The safety netting behaviour of first contact clinicians: a qualitative study

Abstract Background Smoking cessation is a major public health issue. In France, primary care physicians (PCP) are the first contact points for tobacco management. The objective of this study was to understand how PCPs are involved in the management of smoking cessation: ownership, commitment, barriers. Methods A qualitative study was conducted using group and individual semi-structured techniques with PCPs. A thematic analysis of verbatim transcripts was performed to identify concepts and sub-concepts of interest. Saturation was evaluated retrospectively to ensure adequate sample size. Results A sample of 35 PCPs were interviewed, 31 in four focus groups and four in individual interviews. PCPs discussed their roles in the management of tobacco smoking cessation, including the different strategies they are using (e.g., Minimal Intervention Strategy, Motivational Interviewing), the multiple barriers encountered (e.g., lack of time, patients’ resistance to medical advice), the support resources and the treatment and intervention they prescribed (e.g. nicotine replacement therapy, supporting therapist). Conclusions This study provides a better understanding of the beliefs, attitudes, and behaviors of PCPs in managing smoking cessation. Guiding and encouraging patients toward smoking cessation remains a major objective of PCPs. While PCPs reported that progress has been made in recent years in terms of tools, technology and general awareness, they still face major barriers, some of which could be overcome by appropriate training.

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Care to the person in a terminal process in the perception of the nursing students

Rev Rene ◽

10.15253/2175-6783.2015000300015 ◽

2015 ◽

Vol 16 (3) ◽

Author(s):

Rudval Souza da Silva ◽

Claudia Cristina Souza Gribel Oliveira ◽

Álvaro Pereira ◽

Juliana Bezerra do Amaral

Keyword(s):

Data Analysis ◽

Nursing Students ◽

Qualitative Study ◽

Clinical Condition ◽

Theory And Practice ◽

Structured Interviews ◽

Nursing Team ◽

First Contact

Objective: to know the experiences of the nursing students regarding the care to the person in a terminal process. Methods:a qualitative study with data collected through semi-structured interviews held with ten nursing students. Results: fromthe data analysis, two theme categories emerged: Feelings expressed facing the first contact with the patients in a terminalprocess and care to the patient in a terminal process: dichotomy between theory and practice. When experiencing the careto the person in the dying process, students have shown that the feeling of helplessness was the most striking, among otherssuch as sadness, anguish and insecurity. Conclusion: the practices of care of the nursing team disagree with the academicdiscussions, denying the discourse that the nurse should be present with the patient, regardless of his clinical condition.

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Empowering Patients to Self-Manage Common Infections: Qualitative Study Informing the Development of an Evidence-Based Patient Information Leaflet

Antibiotics ◽

10.3390/antibiotics10091113 ◽

2021 ◽

Vol 10 (9) ◽

pp. 1113

Author(s):

Catherine V. Hayes ◽

Bláthnaid Mahon ◽

Eirwen Sides ◽

Rosie Allison ◽

Donna M. Lecky ◽

...

Keyword(s):

Qualitative Study ◽

Community Pharmacy ◽

Patient Information ◽

Self Care ◽

Theoretical Domains Framework ◽

Patient Information Leaflet ◽

Symptom Duration ◽

Information Leaflet ◽

Safety Netting ◽

Common Infections

Common self-limiting infections can be self-managed by patients, potentially reducing consultations and unnecessary antibiotic use. This qualitative study informed by the Theoretical Domains Framework (TDF) aimed to explore healthcare professionals’ (HCPs) and patients’ needs on provision of self-care and safety-netting advice for common infections. Twenty-seven patients and seven HCPs participated in semi-structured focus groups (FGs) and interviews. An information leaflet was iteratively developed and reviewed by participants in interviews and FGs, and an additional 5 HCPs, and 25 patients (identifying from minority ethnic groups) via online questionnaires. Qualitative data were analysed thematically, double-coded, and mapped to the TDF. Participants required information on symptom duration, safety netting, self-care, and antibiotics. Patients felt confident to self-care and were averse to consulting with HCPs unnecessarily but struggled to assess symptom severity. Patients reported seeking help for children or elderly dependents earlier. HCPs’ concerns included patients’ attitudes and a lack of available monitoring of advice given to patients. Participants believed community pharmacy should be the first place that patients seek advice on common infections. The patient information leaflet on common infections should be used in primary care and community pharmacy to support patients to self-manage symptoms and determine when further help is required.

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GPs’ understanding and practice of safety netting for potential cancer presentations: a qualitative study in primary care

British Journal of General Practice ◽

10.3399/bjgp18x696233 ◽

2018 ◽

Vol 68 (672) ◽

pp. e505-e511 ◽

Cited By ~ 12

Author(s):

Julie Evans ◽

Sue Ziebland ◽

John I MacArtney ◽

Clare R Bankhead ◽

Peter W Rose ◽

...

Keyword(s):

Primary Care ◽

Clinical Practice ◽

Qualitative Study ◽

Cancer Diagnosis ◽

Perceived Risk ◽

Low Risk ◽

Diagnostic Strategy ◽

Risk Of Cancer ◽

Safety Netting

BackgroundSafety netting is a diagnostic strategy used in UK primary care to ensure patients are monitored until their symptoms or signs are explained. Despite being recommended in cancer diagnosis guidelines, little evidence exists about which components are effective and feasible in modern-day primary care.AimTo understand the reality of safety netting for cancer in contemporary primary care.Design and settingA qualitative study of GPs in Oxfordshire primary care.MethodIn-depth interviews with a purposive sample of 25 qualified GPs were undertaken. Interviews were recorded and transcribed verbatim, and analysed thematically using constant comparison.ResultsGPs revealed uncertainty about which aspects of clinical practice are considered safety netting. They use bespoke personal strategies, often developed from past mistakes, without knowledge of their colleagues’ practice. Safety netting varied according to the perceived risk of cancer, the perceived reliability of each patient to follow advice, GP working patterns, and time pressures. Increasing workload, short appointments, and a reluctance to overburden hospital systems or create unnecessary patient anxiety have together led to a strategy of selective active follow-up of patients perceived to be at higher risk of cancer or less able to act autonomously. This left patients with low-risk-but-not-no-risk symptoms of cancer with less robust or absent safety netting.ConclusionGPs would benefit from clearer guidance on which aspects of clinical practice contribute to effective safety netting for cancer. Practice systems that enable active follow-up of patients with low-risk-but-not-no-risk symptoms, which could represent malignancy, could reduce delays in cancer diagnosis without increasing GP workload.

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Nursing students' emotions evoked by the first contact with patient's body: A qualitative study

Nurse Education Today ◽

10.1016/j.nedt.2019.104299 ◽

2020 ◽

Vol 85 ◽

pp. 104299

Author(s):

Letizia Dal Santo ◽

Elisa Ambrosi ◽

Michela Maragna ◽

Oliva Marognolli ◽

Federica Canzan

Keyword(s):

Nursing Students ◽

Qualitative Study ◽

First Contact

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Qualitative study on “hydropic degeneration” of The hepatocytes in viral hepatitis

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s042482010016039x ◽

1990 ◽

Vol 48 (3) ◽

pp. 568-569

Author(s):

Le Meizhao ◽

Ye Ming ◽

Song Xiaoming ◽

Xu Jiazhang

Keyword(s):

Qualitative Study ◽

Viral Hepatitis ◽

Chronic Active Hepatitis ◽

Microscopic Observation ◽

Hydropic Degeneration ◽

Light Microscopic Observation ◽

Biopsy Specimens ◽

Endoplasm Reticulum ◽

Mixed Fluid ◽

Peripheral Cytoplasm

“Hydropic degeneration” of the hepatocytes are often found in biopsy of the liver of some kinds of viral hepatitis. Light microscopic observation, compareted with the normal hepatocytes, they are enlarged, sometimes to a marked degree when the term “balloning” degeneration is used. Their cytoplasm rarefied, and show some clearness in the peripheral cytoplasm, so, it causes a hydropic appearance, the cytoplasm around the nuclei is granulated. Up to the present, many studies belive that main ultrastructural chenges of hydropic degeneration of the hepatocytes are results of the RER cristae dilatation with degranulation and disappearance of glycogen granules.The specimens of this study are fixed with the mixed fluid of the osmium acidpotassium of ferricyanide, Epon-812 embed. We have observed 21 cases of biopsy specimens with chronic severe hepatitis and severe chronic active hepatitis, and found that the clear fields in the cytoplasm actually are a accumulating place of massive glycogen. The granules around the nuclei are converging mitochondria, endoplasm reticulum and other organelles.

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