in Albania - Instituti i Shendetit Publik

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ALBANIAN MEDICAL JOURNAL SUPPLEMENTReducing the barriers on pain management inAlbania results from educational seminars withfamily doctorsRudina Rama 1,2 , Ali Xhixha 1 , Lukas Radbruch 31Sue Ryder Albania;2Department of Social Work and Social Policy, Tirana University, Tirana, Albania;3Center for Palliative Care, Malteser Hospital, Bonn, Germany.Aim: Palliative care (PC) is a very limited service inAlbania, provided mainly from non-for-profitsector (NGOs) covering about 30% of the overalldemands. There are very few doctors and nursesqualified on PC and Pain. Training and educationprograms on opioids are quite inexistent and thepatients cannot access opioids easily in Albania. Thisstudy evaluated the attitudes of family doctors onpain assessment, management and opioid usagebefore and after seminars on opioids painmanagement.Methods: The Barrier Questionnaire II was usedto evaluate attitudes towards pain management in227 family doctors (GP) working in the publicprimary health care system in both urban and ruralareas from six cities in Albania (response rate was83.3%). The data collection process was donebefore and after six seminars on opioids with familydoctors in different cities covering all regions of thecountry.Results: Barriers were high among the participatingphysicians with mean scores of 3 or above for 10of 27 items. The danger of addiction to painmedicines as well as the fear that many people withcancer get addicted to pain medicine received thehighest scores. At the end of the seminar, barrierswere significantly lower with the total mean scoresreduced from 2.4±0.6 to 1.6±0.7.Conclusion: High barriers on the use of opioidsamong family physicians in Albania were reducedsignificantly following one-day training course,demonstrating the effectiveness of this intervention.However, more research on the sustainability of thetraining effect is needed in order to draw appropriateconclusions.Keywords: Barrier Questionnaire, non-governmental organizations, palliativecare42 ALBANIAN MEDICAL JOURNAL SUPPLEMENT
INTERNATIONAL PUBLIC HEALTH CONFERENCE IN TIRANA, ALBANIAPatient understanding of moles and skin cancer:factors influencing presentation in primary careMonika Fida 1 , Ermira Vasili 11Faculty of Medicine, University of Medicine, Tirana, Albania.Aim: Cutaneous melanoma (CM) and nonmelanomaskin cancer (NMSC) incidence hasincreased rapidly in past two decades. CM andNMSC have a high chance for cure if detected inan early phase of development. Our aim was toexplore patient understanding of pigmented skinlesions (moles) and skin cancer and factors whichinfluence care-seeking behaviour. The ultimate goalwould be to introduce preventive measures andearly detection means for skin cancers.Method: Semi-structured interviews with all patientsundergoing skin examination and skin cancertreatment in Tirana, Albania in 2012.Results: Patient understanding and awareness wasinfluenced by family and friends experiences ofmoles, skin cancer and other cancers, knowledge ofrisk factors (that is poor) and the media. The reasonsand factors that influence the delay of the patientsfor seeking advice include lack of knowledge of thepatients; mentality regarding the changing moles,poor medical knowledge either by GPs regardingthe excision of the suspicion mole and correctexamination of the moles through thedermatoscopy. Deciding to seek help was oftenprompted by another person or triggered by rapidor multiple changes in a mole. Three of four peoplesubsequently diagnosed with melanoma did notseek help; instead, the dermatologist or rarely GPopportunistically noticed the lesion.Conclusion: Changing moles are often perceivedas non probable skin cancer lesions. Even when thecancer is evident on a clinical basis, the mentality ofthe people in Albania delays the treatment. Thispresentation will have a modest contribute tocurrent national strategies to improve medical andpatients awareness for earlier diagnosis of cancerby highlighting factors that can trigger or act asbarriers for care-seeking behaviors.Keywords: dermatoscopy, melanoma, skin cancer.ALBANIAN MEDICAL JOURNAL SUPPLEMENT43
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