PubMed Health⌕ Search

Biomedical subjects

L G Huijnen

Publications and source records attributed to L G Huijnen.

2 recordsLinked to original sources

[Home visits by community health nurses can contribute to the family practitioner's knowledge of elderly patients].

OBJECTIVE: To determine to what extent the general practitioner (GP) is aware of the health status and functioning of his elderly patients and in which areas this knowledge can be completed with the aid of community nurses. DESIGN: Cross-sectional, descriptive. SETTING: Department of General Practice. State University Limburg, Maastricht, the Netherlands. METHODS: A random sample of 59 patients aged 79 years and over, belonging to the population of a primary health care centre, were visited by community nurses. One patient was lost. The nurses inventoried the patients health complaints and their daily functioning by means of a structured questionnaire. Data from these home visits were compared with data from the same questionnaire, regarding the same patients, which the three GPs of the health centre had filled in on the basis of their medical records. RESULTS: Of the complaints recorded by the community nurses. 34% were not known to the general practitioners. This concerned mainly symptoms of depression, urinary incontinence, disabilities and handicaps of the musculoskeletal system. sleep disturbances, daily functioning and ability to cope. The main determinants of the ability to cope were impaired walking and to a lesser degree symptoms of depression. CONCLUSION: A structured interview of elderly patients by a community nurse yields substantial information about health problems.

Activities of Daily Living↗

How well do general practitioners manage dyspepsia?

This paper reports the incidence of dyspepsia in general practice, the characteristics of patients, the types of complaints presented and the management of the dyspeptic patient by general practitioners. Fourteen general practitioners in the Maastricht region of the Netherlands studied 318 consecutive patients presenting with dyspepsia. Two questionnaires were used: one filled in by the patient (82% response), the other by the physician (100% response). The diagnostic conclusions which were established after three months of follow-up were compared with the diagnostic hypotheses at the initial consultation. The annual consultation rate for dyspepsia was calculated as 27 per 1000 registered subjects. One third of the patients had an earlier history of dyspepsia. Almost all patients (95%) complained of pain, and 37% had been suffering from pain for more than three months before consulting the general practitioner. The general practitioner prescribed medication in 70% of cases; less commonly the patient was referred for x-ray (14%), endoscopy (13%) or to a specialist (11%). A higher age was associated with a higher probability of referral, and with the finding of organic disease. A history of ulcer disease was strongly correlated with the diagnosis of an ulcer during the current episode. The overall concordance between the general practitioner's diagnostic hypothesis at the initial consultation and the diagnostic conclusion after three months of follow-up was 78%; it was highest when minor pathology was suspected. We conclude that dyspepsia is managed well in general practice and is only rarely associated with major lesions. Dyspeptic patients referred to a specialist therefore constitute a highly selected population.

Adolescent↗