scholarly journals General practitioners’ perspectives on care coordination in primary health care: A qualitative study

2018 ◽  
Vol 21 (4) ◽  
pp. 153-159 ◽  
Author(s):  
Ane Drougge Vassbotn ◽  
Hege Sjøvik ◽  
Trond Tjerbo ◽  
Jan Frich ◽  
Ivan Spehar
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Qualitative Study ◽  
General Practitioners ◽  
Care Coordination ◽  
Health Care Professionals ◽  
System Level ◽  
Financial Barriers ◽  
Financial Compensation ◽  
Primary Health

Introduction To explore Norwegian general practitioners’ experiences with care coordination in primary health care. Methods Qualitative study using data from five focus groups with 32 general practitioners in Norway. We analysed the data using systematic text condensation, a descriptive and explorative method for thematic cross-case analysis of qualitative data. Results The general practitioners had different notions of care pathways. They expressed a wish and an obligation to be involved in planning and coordination of primary health-care services, but they experienced organisational and financial barriers that limited their involvement and contribution. General practitioners reported lack of information about and few opportunities for involvement in formal coordination initiatives, and they missed informal arenas for dialogue with other primary health-care professionals. They argued that the general practitioner’s role as coordinator should be recognised by other parties and that they needed financial compensation for contributions and attendance in meetings with the municipality. Discussion General practitioners need informal arenas for dialogue with other primary health-care professionals and access to relevant information to promote coordinated care. There might be an untapped potential for improving patient care involving general practitioners more in planning and coordinating services at the system level. Financial compensation of general practitioners contribution may promote increased involvement by general practitioners.

scholarly journals General practitioners’ views on leadership roles and challenges in primary health care: a qualitative study

2017 ◽  
Vol 35 (1) ◽  
pp. 105-110 ◽  
Author(s):  
Ivan Spehar ◽  
Hege Sjøvik ◽  
Knut Ivar Karevold ◽  
Elin Olaug Rosvold ◽  
Jan C. Frich
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Qualitative Study ◽  
General Practitioners ◽  
Leadership Roles ◽  
Primary Health

scholarly journals The evaluation of knowledge and activities of primary health care professionals in promoting breast-feeding

Medicina ◽  
2009 ◽  
Vol 45 (3) ◽  
pp. 238 ◽  
Author(s):  
Giedra Levinienė ◽  
Aušra Petrauskienė ◽  
Eglė Tamulevičienė ◽  
Jolanta Kudzytė ◽  
Liutauras Labanauskas
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
General Practitioners ◽  
Breast Feeding ◽  
Health Professionals ◽  
Health Care Professionals ◽  
Primary Health ◽  
Breast Feed ◽  
Primary Health Care Centers ◽  
Health Care Centers

The objective of this study was to evaluate the knowledge and activities of Kaunas primary health care center professionals in promoting breast-feeding. Material and methods. A total of 84 general practitioners and 52 nurses participated in the survey, which was carried out in Kaunas primary health care centers in 2006. Data were gathered from the anonymous questionnaire. Results. Less than half of general practitioners (45.1%) and 65% of nurses were convinced that baby must be exclusively breast-fed until the age of 6 months, but only 21.6% of general practitioners and 27.5% of nurses knew that breast-feeding with complementary feeding should be continued until the age of 2 years and longer. Still 15.7% of general practitioners and 25% of nurses recommended pacifiers; 7.8% of general practitioners advised to breast-feed according to hours. Half of the health professionals recommended additional drinks between meals; onethird of them – to give complementary food for the babies before the age of 6 months. One-third (29.6%) of the health professionals surveyed recommended mothers to feed their babies more frequently in case the amount of breast milk decreased. Conclusions. The survey showed that knowledge of medical personnel in primary health care centers about the advantages of breast-feeding, prophylaxis of hypogalactia, and duration of breast-feeding was still insufficient.

scholarly journals Mental Health Stigma at Primary Health Care Centres in Lebanon: Qualitative Study

2021 ◽  
Author(s):  
Racha Abi Hana ◽  
Maguy Arnous ◽  
Eva Heim ◽  
Anaïs Aeschlimann ◽  
Mirja Koschorke ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Primary Health Care ◽  
Mental Disorders ◽  
Qualitative Study ◽  
Mental Health Professionals ◽  
System Level ◽  
Health Concern ◽  
Service Users ◽  
Primary Health

Abstract Background Mental health related stigma is a global public health concern and is considered a major barrier to seeking care. In this study, we explored the role of stigma as a barrier to scaling up mental health services in primary health care (PHC) centres in Lebanon. We focused on the experiences of PHC workers, while providing services to patients with mental disorders, and the perceptions of stigma or discrimination among individuals with mental illness and their families. This study was part of a larger multinational stigma reduction programme, called INDIGO-PRIMARY.Method Semi-structured qualitative interviews (n=46) were carried out, with policy makers (n=3), PHC management (n=4), PHC staff (n=24), service users and family members (n=15). The topic guides explored knowledge, implicit and explicit attitudes of staff, challenges of providing treatment, and patient outcomes including experiences of stigma. All interviews were coded using NVivo and analysed using a thematic coding framework.Results Results were analysed at five stigma-related layers: from structural stigma at the system level, down to provider-based stigma at PHC level, community level stigma, family stigma and self-stigma. Interestingly at the PHC level, stigma reporting differed among staff according to a power gradient. Service users described positive experiences in PHC. Nurses and social workers did not explicitly report incidents of stigma or discrimination but describing patients with mental health disorders as violent or uncooperative, underscored internalized negative views on mental health. GPs and directors were more outspoken than nurses regarding the challenges faced when dealing with mental health patients. Nevertheless, mental health professionals reported that things have been getting increasingly better over recent years.Conclusions This qualitative study revealed that stigma was still a major concern that affects patients with mental disorders and provided a deeper understanding on what should be done to decrease stigma at PHC centres; first addressing structural stigma by revising laws, second shaping interpersonal stigma, third commitment of PHC management to deliver high quality mental health integrated services, and fourth addressing intrapersonal stigma by building public empathy.

scholarly journals Integrative and complementary practices in Primary Care: unveiling health promotion

2020 ◽  
Vol 28 ◽  
Author(s):  
Indiara Sartori Dalmolin ◽  
Ivonete Teresinha Schülter Buss Heidemann
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Health Promotion ◽  
Primary Health Care ◽  
Qualitative Study ◽  
Health Care Professionals ◽  
Daily Life ◽  
Disease Process ◽  
Primary Health ◽  
Three Stages

Objective: to understand the use of integrative and complementary practices as a health promotion action. Method: qualitative study, action-participant type, with the application of Paulo Freire’s Research Itinerary, in which 30 Primary Health Care professionals participated. Thematic research was developed with two Primary Care Units, one that used integrative and complementary practices in daily life and another that focused more on allopathic concepts of assistance. To carry out the three stages of the method used, seven Culture Yarning Circles took place. The critical unveiling took place concurrently with the participation of those surveyed. Results: integrative and complementary practices constitute a form of health care, with the purpose of understanding the human being in the health-disease process, making it possible to work with the different aspects that involve them. In this way, they reduce damages resulting from the excessive use of medications, stimulate comprehensiveness and promote health. Conclusion: integrative and complementary practices are resources for health promotion, through comprehensive care and reducing the use of medications.

scholarly journals Barriers, Facilitators, and Proposals for Improvement in the Implementation of a Collaborative Care Program for Depression: A Qualitative Study of Primary Care Doctor and Nurse Experiences

2021 ◽  
Author(s):  
Enric Aragonès ◽  
Germán López-Cortacans ◽  
Narcís Cardoner ◽  
Catarina Tomé-Pires ◽  
Daniel Porta-Casteràs ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Qualitative Study ◽  
Collaborative Care ◽  
Health Care Professionals ◽  
Care Program ◽  
Primary Health ◽  
Primary Health Care Centers ◽  
Health Care Centers

Abstract Background: Primary care plays a central role in the treatment of depression. Nonetheless, shortcomings in its management and suboptimal outcomes have been identified. Collaborative care models improve processes for the management of depressive disorders and associated outcomes. We developed a strategy to implement the INDI collaborative care program for the management of depression in primary health care centers across Catalonia. The aim of this qualitative study was to evaluate a trial implementation of the program to identify barriers, facilitators, and proposals for improvement. Methods: One year after the implementation of the INDI program in 18 public primary health care centers we performed a qualitative study in which the opinions and experiences of 23 primary care doctors and nurses from the participating centers were explored in focus groups. We performed thematic content analysis of the focus group transcripts. Results: The results were organized into three categories: facilitators, barriers, and proposals for improvement as perceived by the health care professionals involved. The most important facilitator identified was the perception that the INDI collaborative care program could be a useful tool for reorganizing processes and improving the management of depression in primary care, currently viewed as deficient. The main barriers identified were of an organizational nature: heavy workloads, lack of time, high staff turnover and shortages, and competing demands. Additional obstacles were inertia and resistance to change among health care professionals. Proposals for improvement included institutional buy-in to guarantee enduring support and the organizational changes needed for successful implementation.Conclusions: The INDI program is perceived as a useful, viable program for improving the management of depression in primary care. Uptake by primary care centers and health care professionals, however, was poor. The identification and analysis of barriers and facilitators will help refine the strategy to achieve successful, widespread implementation.Trial registration: ClinicalTrials.gov identifier: NCT03285659; Registered 18th September, 2017.

scholarly journals General Practitioners’ Perspectives Over Solutions To Change BZD Prescription Trends – A Qualitative Study

2021 ◽  
Author(s):  
Teresa Reis ◽  
Helena Serra ◽  
Inês Faria ◽  
Miguel Xavier
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Qualitative Study ◽  
General Practitioners ◽  
Public Health Issue ◽  
Structured Interviews ◽  
Health Care Settings ◽  
Prescription Practices ◽  
Primary Health ◽  
Primary Health Care Settings

Abstract Background: This qualitative study explores General Practitioners’ (GPs) perspectives on solutions to address the problem of excessive prescription of benzodiazepines (BZDs). Over-prescription of BZDs at a primary health care settings is a prevalent issue in the region under analysis, but also elsewhere internationally. GPs are the gatekeepers to these medicines in primary care, but for several subjective, organizational and external reasons, they find it difficult to change current prescription patterns. Simultaneously, GPs recognize the issue of BZD excessive prescription practices, and propose possible solutions to invert the trend.Methods: Qualitative data were collected in seven primary health care centers in an interior and mostly rural region of Portugal. We conducted 12 semi-structured interviews with GPs. Interviews were audio-recorded, transcribed verbatim and underwent thematic analysis. The themes were integrated and organized into eight axes for action.Results: Solutions proposed by GPs focused on organizational aspects, such as human resources, infrastructure and training (including on withdrawal schemes), alternative approaches, and wider community-based initiatives to counter societal aspects affecting mental health in the identified region. The themes were integrated and organized into eight axes for action.Conclusions: The findings provide an assessment of the priorities to change excessive BZDs prescription, as suggested by the GPs in primary health care settings, and hence reflecting what they consider to be context specific needs. Both experts and multi-stakeholders bottom-up perspectives should be taken into account when proposing new policies and local strategies to tackle current excessive BZD prescription, especially considering the failure of previous strategies to change this well-known public health issue. We consider that our results to be generalizable to all countries where primary health care plays a central role in care provision.Trial registration: ClinicalTrials.gov number NCT04925596

Dilemmas at a Primary Health Care Center: a baseline study for Computer-Supported Cooperative Health Care Work

1992 ◽  
Vol 31 (03) ◽  
pp. 204-209 ◽  
Author(s):  
T. Timpka ◽  
J. M. Nyce
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
General Practitioners ◽  
Group Process ◽  
Critical Incident ◽  
Care Work ◽  
Work Activity ◽  
Health Care Center ◽  
Health Care Work ◽  
Primary Health

Abstract:For the development of computer-supported cooperative health care work this study investigated, based upon activity theory, daily dilemmas encountered by the members of interprofessional primary health care work groups. The entire staff at four Swedish primary health care centers were surveyed, 199 personal interviews being conducted by the Critical Incident Technique. Medical dilemmas were mainly reported by general practitioners and nurses, organizational dilemmas by laboratory staff, nurses’ aides, and secretaries, and dilemmas in the patient-provider relation by nurses, nurses’ aides, and secretaries. Organizational and communication dilemmas reported by nurses, nurses’ aides, and secretaries often had their cause outside the control of the individual professional. These dilemmas were often “caused” by other group members (general practitioners or nurses), e.g., by not keeping appointment times or by not sharing information with patients. The implication for computer-supported cooperative health care work is that computer support should be planned on two levels. Collective work activity as a whole should benefit from individual clinical decision support for general practitioners and nurses. However, since most patient communication and organizational problems occurred at group level, group process support is required in these areas.

Disaster Management in Rural and Remote Primary Health Care: A Scoping Review

2021 ◽  
Vol 36 (3) ◽  
pp. 362-369
Author(s):  
Katie A. Willson ◽  
Gerard J. FitzGerald ◽  
David Lim
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Primary Health Care ◽  
Mental Health Care ◽  
Disaster Management ◽  
Scoping Review ◽  
Health Care Professionals ◽  
Disaster Preparedness ◽  
Rural And Remote ◽  
Primary Health

AbstractObjective:This scoping review aims to map the roles of rural and remote primary health care professionals (PHCPs) during disasters.Introduction:Disasters can have catastrophic impacts on society and are broadly classified into natural events, man-made incidents, or a mixture of both. The PHCPs working in rural and remote communities face additional challenges when dealing with disasters and have significant roles during the Prevention, Preparedness, Response, and Recovery (PPRR) stages of disaster management.Methods:A Johanna Briggs Institute (JBI) scoping review methodology was utilized, and the search was conducted over seven electronic databases according to a priori protocol.Results:Forty-one papers were included and sixty-one roles were identified across the four stages of disaster management. The majority of disasters described within the literature were natural events and pandemics. Before a disaster occurs, PHCPs can build individual resilience through education. As recognized and respected leaders within their community, PHCPs are invaluable in assisting with disaster preparedness through being involved in organizations’ planning policies and contributing to natural disaster and pandemic surveillance. Key roles during the response stage include accommodating patient surge, triage, maintaining the health of the remaining population, instituting infection control, and ensuring a team-based approach to mental health care during the disaster. In the aftermath and recovery stage, rural and remote PHCPs provide long-term follow up, assisting patients in accessing post-disaster support including delivery of mental health care.Conclusion:Rural and remote PHCPs play significant roles within their community throughout the continuum of disaster management. As a consequence of their flexible scope of practice, PHCPs are well-placed to be involved during all stages of disaster, from building of community resilience and contributing to early alert of pandemics, to participating in the direct response when a disaster occurs and leading the way to recovery.

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