Investigating group-based classes (‘weaning workshops’) to support complementary infant feeding in Irish primary care settings: A cross-sectional survey

AbstractObjectiveThis study aims to 1) investigate current practice regarding ‘weaning workshops’ to support complementary infant feeding delivered within Irish primary care, 2) explore the experiences and opinions of community dietitians regarding optimal content and modes of delivery of weaning workshops, and 3) identify the key factors to be considered in the development and implementation of weaning workshops delivered within primary care.DesignCross-sectional surveySettingIrish primary careParticipants47 community-based dietitiansResultsSixteen dietitians reported that workshops were run in their area with variable frequency, with ten reporting that workshops were never run in their area. Participants reported that mostly mothers of medium socioeconomic status attended weaning workshops when infants were aged between 4-7 months, and that feedback from workshop attendees was predominantly positive. Dietitians identified that key factors to be considered in future development and delivery of weaning workshops are 1) workshop characteristics such as content, timing and venue, 2) organisational characteristics such as availability of resources and multidisciplinary involvement, and 3) attendee characteristics such as socioeconomic status.ConclusionsThis study highlights substantial variability regarding provision of weaning workshops in Ireland, and a lack of standardisation regarding the provider, content, and frequency of workshops where workshops are being delivered. The study also provides unique insights into the experiences and opinions of primary care community dietitians regarding the development and delivery of weaning workshops in terms of optimal content and delivery options. These perspectives will make a valuable contribution given the dearth of evidence in this area internationally.

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Assessing a national policy on strengthening chronic care in primary care settings of a low-resource country using patients' perspectives.

10.21203/rs.3.rs-57447/v1 ◽

2020 ◽

Author(s):

Paibul Suriyawongpaisal ◽

Wichai Aekplakorn ◽

Samrit Srithamrongsaw ◽

Phanuwich Kaewkamjonchai

Keyword(s):

Primary Care ◽

Chronic Care ◽

Care Quality ◽

Local Health ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Mixed Effect ◽

Multiprofessional Team ◽

Primary Care Settings ◽

Healthcare Needs

Abstract Background To improve care for patients with chronic diseases, a recent policy initiative in Thailand focuses on strengthening primary care including training of the team to deliver healthcare based on the concept of Chronic Care Model(CCM). This study conducted a cross-sectional survey of 4,071 patients with hypertension and/or diabetes registered to 25 primary care units and 16 hospital NCD clinics in 11 provinces (76 in total) to examine the effects of provider training and local health systems settings on patients’ perception of the chronic care quality.Methods A home-based interview with questionnaire was conducted on the patients in primary care settings. The questionnaire was adopted from the Thai version of the Patient Assessment of Chronic Illness Care (PACIC+) developed by the MacColl Institute for Healthcare Innovation. The questionnaire contains 20 items from the original PACIC, which measure different parts of the CCM, and an additional 6 items assess the 5A Model.Mixed effect models were employed to compare subscale of patient perception of the care quality between trained upgraded PCUs, upgraded PCUs, ordinary PCUs and NCD clinics. Upgraded PCUs were ordinary PCUs with the multiprofessional team including a physician. Trained upgraded PCUs were upgraded PCUs with the training input.Results Mixed effect models depicted an independent association between every PACIC subscale (as a measure of CCM) and facility type with the maximum likelihood for patients of ordinary PCU reporting high to highest scores (ORs: 1.52-1.76; p<0.05) compared to hospital NCD clinics. This is also the case for patients: seeing the same doctor on repeated visits (ORs: 1.66-1.87; p<0.05) or having phone contacts of the providers (ORs:1.42-1.63; p<0.05). Similarly, across all of the 5A model subscales, ORs for patients attending ordinary PCU responded with high to highest scores were 1.4-2.0 times compared to those for patients attending hospital NCD clinics(p<0.05). Conclusions We could not find evidence to support effectiveness of the training approach. The training failure might indicate a need to address mismatch between health workforce and workload. It also indicates a need to incorporate fidelity check into any training program for chronic care addressing the complex healthcare needs.

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Patient Safety Culture Assessment in Primary Care Settings in Greece

Healthcare ◽

10.3390/healthcare9070880 ◽

2021 ◽

Vol 9 (7) ◽

pp. 880

Author(s):

Ioannis Antonakos ◽

Kyriakos Souliotis ◽

Theodora Psaltopoulou ◽

Yannis Tountas ◽

Maria Kantzanou

Keyword(s):

Primary Care ◽

Patient Safety ◽

Safety Culture ◽

Health Professionals ◽

Improve Patient Safety ◽

Patient Safety Culture ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Survey Tool ◽

Primary Care Settings

Introduction: A positive safety culture is considered a pillar of safety in health organizations and the first crucial step for quality health services. In this context, the aim of this study was to set a reference evaluation for the patient safety culture in the primary health sector in Greece, based on health professionals’ perceptions. Methods: We used a cross-sectional survey with a 62% response rate (n = 459), conducted in primary care settings in Greece (February to May 2020). We utilized the “Medical Office Survey on Patient Safety Culture” survey tool from the Agency for Healthcare Research and Quality (AHRQ). The study participants were health professionals who interacted with patients from 12 primary care settings in Greece. Results: The most highly ranked domains were: “Teamwork” (82%), “Patient Care Tracking/Follow-up” (80% of positive scores), and “Organizational Learning” (80%); meanwhile, the lowest-ranked ones were: “Leadership Support for Patient Safety” (62%) and “Work Pressure and Pace” (46%). The other domains, such as “Overall Perceptions of Patient Safety and Quality” (77%), “Staff Training“ (70%), “Communication about Error” (70%), “Office Processes and Standardization” (67%), and “Communication Openness” (64%), ranked somewhere in between. Conclusions: A positive safety culture was identified in primary care settings in Greece, although weak areas concerning the safety culture should be addressed in order to improve patient safety.

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Modern work patterns of “classic” versus millennial family doctors and their effect on workforce planning for community-based primary care: a cross-sectional survey

Human Resources for Health ◽

10.1186/s12960-020-00508-5 ◽

2020 ◽

Vol 18 (1) ◽

Author(s):

Lindsay Hedden ◽

Setareh Banihosseini ◽

Nardia Strydom ◽

Rita McCracken

Keyword(s):

Primary Care ◽

British Columbia ◽

Workforce Planning ◽

Cross Sectional Study ◽

Full Time ◽

Cross Sectional Survey ◽

Community Based ◽

Cross Sectional ◽

Family Doctors ◽

Primary Care Practices

Abstract Background There are ongoing accessibility challenges in primary care in British Columbia, Canada, with 17% of the population not having a regular source of care. Anecdotal evidence suggests that physicians are moving away from a community-based comprehensive practice model, which could contribute to shortages. Thus, we aimed to identify and describe how family physicians are currently organizing their primary care practices in a large health region in British Columbia and to examine differences between newer graduates and more established physicians. Methods Data for this cross-sectional study were drawn from an annual physician privileging survey. N = 1017 physicians were invited to participate. We categorized practice style into five distinct groupings and compared features across respondent groups, including personal and practice location characteristics, hospital and teaching work, payment and appointment characteristics, and scope of practice. We discuss the implications of styles of practice and associated characteristics on health workforce policy and planning. Results We received responses from 525 (51.6%) physicians. Of these, 355 (67.6%) reported doing at least some community-based primary care. However, only 112 (21.3%) provided this care full time. Most respondents supplemented community-based work with part-time hours in focused practice, hospitals, or inpatient facilities. We found diversity in the scope and style of practice across practice models. Compared to established physicians, new graduates (in practice less than 10 years) work more weekly hours (more patient care, and paperwork in particular). However, we found no difference between new and established physicians in the odds of providing any or full-time community-based primary care. Conclusions Despite a lack of formalized structural reform in British Columbia’s primary care system, most physicians are finding alternative ways to model their practice and shifting away from work at single-location, community-based clinics. This shift challenges assumptions that are relied on for workplace planning that is intended to ensure adequate access to longitudinal, community-based family medicine.

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Factors Related to Intention to Undergo Female Sterilization Among Married Women in Rural Kathmandu, Nepal

Nepal Journal of Epidemiology ◽

10.3126/nje.v6i1.14736 ◽

2016 ◽

Vol 6 (1) ◽

pp. 539-47 ◽

Cited By ~ 4

Author(s):

Adhish Dhungana ◽

Sutham Nanthamongkolchai ◽

Supachai Pitikultang

Keyword(s):

Married Women ◽

Key Factors ◽

Female Sterilization ◽

Cross Sectional Survey ◽

Community Based ◽

Cross Sectional ◽

Hilly Region ◽

Regulation Method ◽

National Family Planning ◽

Living Children

Background: Sterilization is most widely used fertility regulation method in Nepal. However, prevalence of uptake of female sterilization in central hilly region is less than the national average. The objective of the study was to explore the number and factors related to intention of married women to undergo female sterilization in rural Kathmandu which lies within central hilly region. Materials and Methods: This is a community based cross-sectional survey research conducted in rural area of Kathmandu valley. Two hundred and forty currently married women with at least one child of any age were interviewed using a structured pre-tested questionnaire.Results: More than four-fifth of the respondents intended to undergo sterilization. Almost two-third of them wanted to limit their family size by taking this option. More than one-third of women not-intending to undergo sterilization feared weakness after sterilization. Age of the respondents, duration of marriage, and number of living children were significantly associated with intention to undergo sterilization. 15-24 years age group were six times more likely to have the intention for sterilization (OR 6.79, CI 2.28-20.19) compared to age 35 years and above group. Mothers with less than 3 living children are about three times more likely to have the intention to undergo sterilization (OR 2.87, CI 1.3-6.33) compared to women with more than 2 living children. Women married for 6 to 10 years were three times more likely to have the intention (OR 3.0, CI 1.09-8.27). However, gender of the living children was not associated with intention to undergo sterilization.Conclusion: There were significant numbers of women intending to undergo sterilization. Age of the mother, number of living children and the duration of marriage were found to be significantly influencing the intention to undergo sterilization. However, as intention refers to future plan, the respondents’ intention may change over time. The national family planning program also needs to identify the key factors in accepting the sterilization and target these women to increase utilization.

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Validation of Nurse Practitioner Primary Care Organizational Climate Questionnaire: A New Tool to Study Nurse Practitioner Practice Settings

Journal of Nursing Measurement ◽

10.1891/1061-3749.25.1.142 ◽

2017 ◽

Vol 25 (1) ◽

pp. 142-155 ◽

Cited By ~ 9

Author(s):

Lusine Poghosyan ◽

William F. Chaplin ◽

Jonathan A. Shaffer

Keyword(s):

Primary Care ◽

Organizational Climate ◽

Nurse Practitioner ◽

Intent To Leave ◽

Factor Model ◽

Survey Design ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Primary Care Settings ◽

Confirmatory Factor

Background and Purpose: Favorable organizational climate in primary care settings is necessary to expand the nurse practitioner (NP) workforce and promote their practice. Only one NP-specific tool, the Nurse Practitioner Primary Care Organizational Climate Questionnaire (NP-PCOCQ), measures NP organizational climate. We confirmed NP-PCOCQ’s factor structure and established its predictive validity. Methods: A cross-sectional survey design was used to collect data from 314 NPs in Massachusetts in 2012. Confirmatory factor analysis and regression models were used. Results: The 4-factor model characterized NP-PCOCQ. The NP-PCOCQ score predicted job satisfaction (beta = .36; p < .001) and intent to leave job (odds ratio = .28; p = .011). Conclusion: NP-PCOCQ can be used by researchers to produce new evidence and by administrators to assess organizational climate in their clinics. Further testing of NP-PCOCQ is needed.

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Factors Related to Intention to Undergo Female Sterilization Among Married Women in Rural Kathmandu, Nepal

Nepal Journal of Epidemiology ◽

10.3126/nje.v1i1.14736 ◽

2016 ◽

Vol 6 (1) ◽

pp. 539

Author(s):

Adhish Dhungana ◽

Sutham Nanthamongkolchai ◽

Supachai Pitikultang

Keyword(s):

Married Women ◽

Key Factors ◽

Female Sterilization ◽

Cross Sectional Survey ◽

Community Based ◽

Cross Sectional ◽

Hilly Region ◽

Regulation Method ◽

National Family Planning ◽

Living Children

Background: Sterilization is most widely used fertility regulation method in Nepal. However, prevalence of uptake of female sterilization in central hilly region is less than the national average. The objective of the study was to explore the number and factors related to intention of married women to undergo female sterilization in rural Kathmandu which lies within central hilly region. Materials and Methods: This is a community based cross-sectional survey research conducted in rural area of Kathmandu valley. Two hundred and forty currently married women with at least one child of any age were interviewed using a structured pre-tested questionnaire.Results: More than four-fifth of the respondents intended to undergo sterilization. Almost two-third of them wanted to limit their family size by taking this option. More than one-third of women not-intending to undergo sterilization feared weakness after sterilization. Age of the respondents, duration of marriage, and number of living children were significantly associated with intention to undergo sterilization. 15-24 years age group were six times more likely to have the intention for sterilization (OR 6.79, CI 2.28-20.19) compared to age 35 years and above group. Mothers with less than 3 living children are about three times more likely to have the intention to undergo sterilization (OR 2.87, CI 1.3-6.33) compared to women with more than 2 living children. Women married for 6 to 10 years were three times more likely to have the intention (OR 3.0, CI 1.09-8.27). However, gender of the living children was not associated with intention to undergo sterilization.Conclusion: There were significant numbers of women intending to undergo sterilization. Age of the mother, number of living children and the duration of marriage were found to be significantly influencing the intention to undergo sterilization. However, as intention refers to future plan, the respondents’ intention may change over time. The national family planning program also needs to identify the key factors in accepting the sterilization and target these women to increase utilization.

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Prepared and highly committed despite the risk of COVID-19 infection: a cross-sectional survey of primary care physicians’ concerns and coping strategies in Singapore

BMC Family Practice ◽

10.1186/s12875-021-01370-7 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Jerrald Lau ◽

David Hsien-Yung Tan ◽

Gretel Jianlin Wong ◽

Yii-Jen Lew ◽

Ying-Xian Chua ◽

...

Keyword(s):

Primary Care ◽

Coping Strategies ◽

Stress Management ◽

Primary Care Physicians ◽

Well Being ◽

Pandemic Preparedness ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Accessible Information ◽

And Coping

Abstract Background Primary care physicians (PCPs) are first points-of-contact between suspected cases and the healthcare system in the current COVID-19 pandemic. This study examines PCPs’ concerns, impact on personal lives and work, and level of pandemic preparedness in the context of COVID-19 in Singapore. We also examine factors and coping strategies that PCPs have used to manage stress during the outbreak. Methods Two hundred and sixteen PCPs actively practicing in either a public or private clinic were cluster sampled via email invitation from three primary care organizations in Singapore from 6th to 29th March 2020. Participants completed a cross-sectional online questionnaire consisting of items on work- and non-work-related concerns, impact on personal and work life, perceived pandemic preparedness, stress-reduction factors, and personal coping strategies related to COVID-19. Results A total of 158 questionnaires were usable for analyses. PCPs perceived themselves to be at high risk of COVID-19 infection (89.9%), and a source of risk (74.7%) and concern (71.5%) to loved ones. PCPs reported acceptance of these risks (91.1%) and the need to care for COVID-19 patients (85.4%). Overall perceived pandemic preparedness was extremely high (75.9 to 89.9%). PCPs prioritized availability of personal protective equipment, strict infection prevention guidelines, accessible information about COVID-19, and well-being of their colleagues and family as the most effective stress management factors. Conclusions PCPs continue to serve willingly on the frontlines of this pandemic despite the high perception of risk to themselves and loved ones. Healthcare organizations should continue to support PCPs by managing both their psychosocial (e.g. stress management) and professional (e.g. pandemic preparedness) needs.

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