Burnout and its Association with Musculoskeletal Pain among Primary Care Providers

2017 ◽  
Vol 61 (1) ◽  
pp. 1010-1014 ◽  
Author(s):  
Xuanxuan Zhang ◽  
Mark C. Schall ◽  
Richard Sesek ◽  
Sean Gallagher ◽  
Jesse Michel
Keyword(s):  
Primary Care ◽  
Musculoskeletal Pain ◽  
Healthcare Providers ◽  
Primary Care Providers ◽  
Care Providers ◽  
Cross Sectional ◽  
Body Regions ◽  
Increased Risk ◽  
The Right

Burnout is a growing concern among primary care providers (PCPs). The condition may lead to diminished quality of patient care as well as reduced quality of life. Although self-reported musculoskeletal pain is common among healthcare providers, the relationship between burnout and musculoskeletal pain among PCPs has been studied very little. We describe a cross-sectional pilot survey conducted among 38 PCPs (MDs, DOs, PAs, and NPs) in the Midwestern United States. Self-reported feelings of burnout and musculoskeletal pain in different body regions were analyzed using regression models. Results suggested that increasing number of hours worked per day, severity of pain in the neck / shoulder area, and severity of pain in the right wrist were associated with an increased risk of burnout. On the contrary, burnout decreased with increasing age. The findings suggest that additional research is needed to understand the risk factors for burnout among PCPs, particularly during the early stages of their career.

Associations of Eczema Severity and Parent Knowledge With Child Quality of Life in a Pediatric Primary Care Population

2018 ◽  
Vol 57 (13) ◽  
pp. 1506-1514 ◽  
Author(s):  
Corinna J. Rea ◽  
Katherine D. Tran ◽  
Maria Jorina ◽  
Larissa M. Wenren ◽  
Elena B. Hawryluk ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Primary Care ◽  
Treatment Plan ◽  
Life Quality ◽  
Primary Care Providers ◽  
Individual Treatment ◽  
Care Providers ◽  
Large Hospital ◽  
Cross Sectional

We investigated factors associated with quality of life (QOL) in children with eczema. We conducted a cross-sectional analysis of survey data from 224 parents of children with eczema attending a large, hospital-based pediatric clinic. Parents completed a validated eczema severity scale (Patient-Oriented Eczema Measure), a QOL scale (Infants’ Dermatitis QOL Index or Children’s Dermatology Life Quality Index), and a knowledge and understanding questionnaire. In adjusted multivariate analyses, worse eczema severity was associated with worse overall QOL (β = 0.5; 95% confidence interval [CI] = [0.5, 0.6]), while a higher knowledge score was associated with better QOL (β = −3.4; 95% CI = [−6.6, −0.2]). Similarly, even after adjustment for eczema severity, greater understanding of a child’s individual treatment plan was associated with better QOL (β = −0.7; 95% CI = [−1.4, −0.08]), while increased frequency of worrying about a child’s eczema was associated with worse QOL (β = 0.7; 95% CI = [0.03, 1.1]). These results suggest primary care providers may be able to influence QOL through optimal eczema management and family education.

Primary Care of Opioid use Disorder: The End of “the French Model”?

2020 ◽  
Vol 26 (6) ◽  
pp. 346-354 ◽  
Author(s):  
Julie Dupouy ◽  
Sandy Maumus-Robert ◽  
Yohann Mansiaux ◽  
Antoine Pariente ◽  
Maryse Lapeyre-Mestre
Keyword(s):  
Primary Care ◽  
Private Practice ◽  
Primary Care Providers ◽  
Opioid Use Disorder ◽  
Care Providers ◽  
Opioid Use ◽  
Access To Treatment ◽  
Cross Sectional ◽  
Number Of Patients ◽  
French Model

<b><i>Background:</i></b> In France, most patients with opioid use disorder (OUD) have been treated by buprenorphine, prescribed by general practitioners (GP) in private practice since 1996. This has contributed to building a ‘French model’ facilitating access to treatment based on the involvement of GPs in buprenorphine prescription. <b><i>Objectives:</i></b> Our study aimed to assess whether the involvement of primary care in OUD management has changed lately. <b><i>Materials and Methods:</i></b> Using data from the French National Health Insurance database, we conducted a yearly repeated cross-sectional study (2009–2015) and described proportion of opioid maintenance treatment (OMT)-prescribing GPs and OMT-dispensing community pharmacies (CP); and number of patients by GP or CP. <b><i>Results:</i></b> Whereas the number of buprenorphine-prescribing GPs in private practice remained quite stable (decrease of 3%), a substantial decrease in buprenorphine initial prescribers among private GPs was observed. In 2009, 10.3% of private GPs (6,297 from 61,301 French private GPs) prescribed buprenorphine for the initiation of a treatment, whereas they were 5.7% (<i>n</i> = 3,539 from 62,071 private GPs) in 2015 (43.8% decrease). GPs issuing initial prescriptions of buprenorphine tended to care for a higher number of patients treated by buprenorphine (14.6 ± 27.1 patients in 2009 to 16.0 ± 35.4 patients in 2015). The number of CPs dispensing buprenorphine remained quite stable (decrease of 2%), while there was a 7.5% decrease in the total number of French CPs across the study period. <b><i>Conclusions:</i></b> Our results suggest that primary care providers seem less engaged in buprenorphine initiation in OUD patients, while CPs have not modified their involvement towards these patients.

Pearls and pitfalls for prescribing opioids in a climate of increased provider scrutiny

2017 ◽  
Vol 52 (2) ◽  
pp. 190-195
Author(s):  
Joanna Gedzior ◽  
Arlen Kwong
Keyword(s):  
Primary Care ◽  
Healthcare Providers ◽  
Primary Care Providers ◽  
Opiate Addiction ◽  
Opioid Epidemic ◽  
Care Providers ◽  
Health Crisis ◽  
Surgeon General

In August 2016, U.S. Surgeon General Vivek Murthy, MD, MBA, issued a letter to healthcare providers requesting aid in addressing “an urgent health crisis facing America: the opioid epidemic.” In this article, we address some of the more poignant challenges that surface in treating patients with opiate addiction. We provide an outline of recommendations from the leading medical organizations to educate primary care providers on how to navigate patients to decreased or discontinued medication loads.

scholarly journals Private ownership of primary care providers associated with patient perceived quality of care

Medicine ◽  
2017 ◽  
Vol 96 (1) ◽  
pp. e5755 ◽  
Author(s):  
Xiaolin Wei ◽  
Jia Yin ◽  
Samuel Y.S. Wong ◽  
Sian M. Griffiths ◽  
Guanyang Zou ◽  
...  
Keyword(s):  
Primary Care ◽  
Quality Of Care ◽  
Primary Care Providers ◽  
Perceived Quality ◽  
Private Ownership ◽  
Care Providers ◽  
Perceived Quality Of Care

scholarly journals Is quality maternal healthcare all about successful childbirth? Views of mothers in the Wa Municipality, Ghana

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0257401
Author(s):  
Linus Baatiema ◽  
Augustine Tanle ◽  
Eugene Kofuor Maafo Darteh ◽  
Edward Kwabena Ameyaw
Keyword(s):  
Service Delivery ◽  
Maternity Care ◽  
Healthcare Providers ◽  
Care Providers ◽  
Maternal Healthcare ◽  
Cross Sectional ◽  
West Region ◽  
Adverse Pregnancy ◽  
Wa Municipality

Introduction In spite of the countless initiatives of the Ghana government to improve the quality of maternal healthcare, Upper West Region still records poor childbirth outcomes. This study, therefore, explored women’s perception of the quality of maternal healthcare they receive in the Wa Municipality of the Upper West Region of Ghana. Materials and methods This is a qualitative cross-sectional study of 62 women who accessed maternal healthcare in the Wa Municipality of Ghana. We analysed the transcripts using the analytic inductive technique. An inter-coding technique (testing for inter-coding agreement) was employed. The iterative coding process resulted in a coding scheme with four main themes. We used peer-debriefing technique in ensuring credibility and trustworthiness. Results Logistics and equipment; referral service; empathic service delivery; inadequacy of care providers; affordability of service; satisfaction with services received; as well as experience and service delivery were the parameters used by the women in assessing quality maternity care. A number of gaps were reported in the healthcare system including limited healthcare providers, limited beds and inefficient referral system. Conversely, some of them reported that some healthcare providers offered empathetic healthcare. Contrary views were expressed with respect to satisfaction with maternity care. Conclusion Government and all stakeholders seeking to enhance quality of maternal health and accelerate the attainment of the third Sustainable Development Goal need to reconsider the financing of service delivery at health institutions. Indeed, our findings have illustrated that routine workshops on empathetic healthcare are required in efforts to increase the rate of facility-based childbirth, and thereby subside maternal mortality and all adverse pregnancy outcomes.

Musculoskeletal Pain and Impact on Performance in Orchestra Musicians and Actors

2004 ◽  
Vol 19 (2) ◽  
pp. 55-61
Author(s):  
K Engquist ◽  
P Ørbaek ◽  
K Jakobsson
Keyword(s):  
Musculoskeletal Pain ◽  
Odds Ratio ◽  
Reference Group ◽  
Study Groups ◽  
Physical Work ◽  
Prevalence Odds Ratio ◽  
Cross Sectional ◽  
Body Regions ◽  
Increased Risk ◽  
The Impact

We studied the prevalence of musculoskeletal pain and its impact on performance in orchestra musicians and in a reference group of actors, who share the mental stress in a performance situation, but without having the physical work load from an instrument. Swedish musicians (n = 103) from symphony and chamber orchestras and actors (n = 106) participated in a cross-sectional questionnaire study. Musculoskeletal pain was assessed by a further developed Standardized Nordic Questionnaire. The impact of pain on performance (pain affecting playing capacity, decreased playing time, and change of technique) and trouble-related sick leave also was assessed. Pain intensity was assessed by visual analogue scales. Musculoskeletal pain in the neck and shoulders was the most frequently reported problem, with similar prevalence among musicians and actors, around 25% for present pain and 20% for chronic pain (1-year prevalence). Around 10% of the musicians and 5% of the actors reported pain in the hands. Oral pain was reported by 12% of the musicians and 18% of the actors. The number of affected body regions and the intensity of pain were similar in the study groups. The musicians had an increased risk for pain affecting playing capacity. For the neck, the prevalence odds ratio (POR) was 3.0 (95%CI 1.2-7.2; adjusted for age and gender). String instrumentalists had higher risk estimates than nonstring instrumentalists. A gender difference was not observed. Pain in the oral region affecting playing capacity was less common in musicians, with a prevalence odds ratio of 0.4 (95%CI 0.1-0.8). Even though the prevalence of musculoskeletal pain was similar in the two groups of performing artists, the consequences for the work situation were more serious among musicians.

Improving diagnosis and treatment of benign paroxysmal positional vertigo

2021 ◽  
pp. 42-46
Author(s):  
Larry D. McIntire ◽  
Kindall Martin ◽  
Kunal Shah ◽  
Lauren Malinowski ◽  
John Paulson
Keyword(s):  
Primary Care ◽  
Population Health ◽  
Healthcare Costs ◽  
Benign Paroxysmal Positional Vertigo ◽  
Primary Care Providers ◽  
Diagnosis And Treatment ◽  
Care Providers ◽  
Positional Vertigo ◽  
Paroxysmal Positional Vertigo

Background: Vertigo is defined as an illusion of motion caused by a mismatch of information between the visual, vestibular and somatosensory systems. The most common diagnosis associated with whirling vertigo is benign paroxysmal positional vertigo (BPPV), which affects approximately 3.4% of patients older than 60 years of age. Objective: This paper aims to educate primary care providers on how to diagnose BPPV by performing canalith repositioning maneuvers at the initial point of care. Timely treatment of BPPV in the primary care office is believed to reduce healthcare costs by way of limiting unnecessary diagnostic testing and lowering referrals for specialty care. Immediate treatment is also believed to improve the quality of healthcare delivery for the vertigo patient by reducing morbidity and resolving the condition without the need for referrals or imaging. Population Health: A review of the literature finds that delayed diagnosis and treatment of BPPV is associated with a host of deleterious effects on patients. Population health impacts include increased rates of anxiety and depression; loss of work and/or change of career paths; inappropriate use of medications or emergency care resources; decreased access to healthcare services; increased healthcare costs; and reduced quality of care. Diagnosis: A history of positional vertigo and evidence of nystagmus with Dix-Hallpike positioning confirms the diagnosis. A detailed description of the performance of this test is elucidated. Treatment: The observed nystagmus is analyzed and classified based on directionality. Treatment can be initiated immediately with canalith repositioning maneuvers.

scholarly journals Stressors Facing Home-Based Primary Care Providers

Geriatrics ◽  
2019 ◽  
Vol 4 (1) ◽  
pp. 17 ◽  
Author(s):  
Katherine O’Brien ◽  
Sara Bradley ◽  
Vanessa Ramirez-Zohfeld ◽  
Lee Lindquist
Keyword(s):  
Primary Care ◽  
Primary Care Providers ◽  
The United States ◽  
Care Providers ◽  
Cross Sectional ◽  
Home Setting ◽  
Caregiver Support ◽  
Qualitative Survey ◽  
Home Based Primary Care ◽  
Home Based

The numbers of homebound patients in the United States are increasing. Home-based primary care (HBPC) is an effective model of interdisciplinary care that has been shown to have high patient satisfaction rates and excellent clinical outcomes. However, there are few clinicians that practice HBPC and clinicians that do face additional stressors. This study sought to better understand the stressors that HBPC providers face in caring for homebound patients. This was a cross-sectional qualitative survey and analysis of HBPC providers. Responses were categorized into four themes: The patient in the home setting, caregiver support, logistics, and administrative concerns. This research is the first to analyze the stressors that providers of HBPC face in serving the needs of complex homebound patients. Awareness and attention to these issues will be important for the future sustainability of home-based primary care.

scholarly journals Barriers to and solutions for addressing insufficient professional interpreter use in primary healthcare

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Fabienne N. Jaeger ◽  
Nicole Pellaud ◽  
Bénédicte Laville ◽  
Pierre Klauser
Keyword(s):  
Primary Care ◽  
Primary Care Physicians ◽  
Primary Care Providers ◽  
Care Providers ◽  
Key Factors ◽  
Cross Sectional ◽  
Interpreter Use ◽  
Health Authorities ◽  
Professional Interpreter ◽  
Paediatric Primary Care

Abstract Background The aim of this nationwide study was to investigate barriers to adequate professional interpreter use and to describe existing initiatives and identify key factors for successful interpreter policies in primary care, using Switzerland as a case study. Methods Adult and paediatric primary care providers were invited to participate in an online cross-sectional questionnaire-based study. All accredited regional interpreter agencies were contacted first by email and, in the absence of a reply, by mail and then by phone. Local as well as the national health authorities were asked about existing policies. Results 599 primary care physicians participated. Among other reasons, physicians identified cumbersome organization (58.7%), absent financial coverage (53.7%) and lack of knowledge on how to arrange interpreter interventions (44%) as main barriers. The odds of organising professional interpreters were 6.6-times higher with full financial coverage. Some agencies confirmed difficulties providing professional interpreters for certain languages at a timely manner. Degrees of coverage of professional interpreter costs (full coverage to none) and organization varied between regions resulting in different levels of unmet needs. Conclusions Professional interpreter use can be improved through the following points: increase awareness and knowledge of primary care providers on interpreter use and organization, ensure financial coverage, as well as address organizational aspects. Examples of successful interventions exist.

Predictors and Outcomes of Burnout Among Primary Care Providers in the United States: A Systematic Review

2019 ◽  
Vol 77 (5) ◽  
pp. 387-401 ◽  
Author(s):  
Cilgy M. Abraham ◽  
Katherine Zheng ◽  
Lusine Poghosyan
Keyword(s):  
United States ◽  
Primary Care ◽  
Primary Care Providers ◽  
The United States ◽  
Organizational Level ◽  
Care Practice ◽  
Practice Environment ◽  
Care Providers ◽  
Cross Sectional ◽  
Study Designs

Primary care providers (PCPs) in the United States work in challenging environments and may be at risk for burnout. This article identifies the predictors and outcomes of burnout among PCPs in the United States. A comprehensive literature search of eight databases was conducted to identify studies investigating predictors or outcomes of PCP burnout. The Joanna Briggs Institute’s critical appraisal checklists for cross-sectional and cohort studies were used for quality appraisal. Overall, 21 studies met inclusion criteria, had sufficient quality, reported personal and/or organizational predictors of burnout, and described burnout outcomes at the patient, provider, or organizational level. Prevalence of PCP burnout ranged from 13.5% to 60%. The primary care practice environment was the most common predictor of PCP burnout. In conclusion, developing interventions to improve the practice environment may help reduce PCP burnout. Future studies using robust study designs and standardized instruments to consistently measure burnout are needed.

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