engleski

Therapeutic impact of the attitude and new knowledge about diseases

Aim of the study was to investigate the attitude toward patients with the alcoholic disease and its complications, as well as the knowledge of pathophysiology and treatment of ascites in the cirrhosis of the liver, of the physicians at the University Hospitals in Atlanta (GA) and in Zagreb. A questionnaire comprising 14 questions was filled in by the internists and the residents in internal medicine of the Departments of Medicine at University Hospitals Sisters of Mercy and Zagreb in Zagreb and Emory School of Medicine in Atlanta. Thirteen (43.3%) internists and 17 (56.7%) residents in internal medicine from Atlanta and 28 (70.0%) internists and 12 (30.0%) residents in internal medicine from Zagreb took part in the survey. In the Zagreb group was significantly more internists (p=0.025), with significantly more years of specialistic service (p=0.006). A significant difference between the groups was in their answers to the following questions: what is alcoholism (p=0.006), the correct pathophysiological theory of ascites formation is (p=0.0001), the cardiac output in the liver cirrhosis is (p=0.0005), the plasma aldosterone concentration in the liver cirrhosis is (p=0.03), the biological effect of atrial natriuretic peptide is (p=0.0001), the therapeutical effect of spironolactone is (p=0.005) and of paracentesis is (p=0.009), as well as in the frequency of correct answers to the questions: alcoholism is (p=0.002), the cardiac output in the liver cirrhosis is (p=0.001), in the preascitic cirrhosis of the liver, in standing test, aldosterone is (p=0.005). Analysis of the frequency of correct answers within the Atlanta and the Zagreb groups, in the groups of specialists as compared to the residents, showed the statistical significance only in the question the alcoholic cirrhosis is (p=0.02) in the Zagreb group. Shortening of time necessary to accept new knowledges concerning the efficancy of the new or established treatment protocols including alterations in indications or in the method and the time of application by practitioners is indispensable and it is proportional to the knowledge.

liver cirrhosis; therapy; liver cirrhosis; complications; ascites etiology; ascites prevention and control; questionnaires; data collection

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