Periodic health examinations during a pandemic

Introduction: The coronavirus pandemic has changed daily lives. These changes affect many aspects of lives including periodic health examinations. Specialists warn that in the era of the pandemic people abandon examinations. This is a very dangerous phenomenon, which can negatively affect health and general well-being. The aim of this study was to determine the frequency of periodic health examinations during the pandemic period including the use of telephone advice services. Material and methods: The study was carried out in March 2021 among 147 people (120 women and 27 men), in the age range of 18-76 years. The study was carried out by the method of diagnostic survey, with the use of questionnaire technique (authors’ questionnaire). Questions included knowledge of prevention, frequency of periodic health examinations, and health services received by the respondents during the pandemic. Analysis of the survey results provided information on current health problems, time of diagnosis, and course of treatment to date. Results: During the pandemic, the majority of respondents had the opportunity to use a telephone advice, with women more likely to use the telephone advice than men (64.2% vs. 37.0%; p = 0.010). 36.9% of the respondents were satisfied with the service. The main reasons for dissatisfaction with the telephone advice included: inability to examine (33.3%), short telephone advice time (24.2%), misdiagnosis or ineffective treatment (21.2%), long waiting time, difficult contact with the facility (15.2%). Among telephone advice users, 39.1% had chronic diseases; among non- telephone advice users, the percentage was lower at 18.3%. Telephone advice users were significantly less likely to say they did not have periodic health examinations or did not remember when they had them done compared to non- telephone dvice users (p = 0.019). Conclusions: During the pandemic, the majority of respondents had the opportunity to use telephone advice. Only 1/3 were satisfied with the telephone advice, and the main reasons for dissatisfaction were as follows: inability to examine, short telephone advice time, misdiagnosis or ineffective treatment. Telephone advice users were significantly less likely to say they did not have periodic examinations or could not remember when they had them done compared to non-telephone advice users.

The incidence of insomnia among employed and unemployed individuals

Introduction: Insomnia is a complex disorder and requires knowledge of the subjective feelings of the patient. The incidence of insomnia varies depending on the classification and definition used in the study, and usually oscillates between 4–48%. Insomnia lowers quality of life (QoL), which translates into poorer functioning at social and professional levels.The aim of this study was to determine the incidence of insomnia among employed and unemployed individuals with regard to their sociodemographic and socioeconomic data, to analyze the relationship between insomnia, depressive symptoms and chronic diseases, and to assess how insomnia affects QoL.Materials and methods: This survey-based study included 597 people. The following questionnaires were used: the Athens Insomnia Scale (AIS), Beck’s Depression Inventory (BDI), the Short Form 36 Health Survey (SF-36), and a self-developed questionnaire.Results: Insomnia was found in 17.75% (n = 106; p ≤ 0.001) of respondents. There was a statistically significant relationship between insomnia and sex (p = 0.006). Insomnia was more common in women (20.83%; n = 75), people over 56 years of age (27.08%; n = 26; p ≤ 0.001), and those unemployed (26.37%; n = 53; p ≤ 0.001). A statistically significant relationship was demonstrated between depression and insomnia assessed by the AIS (p ≤ 0.001).Conclusions: 1. Insomnia was more common in unemployed individuals. 2. Insomnia was more common in those with hypertension, irrespective of their employment status. Therefore, primary care physicians should use the AIS as part of screening among chronically ill patients. 3. Insomnia was accompanied by depressive symptoms in all groups analyzed in this study, irrespective of their employment status. 4. Insomnia is a serious public and mental health problem. The AIS should be used as part of workers’ periodic health examinations, since ignoring the problem of insomnia decreases QoL.

A Gap Analysis Assessing the Perceptions of Primary Care Physicians in the Management of Kidney Recipients After Transplantation

Objectives: To examine the practice patterns and perceptions of primary care physicians in the management of chronic diseases in kidney recipients, assess care provided to recipients, and identify barriers to the optimal delivery of primary care to recipients. Methods: A self-administered questionnaire on the primary care of kidney recipients was developed and implemented. The survey investigated physician comfort and practice patterns in providing preventive and chronic care to recipients, patient self-management support, and physician perceptions on communication with transplant centers and barriers to ideal care. Results: A total of 210 physicians completed the survey (response rate of 22%). Among the respondents, 73% indicated they were currently providing care to kidney recipients. The majority of physicians specified that they rarely (57%) or never (20%) communicate with transplant centers. Most physicians felt comfortable providing care to recipients for non-transplant-related issues (92.5%), vaccinations (85%), and periodic health examinations (94%). The majority (75.3%) of physicians felt uncomfortable managing the immunosuppressive medications of recipients. Physicians’ most commonly stated barriers to delivering optimal care to recipients were insufficient guidelines provided by the transplant center (68.9%) and lack of knowledge in managing recipients (58.8%). Suggested resources by physicians to improve their comfort level in managing recipients included guidelines and continuing medical educational activities related to transplantation. Conclusions: Our results suggest that there are barriers to delivering optimal primary care to kidney recipients. The approach to providing resources needed to bridge the knowledge gap for physicians in the management of recipients requires further exploration.