Family physicians' perceptions towards quality assurance, Central Luzon Doctors' Hospital

Ideas and information to improve current medical practice come from many sources including the results of formal research studies, quality improvement projects and the clinical experiences and ideas of individual health professionals. Quality assurance is a method of continuously examining processes and making them more effective. It has been developed in an attempt to accelerate and support the change toward evidence-based practice. OBJECTIVE: To determine the awareness of CLDH family physicians regarding quality assurance and its related activities. MATERIALS AND METODS: A survey questionnaire was distributed to all the members of the Department of Family Medicine in CLDH from March 2007 to June 2007. RESULTS: Almost all of the respondents have an acceptable attitude towards QA and believed that their colleagues have an acceptable attitude as well. The major perceived barriers for practicing QA were time constraint and lack of advocacy. Other perceived barriers were lack of budget to hold QA activities on a regular basis and the absence of a formal invitation. Similarly, the most perceived barrier on attending QA activities given by the PAFP was time constraint. In addition were fear of being evaluated, lack of incentive, inapplicability in practice, lack of motivation and support from the officers and limited lectures on QA. Thus, to improve interest in attending QA activities, they recommended that there should be regular activities on QA; encouragement of team work group discussion; incentives support structures, system for feedback and evaluation. Holding of quality assurance activities on a regular basis in the local chapters is the most recommended way to improve the dissemination and implementation of QA practices in localities. Similarly, dissemination through the media and email, making it a pre-requisite for residency training program and providing practice guidelines after completing modules were recommended. CONCLUSION: The respondents have a high level of awareness but low application of QA in their practice. Almost all of them viewed QA positively and agreed that its practice improves patient care. The major perceived barriers for practicing QA were time constraint and lack of advocacy. Conducting regular activities on QA was the suggested way to improve the dissemination and implementation of QA practices in localities and to encourage physicians to attend QA activities.

End stage renal disease: Fight or flight?

Dialysis is one of the treatment options for ESRD. Several investigators have estimated that depression occurs in about 20 to 30 percent of dialysis patients. The treatment of End Stage Renal Disease (ESRD) successfully prolongs the survival of patients with kidney disease but requires that ESRD patients cope with frequent deleterious changes in their health and life situation and shortened survival. Several studies on coping up mechanisms of ESRD patients were collected and reviewed. Self-management of everyday life entailed achieving/maintaining "normalcy" in everyday roles and functioning. Meaning in life is an important motivator in the coping process. Understanding their own needs and accepting support from members of his family and health care community can help them have a quality life.