BAKGRUND: Sömn är ett regelbundet återkommande tillstånd som är livsnödvändigt för att kroppen skall återhämta sig på ett korrekt vis. Personer med insomni och sömnapné är två patientgrupper som lider utav långvariga sömnproblem. Orsakerna till den dåliga sömnen kan vara många, och därför är det viktigt för sjuksköterskan att vara lyhörd och kunna stötta patienterna med hjälp av sina kunskaper gällande de åtgärder och behandlingar som finns att använda sig av. SYFTE: Syftet med denna litteraturöversikt var att belysa vilka åtgärder sjuksköterskan kan tillämpa för att stödja patienter med långvariga sömnproblem. METOD: En litteraturöversikt där 13 vetenskapliga artiklar granskades och analyserades. Fribergs (2006) modell för litteraturöversikter användes vid datainsamling och analysförfarande. RESULTAT: Fyra kategorier framkom ur analysen av de vetenskapliga artiklarna: egenvård, akupunktur, kognitiv beteendeterapi, och stödprogram. Dessa kategorier gör det möjligt för sjuksköterskan att tillämpa stöd till patienterna. Hos patienter med långvariga sömnproblem har de stödjande åtgärderna visat sig ge ökad sömn- och livskvalitet. SLUTSATS: Forskningen kring de långvariga sömnproblemen har ökat under de senaste åren men trots det finns det bristande kunskap om hur sjuksköterskan kan ge de behandlingar och det stödet som patienterna med insomni och sömnapné behöver. / BACKGROUND: Sleep is a periodic state which is essential for the body to recover in a proper manner. Insomnia and people with sleep apnea are two groups of patients out of long-term sleep problems. There are many causes of poor sleep, and that’s why there are so important for the nurse to be sensitive and support patients through their knowledge concerning the actions and processes that exist to use. AIM: The purpose of this literature review was to illustrate which measures nurse can apply to support patients with long-term sleep problems. METHOD: A literature overview, including 13 reviewed and analyzed articles. Fribergs (2006) model for literature overview were used in data collection and analysis procedure. RESULT: Four categories emerged from the analysis of the articles: self-care, acupuncture, cognitive behavioral therapy, and support program. These categories make it enable for the nurse to apply support to patients who suffer out of prolonged sleeping problem. Patients perceive that both their sleep and quality of life improves with the help of different treatments. CONCLUSION: Research into long-term sleep problems has increased in recent years. Despite this, there is a lack of knowledge about how nurse can provide treatment and support for patients with insomnia and sleep apnea.

Le vieillissement fait actuellement l’objet de toutes les attentions, constituant en effet un problème de santé publique majeur. Sa description reste cependant complexe en raison des intrications à la fois individuelles et collectives de sa conceptualisation et d’une dimension subjective forte. Les professionnels de santé sont de plus en plus obligés d’intégrer cette donnée dans leur réflexion et de proposer des protocoles de prise en charge adaptés. Le vieillissement est une évolution inéluctable du corps dont la quantification est établie par l’âge dépendant du temps dit « chronologique ». Ce critère âge est cependant imparfait pour mesurer l’usure réelle du corps soumise à de nombreux facteurs modificateurs dépendant des individus. Aussi, partant de réflexions déjà engagées et consistant à substituer cet âge chronologique par un critère composite appelé « âge biologique », aboutissant à la création d’un indicateur ou score de vieillissement et sensé davantage refléter le vieillissement individuel, une nouvelle méthodologie est proposée adaptée à la pratique de médecine générale. Une première phase de ce travail a consisté à sonder les médecins généralistes sur leur perception et leur utilisation des scores cliniques en pratique courante par l’intermédiaire d’une enquête qualitative et quantitative effectuée en France métropolitaine. Cette étude a montré que l’adéquation entre l’utilisation déclarée et la conception intellectualisée des scores restait dissociée. Les scores constituent un outil d’aide à la prise en charge utile pour cibler une approche systémique souvent complexe dans la mesure où ils sont simples à utiliser (peu d’items et items adaptés à la pratique) et à la validité scientifiquement comprise par le médecin. Par ailleurs, l’âge du patient a été cité comme un élément prépondérant influençant le choix adéquat du score par le médecin généraliste. Cette base de travail a donc servi à proposer une modélisation de l’âge biologique dont la réflexion a porté tant sur le choix du modèle mathématique que des variables constitutives de ce modèle. Une sélection de variables marqueurs du vieillissement a été effectuée à partir d’une revue de la littérature et tenant compte de leur possible intégration dans le processus de soin en médecine générale. Cette sélection a été consolidée par une approche mathématique selon un processus de sélection ascendant à partir d’un modèle régressif. Une population dite « témoin » au vieillissement considéré comme normal a été ensuite constituée servant de base comparative au calcul de l’âge biologique. Son choix a été influencé dans un premier temps par les données de la littérature puis secondairement selon un tri par classification utilisant la méthode des nuées dynamiques. Un modèle de régression linéaire simple a ensuite été construit mais avec de données normalisées selon la méthode des copules gaussiennes suivi d’une étude des queues de distribution marginales. Les résultats ainsi obtenus laissent entrevoir des perspectives intéressantes de réflexion pour approfondir le calcul d’un âge biologique et du score en découlant en médecine générale, sa validation par une étude de morbidité constituant l’étape ultime de ce travail / Ageing is nowadays a major public health problem. Its description remains complex, both individual and collective conceptualization being interlaced with a strong subjective dimension. Health professionals are increasingly required to integrate ageing and prevention into their thought and to create adapted protocol and new tools. Ageing characterizes unavoidable changes in the body. It is usually measured by the age dependent on time and called “chronological age”. However, the criterion « chronological age » reflects imperfectly the actual ageing of the body depending on many individual factors. Also, this criterion has for a long time been replaced by another composite criterion called « biological age » supposed to better reflect the ageing process. In order to build a score of ageing adapted to general practice, a new methodology is proposed suitable for general practitioners. First of all, a first phase of this work consisted in a qualitative and quantitative survey conducted among general practitioners in France. This survey was done to obtain data on the use of predictive scores by general practitioners in their daily practice and their appropriateness, as well as to know the reasons of their non-utilization. Results showed that predictive scores are useful tools in daily practice to target a complex systemic approach insofar as they are simple to use (few items, items suitable for general practice) and their scientific validity is easily understood. In addition, patient’s age has been cited as a major criterion influencing general practitioners use of a predictive score. Results of this first phase have been used to propose a model of biological ageing, with reflexion on mathematical model as well as on component variables of this model. A selection of variables as markers of ageing was carried out from a review of the literature, taking into account their capacity of integration in general practitioners’ daily practice. This selection was completed by a mathematical approach based on an ascending process on a regression model. A control sample, assumed to be "normal ageing" on the basis of current knowledge in general medicine, was then used. This sample was first carried out from a review of the literature and then from a K-means method that classified this sample into several groups. The statistical dependence of measured variables was modeled by a Gaussian copula (taking into account only linear correlations of pairs). A standardized biological age was defined explicitly from these correlation coefficients. The tails of marginal distribution (method of excess) were estimated to enhance the discriminating power of the model. Results suggest interesting possibilities for a biological ageing calculation, and the predictive score they provide, suitable for general practitioners’ daily practice. Its validation by a morbidity and mortality survey will constitute the final phase of this work

AIM: To conduct a systematic literature review on the existing literature on the prevalence of medication errors across the medicines management system in primary care; To explore the systems of error management in primary care; to investigate the prevalence and nature of medication errors in children, 0-12 years, and in older patients, ≥65 years, in primary care; and to explore community pharmacists' interventions on medicines-related problems. METHODS: 1) Systematic literature review; 2) Questionnaire survey of Primary Care Trusts (PCTs), Clinical Commissioning Groups (CCGs) and NHS Area Teams; 3) Retrospective review of the electronic medical records of a random sample of older patients, ≥65 years old, and children 0-12 years old, from 2 general practices in Luton and Bedford CCGs, England; 4) Prospective observation of community pharmacists' interventions on medicines-related problems and prescribing errors from 3 community pharmacies in Luton and Bedford CCGs in England. DATA ANALYSIS: Quantitative data from records review were analysed using Microsoft Excel on data extracted from an Access database. Statistical tests of significance were performed as necessary. Descriptive statistics were conducted on quantitative data from the studies and inductive qualitative analyses were conducted on aspects of the questionnaire survey. RESULTS: • The systematic literature review demonstrated that medication errors are common, and occur at every stage of the medication management system in primary care, with error rates between ≤1% and ≥90%, depending on the part of the system studied and the definitions and methods used. There is some evidence that the prescribing stage is the most susceptible, and that the elderly (over 65 years) and children (under 18 years) are more likely to experience significant errors, although very little research has focussed on these age groups. • The questionnaire survey of PCTS, CCGs and NHSE demonstrated that national and local systems for managing medication errors appeared chaotic, and need to be better integrated to improve error learning and prevention in general practice. • The retrospective review of patients' medical records in general practices demonstrated that prescribing and monitoring errors are common in older patients and in children. 2739 unique prescription items for 364 older patients ≥65 years old were reviewed, with prescribing and monitoring errors detected for 1 in 3 patients involving about 1 in 12 prescriptions. The factors associated with increased risk of errors were: number of unique medications prescribed, being ≥75 years old, being prescribed medications requiring monitoring, and medications from these therapeutic areas: corticosteroid, NSAID, diuretic, thyroid and antithyroid hormones, statins and ACE-I/ARB. 755 unique prescription items for 524 younger patients 0-12 years old were examined, with approximately 1 in 10 prescriptions and 1 in 5 patients being exposed to a prescribing error. Factors associated with increased risk of prescribing errors in younger patients were: being aged ≤10 years old, being prescribed three or more medications, and from similar therapeutic areas as above. Majority of the errors were of mild to moderate severity. • Community pharmacists performed critical interventions as the last healthcare professional defense within the medicines management system in primary care. However, this role is challenged by other dispensary duties including the physical aspects of dispensing and other administrative roles. CONCLUSION Prescribing and monitoring errors in general practice, and older patients and children may be more at risk compared to the rest of the population, though most errors detected were less severe. Factors associated with increased risk for errors in these age groups were multifaceted. The systems for periodic laboratory monitoring for routinely prescribed drugs, particularly in older patients, need to be reviewed and strengthened to reduce preventable hospital admissions. Antibiotic dosing in children in general practice needs to be regularly reviewed through continued professional developments and other avenues. As guidance on local arrangements for error reporting and learning systems are less standardised across primary care organisations, pertinent data from adverse prescribing events and near misses may be lost. Interventions for reducing errors should therefore explore how to strengthen local arrangements for error learning and clinical governance. Community pharmacists and/or primary care pharmacists provide an important defence within the medicines management system in primary care. Policy discussions and review around the role of the pharmacist in primary care are necessary to strengthen this defence, and harness the potential thereof.

Abstract Generalized anxiety disorder (GAD) is a mental health problem, which is characterized by excessive anxiety and worry, problems that are difficult to control. In the general population, the 12-month prevalence of GAD is 2-3%, with the lifetime prevalence being about 5%. However, GAD is more prevalent among primary care utilizers i.e. approximately 5-8% of them suffer from this disorder. Earlier studies have revealed GAD to be associated with a high utilization of health care resources. There were four goals of the present study; i) to investigate the prevalence of GAD among Finnish health care high utilizers, ii) to examine the association between GAD and utilization of different health care services at the population level, iii) to determine whether there would be any association between frequent utilization of health care services, GAD and somatic symptoms and iv) to compare the costs associated with GAD in secondary care in Finland with those attributable to major depressive disorder (MDD). In addition, the Finnish translation of the 7-item GAD scale (GAD-7) was validated. In a sample (n=150) of health care high utilizers in northern Finland, the prevalence of GAD was found to be 4%; GAD-7 was a valid instrument for detecting GAD in these subjects. In Northern Finland 1966 Birth Cohort, there was a significant association between GAD and health care utilization. Those subjects who screened positive for GAD with GAD-7 made 112% more total health care visits than other individuals. The results were statistically significant when controlled for potential confounders. Both GAD symptoms and physical symptoms were risk factors for frequent attendance of health care services, and the individuals who tested positive for GAD exhibited a higher rate of physical symptoms. Secondary care costs of all patients with a new diagnosis of GAD or MDD were calculated 2 years before and after the diagnosis date using the information from the Finnish Hospital Discharge Registers and National Hospital Benchmarking Database. Patients with a history of earlier depression or anxiety disorder had markedly higher costs compared with patients without psychiatric comorbidities. The highest mean individual costs (€19,538) during the 4-year follow-up were observed among patients with new onset of GAD but with a history of other anxiety disorders or MDD. / Tiivistelmä Yleistynyt ahdistuneisuushäiriö on mielenterveyden häiriö, jolle on ominaista ylenmääräinen ahdistuneisuus ja huolestuneisuus, joita on vaikea kontrolloida. Väestöstä noin 2 % on kärsinyt siitä vuoden aikana ja 5 % elinaikanaan. Perusterveydenhuoltoon hakeutuvilla potilailla sen on todettu olevan muuta väestöä yleisempi n. 5-8 %:n täyttäessä diagnostiset kriteerit. Aiemmat tutkimukset ovat viitanneet yleistyneestä ahdistuneisuushäiriöstä kärsivien käyttävän usein runsaasti terveyspalveluita. Tämän tutkimuksen tarkoituksena oli selvittää yleistyneen ahdistuneisuushäiriön esiintyvyyttä terveyspalveluita paljon käyttävillä suomalaisilla henkilöillä, yleistyneen ahdistuneisuushäiriön yhteyttä erilaisten terveyspalveluiden käyttöön väestötasolla, yleistyneen ahdistuneisuushäiriön ja somaattisten oireiden yhteyttä terveyspalveluiden suurkäyttöön ja yleistyneeseen ahdistuneisuushäiriöön erikoissairaanhoidossa liittyviä kustannuksia vertaillen niitä masennukseen liittyviin kustannuksiin. Samalla validoitiin yleistyneen ahdistuneisuushäiriön seulontaan kehitetyn GAD-7 seulan suomenkielinen käännös. Joukossa pohjoissuomalaisia (n=150) terveyspalveluita paljon käyttäviä henkilöitä 4 %:lla todettiin yleistynyt ahdistuneisuushäiriö. Heillä GAD-7-kysely osoittautui toimivaksi seulontatyökaluksi. Pohjois-Suomen 1966 syntymäkohortissa väestötasolla tutkittaessa todettiin yleistyneeseen ahdistuneisuushäiriöön liittyvän runsasta terveyspalveluiden käyttöä. GAD-7-kyselyssä positiivisen testituloksen saaneilla oli kokonaisuudessaan 112 % enemmän terveyspalveluiden käyttöä. Tulokset olivat tilastollisesti merkitseviä myös huomioitaessa mahdolliset sekoittavat tekijät. Lisäksi sekä yleistynyt ahdistuneisuushäiriö että somaattiset oireet liittyivät terveyspalveluiden suurkäyttöön. Sairaaloiden poistoilmoitusrekisteriä ja kansallista sairaaloiden vertailutietokantaa hyödyntäen laskettiin uusien yleistyneen ahdistuneisuushäiriön ja masennuksen diagnoosin saaneiden potilaiden erikoissairaanhoidon kokonaiskustannukset 2 vuotta ennen ja jälkeen diagnoosin. Erityisen suuret kustannukset olivat niillä uuden diagnoosin saaneilla, joilla oli historiassa aiempi masennus tai ahdistuneisuushäiriö. Suurimmat keskimääräiset erikoissairaanhoidon kustannukset (19 538 €) todettiin niillä yliestyneen ahdistuneisuushäiriön diagnoosin saaneilla, joilla aiemmin oli todettu jokin muu ahdistuneisuushäiriö tai masennus.

Background: Home visits are part of general practice work in Germany. Within the context of an expanding elderly population and a decreasing number of general practitioner (GPs), open questions regarding the organisation and adequacy of GPs’ care in immobile patients remain. To answer these questions, we will conduct a representative primary data collection concerning contents and organisation of GPs’ home visits in 2014. Because this study will require considerable efforts for documentation and thus substantial involvement by participating GPs, we conducted a pilot study to see whether such a study design was feasible. Methods: We used a mixed methods design with two study arms in a sample of teaching GPs of the University Halle. The quantitative arm evaluates participating GPs and documentation of home visits. The qualitative arm focuses on reasons for non-participation for GPs who declined to take part in the pilot study. Results: Our study confirms previously observed reasons for non-response of GPs in the particular setting of home visits including lack of time and/or interest. In contrast to previous findings, monetary incentives were not crucial for GPs participation. Several factors influenced the documentation rate of home visits and resulted in a discrepancy between the numbers of home visits documented versus those actually conducted. The most frequently reported problem was related to obtaining patient consent, especially when patients were unable to provide informed consent due to cognitive deficits. Conclusions: The results of our feasibility study provide evidence for improvement of the study design and study instruments to effectively conduct a documentation-intensive study of GPs doing home visits. Improvement of instructions and questionnaire regarding time variables and assessment of the need for home visits will be carried out to increase the reliability of future data. One particularly important methodological issue yet to be resolved is how to increase the representativeness of home visit care by including the homebound patient population that is unable to provide informed consent.

Contexte : Actuellement en France, le taux de participation au dépistage organisé du cancer colorectal (CCR) reste nettement inférieur aux recommandations européennes et ce, malgré l’implication des médecins généralistes.Objectifs : L’objectif général de ce travail de thèse était d’évaluer les pratiques des médecins généralistes en matière de dépistage organisé du CCR, de comprendre les freins au dépistage et d’évaluer les stratégies permettant d’améliorer la participation des patients à ce dépistage.Méthode : Nos travaux se sont appuyés sur les données du programme de dépistage organisé dans le Val-de-Marne. Nous avons reconstitué une cohorte historique de 157 979 patients suivis par 961 médecins généralistes, mené une recherche-action auprès de 21 médecins volontaires et réalisé un essai contrôlé randomisé en grappes incluant 144 médecins et 20 778 patients.Résultats : Une faible part de la variabilité de la probabilité de participation était attribuable à l’hétérogénéité entre médecins (coefficient de corrélation intra-classe, 5,5%). La participation au dépistage était moindre chez les hommes (odds ratio [OR], 0,79 ; IC 95%, 0,78–0,91), les jeunes (50–54 ans, OR, 0.61 ; IC 95%, 0.58–0.63 ; 55–59 ans, OR, 0.76 ; IC 95%, 0.73–0.80) ou les résidents des zones les plus défavorisées (OR, 0.82 ; IC 95%, 0.77–0.87).Nous avons identifiés 7 exigences essentielles pour l'activité de dépistage organisé du cancer colorectal par le médecin généraliste : Être proactif, Être un partenaire, Prendre en compte l’entourage, Se positionner comme expert du problème, Gérer le temps de manière efficiente, Expliquer la réalisation du test et Aider la réalisation du test. Pour chacune, nous avons pu identifier des techniques utilisables en situation de pratique clinique.Les rappels systématiques adressés par voie postale aux médecins généralistes comportant la liste mise à jour de leurs patients éligibles au dépistage n'ont pas augmenté de manière significative la participation des patients au dépistage après prise en compte de l’effet grappe (analyse multiniveau).Conclusions : Des actions ciblées vers les patients les plus jeunes, les hommes et les résidents des zones géographiques les plus défavorisées devraient être encouragées afin de réduire les disparités observées et améliorer l’efficacité globale du programme de dépistage. Des actions sur l'ensemble des médecins généralistes doivent être envisagées : mettre l'approche centrée sur le patient et la pratique réflexive au cœur du projet de formation initiale et continue, et proposer des recommandations de pratique basées sur les données issues de la pratique. / Background: Currently in France, participation rate in organised colorectal cancer (CRC) screening remains well below European guidelines, despite general practitioners involvement.Objectives: The overall objective of this thesis was to assess general practitioners practices in organized CRC screening, to understand barriers to screening participation and to assess strategies to improve patient participation to screening.Methods: Our work was based on data from the organised screening programme in the Val-de-Marne district. We conducted a retrospective cohort of 157 979 patients followed by 961 general practitioners, an action research among 21 volunteer general practitioners and a cluster-randomized controlled trial including 144 general practitioners and 20,778 patients.Results: A small part of the variability of the likelihood of participation was due to the heterogeneity among physicians (intraclass correlation coefficient, 5.5%). Screening participation was significantly lower in males (odds ratio [OR], 0.79; 95% CI, 0.78 to 0.91), the youngest age group (50-54 years, OR, 0.61; 95% CI, 0.58 -0.63; 55-59 years, OR, 0.76; 95% CI, 0.73-0.80) and patients living in socioeconomically deprived areas (OR, 0.82; 95% CI, 0.77-0.87).We have identified seven essential requirements for general practitioners when screening for CRC: Be proactive, Be partners in care, Take into consideration the patient's family and friends, Position themselves as the expert, Manage time efficiently, Explain the test procedure and Help carry out the test. We were able to identify techniques used for each requirement.Systematic reminders sent by post to general practitioners with the updated list of eligible patients for screening did not significantly improve patient participation to organised CRC screening after taking clustering into account (multilevel analysis).Conclusions: Targeted actions to improve CRC screening participation should focus on patients younger than 60 years, males, and individuals living in deprived areas. Actions to enhance the influence of general practitioners on patient participation should be directed to the overall population of general practitioners. Patient-centred care and reflective practice should be at the heart of initial and continuing medical education, and guidelines based on practice data should be proposed.

Background: Smartphones and related applications are increa singly gaining relevance in the healthcare domain. We previously assessed the demands and preferences of medical students towards an application accompanying them during a course on general practice. The current study aims to elucidate the factors associated with adop tion of such a technology. Therefore we provided students with a prototype of an application specifically related to their studies in general practice.

Background: To be able to counter the increasing shortage of general practitioners (GPs) in many countries, it is crucial to remain up‑to‑date with the decisive reasons why young physicians choose or reject a career in this field. Materials and Methods: Qualitative content analysis was performed using data from a cross‑sectional survey among German medical graduates (n = 659, response rate = 64.2%). Subsequently, descriptive statistics was calculated. Results: The most frequent motives to have opted for a GP career were (n = 74/81): Desire for variety and change (62.2%), interest in a long‑term bio‑psycho‑social treatment of patients (52.7%), desire for independence and self‑determination (44.6%), positively perceived work‑life balance (27.0%), interest in contents of the field (12.2%), and reluctance to work in a hospital (12.2%). The most frequent motives to have dismissed the seriously considered idea of becoming a GP were (n = 207/578): Reluctance to establish a practice or perceived associated risks and impairments (33.8%), stronger preference for another field (19.3%), perception of workload being too heavy or an unfavorable work‑life balance (15.0%), perception of too low or inadequate earning opportunities (14.0%), perception of the GP as a \"distributor station\" with limited diagnostic and therapeutic facilities (11.6%), perception of too limited specialization or limited options for further sub‑specialization (10.6%), rejection of (psycho‑) social aspects and demands in general practice (9.7%), and perceived monotony (9.7%). Conclusion: While some motives appear to be hard to influence, others reveal starting points to counter the GP shortage, in particular, with regard to working conditions, the further academic establishment, and the external presentation of the specialty.

Mit der vorliegenden Arbeit sollte untersucht werden, ob die Selbstausfüller-Version des STEP (Standardised assessment of elderly people in primary care in Europe) praktikabel und verständlich ist, ob sie von Patienten und Ärzten akzeptiert wird und ob sie nützlich ist, bisher unbekannte gesundheitliche Probleme der Patienten zu entdecken. 1007 von 1540 Patienten über 65 Jahren, die in 28 sächsische Hausarzt-praxen kamen, beantworteten die Selbstausfüller-Version des STEP. Ermittelt wurde, dass 95,8% der teilnehmenden Patienten den Fragebogen ohne Hilfe ausfüllen konnten. Die durchschnittliche Zeit zum Beantworten des Fragebogens nahm, abhängig vom Alter der Patienten, von 17 bis 25 Minuten zu. Vierzehn der 75 Fragen der Selbstausfüller-Version wurden von mehr als 9% der Patienten nicht beantwortet. Die Patienten gaben bei acht der 14 häufig nicht beantworteten Fragen Verständnisprobleme an. Bei einer Stichprobe von 257 zufällig ausgewählten Patienten wurden 281 gesundheitliche Probleme (1,1 pro Patient) entdeckt, die den Hausärzten noch nicht bekannt gewesen waren. Die Hausärzte gaben an, dass 16,4% dieser neuen Probleme eine Konsequenz hatten, vordergründig die physischen Probleme. Bemerkenswert war, dass die neu entdeckten psycho-sozialen Probleme keinerlei Konsequenzen hatten. Die Selbstausfüller-Version war praktikabel, nützlich und wurde von den meisten Patienten gut akzeptiert. Einige Fragen sollten hinsichtlich der Verständlichkeit überprüft werden. Weitere Studien müssen zeigen, warum einige neu entdeckte Probleme keine Konsequenzen hatten, ob diese Probleme gebessert werden können und ob es nötig ist, diese Probleme zu ermitteln. / The study was designed to evaluate the acceptance of the self-rated version of the Standardized Assessment of Elderly People in primary care in Europe (STEP) by patients and general practitioners, as well as the feasibility, comprehensibility, and usefulness in gaining new information. In all, 1007 of 1540 patients aged 65 and above, from 28 different Saxon general practices took part. We recognized that 96% of the patients were able to fill in the questionnaire by themselves. It took them an average of approximately 20 minutes to do so. Further analysis of 257 randomly selected patients identified 281 previously unknown problems (1.1 per patient). In the practitioners’ opinion, 16% of these problems, particularly physiological and mental ones, could lead to immediate consequences. Remarkably, newly identified psychosocial problems were not followed by any consequences. Fourteen of the 75 questionnaire items were not answered by more than 9% of the participants. Eight of the 14 frequently unanswered items were marked as difficult to understand by the patients. Altogether the self-rating version of the STEP was found to be feasible and useful. It was well accepted among patients; however, some questions need further review to improve their comprehensibility. Furthermore, it should be investigated why some identified problems do not have consequences and whether there is a need to record these issues at all.

No description available.