scholarly journals Facilitating Guideline Implementation in Primary Health Care Practices

2020 ◽  
Vol 11 ◽  
pp. 215013272091626
Author(s):  
Sanne Peters ◽  
André Bussières ◽  
Bart Depreitere ◽  
Stijn Vanholle ◽  
Julie Cristens ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Health Professionals ◽  
Health Care Professionals ◽  
Care Setting ◽  
Primary Care Setting ◽  
Guideline Implementation ◽  
Multidisciplinary Teams ◽  
Primary Health ◽  
Care Practices

Introduction: Many patients continue to receive suboptimal services, inappropriate, unsafe, and costly care. Underutilization of research by health professionals is a common problem in the primary care setting. Although many theoretical frameworks can be used to help address such evidence-practice gaps, health care professionals may not be aware of the benefits of frameworks or of the most appropriate ones for their context and thus, may be faced with the challenge of selecting and using the most relevant one. Aim: The aim of this article was to describe the process used to adapt a knowledge translation framework to meet the local needs of health professionals working in one large primary care setting. Methods: The authors developed a 5-step approach for guideline implementation. This approach was informed by prior research and the authors’ experiences in supporting multidisciplinary teams of health care professionals during the implementation of evidence-based clinical guidelines into primary care practices. To ensure that the 5-step approach was practical and suitable for the context of guideline implementation by multidisciplinary teams in primary health care, the implementation team adapted the “knowledge-to-action” framework using a multistep process. Results: The implementation approach consisted of the following 5 steps: identification, context analysis, development of implementation plan, evaluation, and sustainability. All 5 steps were described alongside details about a national low back pain project. Discussion: This article describes a collaborative, grassroots process that addressed an identified need in one complex context by adapting a knowledge translation framework to meet the local needs of health professionals working in primary care settings. Existing implementation frameworks may be too complex or abstract for use in busy clinical contexts. The 5-step approach presented in this paper resulted in practical steps that are more readily understood by health care professionals and staff on “the ground.”

scholarly journals Body Mass Index Assessment of Health Care Professionals in a Primary Care Setting in Portugal: a Cross Sectional Study

2014 ◽  
Vol 27 (5) ◽  
pp. 609 ◽  
Author(s):  
Inês Campos-Matos ◽  
André Peralta-Santos ◽  
Bernardo Gomes ◽  
Gustavo Borges ◽  
Pedro Aguiar
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Body Mass Index ◽  
Primary Health Care ◽  
Body Mass ◽  
Health Care Professionals ◽  
Care Setting ◽  
Primary Care Setting ◽  
Cross Sectional ◽  
Primary Health

<p><strong>Introduction:</strong> Obesity is an important public health problem because it is a risk factor for numerous diseases and is associated with a higher death risk. Evidence concerning the prevalence of excess weight in health professionals is scarce and this group is often overlooked in weight interventions programs. This paper aims to estimate the prevalence of obesity and overweight among Portuguese primary health care professionals and to describe differences between occupational groups.<br /><strong>Material and Methods:</strong> This was a cross sectional study based on a primary care setting in Portugal in 2011. We collected data on occupation, age, sex and height of professionals from four primary care centers. We did a descriptive analysis of the main variables and an analysis of covariance to compare mean Body Mass Index.<br /><strong>Results:</strong> Our sample represented 52.8% of the total population of the four primary care centers, and 38.6% were overweight and 16.9% were obese. When adjusted for age and gender, health service personnel had the highest average Body Mass Index, followed by nurses, physicians, and superior technicians, in that order.<br /><strong>Discussion:</strong> Although we can’t ensure the generalisation of the results and cannot exclude the possibility of sampling bias, these results suggest high prevalence obesity and overweight in workers of primary health care in Portugal.<br /><strong>Conclusion:</strong> In this primary care setting more than half of the health care professionals were overweight or obese. Tailored interventions might be needed to tackle this issue.</p><p><br /><strong>Keywords:</strong> Body Mass Index; Health Personnel; Obesity; Portugal; Primary Health Care; Prevalence.</p>

scholarly journals Physical activity promotion in the health care setting in Switzerland

2014 ◽  
Vol 62 (2) ◽  
Keyword(s):  
Physical Activity ◽  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Health Professionals ◽  
Care Setting ◽  
Physical Activity Promotion ◽  
Health Care Setting ◽  
Primary Health ◽  
Activity Promotion

The role of regular physical activity for population health has been clearly documented. Improvements in population levels of physical activity require long-term implementation of a combination of measures, including the evidence based approaches described in the “seven best investments for physical activity” (www.globalpa.org.uk): whole-of-school programmes, transport, urban planning, integration of physical activity promotion into primary health care systems, public education, community-wide programmes, sport for all. The health care setting has a particular role in this context, particularly in its access to physically inactive individuals. Switzerland has seen a number of successful research projects in this field, but there has been no wide adaptation of these approaches in the medical community. In recent years, a group of institutions including the Swiss College of Primary Care Medicine, the Policlinique Médicale Universitaire in Lausanne, the Ligue Vaudoise contre les Maladies Cardiovasculaires and the Institute of Social and Preventive Medicine of the University of Zurich have therefore focussed on the development of a physical activity counselling approach based on international evidence as well as on established tools, but streamlined to the specific demands of primary health care providers in Switzerland. PAPRICA (Physical Activity Promotion in Primary Care, www.paprica.ch) has been the result of these developments, and nearly 300 health professionals, most of them primary care physicians, have been successfully trained so far. PAPRICA is implemented together with the Swiss Society for Sports Medicine and a number of regional partners. The development of a national programme structure is currently under preparation. This will allow Switzerland to explore and better use the potential of physicians and other health professionals in the promotion of physical activity and in the fight against non-communicable diseases.

The ‘Research Magnificent’ in Late Life: Psychiatric Epidemiology and the Primary Health Care of Older Adults

1997 ◽  
Vol 27 (3) ◽  
pp. 185-204 ◽  
Author(s):  
Joseph J. Gallo ◽  
Peter V. Rabins ◽  
Steve Iliffe
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Primary Care ◽  
Health Care ◽  
Primary Care Physicians ◽  
Care Setting ◽  
Primary Care Setting ◽  
Psychiatric Epidemiology ◽  
Primary Health ◽  
Mental Disturbances

Objective: Primary care occupies a strategic position in the evaluation, treatment, and prevention of the mental disturbances of later life. This article highlights four themes that are crucial to understanding mental disturbances among older adults: 1) subsyndromal depression, 2) coexisting depression and anxiety, 3) comorbidity of depression and chronic medical conditions, and 4) risk factors for cognitive impairment. Method: The literature was selectively reviewed for each theme to ask the central question, “What can primary care physicians learn about mental disturbances of their older patients from epidemiologic and community studies?” Results: The primary care setting itself is an important venue for an examination of aging issues and mental health. Workers in the “middle ground of psychiatric epidemiology”—primary health care—have not yet reached a full appreciation for the value of research in the primary care setting for enhancing our understanding of the mental disturbances of late life, and how these intersect with other salient factors. Conclusions: Primary care physicians and others who work in primary care should advocate for further mental health integration and research in primary care. Research is needed that will lead to new ways of maximizing the health and quality of life of older adults and their families.

scholarly journals Levels of engagement in primary health care professionals: a comparative study in two Brazilian municipalities

2019 ◽  
Vol 23 (3) ◽  
Author(s):  
Luciano Garcia Lourenção ◽  
Albertina Gomes da Silva ◽  
Márcio Andrade Borges
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Community Health ◽  
Health Professionals ◽  
Health Care Professionals ◽  
Care Services ◽  
Primary Health ◽  
Primary Care Services ◽  
Significant Difference

Abstract Objective: To evaluate the levels of engagement of Primary Health Care professionals in two municipalities. Methods: A descriptive study was carried out with 238 health professionals who work in the Primary Care services of two municipalities in the state of São Paulo. The engagement dimensions of the professionals were investigated through the Utrecht Work Engagement Scale. Results: Female predominance (82.8%), age under 40 years (52.9%). Median working time in primary care of three (municipality A), four years (municipality B). Significant difference in levels of engagement in both municipalities. Community health agents presented mean scores in all dimensions. Significant difference in levels of engagement according to professional category in all dimensions. Conclusion and implications for practice: Municipal health professionals with 100.0% coverage by the Family Health Strategy tend to have higher levels of engagement. Nurses presented greater engagement; community health workers reached lower levels than other professionals did. Engagement is an indicator that contributes to the evaluation of the workforce in the Primary Health Care services and can be used to direct strategies that improve the levels of dedication, absorption and vigor of the professionals, benefiting the organization of the primary care services.

scholarly journals Exacerbations and health care resource utilization in patients with airflow limitation diseases attending a primary care setting: the PUMA study

2016 ◽  
Vol Volume 11 ◽  
pp. 3059-3067 ◽  
Author(s):  
Maria Montes de Oca ◽  
Carlos Aguirre ◽  
Maria Victorina Lopez Varela ◽  
Maria Laucho-Contreras ◽  
Alejandro Casas ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Resource Utilization ◽  
Care Setting ◽  
Primary Care Setting ◽  
Health Care Resource ◽  
Airflow Limitation ◽  
Health Care Resource Utilization

scholarly journals Comprehensiveness and programmatic vulnerability to stds/hiv/aids in primary care

2014 ◽  
Vol 48 (spe) ◽  
pp. 145-151 ◽  
Author(s):  
Luciane Ferreira do Val ◽  
Lucia Yasuko Izumi Nichiata
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Prenatal Care ◽  
Online Survey ◽  
Health Centers ◽  
Multidisciplinary Teams ◽  
Primary Health ◽  
The City ◽  
Hiv Aids




This study aimed to identify programmatic vulnerability to STDs/HIV/AIDS in primary health centers (PHCs). This is a descrip - tive and quantitative study carried out in the city of São Paulo. An online survey was applied (FormSUS platform), involving administrators from 442 PHCs in the city, with responses received from 328 of them (74.2%), of which 53.6% were nurses. At - tention was raised in relation to program - matic vulnerability in the PHCs regarding certain items of infrastructure, prevention, treatment, prenatal care and integration among services on STDs/HIV/AIDS care. It was concluded that in order to reach comprehensiveness of actions for HIV/ AIDS in primary health care, it is necessary to consider programmatic vulnerability, in addition to more investment and reor - ganization of services in a dialogue with the stakeholders (users, multidisciplinary teams, and managers, among others).




scholarly journals Workshop: Health workforce meets HSR: Tackling regional inequalities in health service provision

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Health Services ◽  
Health Workforce ◽  
Health Care Professionals ◽  
Rural Areas ◽  
Hospital Care ◽  
Health Service Provision ◽  
Care Practices ◽  
Do So

Abstract Background Many countries across Europe are facing considerable challenges in providing accessible and high quality care regardless of where people live. A major element is the difficulty that countries face to attract and retain health care professionals to work in remote and rural areas. This applies to primary care services as well as to hospital care, and to the care provided by physicians and other health professionals, including nurses. A widely shared question is therefore how to safeguard access to health care in rural areas and to solve recruitment and retention problems in such regions, both of medical and nursing staff. The workshop will build on last year’s joint workshop of the Sections on HSR and HWR that ended with questions related to how to organize accessible and equitable health services including the workforces required to do so. Objectives This workshop will provide a snapshot of studies from across the European region, with a particular focus on differences between rural and urban health care practices and the types of solutions being used to reduce regional disparities in provision of care. This often refers to retention and recruitment strategies, but the session will also address other types of solutions in the organization of care that can help ensure accessible care, including in vulnerable regions and settings. Tackling this challenge will therefore require a joint approach, tapping into experience from health workforce research as well as wider health services research, bringing together research into the organization and management of healthcare and into the health human resources providing this care, operated from different angles and being informed by different research traditions and data sources. Based on statements, we will discuss the topic of how to organize accessible and equitable health services including the workforces required to do so after the presentations. Key messages Workforce policies should focus on retaining primary care workforce in rural areas and integrated policies should attract new primary care practices. Both in primary care and hospital care new solutions are being sought which should help resolve regional differences in access to care and attractiveness for the health workforce.

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