Scandinavian journal of primary health care
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Scand J Prim Health Care · Sep 2010
Comparative StudyAssociations between successful palliative trajectories, place of death and GP involvement.
General practitioner (GP) involvement may be instrumental in obtaining successful palliative cancer trajectories. The aim of the study was to examine associations between bereaved relatives' evaluation of palliative cancer trajectories, place of death, and GP involvement. ⋯ This study indicates that home death is positively associated with a higher likelihood that bereaved relatives will evaluate the palliative trajectory at home as successful. No specific GP services that were statistically significantly associated with higher satisfaction among relatives could be identified, but contact between GPs and relatives seems important and the impact needs further investigation.
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Scand J Prim Health Care · Jun 2010
Comparative StudyGood pregnancy outcome despite intrahepatic cholestasis.
Pregnant women complaining of itching are screened for intrahepatic cholestasis (ICP) by laboratory tests in primary healthcare. Cases of ICP are referred to specialist care. In Finland, ICP occurs in 1% of pregnancies. The aim was to study the outcome of deliveries. Design. Retrospective study of ICP pregnancies. Data were collected from the hospital discharge register, patient records, and the labour register. ⋯ ICP mothers are found and taken care of appropriately, and thus ICP is only a minor risk for mothers and their children.
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Scand J Prim Health Care · Jun 2010
ReviewWhat do GPs feel about sickness certification? A systematic search and narrative review.
Abstract Objective. To identify GPs' attitudes towards sickness certification. Design. ⋯ Role responsibility focused on the multiple roles GPs had to fulfil, and barriers to good practice were identified both within and outside the healthcare system. Conclusion. Any potential for changing the certification system needs to focus on reducing the potential for conflict, clarification of the roles of all stakeholders, and improving access to specialist occupational health and rehabilitation services.
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Scand J Prim Health Care · Jun 2010
The Patient Experiences Questionnaire for Out-of-Hours Care (PEQ-OHC): data quality, reliability, and validity.
To develop and evaluate the Patient Experiences Questionnaire for Out-of-Hours Care (PEQ-OHC) in Norway. ⋯ The development of the PEQ-OHC followed a rigorous process based on a systematic review, interviews with users, and an expert group which lend the questionnaire content validity. The PEQ-OHC has evidence for data quality, internal consistency, reliability, and construct validity.
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Scand J Prim Health Care · Jun 2010
Serum total cholesterol levels and all-cause mortality in a home-dwelling elderly population: a six-year follow-up.
To investigate the association between serum total cholesterol and all-cause mortality in elderly individuals aged > or = 75 years. Design. A prospective cohort study with a six-year follow-up. ⋯ A random sample (n = 700) of all persons aged > or = 75 years living in Kuopio, Finland. After exclusion of participants living in institutional care and participants using lipid-modifying agents or missing data on blood pressure and cholesterol levels, the final study population consisted of 490 home-dwelling elderly persons with clinical examination. We used the Cox proportional hazard model and the propensity score (PS) method. Main outcome measure. All-cause mortality. Results. In an age- and sex-adjusted analysis, participants with S-TC > or = 6mmol/l had the lowest risk of death (hazard ratio, HR = 0.48, 95% CI 0.33-0.70) compared with those with S-TC < 5 mmol/l. HR of death for a 1 mmol increase in S-TC was 0.78. In multivariate analyses, the HR of death for a 1 mmol increase in S-TC was 0.82 and using S-TC < 5 mmol/l as a reference, the HR of death for S-TC > or = 6 mmol/l was 0.59 (95% CI 0.39-0.89) and for S-TC 5.0-5.9 mmol/l, the HR was 0.62 (95% CI 0.42-0.93). In a PS-adjusted model using S-TC < 5 mmol/l as a reference, the HR of death for S-TC > or = 6 mmol/l was 0.42 (95% CI 0.28-0.62) and for S-TC 5.0-5.9 mmol/l, the HR was 0.57 (95% CI 0.38-0.84). Conclusions. Participants with low serum total cholesterol seem to have a lower survival rate than participants with an elevated cholesterol level, irrespective of concomitant diseases or health status.