OBJECTIVES: 1) To determine elderly patients' preference regarding home versus hospital as the site of treatment of their medical illnesses. 2) To formulate guidelines at the VMMC out patient department on home care.
DESIGN: Descriptive study (survey).
PARTICIPANTS: One hundred fifty elderly patients seen at the VMMC out patient department, 65-82 years of age, diagnosed with chronic obstructive pulmonary disease (COPD), congestive heart failure (CHF) and pneumonia from September 2001 to July 2002.
INTERVENTION: Questionnaires consisting of a sequence of items were administered to the subjects seen at the out patient department, prompting participants to provide specific preference of care received in the home versus a hospital setting.
RESULTS: Of a total of 150 patients included in this study, 114 patients (76 percent) felt safer being treated in the hospital than at home. One hundred and twenty four patients (82.7 percent) reported that clinical recovery was faster in the hospital. One hundred patients (66.7 percent) believe that home treatment would consequently result in complications. One hundred and twenty four (82.7 percent) think that the promptness of an emergency response is delayed in the home.
CONCLUSION: This study shows that the elderly patients prefer the hospital rather than the home as the site of treatment of their medical illnesses.

Human ; Male ; Female ; Aged 80 And Over ; Aged ; Patient Preference ; Pulmonary Disease, Chronic Obstructive ; Pneumonia ; Home Care Services ; Heart Failure

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.

Human ; Male ; Middle Aged ; Depression ; Self Care ; Quality Of Life ; Adaptation, Psychological ; Depressive Disorder ; Motivation ; Kidney Diseases ; Kidney Failure, Chronic

In many instances, the differences between the two types of Diabetes may not always be easily perceived. What is seen in current practice is a combination of signs and symptoms that make diagnosis a bit more complex. This is an illustration of such. Clinical judgment alone may not be enough and laboratory findings will be extremely helpful. The clinician has to develop the skill in decision-making based on all the available data.

Human ; Female ; Adolescent ; Nutritional And Metabolic Diseases ; Glucose Metabolism Disorders ; Diabetes Mellitus, Type 1 ; Diabetes Mellitus, Type 2 ; Diabetes Mellitus

This article discusses some methods by which the facilitator can evaluate effectiveness of small groups in promoting learning. The paper focuses on evaluation of the small group process using the sociogram and Bales' checklist. Additionally, it presents checklists for evaluating facilitation skills. Combination of the tools presented in this article and revision of the content of the checklists to make it more context-specific and attuned to the realities of your small group settings is suggested to maximize the evaluative potential of these tools.

Human ; Male ; Female ; Checklist ; Group Processes ; Learning ; Evaluation Studies As Topic

This clinical pathway is aimed at providing primary care physicians with a practical and evidence-based guide for evaluating signs and symptoms to diagnose Alzheimer's disease.
Human ; DEMENTIA ; CRITICAL PATHWAYS ; ALZHEIMER DISEASE

Sudden cardiac arrest is the leading cause of death in the world and early cardiopulmonary resuscitation (CPR) is the key to saving lives. The survival rate of all out-of-hospital cardiac arrest (OHCA) patients is poor and is estimated to be below 5% worldwide. The actual efficacy of out-of-hospital CPR in the Philippines is still unknown. In this pioneering OHCA CPR reporting, we hope to identify gaps in our emergency medical service (EMS) system as well as to modify and optimize management strategies. Methods: A descriptive study in Manila during the year 2010-2011 by the EMS of Manila Doctors Hospital was done on adult patients who experienced a sudden OHCA. Patient variables, cardiac arrest variables, such as etiology, initial rhythm, and outcome variables, such as immediate return of spontaneous circulation (ROSC) and short-term survival rate after the out-of-hospital CPR were studied. End-points of the study were death or survival to discharge from the hospital. Results: Cardiac etiology was seen in 78.94% of the cases. The initial rhythm upon cardiac arrest was classified as ventricular fibrillation (VF) in 15.79%, pulseless ventricular tachycardia (VT) in 10.53%, pulseless electrical activity (PEA) in 26.31%, or asystole in 47.37% of cases. Return of spontaneous circulation was achieved at 36.84%. The male gender correlated with a higher survival rate of 66.67%. A lethal outcome following OHCA was observed on the field in 63.16% of patients and during the hospital stay in 57.14%. Discussion: Results rendered were not significantly different from neighboring countries. The factors influencing the outcome of out-of-hospital CPR are cardiac etiology of arrest, VT/VF as the initial rhythm of arrest and male sex. The establishment of national OHCA database would significantly improve the quality of medical management.
Human ; EMERGENCY MEDICINE ; HEART ARREST ; CARDIOPULMONARY RESUSCITATION

Background: The journal in its many years of publication has seen changes in its cover design, themes, authorship, and major discussion points. A review can tell us about its focus, and many other factors which make it relevant and able to deliver the needs of its readers. Objective: To determine the contents of the Filipino Family Physician journal involving seven publication years and analyzed them on certain parameters which concern the editorial board and the writers/readers. Method: Content analysis using twenty issues, encompassing seven publication years of the journal was done based on the following parameters: authorship, number of authors, research design, statistics employed, total number of pages, number of references or citations, institutional affiliation, themes or issues addressed, tools and instruments used. Issues analyzed: 2005/2006, 2007, 2008, 2010, 2009-2011. But for 2005, 2006 and 2009, 2011; only 2 issues per publication year were analyzed. Results: No. of pages = 824 for 116 articles contained in 20 issues (4 issues/year), 7.1 pages per article with an average of 23.2 articles published per year or 5.8 articles per issue of the journal. There were 177 authors who wrote for the journal in 20 issues, averaging 35.4 authors who wrote per year's issues. Fifty percent of the authors were residents, 23% mixed, and 15% by consultants. Sixty percent by single authorship and 17% by 3 or more. Sixty percent used descriptive design (cross-sectional, case-control, cohort) and 10% each were case reports and randomized controlled studies. Eighty-six percent used foreign citations with 96% non-Asian sources and only 14% citied Philippine authors. Forty six percent of all the articles were written from university-based health institutions, and 21% by non-training institutions or local chapters. On themes - 15% were on non-communicable diseases of which 10% were on diabetes mellitus and hypertension, 13% each were on behavioral medicine & counseling, and medical education and bioethics. Least written were on nutrition, pharmacoadherence, medical informatics, and economics. Conclusion: Most of the articles published were of single authorship commonly written by a resident/fellow, sometimes with a consultant co-author, usually using the descriptive design, and standardized instruments with good statistical tools or packages commonly citing foreign authors. The articles written were as varied and wide as the fields of interest in Family and Community Medicine and general practice. Subject matter usually about non-communicable diseases like diabetes mellitus and hypertension and behavioral medicine. The authors usually come from training institutions or university-based health facilities.
RESEARCH DESIGN ; JOURNAL ARTICLE ;

To engage and empower the community (Barangay 727, San Andres, Malate, Manila) through a Comprehensive Community Health Program called "Sama-sama sa Malusog na Barangay" (United for a Healthy Community), aimed at capacity building in community health delivery and planning.
Human ; CAPACITY BUILDING ; COMMUNITY HEALTH SERVICES ; DELIVERY OF HEALTH CARE

The objectives if my presentation are: 1. To present a family which has been coping against Human Immunodeficiency Virus. 2. To identify and discuss the various Family Resiliency Factors which made this family respond positively in the midst of this catastrophic disease. 3. To discuss the family physician's role and intervention in a resilient family. 4. To formulate a family wellness plan.
Human ; ACQUIRED IMMUNODEFICIENCY SYNDROME ;

Conclusion: The many aspects of the diabetic foot make it an interesting and challenging concern not only for diabetologists but for all primary care physicians as well. The evaluation, diagnosis, and management of such infections are vital to the well-being of the diabetic patient. Optimal wound care techniques and appropriate technologies are imperative. Education, a multi-disciplinary approach and active participation of all stakeholders are essential elements in the prevention and successful management of this multifaceted disease.
DIABETES