The group practice project in Naestved. Assessment of research activity in the light of community medicine

H. Saelan, A. Krasnik

Abstract

The group practice project in Naestved is an experiment in which attempts have been made to integrate community medical principles in the primary health service. One example of this is in the prevention of ischemic cardio-vascular disease: Persons in whom at risk blood-pressures were discovered were offered treatment and advice in relation to the increase in blood-pressure and other relevant risk factors for the development of ischemic cardio-vascular disease. On the basis of a series of key expressions derived from the community medical principles, assessment of the project was undertaken with information from special casebooks as the data basis. These casebooks were kept by the practitioners and the home nurses who participated concerning a total of 412 persons involved. Despite relatively great variations in the information content in the casebooks from practitioner to practitioner and contact to contact, it is considered that the accumulated information provides an indication about the course and results of the intervention. On the basis of the frequencies with which the practitioners noted confirmed risk factors in the casebooks, it is concluded that the holistic approach, which was emphasized in the project, was also employed. 90% of the patients participating in the project had at least one further medical consultation in the course of one year. Even in the early phases of the project and investigation of participants, great interest and a high percentage participation were demonstrated. The multidisciplinary cooperation, particularly where involvement of home nursing was involved and for whom new tasks were found, was only employed to a limited extent. The general impression of the participants own impressions was also that they preferred to maintain direct contact with their practitioner. 42% of the participants, more women than men, obtained favourable results in the course of intervention of this type for one year. It is concluded that the project could be carried out as planned as regards the main features and that the risk status in the intervention group was reduced. Simultaneously, it became apparent that new distribution of tasks between home nurses and the general practitioner cannot be carried out as a matter of course even when formal conditions in organization permit this and motivation is present among the staff. Finally, it was obvious that a thorough investigation of a population, selected on account of raised blood-pressure, reveals accumulation of a series of other factors of significance for development of ischemic cardio-vascular disease. Despite positive attitudes among the persons involved and the favourable results of medical intervention, it has only been possible to solve these problems to a limited extent in the project form chosen here.

Original languageEnglish
JournalUgeskrift for Laeger
Volume143
Issue number40
Pages (from-to)2604-2610
Number of pages7
ISSN0041-5782
Publication statusPublished - 1 Jan 1981

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