Zmanjševanje dejavnikov tveganja za nastanek srčno-žilnih bolezni pri pacientih, vodenih v referenčni ambulanti družinske medicine - vloga diplomirane medicinske sestre

(magistrsko delo)

Alenka Terbovc (Author), Boštjan Gomišček (Mentor), Ksenija Tušek-Bunc (Co-mentor)

Abstract

Model referenčnih ambulant družinske medicine prinaša spremembe v obravnavi pacientov na primarnem zdravstvenem nivoju, kar ima za posledico zmanjševanje ali odpravljanje dejavnikov tveganja za nastanek srčno-žilnih bolezni. V timu poleg zdravnika in srednje medicinske sestre sodeluje tudi diplomirana medicinska sestra, ki z znanjem, strokovnostjo in individualnim pristopom pomembno doprinese h kakovosti vodenja bolnikov z dejavniki tveganja. Namen magistrske naloge je bil raziskati zmanjšanje dejavnikov tveganja za nastanek srčno-žilnih bolezni med skupinami pacientov, ki so vključeni v obravnavo v referenčni ambulanti družinske medicine in splošni ambulanti. Uporabljena je bila presečna metoda zbiranja podatkov. Primarni podatki so bili zbrani iz predpisanih obrazcev, ki se izpolnjujejo ob presejalnih pregledih za srčno-žilno ogroženost in obdelani v statističnem programu SPSS. V okviru obdelave podatkov smo uporabili regresijo, analizo variance ANOVA, hi-kvadrat in t-test. V teoretičnem delu je bila uporabljena metoda analize literature. Viri literature so bili zbrani na podlagi znanstvene in strokovne literature. Pri kontrolni meritvi je imelo 41,6 % preiskovancev urejen krvni tlak, 45,5 % urejen holesterol ter 53,3 % urejen krvni sladkor. Vsi trije deleži so bili višji kot pri presejalnem pregledu. Delež kadilcev je znašal 23,7 %, kar je bilo prav tako manj kot pri presejalnem pregledu. Visoka srčno-žilna ogroženost (20–40 %) se je znižala pri kontrolni meritvi na 28,0 %, zelo visoka na 6,6 %. Dva- do štirikrat tedensko je bilo telesno aktivnih 54,3 % preiskovancev, petkrat tedensko pa 19,4 %, kar je predstavljalo višje deleže kot pri presejalnem pregledu. Rezultati kontrolne meritve kažejo pri preiskovancih, vodenih v referenčni ambulanti družinske medicine, na statistično značilno boljšo urejenost naslednjih dejavnikov tveganja: krvnega tlaka (x^2= 8,780; p=0,003) in holesterola (x^2= 4,781; p=0,029), ne pa tudi krvnega sladkorja. Pri gibalni aktivnosti je bil rezultat obraten, preiskovanci obravnavani v referenčnih ambulantah družinske medicine so navajali statistično značilno razliko v gibalni aktivnosti (x^2=15,304; p=0,002). Primerjava po spolu v referenčnih ambulantah družinske medicine je ponovno pokazala statistično značilno razliko v srčno-žilni ogroženosti v korist žensk (x^2=19,243: p<0,001). Pri ženskah se je visoka srčno žilna ogroženost znižala na 18,8 % (-6,2 % glede na presejalni pregled), zelo visoka pa na 0,0 % (-3,1 glede na presejalni pregled), pri moških sta se deleža znižala na 26,6 % in 10,9 % (-15,6 % in -4,7 % glede na presejalni pregled). Pacienti, vodeni v referenčni ambulanti družinske medicine, so pomembno izboljšali nekatere izmed dejavnikov tveganja, kar je moč pripisati kakovostni obravnavi, ki jo omogoča model referenčnih ambulant družinske medicine, in hkrati pomembni vlogi diplomirane medicinske sestre v tem modelu

Keywords

referenčna ambulanta družinske medicine;diplomirane medicinske sestre;srčno-žilne bolezni;dejavniki tveganja;kakovost;kazalniki kakovosti;

Data

Language:	Slovenian
Year of publishing:	2015
Typology:	2.09 - Master's Thesis
Organization:	UM FZV - Faculty of Health Sciences
Publisher:	[A. Terbovc]
UDC:	616.1(043.2)
COBISS:	2150052
Views:	1612
Downloads:	367
Average score:	0 (0 votes)
Metadata:

Other data

Secondary language:	English
Secondary title:	REDUCTION OF RISK FACTORS FOR THE OCCURRENCE OF ARDIOVASCULAR DISEASES IN PATIENTS WHO ARE TREATED IN A FAMILY MEDICINE CLINIC – THE ROLE OF THE GRADUATE NURSE
Secondary abstract:	Model of reference family medicine clinic reveals changes in treating patients on primary health level. The consequence is reduction or elimination of risk factors for the occurrence of cardiovascular diseases. Team consists of a doctor, a nurse and a graduate nurse, who significantly improves the quality of controling patients with risk factors by knowledge, proficiency and individual approach. The purpose of the master's degree thesis is to explore the risk factors for the occurrence of cardiovascular diseases among groups of patients, who are treated in the reference medicine family clinic and general clinic. There was a cross-sectional method of data gathering used in this study. Primary data were collected from the prescribed forms, that are filled in when testing for cardiovascular risk, and are statistically analysed by SPSS program. The following statistical methods were used to examine the data: regression analysis, ANOVA, hi-square and t-test. The theoretical part consists of analysing the literature. The literature has been reviewed on the basis of scientific and technical literature. When doing control measurements patients had settled blood pressure in 41,6 %, settled cholesterol in 45,5 % and settled blood sugar in 53,3 %. All three measurements were higher than in screening tests. There were 23,7 % smokers, which is less than in screening tests. High cardiovascular risk (20 to 40 %) has reduced to a 28,0 %, whereas extremely high cardiovascular risk to a 6,6 %. Physical activity 2–4 times per week was stated in 54,3 %, physical activity 5 times per week was stated in 19,4 %, which is higher than in screening test. The results of the control measurements show statistically significant improvements in following factors (x^2=8,780; p=o,oo3) and cholesterol (x^2=4,781; p=0,029) in patients, studied in the family medicine clinic, whereas blood sugar was no longer statistically significant. When controlling physical activity the result was opposite – subjects treated in reference family medicine clinic stated statistically significant difference (x^2=15,304; p=0,002). Gender comparison in the family medicine clinic once again showed (x^2=19,243; p<0,001). When studying women, the high cardiovascular risk reduced to a 18,8 % (-6,2 % based on a screening test), and extremely high cardiovascular risk to a 0,0 % (-3,1 % based on a screening test). When studying men, the measurements have reduced to a 26,6 % and 10,9 % (-15,6 % and -4,7 % based on a screening test). Patients, studied in the family medicine clinic, have essentially improved risk factors due to quality treatment, that is enabled by the model of reference family medicine clinic, and graduate nurse's essential role in this model.
Secondary keywords:	family medicine clinic;qualified nurse;cardiovascular disease;risk factors;quality;quality indicator;
URN:	URN:SI:UM:
Type (COBISS):	Master's thesis/paper
Thesis comment:	Univ. v Mariboru, Fak. za zdravstvene vede
Pages:	VII, 80 f.
ID:	8762421