| 1. |
- Andruškienė, Jurgita, et al.
(author)
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Psychosocial work experiences related to health : a study of Lithuanian hospital employees
- 2015
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In: Work. - 1051-9815 .- 1875-9270. ; 53:3, s. 669-677
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Journal article (peer-reviewed)abstract
- BACKGROUND: Research in the area of workplace health promotion from a salutogenic perspective is lacking in Eastern Europe.OBJECTIVE: To evaluate the relationship between psychosocial work environment and health from a salutogenic perspective among Lithuanian hospital workers.METHODS: Using a cross-sectional design a questionnaire was distributed to staff in a large hospital in Lithuania. Out of 811 employees, 714 completed the survey: 151 physicians, 449 nurses and 114 other staff members (e.g., psychologists, technicians, therapists). A response rate of 88.0% was achieved. The Work Experience Measurement Scale (WEMS) and the Salutogenic Health Indicator Scale (SHIS) were linguistically adapted and used for the first time in a Lithuanian context. Logistic and multiple linear regression models were used for the analyses.RESULTS: Supportive working conditions, positive internal work experiences and time experience contributed the most to good health, defined as a high SHIS index. Having an executive post was significantly related to good work experiences, i.e. a high WEMS score, while being at the age of 40-54 years was associated with a low WEMS score. Physicians had the highest score on supportive working conditions; while nurses had the lowest scores on autonomy.CONCLUSIONS: A salutogenic approach enables an organisation to identify how to improve working conditions for the employees by focusing on possibilities and resources. Individual activities for workplace health promotion among different work groups seem necessary.
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| 2. |
- Andruškienė, Jurgita, et al.
(author)
-
Psychosocial work experiences related to health : a study of Lithuanian hospital employees
- 2015
-
In: WorkA journal of Prevention, Assessment and rehabilitation. - 1051-9815. ; 53:3, s. 669-677
-
Journal article (peer-reviewed)abstract
- BACKGROUND: Research in the area of workplace health promotion from a salutogenic perspective is lacking in Eastern Europe. OBJECTIVE: To evaluate the relationship between psychosocial work environment and health from a salutogenic perspective among Lithuanian hospital workers. METHODS: Using a cross-sectional design a questionnaire was distributed to staff in a large hospital in Lithuania. Out of 811 employees, 714 completed the survey: 151 physicians, 449 nurses and 114 other staff members (e.g., psychologists, technicians, therapists). A response rate of 88.0% was achieved. The Work Experience Measurement Scale (WEMS) and the Salutogenic Health Indicator Scale (SHIS) were linguistically adapted and used for the first time in a Lithuanian context. Logistic and multiple linear regression models were used for the analyses. RESULTS: Supportive working conditions, positive internal work experiences and time experience contributed the most to good health, defined as a high SHIS index. Having an executive postwas significantly related to good work experiences, i.e. a high WEMS score, while being at the age of 40-54 years was associated with a low WEMS score. Physicians had the highest score on supportive working conditions; while nurses had the lowest scores on autonomy. CONCLUSIONS: A salutogenic approach enables an organisation to identify how to improve working conditions for the employees by focusing on possibilities and resources. Individual activities for workplace health promotion among different work groups seem necessary.
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| 3. |
- Bjerrum, Lars, et al.
(author)
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Health Alliance for prudent antibiotic prescribing in patients with respiratory tract infections (HAPPY AUDIT) -impact of a non-randomised multifaceted intervention programme
- 2011
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In: BMC Family Practice. - : Springer Science and Business Media LLC. - 1471-2296. ; 12
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Journal article (peer-reviewed)abstract
- Background: Excessive use of antibiotics is worldwide the most important reason for development of antimicrobial resistance. As antibiotic resistance may spread across borders, high prevalence countries may serve as a source of bacterial resistance for countries with a low prevalence. Therefore, bacterial resistance is an important issue with a potential serious impact on all countries. Initiatives have been taken to improve the quality of antibiotic prescribing in primary care, but only few studies have been designed to determine the effectiveness of multifaceted strategies across countries with different practice setting. The aim of this study was to evaluate the impact of a multifaceted intervention targeting general practitioners (GPs) and patients in six countries with different health organization and different prevalence of antibiotic resistance. Methods: GPs from two Nordic countries, two Baltic Countries and two Hispano-American countries registered patients with respiratory tract infections (RTIs) in 2008 and 2009. After first registration they received individual prescriber feedback and they were offered an intervention programme that included training courses, clinical guidelines, posters for waiting rooms, patient brochures and access to point of care tests (Strep A and C-Reactive Protein). Antibiotic prescribing rates were compared before and after the intervention. Results: A total of 440 GPs registered 47011 consultations; 24436 before the intervention (2008) and 22575 after the intervention (2009). After the intervention, the GPs significantly reduced the percentage of consultations resulting in an antibiotic prescription. In patients with lower RTI the GPs in Lithuania reduced the prescribing rate by 42%, in Russia by 25%, in Spain by 25%, and in Argentina by 9%. In patients with upper RTIs, the corresponding reductions in the antibiotic prescribing rates were in Lithania 20%, in Russia 15%, in Spain 9%, and in Argentina 5%. Conclusion: A multifaceted intervention programme targeting GPs and patients and focusing on improving diagnostic procedures in patients with RTIs may lead to a marked reduction in antibiotic prescribing. The pragmatic before-after design used may suffer from some limitations and the reduction in antibiotic prescribing could be influenced by factors not related to the intervention.
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| 4. |
- Bjerrum, Lars, et al.
(author)
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Health Alliance for Prudent Prescribing, Yield and Use of Antimicrobial Drugs in the Treatment of Respiratory Tract Infections (HAPPY AUDIT)
- 2010
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In: BMC Family Practice. - : Springer Science and Business Media LLC. - 1471-2296. ; 11
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Journal article (peer-reviewed)abstract
- Background: Excessive and inappropriate use of antibiotics is considered to be the most important reason for development of bacterial resistance to antibiotics. As antibiotic resistance may spread across borders, high prevalence countries may serve as a source of bacterial resistance for countries with a low prevalence. Therefore, bacterial resistance is an important issue with a potential serious impact on all countries. The majority of respiratory tract infections (RTIs) are treated in general practice. Most infections are caused by virus and antibiotics are therefore unlikely to have any clinical benefit. Several intervention initiatives have been taken to reduce the inappropriate use of antibiotics in primary health care, but the effectiveness of these interventions is only modest. Only few studies have been designed to determine the effectiveness of multifaceted strategies in countries with different practice setting. The aim of this study is to evaluate the impact of a multifaceted intervention targeting general practitioners (GPs) and patients in six countries with different prevalence of antibiotic resistance: Two Nordic countries (Denmark and Sweden), two Baltic Countries (Lithuania and Kaliningrad-Russia) and two Hispano-American countries (Spain and Argentina). Methods/Design: HAPPY AUDIT was initiated in 2008 and the project is still ongoing. The project includes 15 partners from 9 countries. GPs participating in HAPPY AUDIT will be audited by the Audit Project Odense (APO) method. The APO method will be used at a multinational level involving GPs from six countries with different cultural background and different organisation of primary health care. Research on the effect of the intervention will be performed by analysing audit registrations carried out before and after the intervention. The intervention includes training courses on management of RTIs, dissemination of clinical guidelines with recommendations for diagnosis and treatment, posters for the waiting room, brochures to patients and implementation of point of care tests (Strep A and CRP) to be used in the GPs'surgeries. To ensure public awareness of the risk of resistant bacteria, media campaigns targeting both professionals and the public will be developed and the results will be published and widely disseminated at a Working Conference hosted by the World Association of Family Doctors (WONCA-Europe) at the end of the project period. Discussion: HAPPY AUDIT is an EU-financed project with the aim of contributing to the battle against antibiotic resistance through quality improvement of GPs' diagnosis and treatment of RTIs through development of intervention programmes targeting GPs, parents of young children and healthy adults. It is hypothesized that the use of multifaceted strategies combining active intervention by GPs will be effective in reducing prescribing of unnecessary antibiotics for RTIs and improving the use of appropriate antibiotics in suspected bacterial infections.
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| 5. |
- Håkansson, Anders, et al.
(author)
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Family medicine in the Baltic countries
- 2008
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In: Scandinavian Journal of Primary Health Care. - : Informa UK Limited. - 0281-3432 .- 1502-7724. ; 26:2, s. 67-69
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Journal article (other academic/artistic)
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| 6. |
- Jaruseviciene, Lina, et al.
(author)
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A study of antibiotic prescribing: the experience of Lithuanian and Russian GPs
- 2012
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In: Central European Journal of Medicine. - : Walter de Gruyter GmbH. - 1644-3640. ; 7:6, s. 790-799
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Journal article (peer-reviewed)abstract
- Background. Globally, general practitioners (GPs) write more than 90% of all antibiotic prescriptions. This study examines the experiences of Lithuanian and Russian GPs in antibiotic prescription for upper respiratory tract infections, including their perceptions of when it is not indicated clinically or pharmacologically. Methods. 22 Lithuanian and 29 Russian GPs participated in five focus group discussions. Thematic analysis was used to analyse the data. Results. We identified four main thematic categories: patients' faith in antibiotics as medication for upper respiratory tract infections; patient potential to influence a GP's decision to prescribe antibiotics for upper respiratory tract infections; impediments perceived by GPs in advocating clinically grounded antibiotic prescribing with their patients, and strategies applied in physician-patient negotiation about antibiotic prescribing for upper respiratory tract infections. Conclusions. Understanding the nature of physician-patient interaction is critical to the effective pursuit of clinically grounded antibiotic use as this study undertaken in Lithuania and the Russian Federation has shown. Both physicians and patients must be targeted to ensure correct antibiotic use. Further, GPs should be supported in enhancing their communication skills about antibiotic use with their patients and encouraged to implement a shared decision-making model in their practices.
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| 7. |
- Williamson, Heidi, et al.
(author)
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Supporting patients with body dissatisfaction : a survey of the experiences and training needs of european multi-disciplinary healthcare professionals
- 2018
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In: NursingPlus Open. - 2352-9008. ; 4, s. 8-13
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Journal article (peer-reviewed)abstract
- Appearance-related concerns resulting from disfigurement or pressure to conform to beauty ideals, indiscriminately affect patients’ mental and physical health. Healthcare professionals face the challenge of addressing patients’ support needs. Therefore a European University Consortium developed a course to address learning needs. Prior to its design, a study with multi-disciplinary European healthcare professionals was conducted to maximize its relevance and acceptability. Healthcare professionals (n = 718; 48% nurses, 30% doctors, 22% allied health professionals) were surveyed regarding the nature and impact of patients’ appearance concerns, confidence in key areas associated with detecting/addressing concerns, and training/educational needs. Participants reported that this subject is highly relevant and 70% described the psychosocial impact of appearance concerns across the lifespan resulting from disfiguring conditions, disability, neurological disease, ageing and weight/shape dissatisfaction. Participants, irrespective of their experience, self-reported inadequate knowledge regarding appearance-specific care, 87% requested further information and 70% wanted access to an accredited course; barriers deterring participation in training were identified. Healthcare professionals across multiple specialties are caring for patients with a wide-range of appearance concerns that impact on physical and mental health and want to increase their appearance-specific knowledge and expertise. Results have informed training/courses which have the potential to improve patient care and ameliorate health-related outcomes.
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| 8. |
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| 9. |
- Williamson, Heidi, et al.
(author)
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Supporting patients with body dissatisfaction : a survey of the experiences and training needs of european multi-disciplinary healthcare professionals
- 2018
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In: NursingPlus Open. - : Elsevier BV. - 2352-9008. ; 4, s. 8-13
-
Journal article (peer-reviewed)abstract
- Appearance-related concerns resulting from disfigurement or pressure to conform to beauty ideals, indiscriminately affect patients’ mental and physical health. Healthcare professionals face the challenge of addressing patients’ support needs. Therefore a European University Consortium developed a course to address learning needs. Prior to its design, a study with multi-disciplinary European healthcare professionals was conducted to maximize its relevance and acceptability. Healthcare professionals (n = 718; 48% nurses, 30% doctors, 22% allied health professionals) were surveyed regarding the nature and impact of patients’ appearance concerns, confidence in key areas associated with detecting/addressing concerns, and training/educational needs. Participants reported that this subject is highly relevant and 70% described the psychosocial impact of appearance concerns across the lifespan resulting from disfiguring conditions, disability, neurological disease, ageing and weight/shape dissatisfaction. Participants, irrespective of their experience, self-reported inadequate knowledge regarding appearance-specific care, 87% requested further information and 70% wanted access to an accredited course; barriers deterring participation in training were identified. Healthcare professionals across multiple specialties are caring for patients with a wide-range of appearance concerns that impact on physical and mental health and want to increase their appearance-specific knowledge and expertise. Results have informed training/courses which have the potential to improve patient care and ameliorate health-related outcomes.
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| 10. |
- Zielinski, Andrzej, et al.
(author)
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Differences in referral rates to specialised health care from four primary health care models in Klaipeda, Lithuania
- 2008
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In: BMC Family Practice. - : Springer Science and Business Media LLC. - 1471-2296. ; 9
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Journal article (peer-reviewed)abstract
- Background: Lithuanian primary health care (PHC) is undergoing changes from the systems prevalent under the Soviet Union, which ensured free access to specialised health care. Currently four different PHC models work in parallel, which offers the opportunity to study their respective effect on referral rates. Our aim was to investigate whether there were differences in referrals rates from different Lithuanian PHC models in Klaipeda after adjustment for co-morbidity. Methods: The population listed with 18 PHC practices serving inhabitants in Klaipeda city and region (250 070 inhabitants). Four PHC models: rural state-owned family medicine practices, urban privately owned family medicine practices, state-owned polyclinics and privately owned polyclinics. Information on listed patients and referrals during 2005 from each PHC practice in Klaipeda was obtained from the Lithuanian State Sickness Fund database. The database records included information on age, gender, PHC model, referrals and ICD 10 diagnoses. The Johns Hopkins ACG Case-Mix system was used to study co-morbidity. Referral rates from different PHC models were studied using Poisson regression models. Results: Patients listed with rural state-owned family medicine practices had a significantly lower referral rate to specialised health care than those in the other three PHC models. An increasing co-morbidity level correlated with a higher physician-to self-referral ratio. Conclusion: Family medicine practices located in rural-, but not in urban areas had significantly lower referral rates to specialised health care. It could not be established whether this was due to organisation, training of physicians or financing, but suggests there is room for improving primary health care in urban areas. Patient's place of residence and co-morbidity level were the most important factors for referral rate. We also found that gatekeeping had an effect on the referral pattern with respect to co-morbidity level, so that those with a physician referral were more likely to have had higher co-morbidity.
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