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He G, Ren J, Chen X, Pan Q, Pan T. GP's GP, general practitioner's health and willingness to contract family doctors in China: a national cross-sectional study. BMC PRIMARY CARE 2024; 25:253. [PMID: 38997659 PMCID: PMC11245823 DOI: 10.1186/s12875-024-02492-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 06/26/2024] [Indexed: 07/14/2024]
Abstract
OBJECTIVES General practitioners are trained to care for patients with a high level of responsibility and professional competency. However, there are few reports on the physical and mental health status of general practitioners (GPs) in China, particularly regarding help seeking and self-treatment. The primary aims of this study were to explore GPs' expectations of their own family doctors and their reflection on role positioning, and to explore the objective factors that hinder the system of family doctors. STUDY DESIGN Cross-sectional study. METHODS We conducted an online survey of Chinese GPs. Descriptive statistics were used to summarize the findings. RESULTS More than half of the participants (57.20%) reported that their health was normal over the past year. A total of 420 participants (23.35%) reported having chronic diseases. For sleep duration, 1205 participants (66.98%) reported sleeping 6-8 h per day; 473 participants (26.29%) reported chronic insomnia. Two hundred thirty-one participants (12.84%) had possible depression. A total of 595 (33.07%) participants reported that they had contracted a fixed family doctor. In terms of preventing themselves from contracting for a family doctor, the following factors were identified: lack of sufficient time (54.81%), could solve obstacles themselves (50.97%), and embarrassment (24.24%). The proportion of the contract group (12.44%) taking personal relationship as a consideration was higher than that of the non-contract group (7.64%) (χ2 = 10.934 P = 0.01). Most participants (79.90%) in the non-signed group reported never having seen a family doctor. In terms of obstacles, more than half of the signed group thought that they could solve obstacles themselves, while the non-signed group (39.20%) was less confident in the ability of family doctors than the signed group (29.75%) (χ2 = 15.436, P < 0.01). CONCLUSIONS GPs work under great pressure and lack of self-care awareness, resulting in an increased prevalence of health conditions. Most GPs did not have a regular family doctor. Having a family doctor with a fixed contract is more conducive to the scientific management of their health and provides a reasonable solution to health problems. The main factors hindering GPs from choosing a family doctor were time consumption, abilities to solve obstacles themselves, and trust in the abilities of GPs. Therefore, simplifying the process of family doctor visits, Changing the GPs' medical cognition, and strengthening the policy of GP training would be conducive to promoting a family doctor system that enhances hierarchical diagnosis and treatment. International collaboration could integrate GP health support into global healthcare system.
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Affiliation(s)
- Guoshu He
- Department of General Practice, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310000, China
| | - Jingjing Ren
- Department of General Practice, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310000, China.
| | - Xiaoyang Chen
- Department of General Practice, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310000, China
| | - Qi Pan
- Department of General Practice, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310000, China
| | - Tianyuan Pan
- Department of General Practice, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310000, China
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Sebastián-Sánchez I, Gállego-Royo A, Marco-Gómez B, Pérez-Álvarez C, Urbano Gonzalo O, Delgado-Marroquín MT, Altisent-Trota R, Astier-Peña MP. Gender analysis of Spanish National Questionnaire on behaviours and attitudes of doctors towards their own illness (CAMAPE). J Healthc Qual Res 2022; 38:165-179. [PMID: 36549947 DOI: 10.1016/j.jhqr.2022.11.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 11/22/2022] [Accepted: 11/23/2022] [Indexed: 12/24/2022]
Abstract
INTRODUCTION AND OBJECTIVES Physicians' health is a key element for quality healthcare. Medical professionals have difficulty accepting their role as patients and it might be different among sexes. The aim was to describe behaviours and attitudes of doctors towards their own illness. MATERIALS AND METHODS An online survey was launched through the General Council of Medical Associations webpage for all Spanish registered doctors. A bivariate analysis by sex was performed for all the questionnaire variables using parametric and non-parametric tests. The significance level was p<0.05 (95% confidence interval). RESULTS A total of 4,308 registered doctors (1,858 men and 2,450 women) answered. Women were younger, single, and worked mainly in non-surgical specialities in the public sector. Men were older, married, and worked more frequently in public-private practice. Women had less chronic conditions, except for anxiety disorders (11.52% vs 15.18%). Both sexes, especially women, primarily self-treated (94.29% vs 95.02%), went to work while ill (88.16% vs 90.29%), visited their GP (56% vs 70%), and half of them underwent annual occupational health checks (40% vs 48%). Women self-prescribed more analgesics (93.43% vs 95.63%), more presenteeism (88% vs 90%) and felt more insecure when treating sick fellows (9.96% vs 20.12%) and requested training for it. More women agreed to make deontological recommendations about doctors' health (91.55% vs 96.16%) and considered revalidation may contribute to improve doctors' health (65.29% vs 66.16%). CONCLUSIONS Male and female doctors show illness-health behaviours and attitudes at work to improve. There are differences among male and female doctors. Regarding, medical feminization, ethical recommendations may be of benefit regarding doctors' health-illness issues and considering gender perspective.
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Affiliation(s)
- I Sebastián-Sánchez
- "Universitas" Health Center, Zaragoza, Spain; Public Health Service of Aragon, Spain; University of Zaragoza, GIBA-IIS-Aragón, Spain
| | - A Gállego-Royo
- Public Health Service of Aragon, Spain; University of Zaragoza, GIBA-IIS-Aragón, Spain; "Miguel Servet" University Hospital, Zaragoza, Spain
| | - B Marco-Gómez
- University of Zaragoza, GIBA-IIS-Aragón, Spain; Department of Psychiatry "Royo Villanova" Hospital, Zaragoza, Spain
| | - C Pérez-Álvarez
- University of Zaragoza, GIBA-IIS-Aragón, Spain; Department of Psychiatry "Royo Villanova" Hospital, Zaragoza, Spain
| | - O Urbano Gonzalo
- University of Zaragoza, GIBA-IIS-Aragón, Spain; Anaesthesiology and Resuscitation, "Miguel Servet" Hospital, Zaragoza, Spain
| | - M T Delgado-Marroquín
- Public Health Service of Aragon, Spain; University of Zaragoza, GIBA-IIS-Aragón, Spain; "Delicias Norte" Health Center, Zaragoza, Spain
| | | | - M P Astier-Peña
- University of Zaragoza, GIBA-IIS-Aragón, Spain; Territorial Quality Unit, Territorial Directorate of Camp de Tarragona, Catalan Institut of Health, Generalitat de Catalunya, Spain.
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Astier-Peña MP, Gallego-Royo A, Marco-Gómez B, Pérez-Alvárez C, Delgado-Marroquín MT, Altisent-Trota R. Behaviour and attitudes of Spanish physicians towards their own process of falling ill: Study protocol and validation of CAMAPE questionnaire. J Healthc Qual Res 2022; 37:349-356. [PMID: 35676170 DOI: 10.1016/j.jhqr.2022.04.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 03/08/2022] [Accepted: 04/18/2022] [Indexed: 06/15/2023]
Abstract
UNLABELLED Physicians have not learned their role as patients. Health programmes for doctors are focused on mental health. Nevertheless, anomalous behaviours of ill doctors exist independently of health problems. We present a study to describe behaviour and attitudes of doctors towards their own illness (CAMAPE) including the analysis of questionnaire validation. MATERIAL AND METHODS A mix methodology study based on semi-structured interviews to ill physicians and focus groups with members of medical colleges, occupational medicine services and doctors of ill doctors was performed. A survey was designed. Survey validation process included content and face validity, construct validity through exploratory and confirmatory factor analysis and reliability by Cronbach's Alpha Index. RESULTS A total of 27 interviews to ill doctors and 4 focus group were performed. Content and feasibility assessment was made by experts. Psychometric validation was performed with a sample of 4308 answers (2450 women, 56.87%). A 5-factor (F) model explained 78.08% variance. First factor (F1) "The work might worsen health". Second (F2) "Mental issues, toxic habits and the impact of a bad health on work performance"; Third (F3) presenteeism and sick leaves; Fourth (F4) the handling of an ill colleague and the role of medical colleges. Fifth (F5) the healthcare pathway and potential value of revalidation in medical profession. CONCLUSIONS A comprehensive mixed study on the process of physicians becoming ill has been launched with a reliable questionnaire in a large sample of registered doctors. The analysis will help to formulate gender-sensitive policy and ethical recommendations in relation to sick doctors given the progressive feminisation of the medical profession.
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Affiliation(s)
- M P Astier-Peña
- Médica de Familia, Centro de Salud Univérsitas, Zaragoza, Servicio Aragonés de Salud, Universidad de Zaragoza, GIBA-IIS-Aragón, Spain.
| | - A Gallego-Royo
- Medicina Preventiva y Salud Pública, Servicio Medicina Preventiva y Salud Pública, Hospital Miguel Servet, Zaragoza, Servicio Aragonés de Salud, GIBA-IIS-Aragón, Spain
| | - B Marco-Gómez
- Psiquiatra, Servicio de Psiquiatría, Hospital de Royo Villanova, Zaragoza, Servicio Aragonés de Salud, GIBA-IIS-Aragón, Spain
| | - C Pérez-Alvárez
- Psiquiatra, Servicio de Psiquiatría, Hospital de Royo Villanova, Zaragoza, Servicio Aragonés de Salud, GIBA-IIS-Aragón, Spain
| | - M T Delgado-Marroquín
- Médica de Familia, Centro de Salud de Delicias Norte, Zaragoza, Servicio Aragonés de Salud, Universidad de Zaragoza, GIBA-IIS-Aragón, Spain
| | - R Altisent-Trota
- Médico de Familia, Profesor Titular del Departamento de Medicina, Psiquiatría y Dermatología, Facultad de Medicina, Universidad de Zaragoza, GIBA-IIS-Aragón, Spain
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Schulz S, Hecker F, Sauerbrey U, Wolf F. Illness behaviour and influencing aspects of general practitioners in Germany and their use of the health care system: a qualitative study. BMJ Open 2022; 12:e051404. [PMID: 36180120 PMCID: PMC9528620 DOI: 10.1136/bmjopen-2021-051404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES The aim of this study was to explore aspects that play a role when general practitioners (GPs) become ill and thus gain a more comprehensive understanding of the overall illness behaviour of GPs and their use of the healthcare system. SETTING Primary care practices in Thuringia, Germany. PARTICIPANTS Convenience sample of 16 GPs. DESIGN Qualitative study design with semistructured interviews and content analysis. RESULTS Using our approach of having participants report their own episodes of illness, we found that self-treatment was practised and accepted by all 16 participants. The widespread use of naturopathy and complementary methods seems to be a special feature of German GPs. Formal use of the healthcare system mainly took place through direct consultation with specialists.Our study revealed various aspects influencing the illness behaviour of the GPs and their use of the healthcare system. Some aspects also apply to lay patients, but it became clear how strongly illness behaviour is influenced by participants' activities as physicians. Noteworthy and less described aspects are especially the influence of patients and practice staff, the influence of biographical and professional imprint and the attitudes and values of the physicians.Complex inter-relationships were found between illness behaviour and influencing aspects; these are subjected to a dynamic and recursive process. CONCLUSIONS The illness behaviour of German GPs seems to be comprehensively influenced by their activities as responsible healthcare providers. The ability to perceive and reflect in this regards should already be actively promoted in studies and further education. Further research is needed for a better understanding of the inter-relationships.
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Affiliation(s)
- Sven Schulz
- Institute of General Practice and Family Medicine, Jena University Hospital, Jena, Germany
| | - Friederike Hecker
- Institute of General Practice and Family Medicine, Jena University Hospital, Jena, Germany
| | - Ulf Sauerbrey
- Department of Social Work and Education, Jena University Hospital, Jena, Germany
- Department of Social Work and Education, Neubrandenburg University of Applied Sciences, Neubrandenburg, Germany
| | - Florian Wolf
- Institute of General Practice and Family Medicine, Jena University Hospital, Jena, Germany
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Cohidon C, Mahler L, Broers B, Favrod-Coune T, Moussa A, Sebo P. Primary Care Physicians’ Personal and Professional Attributes Associated With Forgoing Own Care and Presenteeism: A Cross Sectional Study. Int J Public Health 2022; 66:1604442. [PMID: 35242001 PMCID: PMC8886613 DOI: 10.3389/ijph.2021.1604442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 12/21/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: The aim of this study was to describe the prevalence of forgoing care and forgoing sick leave among primary care physicians (PCPs) in Switzerland and to investigate associated factors.Methods: A random sample of 1,000 PCPs in French-speaking regions of Switzerland (participation rate: 50%) was asked whether they had forgone care and sick leave during the last year. Sociodemographic, personal and occupational characteristics were recorded. Logistic regressions were performed to study these behaviours.Results: 37% of respondents reported at least one episode of forgoing care and 29% reported an episode of forgoing sick leave. No associations were found between individual characteristics and forgoing care. A heavy workload was the most common reason evoked for forgoing care. Coming to work when sick (presenteeism) was associated with female sex, younger age, having a chronic illness, working in a suburban area and working full-time.Conclusion: A high proportion of PCPs in Switzerland is forgoing own care and continues to work despite sickness. New generations of PCPs should require careful monitoring, and specific solutions should be sought to reduce these harmful behaviours.
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Affiliation(s)
- Christine Cohidon
- Family Medicine Department, Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
- *Correspondence: Christine Cohidon,
| | - Liv Mahler
- Primary Care Division, Geneva University Hospitals, Geneve, Switzerland
| | - Barbara Broers
- Primary Care Division, Geneva University Hospitals, Geneve, Switzerland
| | | | - Amir Moussa
- Primary Care Unit, University of Geneva, Geneva, Switzerland
| | - Paul Sebo
- Primary Care Unit, University of Geneva, Geneva, Switzerland
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Doctors' experience of becoming patients and its influence on their medical practice: A literature review. Explore (NY) 2019; 16:145-151. [PMID: 31843394 DOI: 10.1016/j.explore.2019.10.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 09/14/2019] [Accepted: 10/20/2019] [Indexed: 11/21/2022]
Abstract
PURPOSE Doctors' illness experiences can deeply influence not only their perceptions of illness and roles but also their medical practice. Researchers and doctors have sought to understand what happens when doctors become patients. However, currently, literature reviews focused exclusively on their illness experiences are lacking. This review examines academic literature and combines it with illness narratives (i.e., pathographies) written by doctors to elucidate the unknown about doctors' experiences and its subsequent influence on medical practice. METHODS An electronic search of the databases Academic Search Complete, Google Scholar, PubMed, ProQuest, and Ichushi-Web was conducted using relevant keywords. The literature reviewed included studies that described doctors' illness experiences or doctors' perspectives on their experiences of being patients. RESULTS Previous studies showed that doctors' disease prognoses are generally better than or similar to those of patients belonging to the general population. However, doctors' documented illness experiences are multi-dimensional and have several common themes. These include the concept of the 'medical self' (behaving as a doctor despite being a patient) and 'role reversal' (the doctor adjusting to the patient role). The other elements of their experiences include barriers to health care, self-treatment and self-doctoring, presenteeism, and 'wounded healers' (those who can heal others using the wisdom from their illness experiences). Most previous literature has omitted the sociocultural and historical dispositions of doctors and their biomedical perspectives of their own afflictions, even though these strongly impact their illness experiences. CONCLUSION Further research that re-contextualises the meaning of illness for doctors is necessary.
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Khan N, Usherwood T. 'We are not invincible': a qualitative study of self-care practices by Australian general practice registrars. Aust J Prim Health 2019; 25:380-386. [PMID: 31474245 DOI: 10.1071/py18169] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Accepted: 05/27/2019] [Indexed: 11/23/2022]
Abstract
Doctors are not well known to look after their own health. The barriers and enablers that doctors face in staying healthy and managing ill health are not fully understood. This study aimed to explore these issues among general practice registrars (trainee general practitioners (GPs)). Semistructured interviews conducted with 14 GP registrars were audio-recorded, transcribed and analysed thematically. Participants noted the benefits of healthy lifestyle and the major barrier of competing priorities. Barriers to having their own GP included uncertainty about colleagues' clinical abilities and about their respect for professional boundaries. Nearly all the participants had self-prescribed and many reported informal consultations with colleagues, although they noted the limitations of these. The participants identified their professional responsibility to maintain a healthy lifestyle and need for a regular GP, the importance of support for these responsibilities by training practices and regional training organisations and the value of training organisations incorporating such support into curriculum and policies.
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Affiliation(s)
- Nadia Khan
- Department of General Practice, Westmead Clinical School, Faculty of Health and Medicine, The University of Sydney, Acacia House, Westmead Hospital, NSW 2145, Australia; and Corresponding author.
| | - Tim Usherwood
- Department of General Practice, Westmead Clinical School, Faculty of Health and Medicine, The University of Sydney, Acacia House, Westmead Hospital, NSW 2145, Australia
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Kobyakova OS, Kulikov ES, Deev IA, Almikeyeva AA, Pimenov ID, Starovoitova EA. Frequency of risk factors for chronic noncommunicable diseases among physicians in Russian Federation on the model of Tomsk Region. КАРДИОВАСКУЛЯРНАЯ ТЕРАПИЯ И ПРОФИЛАКТИКА 2018. [DOI: 10.15829/1728-8800-2018-6-44-50] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Aim. To determine the frequency and structure of risk factors (RF) for chronic noncommunicable diseases (CNCDs) among physicians in the Tomsk Region.Material and methods. The questionnaire was compiled based on the methodological guidelines “Monitoring of risk factors for chronic noncommunicable diseases in practical healthcare”. The questionnaire was provided in electronic format and posted on the site http://www. golosaonline.ru/medto.Results. Doctors of the Tomsk region revealed a high frequency of such RF for CNCDs as chronic as hypodynamia (45,7%), improper feeding (67,6%) and overweight (34,7%).Conclusion. The study showed that the frequency of RF for CNCDs in a Tomsk region was lower than the same one in general population. However, there is a need to develop practical guidelines for healthcare workers.
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Affiliation(s)
| | - E. S. Kulikov
- Siberian State Medical University of the Ministry of Health
| | - I. A. Deev
- Siberian State Medical University of the Ministry of Health
| | | | - I. D. Pimenov
- Siberian State Medical University of the Ministry of Health
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Solenova LG, Nekrasova LA. Healthcare workers: occupational carcinogenic factors and cancer risk. ADVANCES IN MOLECULAR ONCOLOGY 2018. [DOI: 10.17650/2313-805x-2018-5-3-25-39] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
The number of healthcare workers is over two million in Russia. Many of them are exposed to hazardous physical, chemical and biological occupational factors acting along with psychological strain. The results of large epidemiological studies carried out in various countries revealed greater cancer risk in physicians and nurses: cancer of the breast, skin, brain and other sites. Higher cancer risk of lung, breast, uterine, ovary, brain is considered to be associated with ionizing radiation. The female healthcare workers who handle antineoplastic drugs showed a greater risk of birth defects in offspring, spontaneous abortions and breast cancer. In Russia, the growing number of accidents among healthcare workers following transmission of infection by carcinogenic biological factors such as HBV and HIV is observed. Higher risk of reproductive impairments, hyperplasia of the breast and uterine tissues, breast cancer are revealed in nurses working the night shift. In Russia, there is lack of epidemiological studies of cancer risk among healthcare workers, the number of medical personal exposed to occupational carcinogens is unknown. That all does not show the actual situation in our country and does not allow setting priorities in cancer prevention among medical workers.
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Affiliation(s)
- L. G. Solenova
- Research Institute of Carcinogenesis, N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia
| | - L. A. Nekrasova
- Research Institute of Carcinogenesis, N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia
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Kobyakova ОS, Kulikov ES, Deev IA, Almikeeva AA, Pimenov ID, Starovoytova EA. THE PREVALENCE OF CHRONIC NON-COMMUNICABLE DISEASES RISK FACTORS AMONG MEDICAL STAFF. КАРДИОВАСКУЛЯРНАЯ ТЕРАПИЯ И ПРОФИЛАКТИКА 2018. [DOI: 10.15829/1728-8800-2018-3-96-104] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
In the review, the results provided of clinical and epidemiological trials confirming high prevalence of the risk factors of chronic noncommunicable diseases among medical workers, common comorbidity and hence adverse influence on the health. Analysis of literature data underscores the necessity of further long term populational studies of epidemiology, age range, relation to occupation positions, for the main risk factors. Organization of various preventive events is required, that obviously will impact not only health state and life quality, but furthermore, will increase medical care in general.
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Hobson J. In This Issue of Occupational Medicine. Occup Med (Lond) 2017; 67:1. [PMID: 28057879 DOI: 10.1093/occmed/kqw175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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