Factors influencing career intentions on completion of general practice vocational training in England: a cross-sectional study

ObjectivesGeneral practice is experiencing a growing crisis with the numbers of doctors who are training and then entering the profession in the UK failing to keep pace with workforce needs. This study investigated the immediate to medium term career intentions of those who are about to become general practitioners (GPs) and the factors that are influencing career plans.DesignOnline questionnaire survey, with quantitative answers analysed using descriptive statistics and free text data analysed using a thematic framework approach.Setting and participantsDoctors approaching the end of 3-year GP vocational training in the West Midlands, England.Results178 (57.2%) doctors completed the survey. Most participants planned to work as salaried GPs or locums rather than entering a general practice partnership for at least the first 5 years post-completion of training; others failed to express a career plan or planned to leave general practice completely or work overseas. Many were interested in developing portfolio careers.The quality of general practice experience across undergraduate, foundation and vocational training were reported as influencing personal career plans, and in particular perceptions about workload pressure and morale within the training practices in which they had been placed. Experience of a poor work–life balance as a trainee had a negative effect on career intentions, as did negative perceptions about how general practice is portrayed by politicians and the media.ConclusionThis study describes a number of potentially modifiable factors related to training programmes that are detrimentally influencing the career plans of newly trained GPs. In addition, there are sociodemographic factors, such as age, gender and having children, which are also influencing career plans and so need to be accommodated. With ever-increasing workload in general practice, there is an urgent need to understand and where possible address these issues at national and local level.

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Factors Associated with the Caregivers’ Desire to Institutionalize Persons with Dementia: A Cross-Sectional Study

Dementia and Geriatric Cognitive Disorders ◽

10.1159/000494023 ◽

2018 ◽

Vol 46 (5-6) ◽

pp. 298-309 ◽

Cited By ~ 6

Author(s):

Sophie Vandepitte ◽

Koen Putman ◽

Nele Van Den Noortgate ◽

Sofie Verhaeghe ◽

Eric Mormont ◽

...

Keyword(s):

Behavioral Problems ◽

The Elderly ◽

Sociodemographic Factors ◽

Cross Sectional Study ◽

Respite Care ◽

Community Dwelling ◽

Cross Sectional ◽

Factors Associated ◽

Care Services ◽

Modifiable Factors

Background/Aims: Dementia is one of the main reasons for institutionalization among the elderly. Few studies have explored factors associated with the caregivers’ (CG) desire to institutionalize (DTI) a person with dementia (PWD). The objective of this study is to identify modifiable and non-modifiable psychosocial and sociodemographic factors associated with a caregiver’s DTI. Methods: Cross-sectional data of 355 informal CG of community-dwelling PWD were analyzed. Several characteristics were identified in CG and PWD to be included in a multivariable regression model based on the purposeful selection method. Results: Positively modifiable associated factors were: higher CG burden, being affected by behavioral problems, and respite care use. Positively associated non-modifiable factors were: CG older age, being professionally active, and CG higher educational level. Cohabitation and change of professional situation were negatively associated. Conclusion: Although no causality can be assumed, several practical recommendations can be suggested. First of all, these results reconfirm the importance of multicomponent strategies, especially support aimed at decreasing burden and in learning coping strategies. Also, CG might benefit from information about support options, such as respite care services. Finally, special attention should be given to older and working CG. In the latter, flexible and adaptive working conditions might alleviate burden and therefore reduce the DTI of the PWD.

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Benefits and Challenges of Using Virtual Primary Care During the COVID-19 Pandemic: An International Cross-sectional Survey Study (Preprint)

10.2196/preprints.33588 ◽

2021 ◽

Author(s):

Edmond Li ◽

Rosy Tsopra ◽

Geronimo Jimenez ◽

Alice Serafini ◽

Gustavo Gusso ◽

...

Keyword(s):

Primary Care ◽

Care Delivery ◽

Lessons Learned ◽

Survey Study ◽

Free Text ◽

Cross Sectional Survey ◽

Online Questionnaire ◽

Cross Sectional ◽

Face To Face ◽

Remote Care

BACKGROUND With the onset of COVID-19, general practitioners (GPs) and patients worldwide swiftly transitioned from face-to-face to digital remote consultations. There is a need to evaluate how this global shift has impacted patient care, healthcare providers, patient and carer experience, and health systems. OBJECTIVE We explored GPs’ perspectives on the main benefits and challenges of using digital remote care. METHODS GPs across 20 countries completed an online questionnaire between June – September 2020. GPs’ perceptions on main barriers and challenges were explored using free-text questions. Thematic analysis was used to analyse the data. RESULTS A total of 1,605 respondents participated in our survey. The benefits identified included reducing COVID-19 transmission risks, guaranteeing access and continuity of care, improved efficiency, faster access to care, improved convenience and communication with patients, greater work flexibility for providers, and hastening the digital transformation of primary care and accompanying legal frameworks. Main challenges included patient’s preference for face-to-face consultations, digital exclusion, lack of physical examinations, clinical uncertainty, delays in diagnosis and treatment, overuse and misuse of digital remote care, and unsuitability for certain types of consultations. Other challenges include the lack of formal guidance, higher workloads, remuneration issues, organisational culture, technical difficulties, implementation and financial issues, and regulatory weaknesses. CONCLUSIONS At the frontline of care delivery, GPs can provide important insights on what worked well, why, and how during the pandemic. Lessons learned can be used to inform the adoption of improved virtual care solutions, and support the long-term development of platforms that are more technologically robust, secure. INTERNATIONAL REGISTERED REPORT RR2-10.2196/30099

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Do rates of depression vary by level of alcohol misuse in Australian general practice?

Australian Journal of Primary Health ◽

10.1071/py16076 ◽

2017 ◽

Vol 23 (3) ◽

pp. 263 ◽

Cited By ~ 5

Author(s):

Breanne Hobden ◽

Jamie Bryant ◽

Rob Sanson-Fisher ◽

Christopher Oldmeadow ◽

Mariko Carey

Keyword(s):

General Practice ◽

Alcohol Use ◽

Alcohol Misuse ◽

Sociodemographic Factors ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Prevalence Of Depression ◽

Patient Health ◽

Australian General Practice ◽

Disorder Identification

Limited data exist regarding co-occurring alcohol misuse and depression among general practice patients. This study examined the prevalence of depression by level of alcohol misuse, and the sociodemographic factors associated with depression and increased alcohol misuse severity. A cross-sectional survey was administered to 3559 Australian general practice patients. Patients completed their demographic details, the Patient Health Questionnaire (9-item) and the Alcohol Use Disorder Identification Test (Consumption items). The prevalence of alcohol misuse and depression was 6.7%, and depression prevalence varied significantly according to level of alcohol misuse (P<0.001). Age, gender, Aboriginality and number of chronic diseases were associated with depression and higher levels of alcohol misuse. These findings may assist General Practitioners in identifying those at risk of experiencing co-morbid depression and alcohol use, and aid in effective treatment and referral.

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Perception and practice of social distancing among Egyptians in COVID-19 pandemic

The Journal of Infection in Developing Countries ◽

10.3855/jidc.13160 ◽

2020 ◽

Vol 14 (08) ◽

pp. 817-822

Author(s):

Huny Mohamed Bakry ◽

Eman Hassan Waly

Keyword(s):

Disease Transmission ◽

Sociodemographic Factors ◽

Cross Sectional Study ◽

P Value ◽

Public Health Measure ◽

Online Questionnaire ◽

Infectious Disease Transmission ◽

Cross Sectional ◽

Social Distancing ◽

Health Measure

Introduction: Social distancing is principally intended to reduce infectious disease transmission by decreasing interactions among people in a broader community. Keeping social distancing is an essential public health measure to resist the COVID-19 pandemic. Methodology: a cross sectional study was conducted among 1,036 Egyptians using an online questionnaire between 5 and 10 May 2020. Results: There was significant association between the practice of social distancing and some sociodemographic factors as sex, age, education, working status, and place of residence at p value < 0.001 and with community of residence at p value 0.021. Conclusions: Egyptians had good perception for social distancing to prevent transmission of COVID 19, but they were not strictly practicing it.

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Sociodemographic factors associated with acceptance of COVID-19 vaccine and clinical trials in Uganda: a cross-sectional study in western Uganda

BMC Public Health ◽

10.1186/s12889-021-11197-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Isaac Echoru ◽

Patricia Decanar Ajambo ◽

Emmanuel Keirania ◽

Edmund E. M. Bukenya

Keyword(s):

Clinical Trials ◽

Primary School ◽

Sociodemographic Factors ◽

Snowball Sampling ◽

Online Questionnaire ◽

Cross Sectional ◽

Factors Associated ◽

Rural Dwellers ◽

Western Uganda ◽

Health Experts

Abstract Background Health experts agree that widespread use of safe and effective vaccines will rapidly contain the COVID-19 pandemic. The big question is whether these vaccines can easily be accepted by their end-users. Our study aimed at determining sociodemographic factors associated with acceptance of vaccines and clinical trials of COVID-19 in western Uganda. Method A simplified snowball sampling technique was used to select 1067 respondents of 18–70 years in western Uganda using an online questionnaire from July to September 2020. Vaccine acceptability and risk perception were assessed using odds ratio at 95% confidence interval in R software version 3.6.3. Results There were 1067 participants in the study. The majority were males (73.2%) and age group 31–40 years (32.6%). The acceptance rate for COVID-19 vaccination was (53.6%; 572/1067) with those aged 18–20 years, males, elites at tertiary level of education (degree or diploma), students, Muslims, married, non-salary earners and rural dwellers having better odds and likeliness to accept vaccination. Only 44.6% (476/1067) showed interest in clinical trials among which; males, primary school leavers, students, Christians, un-married, respondents who didn’t earn any salary and rural dwellers had better odds and likelihood to participate in clinical trials. Conclusion There was a low level of vaccine acceptance and clinical trial interest in western Uganda. Minority groups in the study i.e., Muslims, students, primary school leavers, un-married rural dwellers among others showed more interest in vaccination and clinical trials. We anticipated fears in the larger part of this community that health experts need to address through reassurance of the community that vaccines are tested and that they are safe and important if we are to rapidly contain the COVID-19 pandemic.

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General practitioners’ experiences with, views of, and attitudes towards, general practice-based pharmacists: a cross-sectional survey

BMC Primary Care ◽

10.1186/s12875-021-01607-5 ◽

2022 ◽

Vol 23 (1) ◽

Author(s):

Ameerah S. Hasan Ibrahim ◽

Heather E. Barry ◽

Carmel M. Hughes

Keyword(s):

General Practice ◽

General Practitioners ◽

Positive Impact ◽

Clinical Skills ◽

Community Pharmacists ◽

Free Text ◽

Full Time ◽

Cross Sectional Survey ◽

Cross Sectional ◽

General Practices

Abstract Background There is limited United Kingdom (UK) literature on general practice-based pharmacists’ (PBPs’) role evolution and few studies have explored general practitioners’ (GPs’) experiences on pharmacist integration into general practice. Therefore, this study aimed to investigate GPs’ experiences with, views of, and attitudes towards PBPs in Northern Ireland (NI). Methods A paper-based self-administered questionnaire comprising four sections was mailed in 2019 to 329 general practices across NI and was completed by one GP in every practice who had most contact with the PBP. Descriptive analyses were used and responses to open-ended questions were analysed thematically. Results The response rate was 61.7% (203/329). There was at least one PBP per general practice. All GPs had face-to-face meetings with PBPs, with three-quarters (78.7%, n = 159) meeting with the PBP more than once a week. Approximately two-thirds of GPs (62.4%, n = 126) reported that PBPs were qualified as independent prescribers, and 76.2% of these (n = 96/126) indicated that prescribers were currently prescribing for patients. The majority of GPs reported that PBPs always/very often had the required clinical skills (83.6%, n = 162) and knowledge (87.0%, n = 167) to provide safe and effective care for patients. However, 31.1% (n = 61) stated that PBPs only sometimes had the confidence to make clinical decisions. The majority of GPs (> 85%) displayed largely positive attitudes towards collaboration with PBPs. Most GPs agreed/strongly agreed that PBPs will have a positive impact on patient outcomes (95.0%, n = 192) and can provide a better link between general practices and community pharmacists (96.1%, n = 194). However, 24.8% of GPs (n = 50) were unclear if the PBP role moved community pharmacists to the periphery of the primary care team. An evaluation of the free-text comments indicated that GPs were in favour of more PBP sessions and full-time posts. Conclusion Most GPs had positive views of, and attitudes towards, PBPs. The findings may have implications for future developments in order to extend integration of PBPs within general practice, including the enhancement of training in clinical skills and decision-making. Exploring PBPs’, community pharmacists’ and patients’ views of this role in general practice is required to corroborate study findings.

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Improving primary palliative care – a Delphi consensus study on measures for general practice in Germany

BMC Primary Care ◽

10.1186/s12875-021-01613-7 ◽

2022 ◽

Vol 23 (1) ◽

Author(s):

Esma Sümeyya Bilgin ◽

Rojda Ülgüt ◽

Nils Schneider ◽

Stephanie Stiel

Keyword(s):

Palliative Care ◽

General Practice ◽

Delphi Study ◽

Health Care Research ◽

Free Text ◽

Delphi Consensus ◽

Intervention Package ◽

Online Questionnaire ◽

Junior Research ◽

Strongly Agree

Abstract Background The majority of severely ill and dying people in Germany can be administered primary palliative care (PPC) by general practitioners (GP). However, the current provision of PPC does not match the needs of the population. Although several public health strategies aim at strengthening the role of GPs in PPC provision, it remains challenging for GP teams to integrate PPC into their daily routines. Aim A Delphi study with GPs was conducted to achieve consensus on specific measures for improving the integration of PPC into everyday GP practice. Methods The study is part of the junior research project “Primary Palliative Care in General Practice” (ALLPRAX). After having developed, tested and evaluated 26 practical measures for GP practices to improve their PPC, a Delphi consensus study among GPs took place. In 2020, 569 GPs were asked to rate the relevance and feasibility of the measures on a 4-point Likert scale via an anonymous online questionnaire. Consensus was defined as a sum percentage of ‘strongly agree’ and ‘somewhat agree’ responses ≥75% after two rounds. Between these rounds, measures that were not consented in the first round were adapted in light of respondents’ free text comments and suggestions. Results The response rate was 11.3% in round 1 (n = 64) and 53.1% in round 2 (n = 34). From the initial n = 26 measures, n = 20 measures achieved consensus and were included in the final intervention package. The consented measures pertained to four main topics: advance care planning with patients, consulting and informing patients and family caregivers, GP office organisation and continuing education. N = 6 measures did not achieve consensus, predominantly due to time and workload constraints. Conclusion The consented measures provide valuable support to improve the provision of PPC by GPs. They can be used freely and flexibly, according to the needs of individual GP teams, and are thus suitable for implementation nationwide. Trial registration The study was registered in the German Clinical Trials Register (Registration N° DRKS00011821; 4 December 2017; https://apps.who.int/trialsearch/) and the German Register of Health Care Research (Registration N° VfD_ALLPRAX_16_003817; 30 March 2017).

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Psychological Distress in Caregivers for People with Dementia: A Population-Based Analysis of a National Cross-Sectional Study

Journal of Alzheimer s Disease ◽

10.3233/jad-210680 ◽

2021 ◽

pp. 1-8

Author(s):

Norio Sugawara ◽

Norio Yasui-Furukori ◽

Kazushi Maruo ◽

Kazutaka Shimoda ◽

Tomiki Sumiyoshi

Keyword(s):

Psychological Distress ◽

Sociodemographic Factors ◽

Population Based ◽

Multivariable Logistic Regression Analysis ◽

Serious Psychological Distress ◽

Forward Selection ◽

Cross Sectional ◽

People With Dementia ◽

Modifiable Factors ◽

Distress Scale

Background: Taking care of patients with dementia is often stressful and exhausting. The burden placed on caregivers (CGs) for care recipients with dementia (CRDs) has been reported to cause psychological distress. Objective: The aim of this study was to evaluate the psychological distress experienced by CGs for CRDs and identify the sociodemographic factors affecting that distress. Methods: We utilized the 2013 Comprehensive Survey of the Living Conditions for CRDs and CGs. Linked data from 643 pairs of CRDs and CGs were extracted. Serious psychological distress experienced by CGs was measured by Kessler’s Psychological Distress scale (K6) with a cutoff point of 13. Factors predictive of psychological distress were evaluated using multivariable logistic regression analysis with the forward selection method. Results: Overall, the mean age of the CGs was 63.5±11.6 years, and 5.3%(34/643) experienced serious psychological distress. Male sex of CRDs, knowing how to access consulting services, spending almost all day for nursing care, and having subjective symptoms within a few days of completing the survey were associated with having serious psychological distress, while older age, participating in shopping as part of the nursing activities, and having their own house were related to freedom from serious psychological distress. Conclusion: Clinicians should be aware of the risk factors for psychological distress in CGs and consider providing support to reduce the distress imposed by modifiable factors. Further studies are warranted to examine whether such efforts would improve the mental health of CGs for CRDs.

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A cross-sectional study exploring attitudes of first year medical students towards psychiatry and factors they identified that would help stimulate their interest

BJPsych Open ◽

10.1192/bjo.2021.412 ◽

2021 ◽

Vol 7 (S1) ◽

pp. S146-S146

Author(s):

Isabel Mark ◽

Victoria Fernandez Garcia De Las Heras

Keyword(s):

Medical Students ◽

Communication Skills ◽

Role Model ◽

P Value ◽

First Year ◽

Free Text ◽

Online Questionnaire ◽

Cross Sectional ◽

Awareness Campaigns ◽

First Year Medical Students

AimsPsychiatry has had long standing recruitment difficulties. Many efforts have been made to explore strategies that encourage interest in the specialty, with early university experience being an important factor in ultimate career choice. The Royal College of Psychiatrists ‘Choose Psychiatry’ guidance for medical schools outlines four key areas of focus: teaching excellence, placement quality, leadership and enrichment activities, with other research reporting similar conclusions. The aim of this study was to assess attitudes towards psychiatry amongst first year medical students, examine what input they would welcome from psychiatrists at this stage of their career and consider if their wishes are in keeping with the ‘Choose Psychiatry’ guidance.MethodAll first-year medical students at St George's University of London were approached in October 2019 and offered the opportunity for early psychiatry exposure. 60 students were recruited. Data were collected in November 2019 via an online questionnaire comprising of baseline demographics, the 30-item Attitudes Towards Psychiatry questionnaire (ATP-30) and a free-text question asking what students would like from psychiatry at this stage of their education. Quantitative data were analysed using Excel, whilst qualitative data were analysed thematically.ResultThe mean ATP-30 score was 113.83 (SD 12.57, range 70-135). Gender, ethnicity and religious background were not associated with a change in ATP score. Undergraduates’ attitudes were more positive than those of postgraduates (independent t-test revealed a p-value of 0.087). Seven themes were identified outlining what students wanted from psychiatry, the most prominent being: (a) learning about the lifestyle of a psychiatrist and finding a role model, (b) exploring the patient perspective, (c) exploring the interaction between psychiatry and specialities and (d) having an opportunity to develop communication skills.ConclusionThe findings demonstrate higher ATP-30 results than previous literature has reported, potentially due to mental health awareness campaigns in recent years. As undergraduates were found to have a higher mean score, targeting them for additional psychiatry contact may be beneficial. Themes identified by students in this study support ‘Choose Psychiatry’ guidance, whilst also highlighting the potential for combining some psychiatry with other specialties in the curriculum. Integration with communication skills teaching might help engage those not initially psychiatry-inclined. Further study will be required to establish whether implementing the suggested strategies can lead to improvement in student ATP-30 scores and ultimately increased recruitment rates.

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Ethical Conduct with Invertebrate Animals: Routes for Inclusive, Humanitarian, and Sustainable Education

Current World Environment ◽

10.12944/cwe.16.3.3 ◽

2021 ◽

Vol 16 (3) ◽

pp. 679-693

Author(s):

Marta Luciane Fischer ◽

Juliana Zacarkin Santos

Keyword(s):

Educational Level ◽

Vocational Training ◽

Ethical Values ◽

Sustainable Society ◽

Online Questionnaire ◽

Cross Sectional ◽

Brazilian Society ◽

Housing Area ◽

Invertebrate Animals ◽

Ecological Importance

Perceptions of nature depend on experiences relating to biodiversity, thus this study investigated the representation of invertebrates in different sections of Brazilian society by means of a questionnaire available from March to December 2015 as a resource in terms of the conservation of nature and human health in order to design an ethical values guide for this relationship. This study tested the hypotheses that there are differences in the conception and representation: a) associated with gender, educational level, use of animals in vocational training, tutoring, and housing area; b) according to the role assigned to invertebrates as a resource, including in conservation and health; and c) that the different representations result in different value assignments used to intermediate decisions on how, when, and why to use invertebrates. Thus, through quantitative and cross-sectional research, our objective was to identify the popular representation of invertebrates. The analysis of the results of an online questionnaire with 281 respondents showed definitions and concepts that were predominantly similar to the tested variables, which suggests that the present study provides evidence for the understanding of the ecological importance of the invertebrates, the belief in their sentience, and disagreement with the substitutive use of vertebrates in experimentation. However, the naturalistic and ecological positions regarding nature prevailed, indicating the persistence of utilitarian values. The results cast interpretive clues that the only by cooperation between education and environmental bioethics will possible the confluence of values and interests of animals and human in favor of a critical, ethical, and sustainable society.

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