ABSTRACT
INTRODUCTION: Despite all efforts, recruitment of healthcare personnel has become increasingly difficult in Greenland as in other remote areas. The aim of this observational study was to describe the extent of health care delivered by nurses in Greenland's healthcare system. Reasons for encounter, diagnostic procedures, treatments and need for a physician's assistance, as well as the nurses' self-perceived competency, were also analysed. METHODS: A total of 42 nurses registered all patient encounters for 10 days in late autumn 2006 in 14 out of 16 healthcare districts in Greenland. RESULTS: Nurses treated 1117 encounters (60%) singlehandedly. The nurses felt competent in what they were doing in 1415 encounters (76%). In 525 encounters (31%), a physician's advice was sought. Either the physician was asked to come or the physician's advice was obtained by telephone. In four cases the nurses did not feel completely competent, but did not seek advice from the physician on call. Feeling competent did not depend on length of experience in Greenland. CONCLUSION: In Greenland, nurses independently receive, diagnose and treat a substantial number of primary healthcare patients. The nurses take care of the patients and perform a number of clinical and laboratory procedures with great confidence. There has been speculation that part of the difficulty in recruiting doctors and healthcare personnel in remote areas may be due to uneasiness about professional responsibilities and, to some extent, lack of confidence. At least among the registering nurses in this study, this did not seem to be a problem.
Subject(s)
Clinical Audit , Clinical Competence/statistics & numerical data , Nurse Administrators/psychology , Physician-Nurse Relations , Task Performance and Analysis , Adult , After-Hours Care , Clinical Competence/standards , Data Interpretation, Statistical , Female , Greenland , Humans , Male , Middle Aged , Nurse Administrators/education , Nurse Administrators/statistics & numerical data , Outcome and Process Assessment, Health Care/methods , Outcome and Process Assessment, Health Care/standards , Practice Patterns, Nurses'/statistics & numerical data , Qualitative Research , Referral and Consultation/statistics & numerical dataSubject(s)
Family Practice/statistics & numerical data , Morbidity , Adolescent , Age Distribution , Arctic Regions , Child , Child Welfare/statistics & numerical data , Child, Preschool , Ear Diseases/epidemiology , Female , Greenland/epidemiology , Health Surveys , Humans , Infant , Infant, Newborn , Male , Respiratory Tract Infections/epidemiology , Sex Distribution , Skin Diseases/epidemiology , Wounds and Injuries/epidemiologyABSTRACT
The prescription pattern to children living in an arctic environment (Nuuk, Greenland) is similar to the pattern seen in other countries e.g. Sweden, Norway or the US, but the prescription rate of both anti-infectives and the total number of drugs is 2-3 times larger. This may reflect differences both in socioeconomic factors, in disease patterns and in sickness rate in children living in the Arctic. Inuit children are known to have a disease pattern that partly differs from the one seen elsewhere. Most drugs were prescribed to the youngest children who also received less phenoxymethylpenicillin and more other anti-infectives. 2/3 of all drugs were prescribed during the winter (November to April). A small group of large scale consumers, 116 children or 7% of the children prescribed drugs, were prescribed anti-infective drugs 3 times or more and were prescribed more than 1/5 of all drugs to children in Nuuk in the year surveyed.
Subject(s)
Drug Utilization , Inuit , Adolescent , Arctic Regions , Child , Child, Preschool , Drug Utilization/standards , Drug Utilization/trends , Female , Greenland , Humans , Infant , MaleABSTRACT
Over a 10-year period, 46 feet with hallux valgus in 36 patients were treated with the McBride procedure. The median age was 35 years. At follow-up of 2 to 11 years after operation, a reduction in the hallux valgus angles, the intermetatarsal angles and the width of the forefeet was found. In patients older than 30 years there were significant reductions. In patients younger than 30 years, the reduction was not significant. The rate of problems with daily footwear was reduced from 36 of 46 feet to 13 of 38 feet. The authors noted few problems and a high rate of satisfied patients, despite the age. In 37 of 46 feet the overall result was found satisfactory by the patients. The authors find that McBride's operation can be used for hallux valgus, also in patients above 30 years, in spite of the generally accepted restriction to younger individuals.
Subject(s)
Hallux Valgus/surgery , Hallux/surgery , Adolescent , Adult , Age Factors , Aged , Child , Female , Follow-Up Studies , Humans , Male , Middle Aged , Surgical Procedures, Operative/methods , Treatment OutcomeABSTRACT
During a 10-year period, 46 feet with hallux valgus in 36 patients were operated on a.m. McBride. At the follow-up examination a median of 9 (2-11) years after the operation, a reduction in the hallux valgus angle from 32 degrees to 26 degrees and in the intermetatarsal angle from 13 degrees to 10 degrees was found; but on analyzing the single parts of the operation, we found that the result was only significant in those patients that had had the original procedures done, i.e., tenotomy and reattachment of the conjoined tendon, lateral capsulotomy, and lateral sesamoidectomy. McBride's operation for hallux valgus should be performed as described by the originator of the method.
