scholarly journals Couple relationship problems—a task for the general practitioner? A cross-sectional survey from Norway

2020 ◽  
Author(s):  
Siri Dalsmo Berge ◽  
Eivind Meland ◽  
Mette Brekke ◽  
Gunnar Tschudi Bondevik ◽  
Frode Thuen ◽  
...  
Keyword(s):  
General Practice ◽  
General Practitioner ◽  
Regression Models ◽  
Good Health ◽  
Couple Relationship ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Relationship Problems ◽  
Logistic Regression Models ◽  
General Practices

Abstract Background A healthy couple relationship is a predictor of good health. There is a lack of knowledge about what role family and couples counselling should have in general practice. Objectives To identify the prevalence of patients who have talked, or want to talk, with their general practitioner (GP) about their couple relationship, to investigate what characterizes these patients and to explore whether they believe that couple relationship problems should be dealt with in general practice. Methods We conducted a cross-sectional survey in 70 general practices in Norway during spring 2019. A questionnaire was answered by 2178 consecutive patients (response rate 75%) in GP waiting rooms. Data were examined using frequencies and linear and logistic regression models. Results We included 2097 responses. Mean age was 49.0 years and 61.3% were women. One in four (25.0%) had already talked with their GP about couple relationship problems, while one in three (33.5%) wanted to talk with their GP about their couple relationship problems. These patients more frequently had experience of divorce, poor self-rated health, an opinion that their couple relationship had a significant impact on their health and lower couple relationship quality when adjusted for age, sex, present marital status and children living at home. We found that 46.4% of patients believed that GPs should be interested in their couple relationship problems. Conclusion Relationship problems are frequently addressed in general practice. GPs should be prepared to discuss this issue to facilitate help for couples earlier than they might otherwise expect.

Chronic disruptive pain in emerging adults with and without chronic health conditions and the moderating role of psychiatric disorders: Evidence from a population-based cross-sectional survey in Canada

2017 ◽  
Vol 17 (1) ◽  
pp. 30-36 ◽  
Author(s):  
Rana A. Qadeer ◽  
Lilly Shanahan ◽  
Mark A. Ferro
Keyword(s):  
Mental Health ◽  
Psychiatric Disorders ◽  
Emerging Adults ◽  
Regression Models ◽  
Daily Functioning ◽  
Moderating Effects ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
Drug Disorders

AbstractBackground and aimsThere has been a growth in the proportion of emerging adults vulnerable to pain-related sequelae of chronic health conditions (CHCs). Given the paucity of research during this important developmental period, this study investigated the association between CHCs and chronic disruptive pain among emerging adults and the extent to which psychiatric disorders moderate this association.MethodsData come from the 2012 Canadian Community Health Survey - Mental Health (CCHS-MH). This cross-sectional survey included 5987 participants that were 15-30 years of age and self-reported their CHCs (n = 2460,41%) and the extent to which pain impacted daily functioning using items from the Health Utilities Index Mark 3 (HUI 3). Group comparisons between respondents with CHCs and healthy controls were made using chi-square tests. Odds ratios (OR) and 95% confidence intervals (CI) were computed from ordinal logistic regression models adjusting for sociodemographic covariates. Product-term interactions between CHCs and psychiatric disorders were included in the models to explore moderating effects. All analyses were weighted to maintain representativeness of the study sample to the Canadian population.ResultsThe mean age of participants was 23.5 (SE 0.1) years and 48% were female. Compared to healthy controls, a greater proportion of participants with CHCs reported having chronic pain (20.3% vs. 4.5%, p < 0.001). Among those with chronic pain, respondents with CHCs reported a greater number of activities prevented because of chronic disruptive pain (χ2 = 222.28, p< 0.001). Similarly, in logistic regression models, participants with CHCs had greater odds of reporting chronic disruptive pain (OR = 4.94, 95% CI = 4.08-5.99). Alcohol (β = –0.66; p = 0.025) and drug abuse/dependence disorders (β = –1.24; p = 0.012) were found to moderate the association between CHCs and chronic disruptive pain. Specifically, the probability of chronic disruptive pain was higher for emerging adults without CHCs and with alcohol or drug disorders; however, among participants with CHCs, probability was higher for those without these disorders.ConclusionsThere is a robust association between CHCs and chronic disruptive pain. The moderating effects suggest that alcohol or drug disorders are especially harmful for emerging adults without CHCs and contribute to higher levels of chronic disruptive pain; however, among those with CHCs, alcohol and illicit drugs may be used as a numbing agent to blunt chronic disruptive pain.ImplicationsFindings from this study have implications for the integration and coordination of services to design strategies aimed at managing chronic disruptive pain and preventing pain-related disabilities later in life. Within the health system, healthcare providers should engage in dialogues about mental health and substance use regularly with emerging adults, be proactive in screening for psychiatric disorders, and continue to monitor the impact of pain on daily functioning. Given the age range of emerging adults, there is tremendous opportunity for clinicians to work cooperatively with colleagues in the education system to support emerging adults with and without CHCs. Overall, clinicians, researchers, educators, and those in social services should continue to be mindful of the complex interrelationships between physical and mental health and chronic disruptive pain and work cooperatively to optimize health outcomes and prevent pain-related disabilities among emerging adults.

Physician Perceptions on Quality of Life and Resuscitation Preferences for Extremely Early Newborns

2021 ◽  
Author(s):  
Danielle LoRe ◽  
Christopher Mattson ◽  
Dalia M. Feltman ◽  
Jessica T. Fry ◽  
Kathleen G. Brennan ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Logistic Regression ◽  
Regression Models ◽  
Mixed Effects ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Comfort Care ◽  
Logistic Regression Models ◽  
Extremely Preterm

Objective The study aimed to explore physician views on whether extremely early newborns will have an acceptable quality of life (QOL), and if these views are associated with physician resuscitation preferences. Study Design We performed a cross-sectional survey of neonatologists and maternal fetal medicine (MFM) attendings, fellows, and residents at four U.S. medical centers exploring physician views on future QOL of extremely early newborns and physician resuscitation preferences. Mixed-effects logistic regression models examined association of perceived QOL and resuscitation preferences when adjusting for specialty, level of training, gender, and experience with ex-premature infants. Results A total of 254 of 544 (47%) physicians were responded. A minority of physicians had interacted with surviving extremely early newborns when they were ≥3 years old (23% of physicians in pediatrics/neonatology and 6% in obstetrics/MFM). The majority of physicians did not believe an extremely early newborn would have an acceptable QOL at the earliest gestational ages (11% at 22 and 23% at 23 weeks). The majority of physicians (73%) believed that having an extremely preterm infant would have negative effects on the family's QOL. Mixed-effects logistic regression models (odds ratio [OR], 95% confidence interval [CI]) revealed that physicians who believed infants would have an acceptable QOL were less likely to offer comfort care only at 22 (OR: 0.19, 95% CI: 0.05–0.65, p < 0.01) and 23 weeks (OR: 0.24, 95% CI: 0.07–0.78, p < 0.02). They were also more likely to offer active treatment only at 24 weeks (OR: 9.66, 95% CI: 2.56–38.87, p < 0.01) and 25 weeks (OR: 19.51, 95% CI: 3.33–126.72, p < 0.01). Conclusion Physician views of extremely early newborns' future QOL correlated with self-reported resuscitation preferences. Residents and obstetric physicians reported more pessimistic views on QOL. Key Points

scholarly journals Influence of the interaction between parental myopia and poor reading and writing habits on prevalence of myopia in school students in Urumqi, China

2021 ◽  
Author(s):  
Haonan Shi ◽  
Jing Fu ◽  
Xiaojing Liu ◽  
Yingxia Wang ◽  
Xianting Yong ◽  
...  
Keyword(s):  
Regression Models ◽  
Unconditional Logistic Regression ◽  
Cross Sectional Survey ◽  
School Students ◽  
Cross Sectional ◽  
Poor Reading ◽  
Reading And Writing ◽  
Multiplicative Interaction ◽  
Logistic Regression Models ◽  
Lying Down

Abstract Background: To evaluate the prevalence of myopia in school students in Urumqi, China, and explore the influence of the interaction between parental myopia and poor reading and writing habits on myopia to identify the at-risk population and provide evidence to help school students avoid developing myopia.Methods: A cross-sectional survey was conducted with 6,883 school students aged 7–20 years in Urumqi in December 2019. The Standard Eye Chart and mydriatic optometry were used to determine whether students had myopia. Falconer’s method was used to calculate the heritability of parental myopia. Multivariate unconditional logistic regression models were used to analyze the risk factors for myopia and the additive and multiplicative interaction of parental myopia and poor reading and writing habits.Results After standardizing the age of the 6,883 students, the overall prevalence rate of myopia was 47.50%. The heritability of parental myopia was 66.57% for boys, 67.82% for girls, 65.02% for the Han group, and 52.71% for other ethnicities. There were additive interactions between parental myopia and poor reading and writing habits; among them, parental myopia and poor reading and writing habits (1) (the distance between the eyes and book is less than 30 cm when reading and writing, fingers block the sight of one eye while holding the pen, and leaning one’s body when reading and writing) increased the risk of myopia by 10.99 times (odds ratio [OR]=10.99, 95% confidence interval [CI]=8.33–14.68), parental myopia and poor reading and writing habits (2) (reading while lying down, walking, or in the car) increased the risk of myopia by 5.92 times (OR=5.92, 95% CI=4.84–7.27). There was no multiplicative interaction between parental myopia and poor reading and writing habits (1) or (2) (OR=0.69, 95% CI=0.44–1.08; OR=0.89, 95% CI=0.66–1.21, respectively).Conclusion The prevalence of myopia among students in Urumqi, Xinjiang is relatively high. The risk of developing myopia is affected by parental myopia and poor reading and writing habits. In addition, parental myopia amplifies the harm caused by poor reading and writing habits, thereby increasing the risk of myopia. Students with parents who have myopia should be targeted during myopia prevention efforts.

Women’s Autonomy and Support for Wife Beating: Findings From a Population-Based Survey in Jordan

2010 ◽  
Vol 25 (3) ◽  
pp. 409-419 ◽  
Author(s):  
Natalia Linos ◽  
Marwan Khawaja ◽  
Mohannad Al-Nsour
Keyword(s):  
Regression Models ◽  
Binary Logistic Regression ◽  
Population Based ◽  
Married Women ◽  
Wife Beating ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
Hypothetical Scenario ◽  
Population Based Survey

The aim of this study is to examine attitudes among married women toward wife beating and to investigate the hypothesis that female individual empowerment is associated with such attitudes within a broader context of societal patriarchy in Jordan. The study uses data from a cross-sectional survey of a representative sample of married women (n = 5,390) conducted in 2002. Associations between acceptance of wife beating and several women’s empowerment variables, including decision-making power, as well as other risk factors were assessed, using odds ratios from binary logistic regression models. The key finding is that the vast majority (87.5%) of Jordanian women believe that wife beating is justified in at least one hypothetical scenario, and justification is negatively associated with empowerment variables and some demographic, geographic, and socioeconomic factors.

scholarly journals Parents’ and guardians’ views and experiences of accessing routine childhood vaccinations during the coronavirus (COVID-19) pandemic: A mixed methods study in England

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0244049
Author(s):  
Sadie Bell ◽  
Richard Clarke ◽  
Pauline Paterson ◽  
Sandra Mounier-Jack
Keyword(s):  
General Practice ◽  
Mixed Methods ◽  
Childhood Vaccination ◽  
Vaccine Preventable Disease ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Preventable Disease ◽  
Telephone Interviews ◽  
Routine Childhood ◽  
General Practices

Objective To explore parents’ and guardians’ views and experiences of accessing National Health Service (NHS) general practices for routine childhood vaccinations during the coronavirus (COVID-19) pandemic in England. Design Mixed methods approach involving an online cross-sectional survey (conducted between 19th April and 11th May 2020) and semi-structured telephone interviews (conducted between 27th April and 27th May 2020). Participants 1252 parents and guardians (aged 16+ years) who reported living in England with a child aged 18 months or under completed the survey. Nineteen survey respondents took part in follow-up interviews. Results The majority of survey respondents (85.7%) considered it important for their children to receive routine vaccinations on schedule during the COVID-19 pandemic; however, several barriers to vaccination were identified. These included a lack of clarity around whether vaccination services were operating as usual, particularly amongst respondents from lower income households and those self-reporting as Black, Asian, Chinese, Mixed or Other ethnicity; difficulties in organising vaccination appointments; and fears around contracting COVID-19 while attending general practice. Concerns about catching COVID-19 while accessing general practice were weighed against concerns about children acquiring a vaccine-preventable disease if they did not receive scheduled routine childhood vaccinations. Many parents and guardians felt their child’s risk of acquiring a vaccine-preventable disease was low as the implementation of stringent physical distancing measures (from March 23rd 2020) meant they were not mixing with others. Conclusion To promote routine childhood vaccination uptake during the current COVID-19 outbreak, further waves of COVID-19 infection, and future pandemics, prompt and sustained national and general practice level communication is needed to raise awareness of vaccination service continuation and the importance of timely vaccination, and invitation-reminder systems for vaccination need to be maintained. To allay concerns about the safety of accessing general practice, practices should communicate the measures being implemented to prevent COVID-19 transmission.

Nurse - patient encounters in general practice: patterns in general practitioner involvement and use of nurse-specific Medicare items

2010 ◽  
Vol 16 (3) ◽  
pp. 224 ◽  
Author(s):  
Catherine M. Joyce ◽  
Leon Piterman
Keyword(s):  
General Practice ◽  
General Practitioner ◽  
Clinical Work ◽  
Test Results ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Practice Nurses ◽  
Australian General Practice ◽  
Data Collections ◽  
Medical Examinations

A significant gap exists in knowledge about general practice nurses’ (GPNs) patient care activities, despite their now strong presence in Australian general practice. The aim of this paper is to explore the extent of direct general practitioner (GP) involvement in nurse–patient consultations, and to compare consultations where nurse-specific Medicare items were claimable with consultations where they were not. Data from the Practice Nurse Work Survey, a national cross-sectional survey conducted between May 2007 and May 2008, were analysed. Of the total 5253 nurse–patient encounters, 29% did not involve any contact between the patient and a GP, either directly before, during or directly after the nurse consultation. Encounters without GP involvement were more likely to be indirect (e.g. by telephone) and off-site (e.g. home visits), and had higher rates of administrative actions such as documentation and arranging visits. Nurse-specific Medicare item numbers applied in less than half (42%) of nurse–patient encounters. Encounters where no such item applied were more likely to involve medical examinations, blood tests, electrical tracings, physical function tests, removal of sutures, test results, assisting at operations and preparing for procedures. These results confirm that existing data collections do not capture the extent and nature of GPNs’ clinical work.

Secular trends in early motor development between 1980 and 2010 in Japan

2021 ◽  
pp. archdischild-2021-322087
Author(s):  
Keisuke Yoshii ◽  
Nobuaki Michihata ◽  
Kyoko Hirasawa ◽  
Satoru Nagata ◽  
Naho Morisaki
Keyword(s):  
Motor Development ◽  
Regression Models ◽  
Secular Trends ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Gross Motor ◽  
Child Characteristics ◽  
Logistic Regression Models ◽  
Birth Characteristics ◽  
Final Cohort

ObjectiveRecent changes in birth characteristics in Japan may have a potential influence on children’s developments. Therefore, we investigated secular trends in gross motor milestones.DesignData were collected from an official Japanese nationwide serial cross-sectional survey conducted every 10 years since 1960. 22 320 participants aged 2–18 months were identified from the four surveys from 1980 to 2010.OutcomesWe assessed whether or not a child achieved four gross motor milestones including rolling over (rolling), sitting without support (sitting), standing with support (standing) and walking alone (walking). The target age was defined as the age when the attainment rate ranged from >5% to >95% of the total. Multivariate logistic regression models were fitted.ResultsThe final cohort included 20 570 children. The target ages were determined as follows: 3–6 months for rolling; 5–9 months for sitting; 6–11 months for standing; and 9–15 months for walking. The attainment rates of sitting, standing and walking in 1990 were higher than those in 2010, even after adjusting for child characteristics (sitting: adjusted OR (aOR)=2.07 (95% CI 1.62 to 2.65); standing: aOR=1.63 (95% CI 1.32 to 2.02); and walking: aOR=1.61 (95% CI 1.34 to 1.95)).ConclusionsThe proportion of children who attained three motor milestones (sitting, standing and walking) by set target ages decreased between 1990 and 2010. The contribution of birth characteristics including a decrease in gestational age and fetal growth, as well as changes in other child characteristics, failed to explain why this decrease occurred.

scholarly journals Contract and ownership type of general practices and patient experience in England: multilevel analysis of a national cross-sectional survey

2017 ◽  
Vol 110 (11) ◽  
pp. 440-451 ◽  
Author(s):  
Thomas E Cowling ◽  
Anthony A Laverty ◽  
Matthew J Harris ◽  
Hilary C Watt ◽  
Felix Greaves ◽  
...  
Keyword(s):  
General Practice ◽  
Patient Experience ◽  
Linear Regression Analysis ◽  
Patient Survey ◽  
Medical Services ◽  
Cross Sectional Survey ◽  
Ownership Type ◽  
Cross Sectional ◽  
Patient Reports ◽  
General Practices

Objective To examine associations between the contract and ownership type of general practices and patient experience in England. Design Multilevel linear regression analysis of a national cross-sectional patient survey (General Practice Patient Survey). Setting All general practices in England in 2013–2014 ( n = 8017). Participants 903,357 survey respondents aged 18 years or over and registered with a general practice for six months or more (34.3% of 2,631,209 questionnaires sent). Main outcome measures Patient reports of experience across five measures: frequency of consulting a preferred doctor; ability to get a convenient appointment; rating of doctor communication skills; ease of contacting the practice by telephone; and overall experience (measured on four- or five-level interval scales from 0 to 100). Models adjusted for demographic and socioeconomic characteristics of respondents and general practice populations and a random intercept for each general practice. Results Most practices had a centrally negotiated contract with the UK government (‘General Medical Services’ 54.6%; 4337/7949). Few practices were limited companies with locally negotiated ‘Alternative Provider Medical Services’ contracts (1.2%; 98/7949); these practices provided worse overall experiences than General Medical Services practices (adjusted mean difference −3.04, 95% CI −4.15 to −1.94). Associations were consistent in direction across outcomes and largest in magnitude for frequency of consulting a preferred doctor (−12.78, 95% CI −15.17 to −10.39). Results were similar for practices owned by large organisations (defined as having ≥20 practices) which were uncommon (2.2%; 176/7949). Conclusions Patients registered to general practices owned by limited companies, including large organisations, reported worse experiences of their care than other patients in 2013–2014.

scholarly journals Characteristics of patients who access zero, one or multiple general practices and reasons for their choices: a study in regional Australia

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Kristen M. Glenister ◽  
John Guymer ◽  
Lisa Bourke ◽  
David Simmons
Keyword(s):  
General Practice ◽  
General Practitioner ◽  
Continuity Of Care ◽  
Rural Areas ◽  
Screening Tests ◽  
Lifestyle Advice ◽  
Cross Sectional Survey ◽  
Similar Frequency ◽  
Younger Age ◽  
General Practices

Abstract Background Most people in Australia visit a General Practitioner each year and are free to choose their General Practitioner and/or practice on each occasion. A proportion of people visit multiple general practices, which can reduce continuity of care, a core value of general practice. Utilisation of multiple general practices is associated with metropolitan residence and younger age. However, it is unclear which factors are associated with utilisation of multiple general practices in rural areas, where there are often General Practitioner workforce shortages and higher proportions of patients who may benefit from continuity of care, including older people and people living with chronic disease. The aim of this study was to compare the characteristics of people in a rural Australian area who accessed multiple general practices in the previous year with people who had accessed one practice, or none. Methods A cross-sectional survey assessed self-reported utilisation and perspective of general practice services, uses of multiple practices, associated reasons, lifestyle advice and screening services received in four regional Victorian towns. Households were randomly selected and residents aged 16+ were eligible to participate in the adult survey. Results Most people had attended a single general practice (78.9%), while 14.4% attended more than one practice and 6.7% attended no practices in the previous 12 months. Compared with utilisation of a single general practice, multiple general practice attendance in the previous year was associated with younger age (adjusted odds ratio (aOR 95% confidence interval) 0.98 per year (0.97–0.99), residence in the regional centre aOR 2.90(2.22–3.78), emergency department (ED) attendance in the last 12 months aOR 1.65(1.22–2.21) and no out of pocket costs aOR 1.36(1.04–1.79)). Reasons for multiple general practice attendance included availability of appointments, cost and access to specific services. Compared with multiple general practice attendance, those attending single practices reported more screening tests but similar frequency of lifestyle advice. People who accessed multiple practices were less likely to report very high satisfaction (51.7% vs 62.9% p < 0.001) or excellent degree of confidence in their doctor (42.0% vs 49.8% p = 0.006) than single practice attendees. Conclusions Those attending single practices report higher satisfaction and confidence in their GP and were less likely to attend ED. Further studies are required to test whether increasing availability of appointments and reducing out-of-pocket expenses would increase single practice attendance and/or decrease healthcare costs overall.

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