Avtor/Urednik		Petek-Šter, Marija; Švab, Igor
Naslov		Kako raziskovati multimorbidnost v družinski medicini?
Prevedeni naslov		How to research multimorbidity in general practice?
Tip		članek
Vir		Zdrav Vars
Vol. in št.		Letnik 48, št. 2
Leto izdaje		2009
Obseg		str. 51-61
Jezik		slo
Abstrakt		Background: Multimorbidity in family medicine is the rule rather than the exception, yet in Slovenia this health problem has not yet been adequately studied. The aim of this systematic literature review was to determine how theissue of multimorbidity has been explored and to identify questions that still need to be addressed. Methods: We consulted Medline for the original English-language scientific articles dealing with the population aged 19 and older, published until mid-August 2008. Key words "multimorbidity, comorbidity, chronic diseases" and "general practice, family medicine, family practice, family physician, primary health care", were used. We evaluated the appropriateness of the collected studies, and incorporated papers on multimorbidity in family medicine into our further analysis. Results: Researchin multimorbidity began in the 1990s, and the number of published studies has been increasing recently. Investigators mostly use quantitative non-interventional studies to determine the extent and importance of multimorbidity and its impact on the quality of life and health care. Qualitative methodology was only used in one research project investigating the attitude of multimorbid patients towards drug use. Conclusions: In order to meet the need for a holistic and patient-centred care, further research on the effectiveness of different approaches to different groups of comorbid patients will be required. The planning of appropriate effective approaches will have to take into consideration physicians' and patients' beliefs and attitudes, which need to be assessed by qualitative methods.
Izvleček		Izhodišča: Multimorbidni bolniki predstavljajo prej pravilo kot izjemo v družinski medicini. V Sloveniji se z raziskovanjem multimorbidnosti še nismo veliko ukvarjali. Namen sistematičnega pregleda literature je bil ugotoviti, kako se raziskuje multimorbidnost in na katera vprašanja raziskovalci še niso zadovoljivo odgovorili. Metode: Iz baze Medline smo s pomočjo ključnih besed "multimorbidity, comorbidity, chronic diseases" in "general practice, family medicine, family practice, family physician, primary health care" izbrali vse do sredine avgusta 2008 objavljene izvirne znanstvene članke v angleškem jeziku, ki so vključevali populacijo, starejšo od 19 let. Ocenili smo ustreznost tako zbranih raziskav in v nadaljno analizo vključili raziskave, kiso obravnavale problem multimorbidnosti v družinski medicini. Rezultati: Raziskovanje multimorbidnosti se je začelo v devetdesetih letih preteklega stoletja, v zadnjih letih pa število objavljenih raziskav narašča. Metodološkogre večinoma za kvantitativne neintervencijske raziskave, ki ugotavljajo pogostost in resnost problema ter vpliv multimorbidnosti na kakovost življenja bolnikov ter posledice za zdravstveno službo. Kvalitativna raziskovalna metodologija je bila uporabljena le v eni raziskavi, ki je želelaosvetliti pogled multimorbidnih bolnikov na jemanje zdravil. Zaključek: Potreba po kompleksni in v bolnika usmerjeni obravnavi zahteva raziskave, s katerimi bi ugotavljali učinkovitost različnih pristopov k obravnavi različnihskupin komorbidnih bolnikov. Pri načrtovanju ustreznih pristopov bi morali upoštevati stališča bolnikov in zdravnikov, ki bi jih lahko pridobili le s pomočjo kvalitativne raziskovalne metodologije.