scholarly journals What makes Care Plus effective in a provincial Primary Health Organisation? Perceptions of primary care workers

2009 ◽  
Vol 1 (3) ◽  
pp. 190 ◽  
Author(s):  
Kyle Eggleton ◽  
Tim Kenealy

INTRODUCTION: Care Plus is a New Zealand chronic care initiative. It provides funding for extra primary care visits for patients with chronic diseases and aims to improve chronic care management, primary health care team work and reduce inequalities in health care. This mixed methodology study aimed to explore characteristics within practices that may contribute to improved clinical outcomes for Care Plus. METHODS: A focus group interview was conducted with a group of health professionals involved in Care Plus in a North Island Primary Health Organisation (PHO). Participants were selected because of their ‘expert status’. Interview analysis used a general inductive approach. A questionnaire was sent to all practice nurses to determine prevalence of characteristics derived from the focus group. FINDINGS: Seven primary care workers involved in Care Plus participated in a focus group from which three major themes emerged: nursing factors, practice organisation factors and general practitioner (GP) factors. Sub-themes identified as patient-centredness, assertive follow-up, nursing knowledge, referral to other health professionals, dedicated appointment times, long consultation time, low cost, GP commitment and teamwork were all considered to be characteristics that could lead to improved clinical outcomes. Questionnaire responses from 18 practice nurses suggest that GPs are under-involved with Care Plus. DISCUSSION: Patients with chronic conditions have complex needs. Care Plus is a nationwide initiative providing funding for chronic care. Some characteristics of nurses, practice organisation and GPs may lead to improved clinical outcomes in Care Plus. A number of these characteristics are supported in the literature. KEYWORDS: Chronic disease; primary health care; primary nursing care; disease management; patient care team

2014 ◽  
Vol 62 (2) ◽  

The role of regular physical activity for population health has been clearly documented. Improvements in population levels of physical activity require long-term implementation of a combination of measures, including the evidence based approaches described in the “seven best investments for physical activity” (www.globalpa.org.uk): whole-of-school programmes, transport, urban planning, integration of physical activity promotion into primary health care systems, public education, community-wide programmes, sport for all. The health care setting has a particular role in this context, particularly in its access to physically inactive individuals. Switzerland has seen a number of successful research projects in this field, but there has been no wide adaptation of these approaches in the medical community. In recent years, a group of institutions including the Swiss College of Primary Care Medicine, the Policlinique Médicale Universitaire in Lausanne, the Ligue Vaudoise contre les Maladies Cardiovasculaires and the Institute of Social and Preventive Medicine of the University of Zurich have therefore focussed on the development of a physical activity counselling approach based on international evidence as well as on established tools, but streamlined to the specific demands of primary health care providers in Switzerland. PAPRICA (Physical Activity Promotion in Primary Care, www.paprica.ch) has been the result of these developments, and nearly 300 health professionals, most of them primary care physicians, have been successfully trained so far. PAPRICA is implemented together with the Swiss Society for Sports Medicine and a number of regional partners. The development of a national programme structure is currently under preparation. This will allow Switzerland to explore and better use the potential of physicians and other health professionals in the promotion of physical activity and in the fight against non-communicable diseases.


2013 ◽  
Vol 5 (1) ◽  
pp. 19 ◽  
Author(s):  
Barbara Daly ◽  
Bruce Arroll ◽  
Nicolette Sheridan ◽  
Timothy Kenealy ◽  
Robert Scragg

INTRODUCTION: There is a worldwide trend for diabetes care to be undertaken in primary care. Nurses are expected to take a leading role in diabetes management, but their roles in primary care are unclear in New Zealand, as are the systems of care they work in as well as their training. AIM: To describe and compare demographic details, education and diabetes experience, practice setting and facilities available for the three main groups of primary health care nurses working in the largest urban area in New Zealand. METHOD: Of the total number of practice nurses, district nurses and specialist nurses working in Auckland (n=1091), 31% were randomly selected to undertake a self-administered questionnaire and telephone interview in 2006–2008. RESULTS: Overall response was 86% (n=284 self-administered questionnaires, n=287 telephone interviews). Almost half (43%) of primary care nurses were aged over 50 years. A greater proportion of specialist nurses (89%) and practice nurses (84%) had post-registration diabetes education compared with district nurses (65%, p=0.005), from a range of educational settings including workshops, workplaces, conferences and tertiary institutions. More district nurses (35%) and practice nurses (32%) had worked in their current workplace for >10 years compared with specialist nurses (14%, p=0.004). Over 20% of practice nurses and district nurses lacked access to the internet, and the latter group had the least administrative facilities and felt least valued. DISCUSSION: These findings highlight an ageing primary health care nursing workforce, lack of a national primary health care post-registration qualification and a lack of internet access. KEYWORDS: Community health nursing; diabetes mellitus; internet; nurses; primary health care


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
G Sessa ◽  
C Milani ◽  
G Occhini ◽  
G Marini ◽  
A Sarro

Abstract Sustainability of the National Health Systems (NHS) has been facing different challenges. A community-oriented Comprehensive Primary Health Care (CommOr C-PHC) could help its survival. Such a framework, focused on health promotion, primary prevention, not communicable disease management, requires new capabilities among health professionals. Considering teamwork and interprofessional collaboration (IPC) as PHC core elements, there is growing recognition of the need of interprofessional education (IPE). Nevertheless, italian medical education is distant from other disciplines and mainly based on hospital care settings. Since this situation represents an obstacle to implement a CommOr C-PHC model of health service, new ways of training students and retraining actual health workers should be developed. The aim of the project is to design IPE programs and to improve IPC within the C-PHC framework, shared learning environments placed in the community were developed. At the end of 2017 a group of young italian health professionals (public health resident, young general practitioner, social assistant, nurse, medical anthropologist, etc) founded the Campaign “2018 Primary Health care: Now or never”, a cultural movement of public health advocacy. Its goals are: The creation of a common cultural background through the study of PHC evidence and best italian and international practices. Organization of workshops all over Italy: peer education training session, site-visits, lectures with Italian and foreigner health professionals, based on need assessment methods. Individuation of learning environments placed in the community and in a primary care setting where students can apprehend social determinants of health, exercise critical thinking and develop transprofessional knowledge. Key messages Young health professionals from Italy, starting from the need for a different educational framework, based on IPE, created a movement to defend the NHS and promote PHC principles. The success and large participation of a national campaign sustaining PHC and aimed at promoting interprofessional education shows the need for a change in the medical education field.


2017 ◽  
Vol 25 ◽  
pp. e26278
Author(s):  
Maria Tereza Soares Rezende Lopes ◽  
Célia Maria Gomes Labegalini ◽  
Vanessa Denardi Antoniassi Baldissera

Objetivo: elaborar os preceitos teóricos das práticas de Educação Permanente em Saúde para a implantação e utilização dos dispositivos da Política Nacional de Humanização na atenção básica brasileira. Método: revisão realista da literatura do período de 2003 a 2016, norteada pela questão de estudo: Quais as práticas de Educação Permanente em Saúde têm sido utilizadas para a implantação e organização dos dispositivos da Política Nacional de Humanização no âmbito da atenção básica? Resultados: metodologias ativas de aprendizagem e grupalidade foram intervenções educativas relevantes para implantação e utilização dos dispositivos de humanização. A partir dessa evidência, foram identificadas duas teorias que explicitam os processos de educação permanente na atenção básica para a implantação e utilização destes dispositivos. Conclusão: as práticas de Educação Permanente são importantes para a implantação e organização dos referidos dispositivos na atenção básica e os preceitos teóricos elaborados podem tornar os trabalhadores da atenção básica permeáveis à sua implantação e facilitar esse processo.ABSTRACTObjective: to develop the theoretical principles of continuing education in health practices for deployment and use of the provisions of Brazil’s National Humanization Policy in primary care. Method: realistic review of literature from 2003 to 2016, guided by the study question: what continuing health education practices have been used to deploy and organize National Humanization Policy provisions in the primary care context? Results: active learning methodologies and grouping were significant educational interventions used to deploy and use humanization provisions. On this evidence, two theories were identified to explain continuing education processes applied in primary care to deploy and use these provisions. Conclusion: continuing education practices are important to deploy and organize these provisions in primary care, and the theoretical principles developed can make primary health care workers receptive to their introduction, and facilitate this process.RESUMENObjetivo: desarrollar los preceptos teóricos de la Educación Permanente en Salud para la implementación y uso de los dispositivos de la Política Nacional de Humanización en la atención básica brasileña. Método: revisión realista de literatura de 2003 a 2016, guiada por la cuestión de estudio: ¿Qué prácticas de Educación Permanente en Salud se han utilizado para la implementación y organización de los dispositivos de la Política Nacional de Humanización en el contexto de la atención primaria? Resultados: metodologías de aprendizaje y grupalidad fueron intervenciones educativas pertinentes para la implementación y uso de los dispositivos de humanización. Desde esta evidencia, se identificaron dos teorías que explican los procesos de educación permanente en la atención básica para la implementación y uso de estos dispositivos. Conclusión: las prácticas de Educación Permanente son importantes para la organización y la implementación de estos dispositivos en la atención básica y los preceptos teóricos elaborados pueden volver a los trabajadores de atención básica permeables para su implementación y así facilitar este proceso. DOI: http://dx.doi.org/10.12957/reuerj.2017.26278


2018 ◽  
Vol 26 ◽  
pp. e31925 ◽  
Author(s):  
Nayara Figueiredo Vieira ◽  
Fernanda Moura Lanza ◽  
Francisco Carlos Félix Lana ◽  
José Ramón Martínez-Riera

Objetivo: avaliar a presença e extensão dos atributos da atenção primária nas ações de controle da hanseníase, na visão dos profissionais de saúde. Método: estudo transversal, envolvendo 251 profissionais da atenção primária de Betim. Utilizou-se o Instrumento de avaliação de desempenho da atenção primária nas ações de controle da hanseníase, mediante entrevistas, sendo o escore calculado por meio da média das respostas dadas pelas Escala de Likert. Foi aprovado pelo Comitê de Ética e Pesquisa da Universidade Federal de Minas Gerais. Resultados: forte orientação do serviço (≥6,6) nos atributos porta de entrada, integralidade dos serviços disponíveis e prestados, e orientação familiar; e fragilidades (<6,6) no acesso, orientação comunitária e profissional. Conclusão: ao avaliar a presença e extensão dos referidos atributos, os profissionais constataram deficiências que prejudicam a qualidade das ações de controle da hanseníase. Torna-se necessário integrar as ações da endemia na atenção primária para eliminar esse grave problema de saúde pública.ABSTRACTObjective: to evaluate the presence and extent of the attributes of primary health care in leprosy control measures in the view of health professionals. Method: this cross-sectional study involved 251 primary health care personnel in Betim. The Assessment Instrument primary care performance in leprosy control measures was used through interviews, with scores calculated as means of Likert Scale responses. The study was approved by the research ethics committee of Minas Gerais Federal University. Results: strengths (≥ 6.6) were service orientation to gateway attributes, comprehensiveness of services available and provided, and the family; and weaknesses (<6.6) were access, and orientation towards the community and health professionals. Conclusion: when evaluating the presence and extent of the attributes, the health professionals found deficiencies that impaired the quality of leprosy control measures. Measures to address the endemic must be integrated into primary care in order to eliminate this serious public health problem.RESUMENObjetivo: evaluar la presencia y extensión de los atributos de la atención primaria en las acciones de control de la lepra desde el punto de vista de profesionales de salud. Método: estudio transversal, involucrando a 251 profesionales de la atención primaria de Betim. Se utilizó el Instrumento de evaluación de rendimiento de la atención primaria en las acciones de control de la lepra, a través de entrevistas, siendo la puntuación calculada a través del promedio de las respuestas dadas por la escala de Likert. Estudio aprobado por el Comité de Ética en Investigación de la Universidad Federal de Minas Gerais. Resultados: fuerte orientación del servicio (≥6,6) en los atributos puerta de entrada, integralidad de los servicios disponibles y ofrecidos, orientación familiar y fragilidades (<6,6) en el acceso, orientación comunitaria y profesional. Conclusión: al evaluar la presencia y extensión de los mencionados atributos, los profesionales constataron deficiencias que perjudican la calidad de las acciones de control de la lepra. Se hace necesario integrar las acciones de la endemia en la atención primaria para eliminar este grave problema de salud pública.


2019 ◽  
Vol 23 (3) ◽  
Author(s):  
Luciano Garcia Lourenção ◽  
Albertina Gomes da Silva ◽  
Márcio Andrade Borges

Abstract Objective: To evaluate the levels of engagement of Primary Health Care professionals in two municipalities. Methods: A descriptive study was carried out with 238 health professionals who work in the Primary Care services of two municipalities in the state of São Paulo. The engagement dimensions of the professionals were investigated through the Utrecht Work Engagement Scale. Results: Female predominance (82.8%), age under 40 years (52.9%). Median working time in primary care of three (municipality A), four years (municipality B). Significant difference in levels of engagement in both municipalities. Community health agents presented mean scores in all dimensions. Significant difference in levels of engagement according to professional category in all dimensions. Conclusion and implications for practice: Municipal health professionals with 100.0% coverage by the Family Health Strategy tend to have higher levels of engagement. Nurses presented greater engagement; community health workers reached lower levels than other professionals did. Engagement is an indicator that contributes to the evaluation of the workforce in the Primary Health Care services and can be used to direct strategies that improve the levels of dedication, absorption and vigor of the professionals, benefiting the organization of the primary care services.


2020 ◽  
Vol 12 (4) ◽  
pp. 37
Author(s):  
Heriberto Fiuza Sanchez ◽  
Raquel Conceição Ferreira ◽  
Andrea Maria Duarte Vargas ◽  
Marcos Azeredo Furquim Werneck ◽  
Efigênia Ferreira e Ferreira

OBJECTIVE: To construct and validate a questionnaire to evaluate the quality of oral health services in primary health care, from patients. METHODS: Initially a theoretical model of evaluation of Primary Health Care was elaborated, based on the evaluation of primary care and integrality in primary care. This model served as the basis for the script of a focus group with patients, aiming to verify the attributes perceived as important for such evaluation. The focus group results substantiated the first version of the questionnaire. Content validation was performed through a committee of experts (five teachers/researchers) and face validation in two pre-tests (37 patients each pre-test). For construct validation, factor analysis was performed and reliability (Kappa coefficient) and internal consistency (Cronbach&#39;s alpha) were verified. RESULTS: Thirty questions were considered for exploratory factor analysis. The anti-image matrix of covariances showed the need to exclude fourteen questions (values &lt;0.5). After this initial analysis, 16 questions remained in the questionnaire. The KMO test, considering the 16 questions, presented a value of 0.84. Cronbach&#39;s alpha was 0.919. The final version contains 16 questions divided into two dimensions: my health unit and the care in my health unit. CONCLUSIONS: The questionnaire allows a strategy that easily evaluates oral health services in primary care, based on the perception of patients.


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