20.500.12556/DKUM-91078 Laična podpora kot nadgradnja celostne oskrbe oseb s sladkorno boleznijo in arterijsko hipertenzijo na primarni zdravstveni ravni v Sloveniji Peer support as part of scaling-up integrated care in people with type 2 diabetes and hypertension at the primary healthcare level in Slovenia Namen raziskave je bil razviti znanstveno utemeljen model laične podpore za osebe s sladkorno boleznijo tipa 2 (SB), z ali brez arterijske hipertenzije (AH), in ovrednotiti vlogo te podpore z vključitvijo usposobljenih oseb za njeno izvajanje. To bi omogočilo nadgradnjo celostne oskrbe teh bolnikov na primarni zdravstveni ravni v Sloveniji. Metode: Pilotna prospektivna intervencijska raziskava tipa pred/potem, z uporabo mešane metodologije, je potekala od maja 2021 do decembra 2023 v urbanem okolju Zdravstvenega doma Ljubljana in ruralnem okolju Zdravstvenega doma Slovenj Gradec. Z namenskim vzorčenjem so bili v dvomesečni strukturirani izobraževalni program vključeni posamezniki s SB, z ali brez AH (n=36), da bi postali usposobljeni za nudenje laične podpore drugim bolnikom (n=226). V skupinah do 10 bolnikov so se srečevali enkrat mesečno, tri mesece zapored. Podatki so bili zbrani iz zdravstvene dokumentacije, kliničnih meritev, vprašalnikov, intervjujev in fokusnih skupin. Rezultati: 31 udeležencev (stopnja zadržanja 86,1 %) je postalo usposobljenih za nudenje laične podpore, s povprečno starostjo 63,9 let (SD 8,9), med njimi 67,7 % žensk. Usposabljanje je bilo ocenjeno kot izvedljivo, visoko sprejemljivo in učinkovito. Znanje udeležencev o SB (p<0,001) in AH (p=0,024) se je po usposabljanju pomembno izboljšalo, prav tako se je po šestih mesecih zmanjšal njihov indeks telesne mase (ITM) (p=0,020). Treh srečanj laične podpore se je udeležilo 200 bolnikov (stopnja zadržanja 88,5 %), s povprečno starostjo 68,3 let (SD 10,5), med njimi 51 % moških. Srečanja so se izkazala za izvedljiva, visoko sprejemljiva in učinkovita, saj se je opolnomočenje bolnikov pomembno izboljšalo (p<0,001). Multivariatni linearni regresijski model je pokazal pomembno povezavo med opolnomočenjem in nižjo starostjo (p=0,009), s prebivanjem v ruralnem okolju (p<0,001) in odsotnostjo zdravljenja z antihiperglikemičnimi zdravili (p=0,015). Zaključek: Za izboljšanje (samo)oskrbe oseb s SB in AH je ključno, da se laična podpora sistematično vključi v zdravstveni sistem kot del kontinuuma celostne oskrbe. Potrebne so nadaljnje raziskave za preučitev dolgotrajnih učinkov in strategij širše implementacije. Aims: The objective of this study was to develop a scientifically valid model of peer support for individuals with type 2 diabetes mellitus (T2DM), with or without comorbid hypertension (HTN), and to evaluate the role of peer support by introducing specially trained peer supporters. This could scale-up integrated care of individuals with T2DM and HTN at the primary healthcare level in Slovenia. Methods: A prospective interventional, mixed-methods pilot study was conducted from May 2021 to December 2023 in two locations: the urban setting of the Community Health Centre Ljubljana and the rural Community Health Centre Slovenj Gradec. Through purposive sampling, a total of 36 individuals with T2DM, with or without HTN, were enrolled in a two-month structured educational programme designed to equip them with the skills necessary to provide lay support to other patients (n=226). Groups of up to 10 participants met once a month for three consecutive months. Data were collected from medical records, clinical measurements, questionnaires, interviews, and focus groups. Results: 31 participants (retention rate of 86.1%) became trained peer supporters, with a mean age of 63.9 years (SD 8.9), 67.7% of them women. The training was considered feasible, highly acceptable and effective. Knowledge about T2DM (p<0.001) and HTN (p=0.024) improved significantly after training, and body mass index (BMI) decreased after 6 months (p=0.020). Three peer support meetings were attended by 200 patients (retention rate of 88.5%), with a mean age of 68.3 years (SD 10.5), 51% of them male. The meetings were feasible, highly acceptable and effective, with a significant increase in patient empowerment (p<0.001). In a multivariate linear regression model, higher empowerment was significantly associated with younger patients (p=0.009), living in a rural area (p<0.001), and not receiving antihyperglycaemics (p=0.015). Conclusion: To enhance the (self)care of people with T2DM and HTN, it is crucial that peer support is systematically integrated into the health system as part of a continuum of integrated care. Further research is needed to examine the long-term effects and strategies for wider implementation. laična podpora sladkorna bolezen tipa 2 hipertenzija opolnomočenje primarno zdravstveno varstvo peer support type 2 diabetes mellitus hypertension empowerment primary healthcare true true false [T. Virtič Potočnik] Slovenski jezik Angleški jezik Doktorska disertacija 2024-10-18 22:45:05 2025-03-19 07:28:31 2025-03-20 03:10:46 0000-00-00 00:00:00 2025 0 Maribor 0 0000-00-00 NiDoloceno NiDoloceno NiDoloceno 0000-00-00 0000-00-00 0000-00-00 616.379-008.64:64-051:616-083(043.3) 229144323 DOK_Virtic_Potocnik_Tina_2025.pdf DOK_Virtic_Potocnik_Tina_2025.pdf 1 938C6E67F15575259A3D20C606A3F329 4daefe5939cf041161257bde504071a1a8a30cac6c1da48c09423dffc7c7798a a0ec1a9a-f9fd-11ef-82ba-00155d000105 https://dk.um.si/Dokument.php?lang=slv&id=189006 Medicinska fakulteta 0 0 0