The Use of Family History in Primary Health Care: A Qualitative Study

The aim of this study is to describe how Belgian family physicians register and use the family history data of their patients in daily practice. Qualitative in-depth semistructured one-to-one interviews were conducted including 16 family physicians in Belgium. These interviews were recorded, transcribed, and analysed. Recurring themes were identified and compared with findings from the existing literature. All interviewed family physicians considered the family history as an important part of the medical records. Half of the surveyed physicians confirmed knowing the family history of at least 50% of their patients. The data on family history were mainly collected during the first consultations with the patient. The majority of physicians did not use a standardised questionnaire or form to collect and to record the family history. To estimate the impact of a family history, physicians seldom use official guidance or resources. Physicians perceived a lack of time and unreliable information provided by their patients as obstacles to collect and interpret the family history. Solutions that foster the use of family history data were identified at the level of the physician and also included the development of specific instruments integrated within the electronic medical record.

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P1.11-23 The Impact of the Family History of Different Cancers on Lung Cancer

Journal of Thoracic Oncology ◽

10.1016/j.jtho.2019.08.1096 ◽

2019 ◽

Vol 14 (10) ◽

pp. S524-S525

Author(s):

J. Li ◽

C. Li ◽

B. Cheng ◽

J. He ◽

W. Liang

Keyword(s):

Lung Cancer ◽

Family History ◽

The Family ◽

History Of ◽

The Impact

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Evaluation of the Quality of Services in Primary Health Care Institutions

Medicina ◽

10.3390/medicina47010009 ◽

2011 ◽

Vol 47 (1) ◽

pp. 9

Author(s):

Leonas Valius ◽

Daiva Rastenytė ◽

Vilija Malinauskienė ◽

Daina Krančiukaitė-Butylkinienė

Keyword(s):

Health Care ◽

Primary Health Care ◽

Family Physician ◽

Family Physicians ◽

Quality Of Services ◽

Primary Health ◽

The Family ◽

Primary Health Care Institutions ◽

Primary Health Care Settings

The aim of the study was to evaluate patients’ satisfaction with the quality of provided services in private primary health care institutions in Kaunas. Material and Methods. A questionnaire-based inquiry of 280 persons registered to family physicians at primary health care settings was performed. The study was carried out using 20-item anonymous questionnaires with questions about the quality of services provided in primary health care settings. Results. More than 50.0% of the respondents stated that they waited for more than 15 minutes at the physician’s office, while 17.0% of the respondents stated that the waiting time exceeded 30 minutes. More than 25.0% of the respondents positively evaluated the possibility to consult their family physician by phone. In 67.0% of patients, the family physician determined the cause of the disorder and administered treatment; in 32.0% of patients, the family physician referred them to a specialist, and 1.0% of patients were urgently sent to hospital. More than 90.0% of the respondents were satisfied with the services provided by their family physicians. Those who were dissatisfied with these services indicated that the provided treatment failed to eliminate the disorder, that they wanted to be referred to a specialist, and that they expected more diagnostic tests to be performed for more effective treatment. Conclusions. A greater part of the patients indicated that the main reason for long waiting at the physician’s office was physicians’ wish to serve too many patients. More than two-thirds (67.0%) of the patients stated that their family physicians determined the cause of the disorder and prescribed treatment. The overwhelming majority (more than 90.0%) of the patients were satisfied with the services provided by their family physicians.

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Knowledge, Health Beliefs, and Self-Efficacy regarding Osteoporosis in Perimenopausal Women

Journal of Osteoporosis ◽

10.1155/2013/853531 ◽

2013 ◽

Vol 2013 ◽

pp. 1-6 ◽

Cited By ~ 13

Author(s):

Renée D. Endicott

Keyword(s):

Pilot Study ◽

Family History ◽

Health Beliefs ◽

Educational Intervention ◽

Self Efficacy ◽

Educational Program ◽

The Family ◽

Perimenopausal Women ◽

History Of ◽

The Impact

The aims of this pilot study were to (1) determine if having a family history of osteoporosis impacts knowledge, health beliefs, and self-efficacy regarding osteoporosis among perimenopausal women aged 42–52 and to (2) describe the impact of an osteoporosis-specific educational intervention had on the knowledge, health beliefs, and self-efficacy of this population. Participants completed three surveys measuring knowledge, health beliefs, and self-efficacy related to osteoporosis before and two months after the educational program. At baseline, no differences were noted in knowledge of osteoporosis among women with and without a family history of osteoporosis, although women with a family history perceived a greater susceptibility for developing osteoporosis than women without the family history. Findings indicate that both groups increased in knowledge of osteoporosis (P<.001). Benefits of calcium increased in the women without a family history of osteoporosis (P<.001) and benefits of exercise increase in women with a family history of osteoporosis (P=.007). There were no significant statistical findings regarding self-efficacy between the two groups of women. Findings indicate that an osteoporosis-specific educational program improves perimenopausal women’s knowledge and some health beliefs.

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Identification of risk factors for recurrent febrile convulsion

Paediatrica Indonesiana ◽

10.14238/pi49.2.2009.87-9 ◽

2009 ◽

Vol 49 (2) ◽

pp. 87

Author(s):

Nadirah Rasyid Ridha ◽

P. Nara ◽

Hadia Angriani ◽

Dasril Daud

Keyword(s):

Family History ◽

Medical Records ◽

Febrile Convulsion ◽

Controlled Study ◽

Multivariate Logistic Regression ◽

Younger Age ◽

Increased Risk ◽

The Family ◽

History Of ◽

Lower Temperature

Background Febrile convulsion (FC) occurs in about 2 to 4percent of all children, approximately one third of whom willthen develop recurrent febrile convulsion (RFC). Risk factorsfor RFC are family history of convulsions, an age of less than 18months, a relatively lower temperature and shorter duration offever preceeding the first FC.Objective The aim of the study was to determine the risk factorsfor RFC.Methods One hundred children aged 6 months to 5 years withFC or RFC were included in this case-controlled study, which wascarried out from July 2006 to June 2007. Data on the children'sfirst FC were collected from medical records and the family historywas taken directly from the parents.Results Fifty children with RFC and 50 children withoutrecurrence were included in this study. An age of less than 18months (P< 0.0001, COR= 71.37), a family history of FC(P< 0.0001, COR= 6.00), and a fever duration ofless than 12hours preceding the first FC (P< 0.0001, COR = 4.96) wereassociated with a risk of recurrence. A relatively lower degree oftemperature at first febrile convulsion did not increase the riskfor RFC (P = 1.21). Multivariate logistic regression showed thatyounger age and shorter duration of fever preceding the first FCwere associated with RFC.Conclusion Younger age and shorter duration of fever precedingthe first FC are associated with an increased risk ofRFC.

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The Roots of Global Health Inequity

10.1093/oso/9780190662455.003.0001 ◽

2017 ◽

Author(s):

Joia S. Mukherjee

Keyword(s):

Health Care ◽

World War Ii ◽

Primary Health Care ◽

Economic Policies ◽

World War ◽

The Public ◽

The World Bank ◽

Primary Health ◽

The Cold War ◽

The Impact

This chapter outlines the historical roots of health inequities. It focuses on the African continent, where life expectancy is the shortest and health systems are weakest. The chapter describes the impoverishment of countries by colonial powers, the development of the global human rights framework in the post-World War II era, the impact of the Cold War on African liberation struggles, and the challenges faced by newly liberated African governments to deliver health care through the public sector. The influence of the World Bank and the International Monetary Fund’s neoliberal economic policies is also discussed. The chapter highlights the shift from the aspiration of “health for all” voiced at the Alma Ata Conference on Primary Health Care in 1978, to the more narrowly defined “selective primary health care.” Finally, the chapter explains the challenges inherent in financing health in impoverished countries and how user fees became standard practice.

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Determinants of substance use among young people attending an urban primary health center in Delhi

International Journal of Adolescent Medicine and Health ◽

10.1515/ijamh-2019-0243 ◽

2020 ◽

Vol 0 (0) ◽

Author(s):

KA Mogan ◽

U Venkatesh ◽

Richa Kapoor ◽

Mukesh Kumar

Keyword(s):

Substance Use ◽

Family History ◽

Young People ◽

Economic Status ◽

Primary Health Center ◽

Socio Economic Status ◽

Primary Health ◽

History Of ◽

Study Participants ◽

Substance Involvement

AbstractIntroductionSubstance abuse remains one of the major challenges in young people, as it is one of the top five causes of disability-adjusted life years (DALY). The present study aims to find the prevalence and determinants of substance use among young people attending an urban primary health center in Delhi.MethodologySystematic random sampling was used to enroll the calculated sample size of 190. Substance use was assessed using ASSIST (an Alcohol Smoking Substance Involvement Screening Tool) and brief intervention was given based on the standard guidelines of ASSIST. The total score among the substance users is calculated and divided into Grades 1, 2 or 3. Log binomial regression was performed to quantify the association between substance use and covariates such as age, sex, education, occupation, family history of substance use, socio-economic status and family type. The association was expressed in odds ratio (OR) with 95 percent confidence interval (CI).ResultThe mean age of study participants was 18.6 ± 4.1, ranges from 10 to 24 years. Out of 48 substance users, 43.7% were consuming only tobacco, 22.9% were consuming only alcohol and 33.3% were polysubstance users. The history of substance use among family members of participants was found to be 46.3%. Median substance involvement score of tobacco, alcohol and cannabis users was 19 (IQR: 14.5–22), 19 (IQR: 13.5–25) and 22.5 (IQR: 22–23), respectively. Among tobacco users, 2.7% were Grade 1 and 7.2% were Grade 2. Four (16%), 20 (80%) and one (4%) of alcohol users were Grades 1, 2 and 3, respectively. Among the cannabis users, four (100%) were in the Grade 2 category. The median age of initiation of substance use among users was 16 (range 13–21) years. The analysis shows substance use was almost 25 times (adjusted OR = 25.84, 95% CI 5.65–118.09) more common among males and it increase by 2.5 times with a decrease in socio-economic status (adjusted OR = 2.52, 95% CI 1.27–5.02) and the result is significant. The substance use was almost 7 times higher when there is a family history of substance usage (adjusted OR = 7.40, 95% CI 2.15–25.4). Residential and marital status were not significantly associated with substance use.ConclusionMale sex, lower socio-economic status, participants currently not going to school/college, family history of substance use were found to be significant predictors of substance use among the study participants.

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Novel SCN5A p.Val1667Asp Missense Variant Segregation and Characterization in a Family with Severe Brugada Syndrome and Multiple Sudden Deaths

International Journal of Molecular Sciences ◽

10.3390/ijms22094700 ◽

2021 ◽

Vol 22 (9) ◽

pp. 4700

Author(s):

Michelle M. Monasky ◽

Emanuele Micaglio ◽

Giuseppe Ciconte ◽

Ilaria Rivolta ◽

Valeria Borrelli ◽

...

Keyword(s):

Genetic Testing ◽

Family History ◽

Risk Stratification ◽

Brugada Syndrome ◽

Electrophysiological Study ◽

Functional Characterization ◽

The Family ◽

Novel Variant ◽

History Of ◽

Scn5a Gene

Genetic testing in Brugada syndrome (BrS) is still not considered to be useful for clinical management of patients in the majority of cases, due to the current lack of understanding about the effect of specific variants. Additionally, family history of sudden death is generally not considered useful for arrhythmic risk stratification. We sought to demonstrate the usefulness of genetic testing and family history in diagnosis and risk stratification. The family history was collected for a proband who presented with a personal history of aborted cardiac arrest and in whom a novel variant in the SCN5A gene was found. Living family members underwent ajmaline testing, electrophysiological study, and genetic testing to determine genotype-phenotype segregation, if any. Patch-clamp experiments on transfected human embryonic kidney 293 cells enabled the functional characterization of the SCN5A novel variant in vitro. In this study, we provide crucial human data on the novel heterozygous variant NM_198056.2:c.5000T>A (p.Val1667Asp) in the SCN5A gene, and demonstrate its segregation with a severe form of BrS and multiple sudden deaths. Functional data revealed a loss of function of the protein affected by the variant. These results provide the first disease association with this variant and demonstrate the usefulness of genetic testing for diagnosis and risk stratification in certain patients. This study also demonstrates the usefulness of collecting the family history, which can assist in understanding the severity of the disease in certain situations and confirm the importance of the functional studies to distinguish between pathogenic mutations and harmless genetic variants.

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Family Physicians’ Standpoint and Mental Health Assessment in the Light of COVID-19 Pandemic—A Nationwide Survey Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18042093 ◽

2021 ◽

Vol 18 (4) ◽

pp. 2093

Author(s):

Tina Vilovic ◽

Josko Bozic ◽

Marino Vilovic ◽

Doris Rusic ◽

Sanja Zuzic Furlan ◽

...

Keyword(s):

Mental Health ◽

Health Care ◽

Perceived Stress ◽

Depression Scale ◽

Family Physicians ◽

Knowledge Score ◽

Well Being ◽

Anxiety And Depression ◽

Event Scale ◽

The Impact

During the coronavirus disease 2019 (COVID-19) outbreak, family physicians (FPs) are the backbone of the healthcare system with considerable impact on the general population, and their well-being is of great importance. The aim of this investigation was to assess FPs mental health, as well as knowledge, attitudes and practices (KAPs) regarding the pandemic, and opinions on non-communicable disease (NCD) health care provided to patients. A cross-sectional study was carried out with a sample of 613 FPs. Anxiety and depression levels were estimated with the Hospital Anxiety and Depression Scale, subjective perceived stress with the Perceived Stress Scale, while trauma-related symptoms were assessed using the Impact on Event Scale-COVID19. KAPs toward the pandemic and opinions regarding NCD patients were evaluated with questionnaires accordingly. Results have shown that age (β = −0.02, p = 0.013) and personal risk of COVID‑19 (β = 1.05, p < 0.001) were significant independent correlates of the knowledge score. A total of 87.7% FPs expressed moderate/high perceived stress, 45.2% moderate/severe trauma-related symptoms, 60.4% borderline/abnormal anxiety levels, and 52.4% borderline/abnormal depression levels. Knowledge score was an independent predictor of perceived stress (β = −0.33, p = 0.023) and anxiety (β = −0.31, p = 0.006) levels. Limited accessibility to healthcare services and decreased number of newly-diagnosed NCD cases were mostly agreed on. The pandemic puts a considerable strain on FPs mental health, as well as on public health measures, due to the decreased overall quality of NCD patient health care. Educational programs may bridge the gaps between FPs’ knowledge. Thus lowering anxiety and improving patient care.

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Cohort study of ageing from Bagé (SIGa-Bagé), Brazil: profile and methodology

BMC Public Health ◽

10.1186/s12889-021-11078-z ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Elaine Thumé ◽

Marciane Kessler ◽

Karla P. Machado ◽

Bruno P. Nunes ◽

Pamela M. Volz ◽

...

Keyword(s):

Older Adults ◽

Health Care ◽

Cohort Study ◽

Primary Health Care ◽

Rio Grande ◽

Cognitive Testing ◽

Rio Grande Do Sul ◽

Primary Health ◽

The Impact

Abstract Background The Bagé Cohort Study of Ageing is a population-based cohort study that has recently completed the first follow-up of a representative sample of older adults from Bagé, a city with more than 100,000 inhabitants located in the state of Rio Grande do Sul, Brazil. This is one of the first longitudinal studies to assess the impact of primary health care coverage on health conditions and inequalities. Our aim is to investigate the prevalence, incidence and trends of risk factors, health behaviours, social relationships, non-communicable diseases, geriatric diseases and disorders, hospitalisation, self-perceived health, and all-cause and specific-cause mortality. In addition, we aim to evaluate socioeconomic and health inequalities and the impact of primary health care on the outcomes under study. Methods/design The study covers participants aged 60 or over, selected by probabilistic (representative) sampling of the urban area of the city of Bagé, which is covered by Primary Health Care Services. The baseline examination included 1593 older adults and was conducted from July 2008 to November 2008. After eight to nine years (2016/2017), the first follow-up was conducted from September 2016 to August 2017. All participants underwent an extensive core assessment programme including structured interviews, questionnaires, cognitive testing (baseline and follow-up), physical examinations and anthropometric measurements (follow-up). Results Of the original participants, 1395 (87.6%) were located for follow-up: 757 elderly individuals (47.5%) were re-interviewed, but losses in data transfer occurred for 22. The remaining 638 (40.1%) had died. In addition, we had 81 (5.1%) refusals and 117 (7.3%) losses. Among the 1373 older adults who were followed down, there was a higher proportion of female interviewees (p=0.042) and a higher proportion of male deaths (p=0.001) in 2016/2017. There were no differences in losses and refusals according to gender (p=0.102). There was a difference in average age between the interviewees (68.8 years; SD ±6.5) and non-interviewees (73.2 years; SD ±9.0) (p<0.001). Data are available at the Department of Social Medicine in Federal University of Pelotas, Rio Grande do Sul, Brazil, for any collaboration.

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Impact of community participation in primary health care: what is the evidence?

Australian Journal of Primary Health ◽

10.1071/py12164 ◽

2015 ◽

Vol 21 (1) ◽

pp. 2 ◽

Cited By ~ 33

Author(s):

Jessamy Bath ◽

John Wakerman

Keyword(s):

Health Care ◽

Primary Health Care ◽

Health Outcomes ◽

Community Participation ◽

Service Providers ◽

Developmental Process ◽

Service Access ◽

Primary Health ◽

Intermediate Outcomes ◽

The Impact

Community participation is a foundational principle of primary health care, with widely reputed benefits including improved health outcomes, equity, service access, relevance, acceptability, quality and responsiveness. Despite considerable rhetoric surrounding community participation, evidence of the tangible impact of community participation is unclear. A comprehensive literature review was conducted to locate and evaluate evidence of the impact of community participation in primary health care on health outcomes. The findings reveal a small but substantial body of evidence that community participation is associated with improved health outcomes. There is a limited body of evidence that community participation is associated with intermediate outcomes such as service access, utilisation, quality and responsiveness that ultimately contribute to health outcomes. Policy makers should strengthen policy and funding support for participatory mechanisms in primary health care, an important component of which is ongoing support for Aboriginal Community Controlled Health Services as exemplars of community participation in Australia. Primary health-care organisations and service providers are encouraged to consider participatory mechanisms where participation is an engaged and developmental process and people are actively involved in determining priorities and implementing solutions.

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