Preventing disease through opportunistic, Rapid EngagEMent by Primary care Teams using behaviour change counselling

2013 ◽  
Author(s):  
Christopher Butler
Keyword(s):  
Primary Care ◽  
Behaviour Change ◽  
Primary Care Teams ◽  
Behaviour Change Counselling

scholarly journals A situational analysis of training for behaviour change counselling for primary care providers, South Africa

2015 ◽  
Vol 7 (1) ◽  
Author(s):  
Zelra Malan ◽  
Bob Mash ◽  
Katherine Everett-Murphy
Keyword(s):  
Primary Care ◽  
Behaviour Change ◽  
Lifestyle Modification ◽  
Qualitative Interviews ◽  
Healthcare Providers ◽  
Primary Care Providers ◽  
Situational Analysis ◽  
Care Providers ◽  
Record Keeping ◽  
Behaviour Change Counselling

Background: Non-communicable diseases and associated risk factors (smoking, alcohol abuse, physical inactivity and unhealthy diet) are a major contributor to primary care morbidity and the burden of disease. The need for healthcare-provider training in evidence-based lifestyle interventions has been acknowledged by the National Department of Health. However, local studies suggest that counselling on lifestyle modification from healthcare providers is inadequate and this may, in part, be attributable to a lack of training.Aim: This study aimed to assess the current training courses for primary healthcare providers in the Western Cape.Setting: Stellenbosch University and University of Cape Town.Methods: Qualitative interviews were conducted with six key informants (trainers of primary care nurses and registrars in family medicine) and two focus groups (nine nurses and eight doctors) from both Stellenbosch University and the University of Cape Town.Results: Trainers lack confidence in the effectiveness of behaviour change counselling and in current approaches to training. Current training is limited by time constraints and is not integrated throughout the curriculum – there is a focus on theory rather than modelling and practice, as well as a lack of both formative and summative assessment. Implementation of training is limited by a lack of patient education materials, poor continuity of care and record keeping, conflicting lifestyle messages and an unsupportive organisational culture.Conclusion: Revising the approach to current training is necessary in order to improve primary care providers’ behaviour change counselling skills. Primary care facilities need to create a more conducive environment that is supportive of behaviour change counselling.

scholarly journals Training practitioners to deliver opportunistic multiple behaviour change counselling in primary care: a cluster randomised trial

BMJ ◽  
2013 ◽  
Vol 346 (mar19 3) ◽  
pp. f1191-f1191 ◽  
Author(s):  
C. C. Butler ◽  
S. A. Simpson ◽  
K. Hood ◽  
D. Cohen ◽  
T. Pickles ◽  
...  
Keyword(s):  
Primary Care ◽  
Behaviour Change ◽  
Randomised Trial ◽  
Cluster Randomised Trial ◽  
Cluster Randomised ◽  
Behaviour Change Counselling

scholarly journals Family Physician’s and Primary Care Team’s Perspectives on Supporting Family Caregivers in Primary Care Networks

2021 ◽  
Vol 18 (6) ◽  
pp. 3293
Author(s):  
Jasneet Parmar ◽  
Sharon Anderson ◽  
Marjan Abbasi ◽  
Saeed Ahmadinejad ◽  
Karenn Chan ◽  
...  
Keyword(s):  
Primary Care ◽  
Family Caregivers ◽  
Healthcare Providers ◽  
Family Physicians ◽  
Care Team ◽  
Primary Care Team ◽  
Caregiver Support ◽  
Team Members ◽  
Primary Care Teams ◽  
Support Family

Background. Research, practice, and policy have focused on educating family caregivers to sustain care but failed to equip healthcare providers to effectively support family caregivers. Family physicians are well-positioned to care for family caregivers. Methods. We adopted an interpretive description design to explore family physicians and primary care team members’ perceptions of their current and recommended practices for supporting family caregivers. We conducted focus groups with family physicians and their primary care team members. Results. Ten physicians and 42 team members participated. We identified three major themes. “Family physicians and primary care teams can be a valuable source of support for family caregivers” highlighted these primary care team members’ broad recognition of the need to support family caregiver’s health. “What stands in the way” spoke to the barriers in current practices that precluded supporting family caregivers. Primary care teams recommended, “A structured approach may be a way forward.” Conclusion. A plethora of research and policy documents recommend proactive, consistent support for family caregivers, yet comprehensive caregiver support policy remains elusive. The continuity of care makes primary care an ideal setting to support family caregivers. Now policy-makers must develop consistent protocols to assess, and care for family caregivers in primary care.

scholarly journals What is the present role for general practitioners in dementia care? Experiences of general practitioners, patients and family carers in Portugal

Dementia ◽  
2020 ◽  
pp. 147130122097771
Author(s):  
Conceição Balsinha ◽  
Steve Iliffe ◽  
Sónia Dias ◽  
Alexandre Freitas ◽  
Joana Grave ◽  
...  
Keyword(s):  
Primary Care ◽  
General Practitioners ◽  
Social Contexts ◽  
Dementia Care ◽  
Family Carers ◽  
Primary Care Teams ◽  
Qualitative Interview Study ◽  
Framework Approach ◽  
Advanced Stages ◽  
Patient Relationships

Background Governments are being challenged to integrate at least part of dementia care into primary care. However, little is known about the current role of general practitioners (GPs) regarding dementia care, especially in countries that do not have dementia strategies in place. The aim of this study was to explore the experiences of GPs, persons with dementia and their family carers in Portuguese primary care settings, to better understand GPs’ contribution to dementia care. Methods A qualitative interview study of participants recruited from six practices in different social contexts within the Lisbon metropolitan area was carried out. Purposive sampling was used to recruit GPs, persons with dementia and carers. Interviews with GPs explored dementia care comprehensiveness, including satisfactory and challenging aspects. Interviews with patients and carers explored the experience of talking to GPs about cognitive impairments and related difficulties and the type of help received. Thematic analysis of interview transcripts was carried out using the framework approach. Results Five major themes were identified: GPs have a limited contribution to dementia care, the case of advanced dementia, doctor–patient relationships, doctor–carer relationships and management of chronic conditions other than dementia. Conclusion General practitioners seemed to contribute little to dementia care overall, particularly regarding symptom management. The exception was patients with advanced stages of dementia, given that specialists no longer followed them up. Remarkably, GPs seemed to be alone within primary care teams in providing dementia care. These findings strongly suggest that Portuguese primary care is not yet prepared to comply with policy expectations regarding the management of dementia.

scholarly journals Outcomes of Primary Care for People With Dementia: What’s Important?

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 164-165
Author(s):  
Laura Wray ◽  
Bonnie Vest ◽  
Laura Brady ◽  
Christina Vair ◽  
Gregory Beehler ◽  
...  
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Health And Safety ◽  
Limited Attention ◽  
Veterans Health ◽  
Cognitive Screening ◽  
Health Administration ◽  
People With Dementia ◽  
Primary Care Teams ◽  
Care Outcomes

Abstract People with dementia (PWD) typically receive most of their healthcare in primary care (PC), but neurocognitive disorders can be challenging to recognize, assess, and manage in that setting. As a result, cognitive impairment in older adults is often missed or not addressed until later stages. The result is poor management of comorbid health conditions, increased healthcare utilization, and negative outcomes for the patient and family. Further, strategies for improvement and barriers to high quality PC for PWD have received limited attention. To improve PC for PWD, it is essential to understand what care outcomes should be targeted. To address this gap, we used a qualitative approach to examine potential outcomes of PC from the perspectives of older adults, family caregivers, primary care teams, and geriatrics specialists (n=79) from two Veterans Health Administration healthcare systems. Participants were interviewed individually or in focus groups. A directed content analysis based on the adapted Donabedian model was employed and expanded to fully capture transcript content. Three main categories of outcomes were identified: Personhood (i.e., independence), Physical Health and Safety, and Quality of Life. Regardless of participant type, respondents focused on similar desired outcomes and, notably, identified outcomes as important for both patients and their broader social context (i.e., caregivers, family). Discussion will: show how findings align with work conducted in specialty and residential care; describe how challenges to attaining these outcomes in PC can be overcome; and, challenge cognitive screening recommendations for PC that are based primarily on risk/benefit analysis of medication-focused outcomes.

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