scholarly journals Exploring primary care providers’ understandings of body image in patient care

Body Image ◽  
2020 ◽  
Vol 35 ◽  
pp. 161-170
Author(s):  
Larkin Lamarche ◽  
K. Alysse Bailey ◽  
Amen Awan ◽  
Cathy Risdon ◽  
Glenda Pauw ◽  
...  
Keyword(s):  
Primary Care ◽  
Body Image ◽  
Patient Care ◽  
Primary Care Providers ◽  
Care Providers

scholarly journals Palliative Care in a Death-Denying Culture: Exploring Barriers to Timely Palliative Efforts for Heart Failure Patients in the Primary Care Setting

2020 ◽  
Vol 38 (1) ◽  
pp. 77-83 ◽  
Author(s):  
Rebecca M. Crimmins ◽  
Lydia Elliott ◽  
Darren T. Absher
Keyword(s):  
Heart Failure ◽  
Primary Care ◽  
Palliative Care ◽  
Patient Care ◽  
Care Setting ◽  
Primary Care Setting ◽  
Primary Care Providers ◽  
Cochrane Library ◽  
Care Providers ◽  
Communication Time

Context: Heart failure (HF) is a complex, life-limiting disease that is prevalent and burdensome. All major cardiology societies and international clinical practice guidelines recommend the integration of palliative care (PC) interventions alongside usual HF management. Objectives: The purpose of this review of the literature was to evaluate the various barriers to the early initiation of PC for HF patients in the primary care setting. Methods: An integrative literature review was conducted in order to assess and incorporate the diverse sources of literature available. An EBSCO search identified relevant articles in the following databases: Medline complete, Academic Search Premier, CINAHL, PsycINFO, Cochrane Library, and SocINDEX. The search was limited to full text, peer reviewed, English only, and published between 2010 and 2019. Results: Barriers to the integration of PC for HF patients include poor communication between provider/patient and interdisciplinary providers, the misperception and miseducation of what PC is and how it can be incorporated into patient care, the unpredictable disease trajectory of HF, and the limited time allowed for patient care in the primary care setting. Conclusion: The results of this review highlight a lack of communication, time, and knowledge as barriers to delivering PC. Primary care providers caring for patients with HF need to establish an Annual Heart Failure Review to meticulously evaluate symptoms and allow the time for communication involving prognosis, utilize a PC referral screening tool such as the Needs Assessment Tool: Progressive Disease-Heart Failure, and thoroughly understand the benefits and appropriate integration of PC.

scholarly journals An Epigenetics-Based, Lifestyle Medicine–Driven Approach to Stress Management for Primary Patient Care: Implications for Medical Education

2019 ◽  
Vol 14 (3) ◽  
pp. 294-303 ◽  
Author(s):  
Jenny Lee ◽  
Frank Papa ◽  
Paresh Atu Jaini ◽  
Sarah Alpini ◽  
Tim Kenny
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Patient Care ◽  
Stress Management ◽  
Health Care Providers ◽  
Primary Care Providers ◽  
Therapeutic Interventions ◽  
Care Providers ◽  
Lifestyle Medicine ◽  
Lifestyle Choices

Over 75% of patients in the primary care setting present with stress-related complaints. Curiously, patients and health care providers all too often see stress as a relatively benign sequela of many common illnesses such as heart disease, cancer, lung disease, dementia, diabetes, and mental illness. Unfortunately, various day-to-day lifestyle choices and environmental factors, unrelated to the presence of any disease, can cause stress sufficient to contribute to the development of various diseases/disorders and suboptimal health. There is evidence suggesting that counseling in stress management–oriented therapeutic interventions (as offered by lifestyle medicine–oriented practitioners) may prevent or reduce the onset, severity, duration, and/or overall burden of stress-related illnesses. Such counseling often involves considerations such as the patient’s nutrition, physical activity, interest in/capacity to meditate, drug abuse/cessation, and so on. Unfortunately, lifestyle medicine–oriented approaches to stress management are rarely offered in primary care—the patient care arena wherein such counseling would likely be best received by patients. Would health care outcomes improve if primary care providers offered counseling in both stress management and positive lifestyle choices? The purpose of this article is to provide both primary care practitioners and educators in health care training programs with an introductory overview of epigenetics. An emerging field of science offering insights into how factors such as stress and lifestyle choices interact with our genes in ways that can both positively and negatively impact the various micro (eg, cellular) through macro (eg, physiologic, pathophysiologic) processes that determine our tendencies toward illness or wellness. A deeper understanding of epigenetics, as provided herein, should enable primary care providers and medical educators to more confidently advocate for the primary benefits associated with counseling in both stress reduction and the pursuit of healthy lifestyle choices.

scholarly journals Expanding Telehealth Competencies in Primary Care: A Longitudinal Interdisciplinary Simulation to Train Internal Medicine Residents in Complex Patient Care

2020 ◽  
Vol 12 (6) ◽  
pp. 745-752
Author(s):  
Rachel Wong ◽  
Patricia Ng ◽  
Tracey Spinnato ◽  
Erin Taub ◽  
Amit Kaushal ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Primary Care ◽  
Patient Care ◽  
Primary Care Providers ◽  
Interdisciplinary Care ◽  
Care Providers ◽  
Coordinated Care ◽  
Post Intervention ◽  
Complex Patient ◽  
Internal Medicine Residents

ABSTRACT Background Despite increasing use of telehealth, there are limited published curricula training primary care providers in utilizing telehealth to deliver complex interdisciplinary care. Objective To describe and evaluate a telehealth curriculum with a longitudinal objective structured clinical examination (OSCE) to improve internal medicine residents' confidence and skills in coordinating complex interdisciplinary primary care via televisits, electronic consultation, and teleconferencing. Methods In 2019, 56 first- and third-year residents participated in a 3-part, 5-week OSCE training them to use telehealth to manage complex primary care. Learners conducted a standardized patient (SP) televisit in session 1, coordinated care via inter-visit e-messaging, and led a simulated interdisciplinary teleconference in session 2. Surveys measured confidence before session 1 (pre), post-session 1 (post-1), and post-session 2 (post-2). SP televisit checklists and investigators' assessment of e-messages evaluated residents' telehealth skills. Results Response rates were pre 100%, post-1 95% (53 of 56), and post-2 100%. Post-intervention, more residents were “confident/very confident” in adjusting their camera (33%, 95% CI 20–45 vs 85%, 95% CI 75–95, P < .0001), e-messaging (pre 36%, 95% CI 24–49 vs post-2 80%, 95% CI 70–91, P < .0001), and coordinating interdisciplinary care (pre 35%, 95% CI 22–47 vs post-2 84%, 95% CI 74–94, P < .0001). More residents were “likely/very likely” to use telemedicine in the future (pre 56%, 95% CI 43–69, vs post-2 79%, 95% CI 68–89, P = .001). Conclusions A longitudinal, interdisciplinary telehealth simulation is feasible and can improve residents' confidence in using telemedicine to provide complex patient care.

scholarly journals Meaningful use care coordination criteria: Perceived barriers and benefits among primary care providers

2015 ◽  
Vol 23 (e1) ◽  
pp. e146-e151 ◽  
Author(s):  
Genna R Cohen ◽  
Julia Adler-Milstein
Keyword(s):  
Primary Care ◽  
Patient Care ◽  
Care Coordination ◽  
Care Transitions ◽  
Meaningful Use ◽  
Primary Care Providers ◽  
Care Providers ◽  
Organizational Strategies ◽  
Primary Care Practices ◽  
Stage 1

Abstract Background Stage 2 and proposed Stage 3 meaningful use criteria ask providers to support patient care coordination by electronically generating, exchanging, and reconciling key information during patient care transitions. Methods A stratified random sample of primary care practices in Michigan ( n  = 328) that had already met Stage 1 meaningful use criteria was surveyed, in order to identify the anticipated barriers to meeting these criteria as well as the expected impact on patient care coordination from doing so. Results The top three barriers, as identified by >65% of the primary care providers surveyed, were difficulty sending and receiving patient information electronically, a lack of provider and practice staff time, and the complex workflow changes required. Despite these barriers, primary care providers expressed strong agreement that meeting the proposed Stage 3 care coordination criteria would improve their patients’ treatment and ensure they know about their patients’ visits to other providers. Conclusion The survey results suggest the need to enhance policy approaches and organizational strategies to address the key barriers identified by providers and practices in order to realize important care coordination benefits.

Team dynamics, clinical work satisfaction, and patient care coordination between primary care providers

2017 ◽  
Vol 42 (1) ◽  
pp. 28-41 ◽  
Author(s):  
Hummy Song ◽  
Molly Ryan ◽  
Shalini Tendulkar ◽  
Josephine Fisher ◽  
Julia Martin ◽  
...  
Keyword(s):  
Primary Care ◽  
Patient Care ◽  
Care Coordination ◽  
Work Satisfaction ◽  
Clinical Work ◽  
Primary Care Providers ◽  
Team Dynamics ◽  
Care Providers

Primary Care Provider Perceptions of Pharmacist Services in an Urban, Safety Net Health System

2019 ◽  
Vol 33 (6) ◽  
pp. 790-798
Author(s):  
Anusha McNamara ◽  
Lenny L. S. Chan ◽  
Shirley L. Wong
Keyword(s):  
Primary Care ◽  
Patient Care ◽  
Medication Management ◽  
Primary Care Providers ◽  
Safety Net ◽  
Direct Patient Care ◽  
Case Conference ◽  
Pharmacy Services ◽  
Care Providers ◽  
Pharmacist Services

While pharmacists have provided services in a multidisciplinary, primary care setting for decades, few publications have yet to evaluate providers’ impressions of- these services. An anonymous 14-item survey distributed to nonresident primary care providers aimed to identify clinical pharmacist services that are most and least helpful to primary care providers, identify barriers to pharmacy services, and develop recommendations to improve pharmacy services in primary care. The most important pharmacist contribution identified by providers is medication management, whereas the least important contributions are case conference, panel management, quality improvement, and transition of care. The primary reasons for referrals to pharmacists included inadequately controlled chronic diseases, poor or questionable adherence, longer visits for more in-depth discussion, and complex regimen requiring frequent monitoring or titration. Providers favored pharmacists working in direct patient care versus indirect patient care activities. Although many providers perceived no barriers to pharmacist service access, pharmacists’ presence and visibility were 2 barriers identified. Most providers preferred comprehensive to disease-specific medication management.

The Perspective of Older Men With Depression on Suicide and Its Prevention in Primary Care

Crisis ◽  
2018 ◽  
Vol 39 (5) ◽  
pp. 397-405 ◽  
Author(s):  
Steven Vannoy ◽  
Mijung Park ◽  
Meredith R. Maroney ◽  
Jürgen Unützer ◽  
Ester Carolina Apesoa-Varano ◽  
...  
Keyword(s):  
Primary Care ◽  
Low Socioeconomic Status ◽  
Thematic Analysis ◽  
Older Men ◽  
Primary Care Providers ◽  
Depression Treatment ◽  
Care Providers ◽  
Low Socioeconomic ◽  
Self Image ◽  
The Impact

Abstract. Background: Suicide rates in older men are higher than in the general population, yet their utilization of mental health services is lower. Aims: This study aimed to describe: (a) what primary care providers (PCPs) can do to prevent late-life suicide, and (b) older men's attitudes toward discussing suicide with a PCP. Method: Thematic analysis of interviews focused on depression and suicide with 77 depressed, low-socioeconomic status, older men of Mexican origin, or US-born non-Hispanic whites recruited from primary care. Results: Several themes inhibiting suicide emerged: it is a problematic solution, due to religious prohibition, conflicts with self-image, the impact on others; and, lack of means/capacity. Three approaches to preventing suicide emerged: talking with them about depression, talking about the impact of their suicide on others, and encouraging them to be active. The vast majority, 98%, were open to such conversations. An unexpected theme spontaneously arose: "What prevents men from acting on suicidal thoughts?" Conclusion: Suicide is rarely discussed in primary care encounters in the context of depression treatment. Our study suggests that older men are likely to be open to discussing suicide with their PCP. We have identified several pragmatic approaches to assist clinicians in reducing older men's distress and preventing suicide.

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