 ambulant (80,6 % predvidenega vzorca), starih 62,4 leta (SD±8,6). 22,4 % je bilo kadilcev; priporočeno raven aerobne telesne aktivnosti je vzdrževalo 330 (48,8 %) sodelujočih, najmanj urejen dejavnik tveganja pa je bil indeks telesne mase (29,3kg/m2). V multivariatnem modelu so vsi dejavniki (ambulante, bolniki in zdravniki) statistično značilno napovedali urejenost dejavnikov tveganja (p<0,005, F=2,7, R2 =0,087). Neodvisne spremenljivke bolje urejenih dejavnikov tveganja so bile: ženski spol, višja starost in višja izobrazba bolnika, uporaba informacijskega sistema v ambulanti, organizacija srčno-žilne preventive in zdravnikova profesionalna aktivnost v projektih preventive. Zaključki: Urejenost dejavnikov tveganja je v največji meri odvisna od značilnosti ambulante, predvsem organizacije na področju preventive, ter od strokovne aktivnosti zdravnika. Vplivajo tudi nekatere splošne značilnosti bolnika. Pomembni so še drugi dejavniki, ki niso bili vključeni v model.


Author(s):  
Ana Sánchez-Taínta ◽  
Ramón Estruch ◽  
Mónica Bulló ◽  
Dolores Corella ◽  
Enrique Gómez-Gracia ◽  
...  

Background The Mediterranean food pattern (MeDiet) has been suggested to have beneficial effects on cardiovascular risk factors. Scarcity of assessment of this effect on large samples of patients at high risk is, however, observed. Our objective was to estimate the association between adherence to MeDiet and the prevalence of risk factors in 3204 asymptomatic high-risk patients. Design Cross-sectional assessment of baseline characteristics of participants in a primary prevention trial. Methods Participants were assessed by their usual primary-care physicians to ascertain the prevalence of diet-related cardiovascular risk factors (diabetes, hypertension, dyslipidemia, or obesity) using standard diagnostic criteria. A dietitian interviewed each participant to obtain a 14-point score measuring the degree of adherence to MeDiet. Results Adherence to MeDiet was inversely associated with individual risk factors and, above all, with the clustering of them. The multivariate adjusted odds ratio to present simultaneously the four risk factors for those above the median value of the MeDiet score was 0.67 (95% confidence interval: 0.53–0.85). The multivariate odds ratios for successive categories of adherence to MeDiet were 1 (ref.), 1.03, 0.85, 0.70 and 0.54 ( P for trend ≤0.001). Conclusion Following a MeDiet was inversely associated with the clustering of hypertension, diabetes, obesity, and hypercholesterolemia among high-risk patients.


Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Chamila Mettananda ◽  
Lixin Li ◽  
Gary Lau ◽  
Rose Wharton ◽  
Linda Bull ◽  
...  

Background: Uncontrolled blood pressure is the most important modifiable risk factor for strokes. Aims and Methods: We determined the prevalence and determinants of blood pressure control in patients with incident transient ischaemic attacks(TIA) and strokes from 2002-2012 in a population-based cohort(Oxford Vascular Study). Controlled blood pressure(BP) was defined as having BP<140/90mmHg and was studied in different cardiovascular risk groups according to the Framingham 10-year general cardiovascular risk(CV-Risk) predicted at time of event and 10years pre-event; low(≤ 10%), moderate(11-19%) and high(≥ 20%) risk. We also studied the associations of controlled BP adjusted for age and sex. Results: Among 1741 patients with incident TIA/strokes, 1051 (60.4%) had known hypertension, of which 891 (84.8%) were on anti-hypertensive treatment. However, only 698 (40.1%) of all and 306 (29.1%) of treated patients had controlled BP. On predicted 10-year CV-Risk at event, 861 (72.5%) of 1188 (77.0%) in high risk group had known hypertension, of which 758 (88.0%) were on treatment. However, only 346 (29.1%) of all in high-risk group and 190 (25.1%) of treated high risk patients had controlled BP. In contrast, 120 (88.2%) of 136 (8.8%) in low risk group had controlled BP. Risk stratification without scoring for BP showed consistent results except the number in high-risk group dropped to 863 (55.9%). Analysis with CV-risk 10years pre-event also showed similar trends. Age(adjusted OR=0.97, 95%CI=0.97-0.98, p<0.001), high CV-risk at event/10years pre-event (0.97, 0.95-0.99, p<0.013, 0.95-0.99, p=0.008), being treated for hypertension(0.43, 0.35-0.52, p<0.001), BMI≥ 30Kg/m2(0.72, 0.55-0.92, p=0.010) and high total cholesterol(0.91, 0.84-0.99, p<0.026) were negatively associated with controlled BP. However history of atrial fibrillation(1.35, 1.03-1.77, p=0.030) and physical dependency(modified-Rankin-Scale>2; 1.54, 1.15-2.06, p<0.001) were positively associated with controlled BP. Conclusions: Premorbid blood pressure control in patients with incident TIA/strokes was inadequate especially in high-risk patients. Controlling BP to targets in elderly and high CV-risk patients would be important in reducing incident TIA/strokes.


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