scholarly journals Osteopathy in Germany: attitudes, beliefs and handling among general practitioners – results of a nationwide cross-sectional questionnaire survey

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Gordian L. Schmid ◽  
Jeremias Kluge ◽  
Tobias Deutsch ◽  
Anne-Kathrin Geier ◽  
Markus Bleckwenn ◽  
...  
Keyword(s):  
General Practitioners ◽  
Spinal Column ◽  
Female Gender ◽  
Chronically Ill ◽  
Treatment Recommendation ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Federal States ◽  
Osteopathic Treatment ◽  
Clinical Conditions

Abstract Background Osteopathy is a type of complementary medicine based on specific manual techniques. In many countries, including Germany, the profession is not officially regulated, and evidence for the effectiveness of osteopathy is insufficient for most diseases. Nevertheless, many health insurances in Germany offer reimbursement for therapy costs, if osteopathy is recommended by a physician. This cross-sectional survey of German general practitioners (GPs) explored beliefs and attitudes towards osteopathic medicine and described their daily interactions with it. Methods A random sample of 1000 GPs from all federal states was surveyed by mail using a self-designed questionnaire. We collected data on sociodemographics, personal experiences with osteopathy, and attitudes and expectations towards osteopathy. In particular, participants were asked about indications for osteopathic treatment and their beliefs about its effectiveness for different patient groups and diagnoses. A self-designed score was used to estimate general attitudes towards osteopathy and identify factors correlated with greater openness. Additionally, we performed logistic regression to reveal factors associated with the frequency of recommending osteopathy to patients. Results Response rate was 34.4%. 46.5% of participants were women, and the median age was 56.0 years. 91.3% of GPs had referred patients to an osteopath, and 88.0% had recommended osteopathy to their patients. However, 57.5% acknowledged having little or no knowledge about osteopathy. Most frequent reasons for a recommendation were spinal column disorders (46.2%), other complaints of the musculoskeletal system (18.2%) and headaches (9.8%). GPs estimated the highest benefit for chronically ill and middle-aged adults. Female gender (OR 2.09; 95%CI 1.29–3.38) and personal treatment experiences (OR 5.14; 95%CI 2.72–9.72) were independently positively associated with more frequent treatment recommendation. Conclusion GPs in Germany have frequent contact with osteopathy, and the vast majority have recommended osteopathic treatment to some extent in their practice, with foci and opinions comparable to other Western countries. The discrepancy between GPs making frequent referrals for osteopathic treatment while self-assessing to have little knowledge about it demonstrates need for intensified research on the collaboration with osteopaths and how to best integrate osteopathic treatments. Our results may help to focus future effectiveness studies on most relevant clinical conditions in general practice.

scholarly journals Attitudes to and experience of disease management programs in primary care—an exploratory survey of general practitioners in Germany

2021 ◽  
Author(s):  
Julian Wangler ◽  
Michael Jansky
Keyword(s):  
Primary Care ◽  
Disease Management ◽  
Patient Care ◽  
General Practitioners ◽  
Linear Regression Analysis ◽  
Chronically Ill ◽  
Disease Management Programs ◽  
Federal States ◽  
Set Up ◽  
Chronically Ill Patients

Summary Background Disease management programs (DMPs) were set up in Germany in 2003 to improve outpatient care of chronically ill patients. The present study looks at the attitudes and experiences of general practitioners (GPs) in relation to DMPs, how they rate them almost 20 years after their introduction and where they see a need for improvement. Methods A total of 1504 GPs in the Federal States of Rhineland Palatinate, Saarland and Hesse were surveyed between December 2019 and March 2020 using a written questionnaire. Results In total, 58% of respondents rate DMPs positively and regard them as making a useful contribution to primary care. The guarantee of regular, structured patient care and greater compliance are regarded as particularly positive aspects. It was also established that diagnostic and therapeutic knowledge was expanded through participation in DMPs. 57% essentially follow the DMP recommendations for (drug) treatment. Despite positive experiences of DMPs in patient care, the GPs surveyed mention various challenges (documentation requirements, frequent changes to the programmes, inflexibility). Univariant linear regression analysis revealed factors influencing the satisfaction with DMPs, such as improvement of compliance and clearly defined procedures in medical care. Conclusion Most of the GPs surveyed consider the combination of continuous patient care and evidence-based diagnosis and treatment to be a great advantage. To better adapt DMPs to the conditions of primary care, it makes sense to simplify the documentation requirements, to regulate cooperation with other healthcare levels more clearly and to give GPs more decision-making flexibility. Increased inclusion of GP experience in the process of developing and refining DMPs can be helpful.

scholarly journals FREQUENCY OF FUNCTIONAL DISABILITY AND COGNITIVE IMPAIRMENTS IN SUB-ACUTE STROKE PATIENTS

2021 ◽  
Vol 10 (2) ◽  
pp. 69-74
Author(s):  
Aisha Sarfaraz ◽  
Dr Abdul Azeem ◽  
Mehwish Butt ◽  
Muhammad Umar
Keyword(s):  
Acute Stroke ◽  
Functional Disability ◽  
Cognitive Impairments ◽  
Age Groups ◽  
Female Gender ◽  
Primary Objective ◽  
P Value ◽  
Stroke Patients ◽  
Cross Sectional Survey ◽  
Cross Sectional

BACKGROUND & OBJECTIVE Stroke is a very common neurological condition affects various aspects of health. The primary objective of this study was to find out the frequency of functional disability and cognitive impairments in Sub-acute Stroke patients. MATERIAL AND METHODS A cross-sectional survey was conducted on 112 Sub-acute Stroke patients in Karachi, Pakistan. Using Barthel Index (BI) and Mini-Mental State Examination (MMSE) test was used to find out the frequency of functional disability and cognitive impairments of Sub-acute Stroke patients. RESULTS The correlation of BI scores with MMSE scores for the Male gender was 0.576 whilst the correlation of BI scores with MMSE scores for the Female gender was 0.440. The severity of functional disability concerning age groups assessed P-value was 0.026 using Chi-Square Test. The severity of functional disability (BI severity) concerning gender, P-value was found 0.097 using the same test. CONCLUSION Functional Disability is directly linked with age. However, there was no linkage established between Cognitive Impairment and age as well as gender. On close inspection, there was a trend between Functional disability and gender but not statistically significant.

scholarly journals Stockpiled personal protective equipment and knowledge of pandemic plans as predictors of perceived pandemic preparedness among German general practitioners

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0255986
Author(s):  
Arno Stöcker ◽  
Ibrahim Demirer ◽  
Sophie Gunkel ◽  
Jan Hoffmann ◽  
Laura Mause ◽  
...  
Keyword(s):  
General Practitioners ◽  
Personal Protective Equipment ◽  
Explanatory Power ◽  
Vital Role ◽  
Protective Equipment ◽  
Linear Regression Models ◽  
Pandemic Preparedness ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Determining Factor

Background The COVID-19 pandemic significantly changed the work of general practitioners (GPs). At the onset of the pandemic in March 2020, German outpatient practices had to adapt quickly. Pandemic preparedness (PP) of GPs may play a vital role in their management of a pandemic. Objectives The study aimed to examine the association in the stock of seven personal protective equipment (PPE) items and knowledge of pandemic plans on perceived PP among GPs. Methods Three multivariable linear regression models were developed based on an online cross-sectional survey for the period March–April 2020 (the onset of the pandemic in Germany). Data were collected using self-developed items on self-assessed PP and knowledge of a pandemic plan and its utility. The stock of seven PPE items was queried. For PPE items, three different PPE scores were compared. Control variables for all models were gender and age. Results In total, 508 GPs were included in the study; 65.16% believed that they were very poorly or poorly prepared. Furthermore, 13.83% of GPs were aware of a pandemic plan; 40% rated those plans as beneficial. The stock of FFP-2/3 masks, protective suits, face shields, safety glasses, and medical face masks were mostly considered completely insufficient or insufficient, whereas disposable gloves and disinfectants were considered sufficient or completely sufficient. The stock of PPE was significantly positively associated with PP and had the largest effect on PP; the association of the knowledge of a pandemic plan was significant but small. PPE scores did not vary considerably in their explanatory power. The assessment of a pandemic plan as beneficial did not significantly affect PP. Conclusion The stock of PPE seems to be the determining factor for PP among German GPs; for COVID-19, sufficient masks are the determining factor. Knowledge of a pandemic plans play a secondary role in PP.

scholarly journals Out-of-Pocket Spending for Cancer Medication, Financial Burden, and Cost Communication with Oncologists in the Last Six Months of Life in Israel

Healthcare ◽  
2021 ◽  
Vol 9 (9) ◽  
pp. 1120
Author(s):  
Aviad Tur-Sinai ◽  
Netta Bentur ◽  
Damien Urban
Keyword(s):  
Private Health Insurance ◽  
Financial Burden ◽  
Female Gender ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Complex Interactions ◽  
The Cost ◽  
Treatment Alternatives ◽  
Financial Burden Of Cancer ◽  
Heavy Financial Burden

Honest communication between oncologists and patients is important in alleviating the financial burden of cancer care. This study explored patient–relative–oncologist communication regarding the affordability of out-of-pocket (OOP) medication and the extent to which this communication addresses itself to the families’ financial burden. A cross-sectional survey was conducted among primary caregivers of deceased cancer patients. About 43% of relatives said that they and/or the patients had paid out of pocket for medications during the last six months of the patient’s life. Most (73%) oncologists suggested an OOP medication without asking about financial ability, 43% hardly explained the advantages of an OOP medication, and 52% hardly explained any treatment alternatives. Older age and female gender were related to less communication about an OOP medication, and better education, greater affluence, and having private health insurance were related to more communication. About 56% of relatives said that OOP payment for medications inflicted a very heavy or heavy financial burden on patients and their households. Physicians’ interest in financial ability and giving explanation lightened the burden. Given the difficulty of explaining the complex interactions of cost and clinical outcomes, oncologists need to be better educated in skills that would enable them to communicate costs more openly and should consider the cost of a treatment when prescribing it.

scholarly journals Collaboration amongst general practitioners and gynaecologists working in primary health care in Germany: a cross-sectional study

2021 ◽  
Vol 22 ◽  
Author(s):  
Barbara Trusch ◽  
Christoph Heintze ◽  
Elena Petelos ◽  
Lorena Dini
Keyword(s):  
Primary Care ◽  
General Practitioners ◽  
Interprofessional Collaboration ◽  
Cross Sectional Study ◽  
Postal Survey ◽  
Sectional Study ◽  
Healthcare Provision ◽  
Cross Sectional ◽  
Federal States ◽  
Key Competencies

Abstract Aim: This cross-sectional study is the first one to explore the collaboration of the influencing factors thereof amongst general practitioners (GPs) and gynaecologists (Gyns) working in primary care in urban and rural settings in Germany. Background: The number of women aged ≥ 50 years is predicted to increase in the next years in Germany. This coincides with the ageing of primary care specialists providing outpatient care. Whereas delegation of tasks to nurses as a form of interprofessional collaboration has been the target of recent studies, there is no data regarding collaboration amongst physicians in different specialisations working in primary care. We explored collaboration amongst GPs and Gyn regarding the healthcare provision to women aged ≥ 50 years. Methods: A quantitative postal survey was administered to GPs and Gyns in three federal states in Germany, focusing on care provision to women aged ≥ 50 years. A total of 4545 physicians, comprising 3514 GPs (67% of the total GP population) randomly selected, and all 1031 Gyns practicing in these states received the postal survey in March 2018. A single reminder was sent in April 2018 with data collection ending in June 2018. Multiple logistic regressions were performed for collaboration, adjusted by age and sex, alongside descriptive methods. Findings: The overall response rate was 31% (1389 respondents): 861 GPs (25%) and 528 Gyns (51%), with the mean respondent age being 54.4 years. Seventy-two per cent were female. Key competencies of collaboration are associated with working in rural federal states and with network participation. Physicians from rural states [odds ratio (OR) = 1.5, 95% confidence interval (CI) = 1.2, 1.9] and physicians in networks (OR = 3.0, CI = 2.3, 3.9) were more satisfied with collaboration. Collaboration to deliver services for women aged ≥ 50 years is more systematic amongst GPs and Gyns who are members of a network; increased networking could improve collaboration, and ultimately, outcomes too.

scholarly journals Task shifting from general practitioners to practice assistants and nurses in primary care: a cross-sectional survey in 34 countries

2021 ◽  
Vol 22 ◽  
Author(s):  
Peter P. Groenewegen ◽  
Wienke G. W. Boerma ◽  
Peter Spreeuwenberg ◽  
Bohumil Seifert ◽  
Willemijn Schäfer ◽  
...  
Keyword(s):  
Primary Care ◽  
General Practitioners ◽  
Professional Training ◽  
Institutional Development ◽  
Task Shifting ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Independent Variables ◽  
Nurse Prescribing ◽  
Number Of Patients

Abstract Aim: To describe variation in task shifting from general practitioners (GPs) to practice assistants/nurses in 34 countries, and to explain differences by analysing associations with characteristics of the GPs, their practices and features of the health care systems. Background: Redistribution of tasks and responsibilities in primary care are driven by changes in demand for care, such as the growing number of patients with chronic conditions, and workforce developments, including staff shortage. The need to manage an expanding range of services has led to adaptations in the skill mix of primary care teams. However, these developments are hampered by barriers between professional domains, which can be rigid as a result of strict regulation, traditional attitudes and lack of trust. Methods: Data were collected between 2011 and 2013 through a cross-sectional survey among approximately 7200 GPs in 34 countries. The dependent variable ‘task shifting’ is measured through a composite score of GPs’ self-reported shifting of tasks. Independent variables at GP and practice level are: innovativeness; part-time working; availability of staff; location and population of the practice. Country-level independent variables are: institutional development of primary care; demand for and supply of care; nurse prescribing as an indicator for professional boundaries; professionalisation of practice assistants/nurses (indicated by professional training, professional associations and journals). Multilevel analysis is used to account for the clustering of GPs in countries. Findings: Countries vary in the degree of task shifting by GPs. Regarding GP and practice characteristics, use of electronic health record applications (as an indicator for innovativeness) and age of the GPs are significantly related to task shifting. These variables explain only little variance at the level of GPs. Two country variables are positively related to task shifting: nurse prescribing and professionalisation of primary care nursing. Professionalisation has the strongest relationship, explaining 21% of the country variation.

Depression and Anxiety Plus Levels of Stress among Secondary School Students during the COVID-19 Lockdown: an Online CrossSectional Survey

2021 ◽  
Author(s):  
Gunn Pungpapong ◽  
Rasmon Kalayasiri
Keyword(s):  
Substance Use ◽  
Secondary School ◽  
Secondary School Students ◽  
Female Gender ◽  
Depression And Anxiety ◽  
Cross Sectional Survey ◽  
School Students ◽  
Cross Sectional ◽  
Increased Risk ◽  
Patient Health

Objective: To assess prevalence and factors associated with depression, anxiety and stress among adolescents experiencing lockdown during the 2019 coronavirus disease 2019 (COVID-19) in both Asian and Western countries. Material and Methods: From May-June 2020, secondary school students were enrolled in an online cross-sectional survey, through social media; including, but not limited to, Instagram, Snapchat, WhatsApp and LINE. We assessed the presence and severity of depression (Patient Health Questionnaire-9), anxiety (Generalized Anxiety Disorder Scale-7) and stress (Perceived Stress Scale-10) within the last month, and assessed significant associations with demographics, degree of social distancing, and other associated issues using univariate and multivariate logistic regression analyses.Results: From 392 respondents (56.4% male, 43.1% female), from Thailand (59.2%), the United Kingdom (26.5%) and other countries (14.3%), we identified depressive symptoms in 58.7%, anxiety in 40.3% and high levels of stress in 9.7%. By multivariate analysis, we found significant associations between being female and depression and anxiety, being in late secondary school years and depression, and changes in patterns of substance use and anxiety and stress. Participants not located in Thailand had increased risk of depression.Conclusion: Our study demonstrated depression, anxiety and stress in six, four and one out of ten adolescents, respectively, who were experiencing lockdowns due to the COVID-19 pandemic. We found female gender, older school years, and changes in substance use patterns to be significantly associated with these mental health conditions.

scholarly journals Online Learning in the Face of COVID-19 Pandemic: Assessment of Students’ Satisfaction at Chitwan Medical College of Nepal

2020 ◽  
Vol 18 (2) ◽  
pp. 40-47
Author(s):  
K. Sharma ◽  
G. Deo ◽  
S. Timalsina ◽  
A. Joshi ◽  
N. Shrestha ◽  
...  
Keyword(s):  
Online Learning ◽  
Student Satisfaction ◽  
Virus Disease ◽  
Female Gender ◽  
Weak Links ◽  
Online Classes ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Medical College ◽  
Students Satisfaction

Background Online learning can play a vital role in the process of teaching and learning during Corona Virus Disease 2019 (COVID-19) pandemic. However, learners’ satisfaction is extremely important in effective implementation of the online learning, especially at institutions where it is newly adopted. Objective To assess satisfaction towards online learning and its predictors among students at Chitwan Medical College, Bharatpur. Method A web-based cross-sectional survey was undertaken among 434 undergraduate and postgraduate students from various academic programs who had participated in the online classes started during this COVID-19 pandemic. A structured questionnaire consisting of 31 items (5-point Likert scale) covering four major student satisfaction domains (learners’ dimensions, technological characteristics, instructors’ characteristics and course management and coordination) was distributed to the students using Google Form. Result More than half (53.5%) of the students were satisfied with the online learning, while 29.7% gave neutral views. Bivariate analyses found that all four domains scores were positively correlated with each other as well as with the students’ overall satisfaction towards learning. In multivariate analysis, female gender [aOR: 2.72, p = 0.013], WiFi as internet modality for learning [aOR: 3.36, p = 0.001) and learners’ dimension score [aOR: 1.27, p<0.001] were the significant predictors of students’ satisfaction. Conclusion Although recently adopted, the satisfaction of the students towards online classes appears good, and prioritizing the identified predictors and working on the weak links could assist in enhancing students’ satisfaction and better outcomes.

scholarly journals Psychosocial factors associated with symptoms of generalized anxiety disorder in general practitioners during the COVID-19 pandemic

2020 ◽  
Vol 68 (7) ◽  
pp. 1228-1234 ◽  
Author(s):  
Alvaro Monterrosa-Castro ◽  
Velia Redondo-Mendoza ◽  
María Mercado-Lara
Keyword(s):  
Anxiety Disorder ◽  
General Practitioners ◽  
Generalized Anxiety Disorder ◽  
Healthcare Providers ◽  
Demographic Factors ◽  
Female Gender ◽  
P Value ◽  
Generalized Anxiety ◽  
Health Providers ◽  
Cross Sectional

Healthcare providers commonly experience symptoms of anxiety during public health crises and pandemics. The objective of the study was to identify the frequency of symptoms of generalized anxiety disorder (GAD) in general practitioners and to estimate the association with particular psychosocial and demographic factors. This is a cross-sectional study, where a total of 531 general practitioners completed an online form that contained sociodemographic variables, questions about fear and perceptions concerning medical work during the COVID-19 pandemic, 7-Item Generalized Anxiety Disorder Scale (GAD-7), questionnaire on psychosomatic problems and Fear of COVID-19 Scale. The presence of symptoms of GAD was defined by a GAD-7 score of 10 or more points. Voluntary and anonymous participation, acceptance of terms, and informed consent were requested. A p value of <0.05 was considered statistically significant. Symptoms of GAD were identified in 4 out of 10 Colombian general practitioners; the following psychosocial and demographic factors were associated with a greater presence of these symptoms: female gender, social discrimination, anguish, job disappointment, nightmares, stress and other symptoms of fear regarding the pandemic. Conversely, feeling protected by the state or employer, being satisfied with their job as a physician, and trusting government measures and information were associated with a lower presence of symptoms of GAD. These findings highlight the importance of timely psychotherapeutic and psychopharmacological interventions in these individuals. The authors suggest mental health providers should be deployed during times of crisis to decrease the risk of developing mental illness.

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