scholarly journals Effectiveness of the palliative care ‘Availability, Current issues and Anticipation’ (ACA) communication training programme for general practitioners on patient outcomes: A controlled trial

2014 ◽  
Vol 28 (8) ◽  
pp. 1036-1045 ◽  
Author(s):  
Willemjan Slort ◽  
Annette H Blankenstein ◽  
Bart PM Schweitzer ◽  
Dirk L Knol ◽  
Henriëtte E van der Horst ◽  
...  
Keyword(s):  
Palliative Care ◽  
General Practitioners ◽  
Patient Outcomes ◽  
Controlled Trial ◽  
Training Programme ◽  
Communication Training ◽  
Care Availability

scholarly journals The ACA training programme to improve communication between general practitioners and their palliative care patients: development and applicability

2012 ◽  
Vol 11 (1) ◽  
Author(s):  
Willemjan Slort ◽  
Annette H Blankenstein ◽  
Bernardina S Wanrooij ◽  
Henriëtte E van der Horst ◽  
Luc Deliens
Keyword(s):  
Palliative Care ◽  
General Practitioners ◽  
Training Programme

Training Medical Specialists in Communication about Medically Unexplained Physical Symptoms: Patient Outcomes from a Randomized Controlled Trial

2016 ◽  
Vol 6 (1) ◽  
pp. 50-60
Author(s):  
Anne Weiland ◽  
Annette H Blankenstein ◽  
Jan L Van Saase ◽  
Henk T Van der Molen ◽  
David Kosak ◽  
...  
Keyword(s):  
Patient Outcomes ◽  
Controlled Trial ◽  
Physical Symptoms ◽  
Communication Training ◽  
Medically Unexplained Physical Symptoms ◽  
Medical Specialists ◽  
Randomized Controlled ◽  
Medically Unexplained ◽  
Unexplained Physical Symptoms

Objectives: Medically unexplained physical symptoms (MUPS) burden patients in their well-being and functioning and have a prevalence of approximately 25-50% in primary and specialist care. Medical specialists often find patients with unexplained symptoms difficult to deal with, whereas patients are not always understood. We report effects on patient outcomes of an evidence-based MUPS-focused communication training for medical specialists.Methods: In a multi-center randomized controlled trial medical specialists and residents allocated to the intervention received a 14-hour MUPS-focused communication training. They practiced a patient-centered approach, including multi-factorial symptom exploration and explanation of MUPS with perpetuating factors. To study intervention effects, each doctor had to include three MUPS patients before and three after the intervention and to ask them to complete questionnaires at baseline and at 3 and 6 months follow-up. The questionnaires included illness worries (Whitely Index), symptom severity (Visual Analogue Scale), distress, depression, anxiety and somatization (4DSQ) and daily functioning (SF-36).Results: A sufficient number of 123 medical specialists and residents participated in the study. They included 478 MUPS patients. Out  of them, 297 patients filled out questionnaires at baseline, 165 patients at 3-months follow-up and 71 patients at 6-months follow-up. Recruitment of patients was lower than expected and patients’ non-response to baseline and follow-up questionnaires was higher than estimated. No significant effects were found on patient outcomes.Conclusions: It remains unclear whether medical specialist training results in better patient outcomes in MUPS as the trial was underpowered. New research with special attention to patient recruitment and retention is needed to answer this question.

scholarly journals General practitioners’ views and experiences in caring for patients after sepsis: a qualitative interview study

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e040533
Author(s):  
Sabine Gehrke-Beck ◽  
Jochen Gensichen ◽  
Katrina M Turner ◽  
Christoph Heintze ◽  
Konrad FR Schmidt
Keyword(s):  
Primary Care ◽  
Critical Illness ◽  
General Practitioners ◽  
Continuity Of Care ◽  
Controlled Trial ◽  
Qualitative Interviews ◽  
Daily Practice ◽  
Training Programme ◽  
Qualitative Interview Study

BackgroundPatients surviving critical illnesses, such as sepsis, often suffer from long-term complications. After discharge from hospital, most patients are treated in primary care. Little is known how general practitioners (GPs) perform critical illness aftercare and how it can be improved. Within a randomised controlled trial, an outreach training programme has been developed and applied.ObjectivesThe aim of this study is to describe GPs’ views and experiences of caring for postsepsis patients and of participating a specific outreach training.DesignSemistructured qualitative interviews.Setting14 primary care practices in the metropolitan area of Berlin, Germany.Participants14 GPs who had participated in a structured sepsis aftercare programme in primary care.ResultsThemes identified in sepsis aftercare were: continuity of care and good relationship with patients, GP’s experiences during their patient’s critical illness and impact of persisting symptoms. An outreach education as part of the intervention was considered by the GPs to be acceptable, helpful to improve knowledge of the management of postintensive care complications and useful for sepsis aftercare in daily practice.ConclusionsGPs provide continuity of care to patients surviving sepsis. Better communication at the intensive care unit–GP interface and training in management of long-term complications of sepsis may be helpful to improve sepsis aftercare.Trial registration numberISRCTN61744782.

scholarly journals Effects and Challenges Regarding Supervision in Palliative Care Teams: Results of a 5-Year Study in South Tyrol (Italy)

2020 ◽  
Keyword(s):  
Palliative Care ◽  
General Practitioners ◽  
Clinical Supervision ◽  
Controlled Trial ◽  
Well Being ◽  
Family Doctors ◽  
Palliative Care Teams ◽  
Positive Assessment ◽  
The Individual

Objective: Evaluating a solution-oriented clinical supervision to improve the quality of care. Design: We performed a randomized, longitudinal controlled trial. A total of 32 health districts were involved in the study. For the evaluation of the intervention, the following dimensions were collected as indicators of the quality of supervision: Quality of life (FACT-G, SF12, POS), psychological stress, depression, burn-out (HADS, BDI-II, VAS scales, HPS), sense of coherence (SOC-13), satisfaction with care, communication and support from the patients and relatives (VAS scales) and working conditions (COPSOQ) from the nursing staff and family doctors. Results: Of the 85 subscales, the SOC Nursing Sum Score (p=0.017), the SF-12 Nursing Sum Scale (p=0.036), and the COPSOQ Scales of General Practitioners showed significant differences in developmental opportunities (p=0.020), leadership (p=0.003), social support (p=0.001) and community spirit (p=0.024). At the second point time of the study, significant differences were found in the subscales of the Palliative Care Outcome Scale (POS) and the subscale of the test instrument Functional Assessment of Cancer Therapy - General (FACT-G) FUNCTIONAL WELL-BEING of the patients. The satisfaction values of nurses and general practitioners with the supervision showed an extremely positive assessment of both nurses and general practitioners regarding supervision. Conclusions: Supervision affects positively the process of palliative home care. It seems important to adjust the number of supervision meetings according to the needs of the individual team in order to achieve an optimized team performance.

scholarly journals Effectiveness of the ACA (Availability, Current issues and Anticipation) training programme on GP-patient communication in palliative care; a controlled trial

2013 ◽  
Vol 14 (1) ◽  
Author(s):  
Willemjan Slort ◽  
Annette H Blankenstein ◽  
Bart PM Schweitzer ◽  
Dirk L Knol ◽  
Luc Deliens ◽  
...  
Keyword(s):  
Palliative Care ◽  
Controlled Trial ◽  
Training Programme ◽  
Patient Communication

scholarly journals Training general practitioners contributes to the identification of palliative patients and to multidimensional care provision: secondary outcomes of an RCT

2016 ◽  
Vol 9 (1) ◽  
pp. e18-e18 ◽  
Author(s):  
Bregje Thoonsen ◽  
Stefanie H M Gerritzen ◽  
Kris C P Vissers ◽  
Stans Verhagen ◽  
Chris van Weel ◽  
...  
Keyword(s):  
Palliative Care ◽  
General Practitioners ◽  
Intervention Group ◽  
Multidisciplinary Care ◽  
Training Programme ◽  
Chronic Obstructive ◽  
Care Needs ◽  
Early Palliative Care ◽  
Contact Frequency ◽  
Palliative Patients

IntroductionTo support general practitioners (GPs) in providing early palliative care to patients with cancer, chronic obstructive pulmonary disease or heart failure, the RADboud university medical centre indicators for PAlliative Care needs tool (RADPAC) and a training programme were developed to identify such patients and to facilitate anticipatory palliative care planning. We studied whether GPs, after 1 year of training, identified more palliative patients, and provided multidimensional and multidisciplinary care more often than untrained GPs.MethodsWe performed a survey 1 year after GPs in the intervention group of an RCT were trained. With the help of a questionnaire, all 134 GPs were asked how many palliative patients they had identified, and whether anticipatory care was provided. We studied number of identified palliative patients, expected lifetime, contact frequency, whether multidimensional care was provided and which other disciplines were involved.ResultsTrained GPs identified more palliative patients than did untrained GPs (median 3 vs 2; p 0.046) and more often provided multidimensional palliative care (p 0.024). In both groups, most identified patients had cancer.ConclusionsRADPAC sensitises GPs in the identification of palliative patients. Trained GPs more often provided multidimensional palliative care. Further adaptation and evaluation of the tools and training are necessary to improve early palliative care for patients with organ failure.Trial registration numberNTR2815; post results.

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