Preparing genomic revolution: Attitudes, clinical practice, and training needs in delivering genetic counseling in primary care in Hong Kong and Shenzhen, China

Background: In recent years, germline testing of women with a risk of developing breast and ovarian cancer has increased rapidly. This is due to lower costs for new high-throughput sequencing technologies and the manifold preventive and therapeutic options for germline mutation carriers. The growing demand for genetic counseling meets a shortfall of counselors and illustrates the need to involve the treating clinicians in the genetic testing process. This survey was undertaken to assess their state of knowledge and training needs in the field of genetic counseling and testing. Methods: A cross-sectional survey within the European Bridges Study (Breast Cancer Risk after Diagnostic Gene Sequencing) was conducted among physician members (n = 111) of the German Cancer Society who were primarily gynecologists. It was designed to examine their experience in genetic counseling and testing. Results: Overall, the study revealed a need for training in risk communication and clinical recommendations for persons at risk. One-third of respondents communicated only relative disease risks (31.5%) instead of absolute disease risks in manageable time spans. Moreover, almost one-third of the respondents (31.2%) communicated bilateral and contralateral risk-reducing mastectomy as an option for healthy women and unilateral-diseased breast cancer patients without mutations in high-risk genes (e.g. BRCA1 or BRCA2). Most respondents expressed training needs in the field of risk assessment models, the clinical interpretation of genetic test results, and the decision-making process. Conclusion: The survey demonstrates a gap of genetic and risk literacy in a relevant proportion of physicians and the need for appropriate training concepts.

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Primary care research networks: perspectives, research interests and training needs of members

CrossRef Listing of Deleted DOIs ◽

10.1191/1463423602pc087oa ◽

2002 ◽

Vol 3 (1) ◽

pp. 4-10 ◽

Cited By ~ 1

Author(s):

Greta Rait ◽

Stephen Rogers ◽

Paul Wallace

Keyword(s):

Primary Care ◽

Training Needs ◽

Research Networks ◽

Primary Care Research ◽

Care Research ◽

And Training

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Roles, Attitudes, and Training Needs of Behavioral Health Clinicians in Integrated Primary Care

Journal of Mental Health Counseling ◽

10.17744/mehc.37.2.p84818638n07447r ◽

2015 ◽

Vol 37 (2) ◽

pp. 175-188 ◽

Cited By ~ 5

Author(s):

Bethany Glueck

Keyword(s):

Primary Care ◽

Behavioral Health ◽

Training Needs ◽

Integrated Primary Care ◽

Mental Health Providers ◽

Health Providers ◽

Structured Interviews ◽

And Training ◽

Health Clinician

As integrated primary care (IPC) evolves, so does the new role of the behavioral health clinician (BHC). At present, mental health providers from various specialties are working as BHCs and adapting their training and skills to work as part of the medical team. The purpose of this qualitative study is to explore the experiences of BHCs who work in IPC so as to better understand their roles, attitudes, and training needs. The themes that emerged from semi-structured interviews suggest that the roles of a BHC are multifaceted and rooted in a holistic mind-body approach. Participants supported the need for additional training in graduate programs and internships for integrated care. The results informed a conceptual model of BHCs working in IPC.

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A pilot study on the validity and psychometric properties of the electronic EQ-5D-5L in routine clinical practice

Health and Quality of Life Outcomes ◽

10.1186/s12955-021-01898-3 ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Cindy Lo Kuen Lam ◽

Emily Tsui Yee Tse ◽

Carlos King Ho Wong ◽

Joyce Sau Mei Lam ◽

Sikky Shiqi Chen ◽

...

Keyword(s):

Primary Care ◽

Hong Kong ◽

Clinical Practice ◽

Psychometric Properties ◽

Electronic Version ◽

Routine Clinical Practice ◽

Chinese Patients ◽

Global Rating ◽

Vas Scores ◽

Eq Vas

Abstract Background Electronic measurement of health-related quality of life (HRQOL) may facilitate timely and regular assessments in routine clinical practice. This study evaluated the validity and psychometric properties of an electronic version of the EQ-5D-5L (e-EQ-5D-5L) in Chinese patients with chronic knee and/or back problems. Methods 151 Chinese subjects completed an electronic version of the Chinese (Hong Kong) EQ-5D-5L when they attended a primary care or orthopedics specialist out-patient clinic in Hong Kong. They also completed the Chinese Western Ontario and McMaster University Osteoarthritis Index (WOMAC), a Pain Rating Scale, and a structured questionnaire on socio-demographics, co-morbidities and health service utilization. 32 subjects repeated the e-EQ-5D-5L two weeks after the baseline. 102 subjects completed e-EQ-5D-5L and 99 completed the Global Rating on Change Scale at three-month clinic follow up. Construct validity was assessed by the association of EQ-5D-5L scores with external criterion of WOMAC scores. We tested mean differences of WOMAC scores between adjacent response levels of the EQ-5D-5L dimensions by one-way ANOVA, test–retest reliability by intra-class correlation, sensitivity by known group comparisons and responsiveness by changes in EQ-5D-5L scores over 3 months. Results There was an association between EQ-5D-5L and WOMAC scores. Mean WOMAC scores increased with the increase in adjacent response levels of EQ-5D-5L dimensions. Test–retest intraclass correlation coefficient (ICC) of EQ-5D-5L utility and EQ-VAS scores were 0.76 and 0.83, respectively, indicating good reliability. There were significant differences in the proportions reporting limitations in the EQ-5D-5L dimensions, the utility and VAS scores between the mild and severe pain groups (utility = 0.28, p = 0.001; VAS = 11.46, p < 0.001), and between primary care and specialist out-patient clinic patients (utility = 0.15, p = 0.001; VAS = 10.21, p < 0.001), supporting sensitivity. Among those reporting ‘better’ global health at three-months, their EQ-5D-5L utility and EQ-VAS scores were significantly increased from baseline (utility = 0.18, p < 0.001; VAS = 10.75, p = 0.005). Conclusions The electronic version of the EQ-5D-5L is valid, reliable, sensitive and responsive in the measurement of HRQOL in Chinese patients with chronic knee or back pain in routine clinical practice.

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Fighting against COVID-19: preparedness and implications on clinical practice in primary care in Shenzhen, China

BMC Family Practice ◽

10.1186/s12875-020-01343-2 ◽

2020 ◽

Vol 21 (1) ◽

Author(s):

Desiree Man-Sik Tse ◽

Zhuo Li ◽

Ye Lu ◽

Yang Li ◽

Ying Liu ◽

...

Keyword(s):

Primary Care ◽

Clinical Practice ◽

Online Survey ◽

Disease Outbreaks ◽

Logistic Models ◽

Training Needs ◽

Vital Role ◽

Infectious Disease Outbreak ◽

Care Services ◽

Perceived Preparedness

Abstract Background The new coronavirus pneumonia (NCP) caused by COVID-19 has affected more than 46 million people worldwide. In China, primary care has played a vital role during the COVID-19 outbreak, and it is important to examine the challenges faced by general practitioners (GPs). This study investigated the roles, preparedness and training needs of GPs in China in managing the NCP outbreak. Based on the outcomes of the study, we hope to take lessons and identify how GPs could be supported in delivering their gatekeeping roles and clinical duties in times of infectious disease outbreak. Methods An online survey on the official website of Shenzhen Continuing Education Center. It included questions on GPs’ demographics, their awareness of COVID-19 and their preparedness in managing suspected cases of NCP, as well as referrals and their training needs. Conditional multi-variate logistic models were used to investigate the relationships between GPs’ preparedness, situational confidence and anxiety. Results GPs’ clinical practice was significantly affected. GPs endeavoured to answer a flood of COVID-19-related enquiries, while undertaking community preventive tasks. In addition to in-person consultations, GP promoted COVID-19 awareness and education through telephone consultations, physical posters and social media. Overall GPs in Shenzhen felt well supported with adequate Personal Protective Equipment (PPE) and resources from secondary care services. Higher levels of self-perceived preparedness (OR = 2.19; 95%CI, 1.04–4.61), lower level of anxiety (OR = 0.56; 95%CI, 0.29–1.09) and fewer perceived family worries (OR = 0.37; 95%CI, 0.12–1.12) were associated with better confidence in coping at work. Conclusions Training and supporting GPs while reducing their (and their families’) anxiety increase their confidence in delivering the important roles of gatekeeping in face of major disease outbreaks.

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