Practices of Family Health Staff for Chronic Diseases: Information, Education, Follow-up, and Guidance Activities

Year 2023, , 639 - 648, 28.09.2023

Esma Atasoy , Funda Özpulat

https://doi.org/10.53424/balikesirsbd.1094868

Abstract

Aim: The purpose of this study is to determine the practices and approaches of family health workers in managing chronic illness. Materials and Methods: The study was conducted descriptively in 2021 with 101 family health workers. Results: According to findings, 20.8% of family health workers screen healthy individuals for diabetes risk and refer them to family physicians; 32.7% do not assess individuals with a chronic disease other than diabetes for diabetes risk and do not refer them to the family physician; 77.2% screen all pregnant women who refer to them for gestational diabetes and refer them to the family physician for glucose tolerance testing; 47.5% screen all individuals with a history of childhood diabetes for diabetes and refer them to their family physician for measurement of the glucose tolerance test; 34.7% measure systolic and diastolic values of all healthy individuals at least once; 40.6% do not assess adolescent individuals for adolescent hypertension and do not refer them to a family physician; 32.7% inform more than half of those at high risk for cholesterol about healthy eating, and 31.7% inform more than half about physical activity; 33.7% determine the body mass index (BMI) of more than half of healthy individuals and the BMI of individuals with a chronic disease at least once. Conclusion: It is necessary to improve the activities of informing, educating, monitoring, and referring, which are among the fundamental roles and responsibilities of family health workers in preventing and combating chronic diseases. Policies should be developed to encourage and engage individuals in acquiring healthy lifestyle behaviors and behavior change.

Keywords

Family Health Worker, Chronic Diseases, Disease Management, Body Mass Index, Diabetes, Cancer, High Blood Pressure

Aile Sağlığı Elemanlarının Kronik Hastalıklara Yönelik Uygulamaları Kronik Hastalıklara Yönelik Uygulamaları: Bilgilendirme, Eğitim, İzlem ve Yönlendirme Faaliyetleri

Abstract

Amaç: Araştırma aile sağlığı elemanlarının sık görülen kronik hastalıklara yönelik uygulama ve yaklaşımlarının belirlenmesi amacıyla yapılmıştır. Gereç ve Yöntem: Tanımlayıcı türdeki bu araştırma 2021 yılında 101 aile sağlığı elemanıyla gerçekleştirilmiştir. Bulgular: Aile sağlığı elemanlarının %20.8’i sağlıklı bireyleri diyabet riski açısından değerlendirip aile hekimine yönlendirmekte; %32.7’si diyabet haricinde herhangi bir kronik hastalığı bulunan bireyleri diyabet riski açısından değerlendirmemekte ve aile hekimine yönlendirmemekte; %77.2’si kendilerine başvuran tüm gebeleri gebelik diyabeti açısından değerlendirip glikoz tolerans testi ölçümü için aile hekimine yönlendirmekte; %47.5’i çocukluk çağı diyabet öyküsü olan tüm bireyleri diyabet izlemi açısından değerlendirmekte ve glikoz tolerans testi ölçümleri için aile hekimine yönlendirmekte; %34.7’si tüm sağlıklı bireylerin sistolik ve diastolik değerlerini en az 1 kere ölçmekte; %40.6’sı ise adölesan bireyleri adölesan dönem HT açısından değerlendirmeyip aile hekimine yönlendirmemekte; %32.7’si kendilerine başvuran yüksek kolesterol riski olan bireylerin yarısından fazlasını sağlıklı beslenme, %31.7’si fiziksel aktivite hakkında bilgilendirmektedir. Aile sağlığı elemanlarının %33.7’si sağlıklı bireylerin yarısından çoğunun en az 1 kez Beden Kitle İndeksini (BKİ) ve herhangi bir kronik hastalığı bulunan bireylerin BKİ’sini değerlendirmektedir.
Sonuç: Aile Sağlığı elemanlarının kronik hastalıkları önleme ve mücadelede temel rol ve sorumlulukları arasında yer alan bilgilendirme, eğitim, izlem ve yönlendirme faaliyetlerinin geliştirilmesi gerekmektedir. Aile sağlığı elemanlarının sağlıklı yaşam biçimi davranışları kazandırma ve davranış değişikliğini takip etme bakımından teşvik edilmesi ve katılımı sağlayacak politikalar geliştirilmesi önerilmektedir.

Keywords

Aile Sağlığı Elemanı, Kronik Hastalıklar, Hastalık Yönetimi, Beden Kütle İndeksi, Diyabet, Kanser, Yüksek Tansiyon

References

• Altamimi, S., Alshoshan, F., Al Shaman, G., Tawfeeq, N., Alasmary, M., Ahmed, A.E. (2016). Health promotion practices as perceived by primary health care professionals at the Ministry of National Guard Health Affairs, Saudi Arabia, Qatar Medical Journal, 1, 4. http://dx.doi.org/10.5339/qmj.2016.4
• Choi, J.W., Shin, J.H., Kim, M.J, Park, S.K., Songn, K.I., Hur, I.C. (2018). Factors related to blood pressure control and the effect of an education program performed by family physicians on patients with hypertension. Korean Journal of Family Practice, 8(2), 175-181. https://doi:10.21215/kjfp.2018.8.2.175
• Dünya Sağlık Örgütü Türkiye Ofisi (2018). Türkiye Hane Halkı Sağlık Araştırması: Bulaşıcı Olmayan Hastalıkların Risk Faktörleri Prevalansı (STEPS) 2017. Editörler: Üner S, Balcılar M, Ergüder T., Ankara. Retrived 24.04.2022 from https://www.euro.who.int/__data/assets/pdf_file/0009/383985/turkey-risk-factors-tur.pdf.
• Godwin, M., Williamson, T., Khan S., Kaczorowski J., Asghari S., Morkem R, et al. (2015). Preva¬lence and management of hypertension in primary care practices with electronic medical records: a report from the Canadian Primary Care Sentinel Surveillance Network. Canadian Medical Association Journal Open, 3(1), E76-82. https://doi.org/10.9778/cmajo.20140038
• Hidalgo, K.D., Mielke, G.I., Parra, D.C., Lobelo, F., Simões, E.J., Gomes G.O., Florindo A.A., Bracco, M., Moura L., Brownson R.C., Pratt, M., Ramos, L.R., Halla P.C. (2016). Health promoting practices and personal lifestyle behaviors of Brazilian health professionals. BMC Public Health, 16(1), 1114. https://doi.org/10.1186/s12889-016-3778-2
• Hobbs, F.D.R, Bankhead, C., Mukhtar, T., Stevens, S., Perera-Salazar, R., Holt, T., Salisbury, C. (2016). Clinical workload in UK primary care: a retrospective analysis of 100 million consultations in England, 2007–14. Lancet, 387(10035), 2323-2330. https://doi.org/10.1016/S0140-6736(16)00620-6
• Kadu, M.K., Stolee, P. (2015). Facilitators and barriers of implementing the chronic care model in primarycare: a systematic review. BMC Family Practice, 16(12), 1-14. https://doi.org/10.1186/s12875-014-0219-0
• Kvedar, J.C., Fogel, A.L., Elenko, E., Zohar, D. (2016). Digital medicine’smarch on chronic disease. Nature Biotechnology, 34(3), 239-246. https://doi.org/10.1038/nbt.3495
• Lundberg, K., Jong, M.C, Kristiansen, L., Jong, M. (2017). Health promotion in practice—district nurses' experiences of working with health promotion and lifestyle interventions among patients at risk of developing cardiovascular disease. Explore,13(2), 108-115. https://doi.org/10.1016/j.explore.2016.12.001
• Norfula, A., Martsolf, G., de Jacqc, K., Poghosyanc, L. (2017). Utilization of registered nurses in primary care teams: A systematic review. International Journal of Nursing Studies, 74, 15–23. https://doi.org/10.1016/j.ijnurstu.2017.05.013
• Prazeres, F., Santiago, L. (2015). Prevalence of multimorbidity in the adult population attending primary care in Portugal: a crosssectional study. BMJ Open, 5, e009287. https://doi.org/10.1136/bmjopen-2015-009287
• Rani, J.G. (2018). Effect of health promotion program among patients with newly diagnosed diabetes mellitus regarding lifestyle modification. Manipal Journal of Nursing and Health Sciences, 2018; 4(2):31-35. Retrived 24.04.2022 from https://ejournal.manipal.edu/mjnhs/docs/Volume%204_Issue%202/FullText/7%20Jhansi%20Rani.pdf
• Rothman, A.A., Wagner, E.H. (2003). Chronic illness management: what is the role of primary care? Annals of Internal Medicine, 138(3), 256-61. https://doi.org/10.7326/0003-4819-138-3-200302040-00034
• Sung, N.J., Choi, Y.J., Lee, J.H. (2018). Primary care comprehensiveness can reduce emergency department visits and hospitalization in people with hypertension in South Korea. International Journal of Environmental Research and Public Health, 15(2), 272. https://doi.org/10.3390/ijerph15020272
• The International Diabetes Federation (2019). IDF Diabetes Atlas Ninth edition. 9th Edition. Retrived 24.04.2022 from https://diabetesatlas.org/atlas/ninth-edition/
• Tronieri, J.S., Wadden, T.A., Chao, A.M., Tsai, A.G. (2019). Primary care ınterventions for obesity: review of the evidence. Current Obesity Reports, 8(2), 128–136 https://doi.org/10.1007/s13679-019-00341-5
• UNICEF, WHO. (2018). A vision for primary healthcare in the 21st century: towards universal health coverage and the Sustainable Development Goals. Geneva: World Health Organization and the United Nations Children’s Fund (UNICEF), (WHO/HIS/SDS/2018.X). Licence: CC BY-NC-SA 3.0 IGO. World Health Organization andt he United Nations Children’s Fund (UNICEF). Retrived 24.04.2022 from https://apps.who.int/iris/handle/10665/328065
• Walsh, K., Grech, C., Hill, K. (2019). Health advice and education given to overweight patients by primary care doctors and nurses: A scoping literature review. Preventive Medicine Reports, 14(2019), 100812. https:// doi:10.1016/j.pmedr.2019.01.016
• WHOa. Non communicable diseases country profiles 2018. Geneva: World Health Organization; 2018. Licence: CC BY-NC-SA 3.0 IGO.
• WHOb. Primary healthcare (PHC). Retrived 24.04.2022 from https://www.who.int/health-topics/primary-health-care#tab=tab_1
• WHOc. Non communicable diseases. Retrived 24.04.2022 from https://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases
• Yıldırım J.G. (2017). Kronik hastalığı olan bireylere yönelik ilaç öz-yönetimi (Kişisel uygulama kitabı). Ege Üniv. Basımevi. ISBN: 978-605-63857-3-5. İzmir
• Yıldırım J.G. (2021) Self-Management of Chronic Diseases: A Descriptive Phenomenological Study, Social Work in Public Health 36(2), 300-310, https:// doi.org/10.1080/19371918.2020.1859034